Body composition changes in patients with systolic heart failure treated with beta blockers: A pilot study

Lainščak, Mitja; Keber, Irena; Anker, Stefan D.

doi:10.1016/j.ijcard.2005.01.061

Cited by 81 publications

(46 citation statements)

References 26 publications

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“…In our group of patients, no significant rise in total body weight was observed at the follow-up visit, but there was a significant increase in fat mass and percentage fat mass ( Table 2). A similar observation was reported previously as a general effect of BBs and could be due to inhibition of lipolysis [30,31].…”

Section: Discussionsupporting

confidence: 88%

Bisoprolol pharmacokinetics and body composition in patients with chronic heart failure: a longitudinal study

Trobec

Grabnar

Kos

et al. 2016

Eur J Clin Pharmacol

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In patients with chronic heart failure, bisoprolol clearance was associated with estimated renal function; thus, in moderately and severely decreased renal function, patients may need to have their dose adjusted. Patients with low body weight or low SMI have greater fluctuations and higher maximal plasma concentrations of bisoprolol because of the lower volume of distribution. Longitudinal changes of bisoprolol pharmacokinetics were not associated with changes in body composition.

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Section: Discussionsupporting

confidence: 88%

Bisoprolol pharmacokinetics and body composition in patients with chronic heart failure: a longitudinal study

Trobec

Grabnar

Kos

et al. 2016

Eur J Clin Pharmacol

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“…Apart from well established mechanisms such as reduction of sympathetic drive and prevention of arrhythmia [17], other mechanisms should be mentioned [18]. Among other beneficial properties, beta-blockers improve the metabolic profile in terms of insulin sensitivity [19] and substrate utilization [20]. A considerable proportion of patients could have developed cachexia, an irreversible condition with grim outcome [9].…”

Section: Discussionmentioning

confidence: 99%

The burden of chronic obstructive pulmonary disease in patients hospitalized with heart failure

Lainščak

Hodoscek

Düngen

et al. 2009

Wien Klin Wochenschr

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“…Also, therapeutic interventions aimed at modulating sympathetic activity have been shown to result in favorable metabolic effects, including reduced basal metabolic rate and reduced lipolysis (23,40). Direct evidence of the role of autonomic nervous activity on food intake and muscle protein degradation during human diseases is lacking.…”

Section: Autonomic Nervous Systemmentioning

confidence: 99%

Neural control of the anorexia-cachexia syndrome

Laviano¹,

Inui²,

Marks³

et al. 2008

American Journal of Physiology-Endocrinology and Metabolism

111

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cachexia syndrome is a debilitating clinical condition characterizing the course of chronic diseases, which heavily impacts on patients' morbidity and quality of life, ultimately accelerating death. The pathogenesis is multifactorial and reflects the complexity and redundancy of the mechanisms controlling energy homeostasis under physiological conditions. Accumulating evidence indicates that, during disease, disturbances of the hypothalamic pathways controlling energy homeostasis occur, leading to profound metabolic changes in peripheral tissues. In particular, the hypothalamic melanocortin system does not respond appropriately to peripheral inputs, and its activity is diverted largely toward the promotion of catabolic stimuli (i.e., reduced energy intake, increased energy expenditure, possibly increased muscle proteolysis, and adipose tissue loss). Hypothalamic proinflammatory cytokines and serotonin, among other factors, are key in triggering hypothalamic resistance. These catabolic effects represent the central response to peripheral challenges (i.e., growing tumor, renal, cardiac failure, disrupted hepatic metabolism) that are likely sensed by the brain through the vagus nerve. Also, disease-induced changes in fatty acid oxidation within hypothalamic neurons may contribute to the dysfunction of the hypothalamic melanocortin system. Ultimately, sympathetic outflow mediates, at least in part, the metabolic changes in peripheral tissues. Other factors are likely involved in the pathogenesis of the anorexia-cachexia syndrome, and their role is currently being elucidated. However, available evidence shows that the constellation of symptoms characterizing this syndrome should be considered, at least in part, as different phenotypes of common neurochemical/metabolic alterations in the presence of a chronic inflammatory state. melanocortin; cytokines; serotonin; malonyl-coenzyme A; vagus nerve; sympathetic output THE ANOREXIA-CACHEXIA SYNDROME is a debilitating condition characterizing the clinical journey of patients suffering from chronic diseases including cancer, chronic obstructive pulmonary disease, tuberculosis, chronic heart failure, and end-stage renal insufficiency (64). As an experimental model, it represents a reliable and unique tool for the investigation of the mechanisms regulating energy intake and homeostasis. Beyond its relevance to human physiology, this syndrome impacts on clinical practice since it is highly prevalent and negatively influences patients' morbidity, mortality (66), and quality of life (57).The anorexia-cachexia syndrome is clinically characterized by a number of signs and symptoms interfering with energy intake (i.e., reduced appetite, early satiety, changes in taste/ smell) and affecting nutritional status (i.e., increased metabolic rate, weight loss, hormonal alterations, muscle and adipose tissue wasting, functional impairment, fatigue). At the biochemical and molecular levels, the main features of the anorexia-cachexia syndrome are the profound alterations of brain neurochemis...

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Body composition changes in patients with systolic heart failure treated with beta blockers: A pilot study

Cited by 81 publications

References 26 publications

Bisoprolol pharmacokinetics and body composition in patients with chronic heart failure: a longitudinal study

Bisoprolol pharmacokinetics and body composition in patients with chronic heart failure: a longitudinal study

The burden of chronic obstructive pulmonary disease in patients hospitalized with heart failure

Neural control of the anorexia-cachexia syndrome

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