Usefulness of the plasma branched-chain amino acid/aromatic amino acid ratio for predicting future cardiac events in patients with heart failure

BackgroundHeart failure (HF) is a hypercatabolic state that promotes branched-chain amino acid (BCAA) catabolic activity in the heart and skeletal muscle and reduces protein synthesis in the liver. Consequently, plasma free aromatic amino acids (AAAs) are increased. We investigated the prognostic value of the BCAA/AAA ratio (Fischer’s ratio, FR) in patients with HF.MethodsWe enrolled 157 consecutive patients hospitalized for worsening HF (81...