{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:11:11Z","timestamp":1792620671955,"version":"4.5.0"},"reference-count":21,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The aim of the present observational study was to evaluate the early effect of free-form essential amino acid (EAA) supplementation on cardiac and muscular performance in elderly patients with chronic heart failure (HF) with reduced ejection fraction (HFrEF) and sarcopenia, as add-on to the optimized medical therapy (OMT) for HF. The present study included 60 elderly Caucasian patients suffering from HFrEF and sarcopenia. At the baseline and at follow-up, all patients underwent complete physical examination with the determination of the main anthropometric and hemodynamic parameters. After 6 months of supplementation with EAAs, we observed significant improvements in the parameters of sarcopenia. In addition, there was a significant improvement in glycol-metabolic parameters, and in inflammatory index as high sensitivity C-reactive protein (hs-CRP). In accordance with these results, significant decreases were observed in circulating levels of oxidative stress biomarkers Nox-2 (p &lt; 0.001) and 8-Isoprostane (p &lt; 0.001), and platelet aggregation biomarkers such as sP-Selectin (p &lt; 0.001) and Gp-VI (p &lt; 0.001). Of particular interest, after 6 months\u2019 follow-up, there was a significant improvement in LVEF and global longitudinal strain (GLS). In conclusion, this study demonstrates that targeted nutritional intervention with EEAAs represents a viable therapeutic strategy for addressing the complex interplay between cardiac dysfunction and skeletal muscle wasting in elderly HF patients.<\/jats:p>","DOI":"10.3390\/ijms26157533","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T07:45:11Z","timestamp":1754466311000},"page":"7533","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Early Effect of Supplementation with Essential Amino Acids on Cardiac Performance in Elderly Patients with Heart Failure and Sarcopenia"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-9715","authenticated-orcid":false,"given":"Giuseppe","family":"Armentaro","sequence":"first","affiliation":[{"name":"Geriatrics Division, \u201cRenato Dulbecco\u201d University Hospital of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0793-1225","authenticated-orcid":false,"given":"Velia","family":"Cassano","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Loiacono","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Fuoco","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0136-4594","authenticated-orcid":false,"given":"Giandomenico","family":"Severini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Alberto","family":"Pastura","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Panza","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilisa","family":"Panza","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3198-7090","authenticated-orcid":false,"given":"Elisa","family":"Mazza","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Miceli","sequence":"additional","affiliation":[{"name":"Geriatrics Division, \u201cRenato Dulbecco\u201d University Hospital of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Pujia","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"},{"name":"Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Gr\u00e6cia, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7048-5830","authenticated-orcid":false,"given":"Tiziana","family":"Montalcini","sequence":"additional","affiliation":[{"name":"Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Gr\u00e6cia, 88100 Catanzaro, Italy"},{"name":"Department of Clinical and Experimental Medicine, University Magna Gr\u00e6cia, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1674-5317","authenticated-orcid":false,"given":"Angela","family":"Sciacqua","sequence":"additional","affiliation":[{"name":"Geriatrics Division, \u201cRenato Dulbecco\u201d University Hospital of Catanzaro, 88100 Catanzaro, Italy"},{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia of Catanzaro, 88100 Catanzaro, Italy"},{"name":"Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Gr\u00e6cia, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s10741-014-9436-9","article-title":"Amino Acids and Derivatives, a New Treatment of Chronic Heart Failure?","volume":"20","author":"Carubelli","year":"2015","journal-title":"Heart Fail. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1007\/s00394-019-02108-z","article-title":"The Effect of Protein and Essential Amino Acid Supplementation on Muscle Strength and Performance in Patients with Chronic Heart Failure: A Systematic Review","volume":"59","author":"Nichols","year":"2020","journal-title":"Eur. J. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European Consensus on Definition and Diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s40520-025-03049-w","article-title":"Gliflozines as Add-on to Arni in Echocardiographic, Sarcopenic and Oxidative Stress Parameters in Elderly Patients with Chronic Heart Failure","volume":"37","author":"Armentaro","year":"2025","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1038\/s43587-024-00797-8","article-title":"Multi-Omic Profiling of Sarcopenia Identifies Disrupted Branched-Chain Amino Acid Catabolism as a Causal Mechanism and Therapeutic Target","volume":"5","author":"Zuo","year":"2025","journal-title":"Nat. Aging"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1017\/S0007114517003816","article-title":"Systematic Review and Meta-Analysis of the Effect of Protein and Amino Acid Supplements in Older Adults with Acute or Chronic Conditions","volume":"119","author":"Cheng","year":"2018","journal-title":"Br. J. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1093\/cvr\/cvad005","article-title":"Dietary Essential Amino Acids for the Treatment of Heart Failure with Reduced Ejection Fraction","volume":"119","author":"Ragni","year":"2023","journal-title":"Cardiovasc. Res."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Gao, C., and Hou, L. (2023). Branched Chain Amino Acids Metabolism in Heart Failure. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1279066"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"de Jorge-Huerta, L., Marco-Alacid, C., Grande, C., and Velardo Andr\u00e9s, C. (2024). A Narrative Review of the Diagnosis and Treatment of Sarcopenia and Malnutrition in Patients with Heart Failure. Nutrients, 16.","DOI":"10.3390\/nu16162717"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/s12603-016-0743-9","article-title":"Effectiveness of Cardiac Rehabilitation for Prevention and Treatment of Sarcopenia in Patients with Cardiovascular Disease\u2014A Retrospective Cross-Sectional Analysis","volume":"21","author":"Harada","year":"2017","journal-title":"J. Nutr. Heal. Aging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"16E","DOI":"10.1016\/j.amjcard.2008.02.075","article-title":"Intracellular Mechanisms of Metabolism Regulation: The Role of Signaling via the Mammalian Target of Rapamycin Pathway and Other Routes","volume":"101","author":"Flati","year":"2008","journal-title":"Am. J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/S0735-1097(00)00531-3","article-title":"Development and evaluation of the Kansas City cardiomyopathy questionnaire: A new health status measure for heart failure","volume":"35","author":"Green","year":"2000","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"230912","DOI":"10.3945\/jn.116.230912","article-title":"Inflammaging and Skeletal Muscle: Can Protein Intake Make a Difference?","volume":"146","author":"Draganidis","year":"2016","journal-title":"J. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"39","DOI":"10.4137\/CMC.S14016","article-title":"Effects of Oral Amino Acid Supplements on Functional Capacity in Patients with Chronic Heart Failure","volume":"8","author":"Lombardi","year":"2014","journal-title":"Clin. Med. Insights Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1080\/21551197.2022.2070321","article-title":"Intakes of Total and Branched-Chain Essential Amino Acids Are Positively Associated with Handgrip Strength in African American and White Urban Younger and Older Adults","volume":"41","author":"Kuczmarski","year":"2022","journal-title":"J. Nutr. Gerontol. Geriatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"104E","DOI":"10.1016\/j.amjcard.2008.03.008","article-title":"Oral Amino Acid Supplements Improve Exercise Capacities in Elderly Patients with Chronic Heart Failure","volume":"101","author":"Aquilani","year":"2008","journal-title":"Am. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/0002-9149(86)90771-X","article-title":"Echocardiographic Assessment of Left Ventricular Hypertrophy: Comparison to Necropsy Findings","volume":"57","author":"Devereux","year":"1986","journal-title":"Am. J. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s40256-020-00445-7","article-title":"Effect of Sacubitril\/Valsartan on Neurocognitive Function: Current Status and Future Directions","volume":"21","author":"Galo","year":"2021","journal-title":"Am. J. Cardiovasc. Drugs"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Armentaro, G., D\u2019Arrigo, G., Miceli, S., Cassano, V., Perticone, M., Maio, R., Marra, A.M., Arturi, F., Cittadini, A., and Tripepi, G. (2022). Long Term Metabolic Effects of Sacubitril\/Valsartan in Non-Diabetic and Diabetic Patients With Heart Failure Reduced Ejection Fraction: A Real Life Study. Front. Physiol., 13.","DOI":"10.3389\/fphys.2022.897109"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/15\/7533\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:22:55Z","timestamp":1760034175000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/15\/7533"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":21,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["ijms26157533"],"URL":"https:\/\/doi.org\/10.3390\/ijms26157533","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,4]]}}}