Clinical Nutrition Open Science (Oct 2024)

Associations of serum branched-chain amino acid and marine omega-3 fatty acid levels with exercise intolerance in heart failure patients

  • Takeshi Sota,
  • Yoshiharu Kinugasa,
  • Natsuko Nakayama,
  • Kensuke Nakamura,
  • Masayuki Hirai,
  • Masahiko Kato,
  • Taisuke Ono,
  • Masashige Takahashi,
  • Hisashi Matsuo,
  • Ryuichi Matsukawa,
  • Ichiro Yoshida,
  • Shigeo Kakinoki,
  • Kazuya Yonezawa,
  • Yoshihiro Himura,
  • Takashi Yokota,
  • Kazuhiro Yamamoto,
  • Miyuki Tsuchihashi-Makaya,
  • Shintaro Kinugawa

Journal volume & issue
Vol. 57
pp. 241 – 252

Abstract

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Summary: Background & Aims: Branched-chain amino acids (BCAAs), and the marine omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), prevent physical decline in older people. However, their combined effect on physical function in heart failure (HF) is unclear. This study aimed to investigate the association of BCAAs and EPA/DHA with exercise tolerance in people with HF. Methods: In total, 124 patients with HF were prospectively enrolled, and their serum BCAA and EPA/DHA levels, dietary pattern, and 6-minute walking distance (6-MWD) were assessed. Results: Lower 6-MWD quantiles contained more female patients than higher 6-MWD quantiles. Patients with a shorter 6-MWD were older and had a smaller leg circumference, higher B-type natriuretic peptide concentrations, and lower BCAA and EPA/DHA levels than those with longer 6-MWD (all P < 0.05). Patients with a shorter 6-MWD had an imbalanced dietary pattern with low intakes of oily fish, soy products, and vegetables. Meanwhile, their estimated nutrient intakes were high in saturated fatty acids and sucrose and low in polyunsaturated fatty acids and dietary fiber (all P < 0.05). According to multivariate analysis, low EPA/DHA concentrations (per 50 μg/mL decrease) [odds ratio, 95% confidence interval: 1.479 (1.025–2.137)], low dietary fiber intake (per 1 g/1000kcal decrease) [1.524 (1.098–2.119)], and high sucrose intake (per 1 g/1000kcal increase) [1.170 (1.040–1.310)] were independently associated with short 6-MWD (the lowest quantile of 6-MWD, <350m) (P < 0.05). When the effect of EPA/DHA and BCAAs on 6-MWD was assessed, the impact of low EPA/DHA concentrations on short 6-MWD was stronger in patients with low BCAA levels (P < 0.05 for interaction). Conclusions: Patients with HF and impaired exercise tolerance consumed an imbalanced diet; the combination of low BCAA and low EPA/DHA concentrations was associated with exercise intolerance in these patients.

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