Highlights
- •epidemiological data about prevalence of cardiac cachexia remain scarce
- •patophysiology of cardiac cachexia is complex and multifactorial
- •diagnostic and prognostic biomarkers are under investigation in cardiac cachexia
- •no evidence based strategy for cachexia available but many interventions in clinical trials
Abstract
Cardiac cachexia (CC) is the clinical entity at the end of chronic natural course
of heart failure (HF). Despite the efforts, even the most recent definition of cardiac
cachexia has been challenged, more precisely the addition of new criteria on top of
obligatory weight loss. The pathophysiology of CC is complex and multifactorial. Better
understanding of pathophysiological pathways in body wasting will contribute to establish
potentially novel treatment strategies. The complex biochemical network related with
CC and HF pathophysiology underlines that a single biomarker cannot reflect all of
the features of the disease. Biomarkers that could pick-up the changes in body composition
before they convey into clinical manifestations of CC would be of great importance.
The development of preventive and therapeutic strategies against cachexia, sarcopenia
and wasting disorders is perceived as an urgent need by healthcare professionals.
The treatment of body wasting remains an unresolved challenge to this day. As CC is
a multifactorial disorder, it is unlikely that any single agent will be completely
effective in treating this condition. Among all investigated therapeutic strategies,
aerobic exercise training in HF patients is the most proved to counteract skeletal
muscle wasting and is recommended by treatment guidelines for HF.
Abbreviations:
ActRIIB (Activin type II B receptors), AET (Aerobic exercise training), BCAA (Branched chain amino acid), C6M (MMP-generated degradation fragment of collagen 6), CAF (C-terminal agrin fragment), CC (cardiac cachexia), GDF15 (growth differentiation factor 15), HF (heart failure), IC6 (type VI collagen N-terminal globular domain epitope), IGF-1 (Insulin-like growth factor 1), P3NP (N-terminal propeptide of type III procollagen), RAAS (renin–angiotensin–aldosterone axis), SNS (sympathetic nervous system), sTNFRs (Soluble tumor necrosis factor receptors (sTNFRs)), TNF-α (tumor necrosis factor alpha), UPP (ubiquitin–proteasome pathway)Keywords
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Article info
Publication history
Published online: October 15, 2015
Accepted:
October 13,
2015
Received:
October 12,
2015
Footnotes
☆This paper is also published in J Cachexia Sarcopenia Muscle.
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
