THE NUTRITION STATUS OF PATIENTS IN THE CLINIC FOR HEART FAILURE

Srčno popuščanje je bolezensko stanje, kjer prizadeto srce ne more prečrpati dovolj krvi, da bi lahko zadostno preskrbelo tkiva in organe. Kronično srčno popuščanje je klinični sindrom, katerega vzrok so lahko različne bolezni. Najpogostejši vzroki so koronarna bolezen, arterijska hipertenzija in bolezni srčnih zaklopk. Srčno popuščanje je v populaciji prisotno pri 2-5%, pri starejših nad 65 let, pa pri več kot 10%. Zaradi daljše pričakovane življenjske dobe, so napovedi za prihodnost še bolj črnoglede. Srčno popuščanje je edina bolezen srca in ožilja, pri kateri pogostost že nekaj let narašča. Bolniki potrebujejo dolgotrajno ali celo vseživljenjsko obravnavo, ki jo skušamo individualno prilagoditi. V ta namen so bile ustanovljene Ambulante za srčno popuščanje v skoraj vseh bolnišnicah v državi. Po več kot petnajstih letih delovanja so se izkazale ko zelo učinkovite. V začetku je bila večja pozornost zdravljenja srčnega popuščanja usmerjena v medikamentozno terapijo. Kasneje se je v obravnavo vključila edukacija in zdravstvena vzgoja o nefarmakoloških ukrepih. Zadnjih nekaj let svoje mesto ob medikamentozni terapiji in nefarmakoloških ukrepih dobiva tudi prehranska obravnava bolnika. V preteklosti je bila pozornost usmerjena bolj k obravnavi prekomerne prehranjenosti, ki je tudi dejavnik tveganja za srčno žilne bolezni. V današnjem času, pa so aktivnosti v klinični praksi usmerjene tudi v zgodnje odkrivanje in preprečevanje podhranjenosti. Podhranjenost pri bolnikih s srčnim popuščanjem je vzrok za pogostejše zaplete pri zdravljenju, podaljšane hospitalizacije, večje število ponovnih sprejemov, slabšo kakovost življenja tudi višji stroški zdravljenja. Za odkrivanje podhranjenosti se opravi prehranska anamneza. Najhitrejši, enostaven in poceni način je uporaba vprašalnika.Heart failure is a condition where the affected heart is unable to pump enough blood to be able to adequately supply the tissues and organs. Chronic heart failure is a clinical syndrome which may cause a variety of diseases. The most common causes are coronary artery disease, arterial hypertension and valvular heart disease. Heart failure is present in a population at 2-5%, in people over 65 years of age in more than 10%. Due to a longer life expectancy, the future forecast is even more pessimistic. Heart failure is the only cardiovascular disease in which the frequency has been in increase for a few years. We are trying to individually adjust requiring long-term or even lifelong treatment to patients. For this purpose, clinic for heart failure in almost all hospitals in the country have been established. After more than fifteen years they have proved as very effective. At the beginning, greater attention was directed towards medical therapy in the treatment of heart failure. Later, knowledge and health education about non-pharmacological interventions were included. In recent years alongside drug therapy and non-pharmacological interventions also nutritional treatment of the patient has been applied. In the past, attention was paid more how to treat obesity, which is also a risk factor for cardiovascular disease. Nowadays, in clinical practice there are also activities focused on early detection and prevention of malnutrition. Malnutrition in patients with heart failure is the cause of frequent complications regarding treatment, prolonged hospitalization, increased number of re-admissions causing treatment costs increase, and poorer quality of life. For this purpose, dietary history questionnaire is the fastest, easiest and cheapest tool for malnutrition detection