Impact of an oral amino acid-containing formulation on clinical and functional outcomes in patients with and without heart failure undergoing cardiac rehabilitation program: a pilot study.

OBJECTIVES: Skeletal muscle dysfunction and malnutrition are common in patients with cardiovascular disease (CVD), particularly those with heart failure (HF), and may reduce the benefits of cardiac rehabilitation (CR). Amino acid supplementation may enhance exercise-induced adaptations, but evidence during CR remains limited. METHODS: We conducted a pilot study including 25 patients with CVD, of whom 13 (52 %) had HF, undergoing a 3-month CR program with oral amino acid-containing nutritional formulation. Clinical and nutritional status, quality of life, psychological well-being, physical performance, exercise capacity, laboratory findings, and echocardiographic parameters were assessed at baseline and after 3 months. RESULTS: Significant improvements were observed in NYHA class, Mini Nutritional Assessment-Short Form, Minnesota Living with Heart Failure Questionnaire, Hospital Anxiety and Depression Scale, and Short Physical Performance Battery (all p<0.05). Exercise capacity improved, with a mean increase of 59.4 m in the 6-min walk test (p<0.001) and lower Borg scores (p=0.003). NT-proBNP levels decreased (p=0.023). Left ventricular ejection fraction remained unchanged, whereas global longitudinal strain and left atrial volume index improved (p≤0.007). CONCLUSIONS: Oral amino acid-containing supplementation combined with CR was associated with improved functional capacity, nutritional status, quality of life, and favorable changes in LV myocardial deformation. Larger randomized trials are needed to confirm these findings and determine the incremental contribution of this nutritional formulation.