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Introduction: Introduction: inflammatory activity (IA) is a cause of hypoalbuminemia in patients with acute heart failure (AHF). Objectives: the main objective of this study was to evaluate whether an AI modulator treatment contributes to correcting albuminemia in this context. Methods: in this clinical trial 43 patients with AHF, hypoalbuminemia (serum albumin  3.4 g/dl), and elevated IA [C-reactive protein (CRP)  25 mg/l] were randomly assigned to receive omega-3 fatty acids (4 g daily) or placebo for 4 weeks. Albuminemia and CRP were reassessed at weeks 1 and 4. An analysis of variance for repeated measures was performed. Results: mean age was 75.6 ± 8.8 years, 72.1 % were male, and the most frequent etiology was ischemic (46.5 %). The two groups were homogeneous in their baseline characteristics. A significant increase in albumin concentration was found at week 4 from baseline (p for the effect of time < 0.001), with no differences between groups at week 1 or week 4. CRP decreased significantly in week 1 (p for the effect of time < 0.001), with no differences between groups in either week 1 or week 4. Conclusion: in patients with AHF, hypoalbuminemia, and elevated AI albuminemia normalizes in week 4, while CRP already drops significantly during the first week. In this context both effects are independent of the addition of high doses of omega-3 fatty acids.

Background: Undernutrition is common among acute heart failure patients and its prognosis impact has been established. The prognosis role of undernutrition among chronic heart failure patients is not known. Objetive:The aim of this study were to evaluate the influence of nutritional status on long-term mortality in patients with chronic hear failure., Methods: 304 consecutively patients attended in our Heart failure Unit from November 2011 to November 2016 were prospectively analysed. A global nutritional assessment was performed and the states of undernutrition and at risk of malnutrition were assessment by the Mini Nutritional Assessment test. Their possible independent association with mortality was analyzed by Cox multivariate analysis., Results: The mean age was 74.6 ± 10.1 years, 41.1% were female and the most frequent aetiology was ischemic heart disease (39.1%). 11.5% of the patients were classified as undernourished and 38.2% were classified as at risk of malnutrition. The remaining 50.3% were classified by the MNA as adequate nutritional status. After 28 months (median of follow-up), mortality was 68.9%, 33.3% and 15.2%, respectively (Log-rank, p < 0.001). When Cox multivariate analysis was performed, the state of undernutrition was an independent predictor of mortality (Hazard ratio 2.73; 95% confidence interval, 1.55-4.81; p < 0.001)., Conclusions: The prevalence of undernutrition and risk of malnutrition reaches high levels in chronic heart failure patients. Moreover, the state of undernutrition by Mini Nutritional Assessment score is an independent predictor of mortality in these patients.