PMID- 24063924
OWN - NLM
STAT- MEDLINE
DCOM- 20140708
LR  - 20161125
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 169
IP  - 3
DP  - 2013 Nov 5
TI  - Cardiac cachexia is associated with right ventricular failure and liver 
      dysfunction.
PG  - 219-24
LID - S0167-5273(13)01717-8 [pii]
LID - 10.1016/j.ijcard.2013.08.134 [doi]
AB  - BACKGROUND: The mechanisms involved in cardiac cachexia remain poorly understood. 
      We examined the association of right ventricular (RV) and hepatic dysfunction 
      with cardiac cachexia. METHODS: We prospectively enrolled 118 patients with left 
      ventricular ejection fraction (LVEF) </=40%, which were subgrouped as follows: New 
      York Heart Association (NYHA) class II (n=59), NYHA class III without cachexia 
      (n=41) and NYHA class III with cachexia (n=18). All patients underwent blood 
      collection, echocardiography and exercise testing. RESULTS: Reduced systolic RV 
      function (tricuspid annular plane systolic excursion [TAPSE] </=15 mm), was present 
      in 80% of cachectic patients. When comparing NYHA class II patients vs. 
      non-cachectic and cachectic NYHA class III patients we found a stepwise decrease 
      in systolic RV function (TAPSE 19 [16-23] vs. 16 [13-19] vs. 14 [9-15] mm, 
      respectively; p<0.001) and an increase in right atrial pressure (RAP; >10 mm Hg: 
      6.8 vs. 27.5 vs. 75.0%, respectively; p<0.001), indicating a higher degree of 
      congestive right HF in cardiac cachexia. Systolic and diastolic function of the 
      left ventricle did not differ between non-cachectic and cachectic patients in 
      NYHA class III. Serum alkaline phosphatase and direct bilirubin correlated with 
      TAPSE and RAP, and were highest in cachectic patients (all p </= 0.002), suggesting 
      cholestatic dysfunction due to liver congestion. In multivariable regression 
      analysis, RV dysfunction, cholestatic liver parameters and albumin were 
      independently associated with the presence of cardiac cachexia. CONCLUSION: 
      Patients with cardiac cachexia display a more pronounced degree of right HF, 
      cholestatic liver dysfunction and hypoalbuminemia compared to non-cachectic 
      patients of similar LVEF and NYHA class.
CI  - (c) 2013.
FAU - Valentova, Miroslava
AU  - Valentova M
AD  - Applied Cachexia Research, Department of Cardiology, Charite Medical School, 
      Campus Virchow-Klinikum, Berlin, Germany; 1st Department of Internal Medicine, 
      Faculty Hospital, Bratislava, Slovak Republic. Electronic address: 
      miroslava.valentova@charite.de.
FAU - von Haehling, Stephan
AU  - von Haehling S
FAU - Krause, Christian
AU  - Krause C
FAU - Ebner, Nicole
AU  - Ebner N
FAU - Steinbeck, Lisa
AU  - Steinbeck L
FAU - Cramer, Larissa
AU  - Cramer L
FAU - Doehner, Wolfram
AU  - Doehner W
FAU - Murin, Jan
AU  - Murin J
FAU - Anker, Stefan D
AU  - Anker SD
FAU - Sandek, Anja
AU  - Sandek A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130908
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Aged
MH  - Cachexia/blood/*diagnostic imaging/*epidemiology
MH  - Cholestasis/blood/diagnostic imaging/epidemiology
MH  - Female
MH  - Humans
MH  - Liver Diseases/blood/*diagnostic imaging/*epidemiology
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Ultrasonography
MH  - Ventricular Dysfunction, Right/blood/*diagnostic imaging/*epidemiology
OTO - NOTNLM
OT  - Cardiac cachexia
OT  - Chronic heart failure
OT  - Liver function tests
OT  - Right heart function
EDAT- 2013/09/26 06:00
MHDA- 2014/07/09 06:00
CRDT- 2013/09/26 06:00
PHST- 2013/04/23 00:00 [received]
PHST- 2013/07/22 00:00 [revised]
PHST- 2013/08/30 00:00 [accepted]
PHST- 2013/09/26 06:00 [entrez]
PHST- 2013/09/26 06:00 [pubmed]
PHST- 2014/07/09 06:00 [medline]
AID - S0167-5273(13)01717-8 [pii]
AID - 10.1016/j.ijcard.2013.08.134 [doi]
PST - ppublish
SO  - Int J Cardiol. 2013 Nov 5;169(3):219-24. doi: 10.1016/j.ijcard.2013.08.134. Epub 
      2013 Sep 8.