{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:56:44Z","timestamp":1773413804961,"version":"3.50.1"},"reference-count":28,"publisher":"Ubiquity Press, Ltd.","issue":"1","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["gh"],"abstract":"<jats:p>Background: Malnutrition is common in heart failure (HF) and is associated with poor outcomes; however, longitudinal changes in the nutritional status of patients with HF are poorly investigated.\nObjectives: To assess the prognostic impact of changes in Controlling Nutritional Status (CONUT) score and identify predictors of malnutrition improvement in hospitalized patients with HF.\nMethods: We analyzed data on 4,016 patients from a nationwide acute HF registry in Japan (UMIN ID: UMIN000036592). We identified 812 patients with moderate or severe malnutrition at admission (CONUT score \u22655) and stratified them into an improvement (IMP, n = 168) or non-improvement (Non-IMP, n = 644) group based on in-hospital change in CONUT score. The primary outcome was all-cause mortality; the secondary outcome was a composite endpoint of all-cause mortality and HF rehospitalization.\nResults: Over a median follow-up of 712 days (IQR, 392\u2013768 days), all-cause mortality was significantly lower in the IMP group than in the Non-IMP group (11.90% vs. 30.12%; log-rank P &lt; 0.0001). The composite endpoint was also lower in the IMP group (29.76% vs. 47.98%; log-rank P &lt; 0.0001). After propensity score matching, the IMP group had consistently lower all-cause mortality and composite endpoints than the Non-IMP group (log-rank P = 0.0002; log-rank P = 0.041). Multivariable Cox proportional hazards model for all-cause mortality with overlap weighting demonstrated that CONUT improvement was associated with lower all-cause mortality (HR, 0.357; 95% CI, 0.205\u20130.624; P = 0.0003).\nConclusion: In hospitalized patients with acute HF and moderate to severe malnutrition, improvement in CONUT score during hospitalization was associated with lower post-discharge mortality and rehospitalization.<\/jats:p>","DOI":"10.5334\/gh.1534","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:45:56Z","timestamp":1773398756000},"page":"20","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of In-Hospital Nutritional Status Improvement in Heart Failure: Insights From JROADHF-NEXT Registry"],"prefix":"10.5334","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9687-9256","authenticated-orcid":false,"given":"Toshitaka","family":"Okabe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Kida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3899-4405","authenticated-orcid":false,"given":"Nobuyuki","family":"Enzan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masataka","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5076-2052","authenticated-orcid":false,"given":"Takahiro","family":"Okumura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2416-5865","authenticated-orcid":false,"given":"Takeshi","family":"Kitai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Tohyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3434-5864","authenticated-orcid":false,"given":"Tatsunori","family":"Taniguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9774-4513","authenticated-orcid":false,"given":"Shouji","family":"Matsushima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2456-8525","authenticated-orcid":false,"given":"Yuya","family":"Matsue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Tsutsui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3285","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"issue":"36","key":"key20260313104554_B1","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","year":"2021","journal-title":"Eur Heart J"},{"issue":"17","key":"key20260313104554_B2","first-page":"e263","article-title":"AHA\/ACC\/HFSA Guideline for the management of heart failure: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"79","year":"2022","journal-title":"J Am Coll Cardiol"},{"issue":"8","key":"key20260313104554_B3","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1253\/circj.CJ-25-0002","article-title":"Japanese Circulation Society and the Japanese Heart Failure Society Joint Working Group. JCS\/JHFS 2025 Guideline on Diagnosis and Treatment of Heart Failure","volume":"89","year":"2025","journal-title":"Circ J"},{"key":"key20260313104554_B4","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1136\/heartjnl-2018-313312","article-title":"Malnutrition, congestion and mortality in ambulatory patients with heart failure","volume":"105","year":"2019","journal-title":"Heart"},{"key":"key20260313104554_B5","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jjcc.2025.05.013","article-title":"Current findings and challenges on frailty, sarcopenia, and cachexia in older patients with heart failure: insights from the FRAGILE-HF study","volume":"87","year":"2026","journal-title":"J Cardiol"},{"issue":"4","key":"key20260313104554_B6","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1007\/s11739-023-03230-x","article-title":"Controlling nutritional status score predicts 2-year outcomes in elderly patients admitted for acute heart failure","volume":"18","year":"2023","journal-title":"Intern Emerg Med"},{"key":"key20260313104554_B7","first-page":"38","article-title":"CONUT: A tool for controlling nutritional status. First validation in a hospital population","volume":"20","year":"2005","journal-title":"Nutr Hosp"},{"issue":"3","key":"key20260313104554_B8","article-title":"Prognostic and clinicopathological significance of the Controlling Nutritional Status (CONUT) score in patients with lymphoma: A meta-analysis","volume":"14","year":"2024","journal-title":"BMJ Open"},{"issue":"9","key":"key20260313104554_B9","doi-asserted-by":"crossref","first-page":"3146","DOI":"10.1080\/01635581.2022.2059091","article-title":"The Controlling Nutritional Status (CONUT) score and prognosis in malignant tumors: A systematic review and meta-analysis","volume":"74","year":"2022","journal-title":"Nutr Cancer"},{"issue":"10","key":"key20260313104554_B10","article-title":"CONUT score as a predictor of mortality risk in acute and chronic heart failure: A meta-analytic 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chronic heart failure","volume":"4","year":"2016","journal-title":"JACC Heart Fail"},{"issue":"1","key":"key20260313104554_B21","article-title":"The role of the gut microbiota in the onset and progression of heart failure: insights into epigenetic mechanisms and aging","volume":"16","year":"2024","journal-title":"Clin Epigenetics"},{"issue":"6","key":"key20260313104554_B22","article-title":"Interconnection between cardiac cachexia and heart failure-protective role of cardiac obesity","volume":"11","year":"2022","journal-title":"Cells"},{"issue":"4","key":"key20260313104554_B23","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1007\/s11010-024-05043-8","article-title":"Renin angiotensin system-induced muscle wasting: putative mechanisms and implications for clinicians","volume":"480","year":"2025","journal-title":"Mol Cell 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