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首页> 外文期刊>Journal of cardiac failure >Nutrition, Obesity, and Cachexia in Patients With Heart Failure: A Consensus Statement from the Heart Failure Society of America Scientific Statements Committee
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Nutrition, Obesity, and Cachexia in Patients With Heart Failure: A Consensus Statement from the Heart Failure Society of America Scientific Statements Committee

机译：心力衰竭患者的营养，肥胖和恶病症：美国科学陈述委员会心力衰竭社会的共识声明

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Dietary guidance for patients with heart failure (HF) has traditionally focused on sodium and fluid intake restriction, but dietary quality is frequently poor in patients with HF and may contribute to morbidity and mortality. Restrictive diets can lead to inadequate intake of macronutrients and micronutrients by patients with HF, with the potential for deficiencies of calcium, magnesium, zinc, iron, thiamine, vitamins D, E, and K, and folate. Although inadequate intake and low plasma levels of micronutrients have been associated with adverse clinical outcomes, evidence supporting therapeutic repletion is limited. Intravenous iron, thiamine, and coenzyme Q10 have the most clinical trial data for supplementation. There is also limited evidence supporting protein intake goals. Obesity is a risk factor for incident HF, and weight loss is an established approach for preventing HF, with a role for bariatric surgery in patients with severe obesity. However weight loss for patients with existing HF and obesity is a more controversial topic owing to an obesity survival paradox. Dietary interventions and pharmacologic weight loss therapies are understudied in HF populations. There are also limited data for optimal strategies to identify and address cachexia and sarcopenia in patients with HF, with at least 10%-20% of patients with ambulatory systolic HE developing clinically significant wasting. Gaps in our knowledge about nutrition status in patients with HF are outlined in this Statement, and strategies to address the most clinically relevant questions are proposed.
机译：心力衰竭（HF）患者的膳食指导传统上集中于钠和液体摄入限制，但患有HF患者的膳食质量往往差，可能有助于发病率和死亡率。限制性饮食可能导致HF患者摄入不足的常规营养素和微量营养素，钙，镁，铁，硫胺素，维生素D，E和K和叶酸缺乏潜力。虽然摄入量和低血浆微量营养素的低血浆水平与不良临床结果有关，但有限支持治疗性的证据是有限的。静脉注射铁，硫胺素和辅酶Q10具有最多的补充临床试验数据。还有有限的证据支持蛋白质摄入目标。肥胖是事故HF的危险因素，减肥是预防患者的既定方法，具有严重肥胖症患者的畜牧手术作用。然而，由于肥胖的生存悖论，现有HF和肥胖患者的减肥是一种更有争议的话题。在HF群体中，将在膳食干预和药理体重减轻疗法中进行。最佳策略的数据有限，以识别和解决HF患者的恶毒症和SARCOPENIA，至少有10％-20％的患者，他在临床上发挥临床萎缩。在我们关于HF患者的营养状况的知识中，在本声明中概述了营养状况，并提出了解决最相关问题的策略。

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