Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2016, 25(1):31-38

The role of cachexia and obesity in patients with chronic heart failure

Valentová M1, Murín J2
1 Oddelenia kardiológie a pneumológie, Univerzitná klinika Göttingen, Göttingen, Nemecko
2 I. interná klinika LF UK a UNB, Nemocnica Staré Mesto, Bratislava, Slovenská republika

Normal weight, or even underweight, are known to be associated with a worse prognosis in patients with chronic heart failure. Cachexia, defined as an unintentional weight loss, is linked to 1-year mortality of 50%. Cachexia results from a decreased calorie intake due to appetite loss and malabsorption on one hand. On the other hand, increased catabolism, which arises from overexpression of proinflammatory cytokines and activation of renin-angiotensin-aldosterone-system, exacerbates cachexia. These abnormalities may be linked to right heart failure and consecutive venous congestion. Gut dysfunction, which is due to congestive right heart failure, seems to be another important trigger for cachexia, for which there is no evidence-based specific treatment so far. Additional to an optimal treatment of heart failure, factors such as exercise and nutrition play a role in improving cachexia.

Keywords: chronic heart failure; cachexia; gut function

Published: January 1, 2016  Show citation

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Valentová M, Murín J. The role of cachexia and obesity in patients with chronic heart failure. Cardiology Letters. 2016;25(1):31-38.
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    References

    1. Braunwald E. Heart failure. JACC Heart Fail 2013;1(1):1-20. Go to original source...
    2. McMurray JJV, Stewart S. The burden of heart failure. Eur Heart J Suppl 2002;4(Suppl D):D50-58. Go to original source...
    3. Pernický M, Murín J. Pacienti v Ústavnej pohotovostnej službe na Internej klinike. Cardiology Lett 2010;19(4):201-205.
    4. Ceia F, Fonseca C, Mota T, Morais H, Matias F, de Sousa A, et al. Prevalence of chronic heart failure in Southwestern Europe: the EPICA study. Eur J Heart Fail 2002;4(4):531-539. Go to original source...
    5. Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the Future of Cardiovascular Disease in the United States A Policy Statement From the American Heart Association. Circulation 2011;123(8):933944. Go to original source...
    6. Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KKL, et al. Long-Term Trends in the Incidence of and Survival with Heart Failure. N Engl J Med 2002;347(18):1397-1402. Go to original source...
    7. De Giuli F, Khaw K-T, Cowie MR, Sutton GC, Ferrari R, PooleWilson PA. Incidence and outcome of persons with a clinical diagnosis of heart failure in a general practice population of 696,884 in the United Kingdom. Eur J Heart Fail 2005;7(3):295302. Go to original source...
    8. Hobbs FDR, Roalfe AK, Davis RC, Davies MK, Hare R, Midlands Research Practices Consortium (MidReC). Prognosis of all-cause heart failure and borderline left ventricular systolic dysfunction: 5 year mortality follow-up of the Echocardiographic Heart of England Screening Study (ECHOES). Eur Heart J 2007;28(9):1128-1134. Go to original source...
    9. Horwich TB, Fonarow GC, Hamilton MA, MacLellan WR, Woo MA, Tillisch JH. The relationship between obesity and mortality in patients with heart failure. J Am Coll Cardiol 2001;38(3):789795. Go to original source...
    10. Kenchaiah S, Evans JC, Levy D, Wilson PWF, Benjamin EJ, Larson MG, et al. Obesity and the Risk of Heart Failure. N Engl J Med 2002;347(5):305-313. Go to original source...
    11. Voulgari C, Tentolouris N, Dilaveris P, Tousoulis D, Katsilambros N, Stefanadis C. Increased Heart Failure Risk in NormalWeight People With Metabolic Syndrome Compared With Metabolically Healthy Obese Individuals. J Am Coll Cardiol 2011 20;58(13):1343-1350. Go to original source...
    12. Oreopoulos A, Padwal R, Kalantar-Zadeh K, Fonarow GC, Norris CM, McAlister FA. Body mass index and mortality in heart failure: a meta-analysis. Am Heart J 2008;156(1):13-22. Go to original source...
    13. Clark AL, Chyu J, Horwich TB. The obesity paradox in men versus women with systolic heart failure. Am J Cardiol 2012;110(1):7782. Go to original source...
    14. Lavie CJ, Alpert MA, Arena R, Mehra MR, Milani RV, Ventura HO. Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure. JACC Heart Fail 2013;1(2):93102. Go to original source...
    15. Adamopoulos C, Meyer P, Desai RV, Karatzidou K, Ovalle F, White M, et al. Absence of obesity paradox in patients with chronic heart failure and diabetes mellitus: a propensity-matched study. Eur J Heart Fail 2011;13(2):200-206. Go to original source...
    16. Authors/Task Force Members, McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Böhm M, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur J Heart Fail 2012;14(8):803-869. Go to original source...
    17. Anker SD, Ponikowski P, Varney S, Chua TP, Clark AL, Webb-Peploe KM, et al. Wasting as independent risk factor for mortality in chronic heart failure. Lancet 1997;349(9058):1050-1053. Go to original source...
    18. Wallengren O, Lundholm K, Bosaeus I. Diagnostic criteria of cancer cachexia: relation to quality of life, exercise capacity and survival in unselected palliative care patients. Support Care Cancer 2013; 21(6):1569-1577. Go to original source...
    19. Argilés JM, Busquets S, Stemmler B, López-Soriano FJ. Cancer cachexia: understanding the molecular basis. Nat Rev Cancer 2014;14(11):754-762. Go to original source...
    20. Evans WJ, Morley JE, Argilés J, Bales C, Baracos V, Guttridge D, et al. Cachexia: a new definition. Clin Nutr Edinb Scotl 2008;27(6):793-799. Go to original source...
    21. Anker SD, Negassa A, Coats AJS, Afzal R, Poole-Wilson PA, Cohn JN, et al. Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensinconverting-enzyme inhibitors: an observational study. Lancet 2003;361(9363):1077-1083. Go to original source...
    22. Thompson MP, Cooper ST, Parry BR, Tuckey JA. Increased express­ ion of the mRNA for hormone-sensitive lipase in adipose tissue of cancer patients. Biochim Biophys Acta 1993;1180(3):236242. Go to original source...
    23. Polak J, Kotrc M, Wedellova Z, Jabor A, Malek I, Kautzner J, et al. Lipolytic Effects of B-Type Natriuretic Peptide1-32 in Adipose Tissue of Heart Failure Patients Compared With Healthy Controls. J Am Coll Cardiol 2011;58(11):1119-1125. Go to original source...
    24. Levine B, Kalman J, Mayer L, Fillit HM, Packer M. Elevated circu­ lating levels of tumor necrosis factor in severe chronic heart failure. N Engl J Med 1990;323(4):236-241. Go to original source...
    25. Agnoletti L, Curello S, Bachetti T, Malacarne F, Gaia G, Comini L, et al. Serum From Patients With Severe Heart Failure Downregulates eNOS and Is Proapoptotic : Role of Tumor Necrosis Factor-{alpha}. Circulation 1999;100(19):1983-1991. Go to original source...
    26. Braun TP, Marks DL. Pathophysiology and treatment of inflammatory anorexia in chronic disease. J Cachexia Sarcopenia Muscle 2010;1(2):135-145. Go to original source...
    27. Yoshida T, Tabony AM, Galvez S, Mitch WE, Higashi Y, Sukhanov S, et al. Molecular mechanisms and signaling pathways of angio­ tensin II-induced muscle wasting: potential therapeutic targets for cardiac cachexia. Int J Biochem Cell Biol 2013;45(10):23222332. Go to original source...
    28. Brink M, Wellen J, Delafontaine P. Angiotensin II causes weight loss and decreases circulating insulin-like growth factor I in rats through a pressor-independent mechanism. J Clin Invest 1996;97(11):2509-2516. Go to original source...
    29. Laviano A, Meguid MM, Inui A, Muscaritoli M, Rossi-Fanelli F. Therapy Insight: cancer anorexia-cachexia syndrome-when all you can eat is yourself. Nat Clin Pract Oncol 2005;2(3):158165. Go to original source...
    30. Suzuki H, Asakawa A, Amitani H, Nakamura N, Inui A. Cancer cachexia-pathophysiology and management. J Gastroenterol 2013;48(5):574-594. Go to original source...
    31. Sandek A, Bjarnason I, Volk H-D, Crane R, Meddings JB, Niebauer J, et al. Studies on bacterial endotoxin and intestinal absorption function in patients with chronic heart failure. Int J Cardiol 2012;157(1):80-85. Go to original source...
    32. Arutyunov GP, Kostyukevich OI, Serov RA, Rylova NV, Bylova NA. Collagen accumulation and dysfunctional mucosal barrier of the small intestine in patients with chronic heart failure. Int J Cardiol 2008;125(2):240-245. Go to original source...
    33. King D, Smith ML, Chapman TJ, Stockdale HR, Lye M. Fat Mal­ absorption in Elderly Patients with Cardiac Cachexia. Age Ageing 1996;25(2):144-149. Go to original source...
    34. King D, Smith ML, Lye M. Gastro-intestinal protein loss in elderly patients with cardiac cachexia. Age Ageing 1996;25(3):221223. Go to original source...
    35. Sandek A, Swidsinski A, Schroedl W, Watson A, Valentova M, Herrmann R, et al. Intestinal Blood Flow in Patients With Chronic Heart Failure: A Link With Bacterial Growth, Gastrointestinal Symptoms, and Cachexia. J Am Coll Cardiol 2014;64(11):10921102. Go to original source...
    36. Sandek A, Bauditz J, Swidsinski A, Buhner S, Weber-Eibel J, von Haehling S, et al. Altered intestinal function in patients with chronic heart failure. J Am Coll Cardiol 2007;50(16):15611569. Go to original source...
    37. Valentova M, von Haehling S, Doehner W, Ebner N, Bekfani T, Elsner S, et al. Intestinal congestion and right ventricular dysfunction - a link with appetite loss, inflammation and cachexia in chronic heart failure. Under review.
    38. Niebauer J, Volk HD, Kemp M, Dominguez M, Schumann RR, Rauchhaus M, et al. Endotoxin and immune activation in chronic heart failure: a prospective cohort study. Lancet 1999;353(9167):1838-1842. Go to original source...
    39. Anker SD, Egerer KR, Volk HD, Kox WJ, Poole-Wilson PA, Coats AJ. Elevated soluble CD14 receptors and altered cytokines in chronic heart failure. Am J Cardiol 1997;79(10):1426-1430. Go to original source...
    40. Genth-Zotz S, von Haehling S, Bolger AP, Kalra PR, Wensel R, Coats AJS, et al. Pathophysiologic quantities of endotoxin-induced tumor necrosis factor-alpha release in whole blood from patients with chronic heart failure. Am J Cardiol 2002;90(11):1226-1230. Go to original source...
    41. Valentova M, von Haehling S, Krause C, Ebner N, Steinbeck L, Cramer L, et al. Cardiac cachexia is associated with right ventricular failure and liver dysfunction. Int J Cardiol 2013;169(3):219224. Go to original source...
    42. Melenovsky V, Kotrc M, Borlaug BA, Marek T, Kovar J, Malek I, et al. Relationships Between Right Ventricular Function, Body Composition, and Prognosis in Advanced Heart Failure. J Am Coll Cardiol 2013;62(18):1660-1670. Go to original source...
    43. Meyer P, Filippatos GS, Ahmed MI, Iskandrian AE, Bittner V, Perry GJ, et al. Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure. Circulation 2010;121(2):252-258. Go to original source...
    44. Ghio S, Gavazzi A, Campana C, Inserra C, Klersy C, Sebastiani R, et al. Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol 2001;37(1):183-188. Go to original source...
    45. Colombo PC, Onat D, Harxhi A, Demmer RT, Hayashi Y, Jelic S, et al. Peripheral venous congestion causes inflammation, neurohormonal, and endothelial cell activation. Eur Heart J 2014;35(7):448-454. Go to original source...
    46. Giannakopoulos G, Roffi M, Frangos C, Noble S. Symptom im­ provement and cachexia reversal in an 84-year-old woman after percutaneous closure of atrial septal defect. J Am Geriatr Soc 2015;63(2):416-418. Go to original source...
    47. Roux CW le, Ghatei MA, Gibbs JSR, Bloom SR. The putative satiety hormone PYY is raised in cardiac cachexia associated with primary pulmonary hypertension. Heart 2005;91(2):241242. Go to original source...
    48. Ebner N, Elsner S, Springer J, von Haehling S. Molecular mechan­ isms and treatment targets of muscle wasting and cachexia in heart failure: an overview. Curr Opin Support Palliat Care 2014;8(1):15-24. Go to original source...

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