Cachexia is a prevalent pathological condition associated with chronic heart
failure. Its occurrence predicts increased morbidity and mortality independent
of important clinical variables such as age, ventricular function, or heart
failure functional class. The clinical consequences of cachexia are dependent on
both weight loss and systemic inflammation, which accompany cachexia
development. Skeletal muscle wasting is an important component of cachexia; it
often precedes cachexia development and predicts poor outcome in heart failure.
Cachexia clinically affects several organs and systems. It is a multifactorial
condition where underlying pathophysiological mechanisms are not completely
understood making it difficult to develop specific prevention and treatment
therapies. Preventive strategies have largely focused on muscle mass
preservation. Different treatment options have been described, mostly in small
clinical studies or experimental settings. These include nutritional support,
neurohormonal blockade, reducing intestinal bacterial translocation, anemia and
iron deficiency treatment, appetite stimulants, immunomodulatory agents,
anabolic hormones, and physical exercise regimens. Currently, nonpharmacological
therapy such as nutritional support and physical exercise are considered central
to cachexia prevention and treatment.
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