© 2014 American Society for Parenteral and Enteral Nutrition

ncp.sagepub.com hosted at online.sagepub.com Clinical Research Although treatment of advanced heart failure (AHF) has improved significantly in recent decades, clinical prognosis remains poor, with half of patients dying within 4 years of diagnosis.1 Malnutrition is known to influence the progression of many chronic diseases, including AHF, where it has been shown to predict adverse outcomes.2,3 Cardiac cachexia, often characterized by weight loss, increased lipolysis, lack of appe-tite, malabsorption, and homeostatic disruption of multiple body systems, is known to affect prognosis.4,5 The Mini Nutritional Assessment (MNA) is a simple ques-tionnaire-based tool that is notably sensitive (96%), specifi