The wasting continuum in heart failure: from sarcopenia to cachexia.
Sarcopenia (muscle wasting) and cachexia share some pathophysiological aspects. Sarcopenia affects approximately 20 %, cachexia <10 % of ambulatory patients with heart failure (HF). Whilst sarcopenia means loss of skeletal muscle mass and strength that predominantly affects postural rather than non-postural muscles, cachexia means loss of muscle and fat tissue that leads to weight loss. The wasting continuum in HF implies that skeletal muscle is lost earlier than fat tissue and may lead from sarcopenia to cachexia. Both tissues require conservation, and therapies that stop the wasting process have tremendous therapeutic appeal. The present paper reviews the pathophysiology of muscle and fat wasting in HF and discusses potential treatments, including exercise training, appetite stimulants, essential amino acids, growth hormone, testosterone, electrical muscle stimulation, ghrelin and its analogues, ghrelin receptor agonists and myostatin antibodies.
Department of Cardiology and Pneumology,University of Göttingen Medical School,Göttingen,Germany.
Stephan
S
von Haehling
D000273:Adipose Tissue / Q000378:metabolism*; D000601:Amino Acids, Essential / Q000627:therapeutic use; D001066:Appetite; D002100:Cachexia / Q000209:etiology / Q000628:therapy; D015444:Exercise; D006333:Heart Failure / Q000150:complications*; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000378:metabolism*; D055948:Sarcopenia / Q000209:etiology / Q000628:therapy
D000601:Amino Acids, Essential; D006728:Hormones
Cachexia; Fat tissue; HF heart failure; Heart failure; Muscle; Sarcopenia; Wasting