Key result
Moderate/severe ADHF is linked to ~40% lower fecal elastase levels compared to controls.
Why the study?
Exocrine pancreatic dysfunction and appetite hormone levels may contribute to malnutrition in advanced stages of acute decompensated heart failure, but their roles are not well defined.
Do fecal elastase and blood ghrelin levels differ between patients with acute decompensated heart failure and healthy controls?
Observational (n=83)
Do fecal elastase and blood ghrelin levels differ between patients with acute decompensated heart failure and healthy controls?
Absolute Event Rate: 168.7% vs 278.9%
p-value: p=0.002
Fecal elastase levels are significantly reduced in patients with moderate to severe acute decompensated heart failure, suggesting exocrine pancreatic dysfunction may contribute to malnutrition in this population.
Exocrine pancreatic assessment may flag malnutrition risk in HF; hypothesis-generating and requires prospective trials before any clinical role.
OBJECTIVES: Exocrine pancreatic dysfunction may contribute to malnutrition and lack of appetite in the advanced stages of heart failure. Nutritional assessment was carried out on patients diagnosed with mild or moderate/severe heart failure. Fecal elastase levels are an indicator of pancreatic exocrine function and ghrelin is an appetite hormone which is also investigated for its contribution to malnutrition. STUDY DESIGN: This is an observational study. 52 patients (32 males, 20 females) aged over eighteen years and hospitalized for acute decompensated heart failure (ADHF) were included in the study. They were compared with 31 people (16 male, 15 female) of the same age as Control Group (C). Patients in New York Heart Association (NYHA) stages 1 and 2 were grouped as mild (miADHF), while those in NYHA stages 3 and 4 were grouped as moderate/severe ADHF (seADHF). Fecal and blood samples were taken at admission. In ADHF patients, exocrine pancreatic functions and their relationship with malnutrition were evaluated. Statistical analyses were performed using Tukey's test, the independent-sample t-test, the Kruskal-Wallis test, the Mann-Whitney U-test, the chi-square test and Pearson's bivariate correlation analysis. RESULTS: Significantly decreased fecal elastase levels were found when moderate/severe ADHF patients and the control group were compared. (C 278.9±144.8, miADHF 336.6±181.7, seADHF 168.7±153.6, p=0.002). 10 seADHF patients (50%) had severe, 4 (20%) moderate, and 6 (30%) mild pancreatic insufficiency. Ghrelin levels were higher in seADHF patients compared to C and miADHF patients (C 69.7±34.6, miCHF 82.5±48.2, SeADHF 105.0±78.1 p=0.361). CONCLUSION: Fecal elastase and ghrelin hormone levels can contribute to the determination of malnutrition in ADHF patients.
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A 2015 study conducted an observational in Acute decompensated heart failure (ADHF) (n=83). Moderate/severe acute decompensated heart failure vs. Healthy controls and mild ADHF was evaluated on Fecal elastase levels (p=0.002). Moderate/severe acute decompensated heart failure was associated with significantly decreased fecal elastase levels compared to controls (168.7±153.6 vs 278.9±144.8; p=0.002).
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