Dietary Habits are Related to Outcomes in Patients With Advanced Heart Failure Awaiting Heart Transplantation

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• 作者：Heike Spaderna ; PhD¹ ; ^{spaderna@uni-wuppertal.de} ; Daniela Zahn ; PhD¹ ; Johanna Pretsch ; PhD² ; Sonja L. Connor ; MS ; RD³ ; Armin Zittermann ; PhD⁴ ; Stefanie Schulze Schleithoff ; PhD⁴ ; Katrina A. Bramstedt ; PhD⁵ ; Jacqueline M.A. Smits ; MD ; PhD⁶ ; Gerdi Weidner ; PhD⁷ ; ^{gweidner@sfsu.edu}
• 关键词：Epidemiology ; dietary habits ; prognosis ; waiting list ; heart transplantation
• 刊名：Journal of Cardiac Failure
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：19
• 期：4
• 页码：240-250
• 全文大小：398 K

文摘

Background

Empirical evidence supporting the benefits of dietary recommendations for patients with advanced heart failure is scarce. We prospectively evaluated the relation of dietary habits to pre-transplant clinical outcomes in the multisite observational Waiting for a New Heart Study.

Methods and Results

A total of 318 heart transplant candidates (82 % male, age 53 ¡À 11 years) completed a Food Frequency Questionnaire (foods high in salt, saturated fats, poly-/monounsaturated fats [PUFA+MUFA], fruit/vegetables/legumes, and fluid intake) at time of waitlisting. Cox proportional hazard models controlling for heart failure severity (eg, Heart Failure Survival Score, creatinine) estimated cause-specific hazard ratios (HRs) associated with each dietary habit individually, and with all dietary habits entered simultaneously. During follow-up (median 338 days, range 13-1,394), 54 patients died, 151 received transplants (110 in high-urgency status, 41 electively), and 45 became delisted (15 deteriorated, 30 improved). Two robust findings emerged: Frequent intake of salty foods, which correlated positively with saturated fat and fluid intake, was associated with transplantation in high-urgency status (HR 2.90, 95 % confidence interval [CI] 1.55-5.42); and frequent intake of foods rich in PUFA+MUFA reduced the risk for death/deterioration (HR 0.49, 95 % CI 0.26-0.92).

Conclusions

These results support the importance of dietary habits for the prognosis of patients listed for heart transplantation, independently from heart failure severity.