New paper investigates association between malnutrition and secondary mitral regurgitation in HF patients

This June 2023 paper highlights the association between malnutrition risk and mortality among patients with heart failure (HF; left ventricular ejection fraction 20-50%) that also have secondary mitral regurgitation (MR).  The COAPT trial compared the survival and quality of life between patients treated with transcatheter edge-to-edge repair (TEER) plus guideline-directed medical therapy (GDMT) versus GDMT alone. Among 552 trial participants, 17% screened in for malnutrition per the geriatric nutritional risk index (GNRI tool). Malnutrition was associated with higher all-cause mortality rates. The COAPT study previously showed better survival for patients with secondary MR treated with TEER + GDMT as compared to GDMT alone. In this analysis, the survival benefit from TEER was consistent between patients with or without baseline malnutrition per GNRI. This study suggests that even malnourished patients with HF benefit from interventions such as TEER. However it should be remembered that GNRI is a screening tool comprised of weight, ideal weight and serum albumin and does not diagnose malnutrition. Also this analysis does not indicate whether a nutritional intervention for patients who screened in for malnutrition would be associated with improved survival.