Inadequate nutritional intake for daily life activity of clinically stable patients with chronic heart failure

We investigated the nutritional adequacy and energy availability in 57 normal-weight patients with chronic heart failure (HF) and 49 matched healthy sedentary subjects. We found that the chronic HF patients had a higher total energy expenditure (1,700 ± 53 vs 1,950 ± 43 kcal/day; p <0.01), a negative calorie balance (104 ± 35 vs −186 ± 40 kcal/day; p <0.01), a negative nitrogen balance (2.2 ± 0.5 vs −1.7 ± 0.4 g/day; p <0.01), and a hypercatabolic hormonal status (cortisol/insulin ratio 32 ± 1.7 vs 65 ± 5.1; p <0.01). We conclude that patients with chronic HF had an inadequate calorie intake to support energetic needs for daily activities, with consequent important protein breakdown that causes muscular wasting.