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BACKGROUND Heart failure (HF) is a hypercatabolic state that promotes branched-chain amino acid (BCAA) catabolic activity within the heart and skeletal muscle mass and lowers protein synthesis within the liver. Consequently, plasma free fragrant amino acids (AAAs) tend to be increased. We investigated the prognostic worth of the BCAA/AAA ratio (Fischer's ratio, FR) in customers with HF. PRACTICES We enrolled 157 successive clients hospitalized for worsening HF (81 men, 76 women; mean ± SD age