☆ 4.7 Review

Relevance of nutritional assessment and treatment to counteract cardiac cachexia and sarcopenia in chronic heart failure

CLINICAL NUTRITION (2021)

Journal

CLINICAL NUTRITION

Volume 40, Issue 9, Pages 5141-5155

Publisher

CHURCHILL LIVINGSTONE

DOI: 10.1016/j.clnu.2021.07.027

Keywords

Cardiac cachexia; Sarcopenia; Chronic heart failure; Muscle wasting; Malnutrition

Funding

Centro de Investigacion Biomedica en Red-Fisiopatologia de la Obesidad y Nutricion
Miguel Servet project
initiatives of Instituto de Salud Carlos III (ISCIII) [CP17/0008]
European Regional Development Fund
Consolidacion y Estructuracion de Unidades de Investigacion Competitivas from Xunta de Galicia [IN607B2020/09]
ISCIII [CP17/0008]

Ask authors/readers for more resources

Protocol

Community support

Reagent

Community support

Automated Summary New
Abstract

Chronic heart failure often leads to involuntary weight loss and muscle wasting, necessitating careful nutritional evaluation and treatment to prevent or improve cardiac cachexia and sarcopenia, as well as improve the course of the disease.

Chronic heart failure (CHF) is frequently associated with the involuntary loss of body weight and muscle wasting, which can determine the course of the disease and its prognosis. While there is no gold standard malnutrition screening tool for their detection in the CHF population, several bioelectrical and imaging methods have been used to assess body composition in these patients (such as Dual Energy X-Ray Absorptiometry and muscle ultrasound, among other techniques). In addition, numerous nutritional biomarkers have been found to be useful in the determination of the nutritional status. Nutritional considerations include the slow and progressive supply of nutrients, avoiding high volumes, which could ultimately lead to refeeding syndrome and worsen the clinical picture. If oral feeding is insufficient, hypercaloric and hyperproteic supplementation should be considered. beta-Hydroxy-beta-methylbutyrate and omega-3 polyunsaturated fatty acid administration prove to be beneficial in certain patients with CHF, and several interventional studies with micronutrient supplementation have also described their possible role in these subjects. Taking into account that CHF is sometimes associated with gastrointestinal dysfunction, parenteral nutritional support may be required in selected cases. In addition, potential therapeutic options regarding nutritional state and muscle wasting have also been tested in clinical studies. This review summarises the scientific evidence that demonstrates the necessity to carry out a careful nutritional evaluation and nutritional treatment to prevent or improve cardiac cachexia and sarcopenia in CHF, as well as improve its course. (C) 2021 The Author(s). Published by Elsevier Ltd.

Authors

I am an author on this paper

Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7

Not enough ratings

Secondary Ratings

Novelty

Significance

Scientific rigor

Rate this paper

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

Jenjiratchaya Thanapholsart, Ehsan Khan, Tevfik F. Ismail, Geraldine A. Lee

Summary: Cardiac cachexia is a complex muscle wasting process associated with chronic heart failure, resulting in weight loss, decreased physical activity, and reduced quality of life. This review discusses the pathophysiology of cardiac cachexia, including hormonal changes, mechanisms of muscle wasting, and gastrointestinal abnormalities. These pleiotropic mechanisms highlight the intricate interplay between affected systems, contributing to the clinical challenge of managing cardiac cachexia. The review provides a summary of the current understanding of cardiac cachexia and identifies gaps for further research in this field.

AMERICAN JOURNAL OF THE MEDICAL SCIENCES (2023)