Major Predictors of Incidence of Congestive Heart Failure and the Responsive Character of Enteral Nutrition: Meta-Analysis

BACKGROUND: Statistical data from the USA estimate that 5.7 million Americans over 20 years of age have congestive heart failure (CHF) and this number is expected to increase approximately 46.0% between 2012 and 2030. In Brazil, there are no epidemiological studies involving the incidence of heart failure; however, according to other countries, it can be estimated that up to 6.4 million Brazilians suffer from this syndrome. Randomized and controlled clinical studies on the efficacy of enteral nutrition (EN) in patients with CHF are lacking. The aim of the present study was to perform a systematic review of the main predictors of CHF that promote EN, as well as to find if the literary findings were conclusive in the efficacy of EN for treatment and prophylaxis of CHF. METHODS: A total of 105 papers were submitted to the eligibility analysis, after which 28 studies were selected, following the rules of the systematic review - PRISMA. The search strategy was followed in MEDLINE/Pubmed, Web of Science, ScienceDirect Journals (Elsevier), Scopus (Elsevier) and ONEFile (Gale), with the following steps: search for mesh terms and use of bouleanos “and” between terms and “or” between historical findings. RESULTS: The present study listed the major predictors of CHF with indication for EN. After testing the normality of each group of variables of causes of decompensation in CHF, it was analyzed that all the variables did not present normal distribution, with P < 0.10. Thus, a non-parametric Kruskal-Wallis analysis was performed, obtaining P > 0.05 in all analyses, that is, in all groups of causes of decompensation in CHF, there was no statistical difference in each group studied. CONCLUSION: There is still no known influence of the efficacy of EN on increasing survival and reducing the morbidity of patients with CHF because there are few clinical trials that have evaluated this question; however, EN is very indicated in the attempt to mitigate the weight loss in these patients.