Current opportunities for nutritional support in patients with heart failure: a review

Chronic heart failure is a prevalent syndrome that develops as a result of virtually any organic cardiovascular disease. The high risk of hospitalization, disability, and mortality in chronic heart failure imposes a substantial burden on the health care system and is associated with considerable economic costs. Currently, the main principles of managing patients with chronic heart failure focus on neurohumoral blockade and regulation of circulating blood volume. At the same time, patients’ nutritional status is often overlooked. This approach is largely due to the lack of large-scale clinical trials evaluating correction of cachexia or sarcopenia in patients with chronic heart failure, as well as the absence of comprehensive dietary recommendations for this population. Patients with chronic heart failure face barriers to improving natural dietary intake, and there is insufficient evidence to support the regular use of any dietary supplements. However, some studies suggest that nutritional interventions may be beneficial in chronic heart failure. The work aimed to search for and analyze published data from the Russian Scientific Electronic Library (eLIBRARY.RU) and PubMed to summarize current evidence and provide an overview of the effectiveness of potential nutritional support strategies in chronic heart failure. Current data are presented on metabolic imbalance, the obesity paradox, the role of sodium, dietary patterns, and various dietary supplements in chronic heart failure. Recent studies on nutritional interventions in patients with chronic heart failure, including those with sarcopenia and cachexia, are briefly analyzed. The important role of additional protein supplementation in the management of chronic heart failure is emphasized.