Association among nutritional status, echocardiographic parameters and circulating endogenous biogenic amines in patients with heart failure

• Grant number: 24/15718-9
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2024
• End date: November 30, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Silméia Garcia Zanati Bazan
• Grantee: Andreiza Mara Gomes Lana
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil
• Associated research grant: 23/08537-5 - IMPACT OF DIFFERENT STAGES OF HEART FAILURE ON METABOLOMIC PROFILE, CIRCULATING ENDOGENOUS BIOGENIC AMINES LEVELS AND CLINICAL-NUTRITIONAL PARAMETERS, AP.R

Abstract

Heart failure (HF) is a complex clinical syndrome, characterized by the heart's inability to pump blood to meet the body's physiological and metabolic needs, leading to specific signs and symptoms, including dyspnea, edema of the lower limbs or fatigue. HF presents irregular progression, with acute phases of decompensation that often require hospitalization, poor prognosis and frequent morbidities, complex treatments and polypharmacy, which imply changes in lifestyle and compromise the quality of life of the patient and family. Among the factors associated with a worse prognosis, weight loss or cachexia are aggravating factors that deserve to be highlighted. In patients with HF, the incidence of malnutrition varies between 8% and 57%, depending on the level of severity; its presence increases the mortality of these patients between 2 and 10 times. From a pathophysiological point of view, the mechanisms associated with nutritional impairment in patients with HF are not fully known, but appear to involve changes resulting from decreased food intake, increased loss of nutrients, use of medications, hypercatabolism, inflammation, increased sympathetic stimulation and the cortisol/dehydroepiandrosterone (DHEA) ratio, stimulation of the renin-angiotensin-aldosterone system, oxidative stress, alteration of biogenic amines. Biogenic amines (BAs) are stable nitrogenous compounds, formed mainly by the decarboxylation of amino acids or also by amination and transamination of aldehydes and ketones, present in foods and well known for their toxic effects on humans. However, ABs also comprise compounds that are part of the regulation of endogenous processes, for example, catecholamines such as adrenaline or dopamine function as hormones and neurotransmitters. Studies have demonstrated the involvement of intracellular cells and amines in cardiac physiology and also in the metabolic and functional effects in response to increased cardiac output. Regarding BAs and nutritional status, a review presented a possible role of molecules in skeletal muscle pathophysiology, potentially influencing muscle fiber levels and strength. However, there are still few studies that evaluate amines in patients with HF; Even fewer studies show an association between sarcopenia amines and changes in nutritional status. The aim of this study will be to evaluate the relationship between circulating biogenic amine levels, nutritional status and echocardiographic parameters in patients with HF. Cross-sectional study to be carried out with patients being monitored at the Cardiology outpatient clinic of the Hospital das Clínicas of the Faculty of Medicine of Botucatu - UNESP, already approved by the Institution's Ethics Committee. Patients' clinical, cardiac and nutritional information will be collected. Patients' plasma amine levels will be assessed. The variables will be subjected to descriptive and comparative analysis using specific tests according to their behavior.