The complex pathophysiology of cardiac cachexia: A review of current pathophysiology and implications for clinical practice

TY - JOUR

T1 - The complex pathophysiology of cardiac cachexia

T2 - A review of current pathophysiology and implications for clinical practice

AU - Thanapholsart, Jenjiratchaya

AU - Khan, Ehsan

AU - Ismail, Tevfik F.

AU - Lee, Geraldine A.

N1 - Publisher Copyright: © 2022 The Authors

PY - 2023/1

Y1 - 2023/1

N2 - Cardiac cachexia is a muscle wasting process that often develops in those with chronic heart failure resulting in weight loss, low levels of physical activity, reduced quality of life, and is associated with a poor prognosis. The pathology of cardiac cachexia is complex with new evidence emerging that implicates several body systems. This review describes the pathophysiology associated with cardiac cachexia and addresses: 1) hormonal changes- neurohormonal abnormalities and metabolic hormone imbalance; 2) mechanisms of muscle wasting in cardiac cachexia, and the integral mechanisms between changed hormones due to cardiac cachexia and muscle wasting processes, and 3) associated abnormalities of gastrointestinal system that contribute to cardiac cachexia. These pleiotropic mechanisms demonstrate the intricate interplay between the affected systems and account for why cardiac cachexia is difficult to manage clinically. This review summarises current pathophysiology of cardiac cachexia and highlights symptoms of cardiac cachexia, implications for clinical practice and research gaps.

AB - Cardiac cachexia is a muscle wasting process that often develops in those with chronic heart failure resulting in weight loss, low levels of physical activity, reduced quality of life, and is associated with a poor prognosis. The pathology of cardiac cachexia is complex with new evidence emerging that implicates several body systems. This review describes the pathophysiology associated with cardiac cachexia and addresses: 1) hormonal changes- neurohormonal abnormalities and metabolic hormone imbalance; 2) mechanisms of muscle wasting in cardiac cachexia, and the integral mechanisms between changed hormones due to cardiac cachexia and muscle wasting processes, and 3) associated abnormalities of gastrointestinal system that contribute to cardiac cachexia. These pleiotropic mechanisms demonstrate the intricate interplay between the affected systems and account for why cardiac cachexia is difficult to manage clinically. This review summarises current pathophysiology of cardiac cachexia and highlights symptoms of cardiac cachexia, implications for clinical practice and research gaps.

KW - Cardiac cachexia

KW - Heart failure

KW - Malnutrition

KW - Muscle wasting

KW - Weight loss

UR - https://www.scopus.com/pages/publications/85140603262

U2 - 10.1016/j.amjms.2022.08.016

DO - 10.1016/j.amjms.2022.08.016

M3 - Review article

C2 - 36055378

AN - SCOPUS:85140603262

SN - 0002-9629

VL - 365

SP - 9

EP - 18

JO - American Journal of the Medical Sciences

JF - American Journal of the Medical Sciences

IS - 1

ER -