Dietary Habits are Related to Outcomes in Patients With Advanced Heart Failure Awaiting Heart Transplantation |
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Authors: | Heike Spaderna Daniela Zahn Johanna Pretsch Sonja L. Connor Armin Zittermann Stefanie Schulze Schleithoff Katrina A. Bramstedt Jacqueline M.A. Smits Gerdi Weidner |
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Affiliation: | 1. Department of Pediatrics, Medical College of Wisconsin and Children''s Hospital of Wisconsin, 999 N. 92nd St., Milwaukee, WI 53226, United States of America;2. Herma Heart Institute, Department of Pediatrics and Division of Pediatric Cardiology, Medical College of Wisconsin and Children''s Hospital of Wisconsin, PO Box 1997, MS 713, Milwaukee, WI 53201, United States of America |
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Abstract: | BackgroundEmpirical 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 ResultsA total of 318 heart transplant candidates (82% male, age 53 ± 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).ConclusionsThese results support the importance of dietary habits for the prognosis of patients listed for heart transplantation, independently from heart failure severity. |
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