title: Metabolic and immunologic derangements in cardiac cachexia: where to from here?
abstract: The onset of cardiac cachexia is characterized by a defined severe weight loss in patients with advanced chronic heart failure and it predicts an increased mortality in these patients. Recent studies with potential therapeutics investigated the effects and efficiency of beta-blockers, ghrelin, or ghrelin-agonists in cachexia. These and other new studies, like the influence of heart transplantation on cardiac cachexia, give prospect into potential therapeutic options in the future. General aim of the treatment strategy is to prevent the onset and retard the progress of cachexia. This could be achieved by modifying the metabolic, neurohormonal and immune system abnormalities, e.g. with beta-blockers and angiotensin-converting enzyme inhibitors. However, these alterations interact in a complex pathophysiological process, which is supposed to end in a vicious circle and thereby the wasting process is further promoted. To interrupt this, an early start of therapy is important to decelerate the development of cardiac cachexia. Many further investigations are needed to find out more about the pathophysiological pathways, to confirm the previous results, and to evaluate new therapeutics.
authors.affiliation: Dept. of Cardiology, Applied Cachexia Research, Charité, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Strassburg
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D002100:Cachexia / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism* / Q000503:physiopathology; D019587:Dietary Supplements; D018450:Disease Progression; D015444:Exercise / Q000502:physiology; D006333:Heart Failure / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D018384:Oxidative Stress / Q000502:physiology; D011379:Prognosis; D013148:Spironolactone / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone