Aims Malnutrition is common and associated with worse clinical outcomes in patients with heart failure (HF). The Controlling Nutritional Status (CONUT) score is an integrated index for evaluating diverse aspects of the complex mechanism of malnutrition. However, the relationship between the severity of malnutrition assessed by the CONUT score and clinical outcomes of HF patients receiving cardiac resynchronisation therapy (CRT) has not been fully clarified. Methods Clinical records of 263 patients who underwent pacemaker or defibrillator implantation for CRT between March 2003 and October 2020 were retrospectively evaluated. The CONUT score was calculated from laboratory data obtained before CRT device implantation. Patients were divided into three groups: normal nutrition (CONUT scores 0–1, n=58), mild malnutrition (CONUT scores 2–4, n=132) and moderate or severe malnutrition (CONUT scores 5–12, n=73). The primary endpoint was all-cause mortality. Results The moderate or severe malnutrition group had a lower body mass index, more advanced New York Heart Association functional class, higher Clinical Frailty Scale score, lower levels of haemoglobin and higher levels of N-terminal probrain natriuretic peptide (all p<0.05). In the moderate or severe malnutrition group, the CRT response rate was significantly lower than for the other two groups (p=0.001). During a median follow-up period of 31 (10–67) months, 103 (39.1%) patients died. Kaplan-Meier analysis revealed that the moderate or severe malnutrition group had a significantly higher mortality rate (log-rank p<0.001). A higher CONUT score and CONUT score ≥5 remained significantly associated with all-cause mortality after adjusting for previously reported clinically relevant factors and the conventional risk score (VALID-CRT risk score) (all p<0.05). Conclusions A higher CONUT score before CRT device implantation was strongly associated with HF severity, frailty, lower CRT response rate and subsequent long-term all-cause mortality. Data are available on reasonable request.

中文翻译：

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控制营养状态 (CONUT) 评分在接受心脏再同步化治疗的患者中的预后重要性

目标 营养不良是常见的，并且与心力衰竭 (HF) 患者的较差临床结果相关。控制营养状况 (CONUT) 评分是一个综合指数，用于评估营养不良复杂机制的各个方面。然而，通过 CONUT 评分评估的营养不良严重程度与接受心脏再同步化治疗 (CRT) 的 HF 患者的临床结果之间的关系尚未完全阐明。方法回顾性评价2003年3月至2020年10月263例接受CRT起搏器或除颤器植入的患者的临床资料。CONUT 分数是根据 CRT 设备植入前获得的实验室数据计算的。患者分为三组：正常营养（CONUT 评分 0-1，n=58）、轻度营养不良（CONUT 评分 2-4、n=132）和中度或重度营养不良（CONUT 评分 5-12，n=73）。主要终点是全因死亡率。结果中度或重度营养不良组体重指数较低，纽约心脏协会功能分级较高，临床虚弱量表评分较高，血红蛋白水平较低，N末端脑钠肽前体水平较高（均p<0.05）。在中度或重度营养不良组中，CRT 反应率显着低于其他两组（p=0.001）。在 31 (10-67) 个月的中位随访期间，103 名 (39.1%) 患者死亡。Kaplan-Meier 分析显示，中度或重度营养不良组的死亡率显着升高（对数秩 p<0.001）。在调整了先前报告的临床相关因素和常规风险评分（VALID-CRT 风险评分）后，较高的 CONUT 评分和 CONUT 评分≥5 仍与全因死亡率显着相关（所有 p<0.05）。结论 CRT 装置植入前较高的 CONUT 评分与 HF 严重程度、虚弱、较低的 CRT 反应率和随后的长期全因死亡率密切相关。可根据合理要求提供数据。