Nutritional Therapy for Acute Heart Failure Patients Admitted to the Cardiovascular Intensive Care Unit and Its Impact on the Nutritional Status at Discharge

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Acute heart failure (n=141). Intervention: Nutritional dose on day 3 (energy and protein intake). Primary outcome: Geriatric Nutritional Risk Index (GNRI) at discharge (standardized β=0.210 for energy, β=0.248 for protein, p=0.029 for energy, 0.007 for protein).

Q: What does this research mean for the field?

Higher energy and protein intake on day 3 in the cardiovascular intensive care unit is independently associated with an improved Geriatric Nutritional Risk Index at discharge in acute heart failure patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Mayuko Fukuse; Hiroki Nakano; Junya KAMESAKO; Koichi Kamioka; Jun Yamashita; Yasushi Miyazawa

doi:10.1253/circrep.cr-25-0212

September 16, 2026Circulation ReportsOpen Access

Nutritional Therapy for Acute Heart Failure Patients Admitted to the Cardiovascular Intensive Care Unit and Its Impact on the Nutritional Status at Discharge

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Key result

Higher day 3 ICU energy and protein doses are linked to better discharge GNRI in AHF.

standardized β=0.210 for energy, β=0.248 for protein
P=0.029 for energy, 0.007 for protein
n=141

Why the study?

Does early nutritional therapy improve nutritional status at discharge in acute heart failure patients admitted to the cardiovascular intensive care unit?

Key Points

To evaluate the impact of heart failure severity, respiratory management, and early nutritional intake in the cardiovascular intensive care unit on patient nutritional status at discharge.
Single-center observational study assessing 141 acute heart failure patients admitted to a cardiovascular intensive care unit.
Patients were grouped by respiratory management: invasive positive pressure ventilation (IPPV, N=21), non-invasive positive pressure ventilation (NPPV, N=36), and oxygen supplementation (O2S, N=84).
Linear regression analysis was conducted to assess the association of day 3 and day 7 caloric and protein intake with the Geriatric Nutritional Risk Index (GNRI) at discharge.
Nutritional intake relative to caloric goal averaged 75±37% on day 3 (total 1,064±541 kcal/day; protein 42.6±20.3 g/day) and 88±29% on day 7 (total 1,254±429 kcal/day; protein 46.8±16.6 g/day).
In linear regression adjusted for APACHE II score (Model 3), day 3 energy intake was significantly associated with discharge GNRI (B=0.003, 95% CI: 0.000–0.005, P=0.029).
Day 3 protein intake was also independently associated with discharge GNRI in Model 3 (B=0.092, 95% CI: 0.026–0.157, P=0.007).

Study Design

Type

Observational (n=141)

Multicenter

No

Structured PICO

Does early nutritional therapy improve nutritional status at discharge in acute heart failure patients admitted to the cardiovascular intensive care unit?

P

Population

141 patients aged ≥20 years with acute heart failure admitted to the cardiovascular intensive care unit, excluding those with acute coronary syndrome, early discharge, or in-hospital death.

E

Exposure

Early nutritional therapy (energy and protein intake assessed on day 3 and day 7 of CICU admission)

O

Outcome

Geriatric Nutritional Risk Index (GNRI) at dischargesurrogate

Main Result

Effect estimate: standardized β=0.210 for energy, β=0.248 for protein

p-value: p=0.029 for energy, 0.007 for protein

Limitations

Single-center study with a relatively small sample size, limiting generalizability and statistical power.
Lack of subgroup analyses stratified by body weight and baseline nutritional status.
Administered nutritional dosage may differ from the actually absorbed amount depending on gastrointestinal function.
Exclusion of mild cases discharged within 7 days and severe cases who died during hospitalization may introduce selection bias.
Reverse causality cannot be completely excluded.
GNRI at discharge may be affected by residual fluid overload.
Single-center study with a relatively small sample size
Subgroup analyses stratified by body weight and baseline nutritional status could not be evaluated
Mild cases discharged within 7 days and severe cases who died during hospitalization were excluded, potentially introducing selection bias
Reverse causality cannot be completely excluded
GNRI at discharge may be affected by fluid overload

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Implication

Higher energy and protein intake on day 3 of CICU admission is independently associated with better nutritional status at discharge in patients with acute heart failure.

Abstract

Background: Nutritional status at discharge is a prognostic factor in acute heart failure (AHF) patients, but its relationship with early-phase nutritional therapy in the cardiovascular intensive care unit (CICU) remains unclear, so we evaluated the effects of HF severity, respiratory management, and nutritional dosage on nutritional status in AHF patients.

Discussion

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Cite This Study

Fukuse et al. (2026) conducted an observational in Acute heart failure (n=141). Nutritional dose on day 3 (energy and protein intake) was evaluated on Geriatric Nutritional Risk Index (GNRI) at discharge (standardized β=0.210 for energy, β=0.248 for protein, p=0.029 for energy, 0.007 for protein). Higher energy and protein doses on day 3 in the intensive care unit were independently associated with a better Geriatric Nutritional Risk Index at discharge in patients with acute heart failure.

synapsesocial.com/papers/6aad0ad5de0393d728b891bb https://doi.org/10.1253/circrep.cr-25-0212

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Nutritional Therapy for Acute Heart Failure Patients Admitted to the Cardiovascular Intensive Care Unit and Its Impact on the Nutritional Status at Discharge

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Nutritional Therapy for Acute Heart Failure Patients Admitted to the Cardiovascular Intensive Care Unit and Its Impact on the Nutritional Status at Discharge

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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