The pathophysiology of cardiac cachexia.

PURPOSE OF REVIEW: Cardiac cachexia, the loss of lean body mass that affects a large proportion of patients with chronic heart failure, is associated with increased morbidity and mortality. The pathophysiology of cardiac cachexia is complex and multifactorial, but recent studies are providing new information that is helping to clarify the pathophysiology and new targets for treatment. RECENT
FINDINGS: New attention is being paid to developing a definition as well as a clinically relevant way to diagnose this syndrome. The adverse clinical effects of cachexia are being emphasized by new research on the obesity paradox, suggesting that cardiac cachexia is such a detrimental process that obesity actually confers a survival benefit. This information is useful in developing practical approaches to managing body weight and lean tissue in chronic heart failure patients and may provide therapeutic targets. New mechanisms and pathways that mediate cardiac cachexia are being identified and appear to act by increasing energy requirements, reducing energy intake, impairing nutrient absorption, and causing metabolic alterations.
SUMMARY: Recent studies have helped to better delineate multifactorial mechanisms in the pathophysiology of cardiac cachexia that may lead to more effective treatments to address this common and important syndrome in patients with chronic heart failure.