Electrical and Hormonal Biomarkers in Cachectic Elderly Women with Chronic Heart Failure

Abstract

Background: Cachexia is an unfavorable metabolic syndrome causing involuntary weight loss followed by muscle wasting, which can lead to the exacerbation of chronic heart failure (CHF), and considerably increases mortality rate among CHF patients. Unfortunately, until now it has not been possible to determine factors that could improve clinical options for cachexia management or enable the identification of patients at risk of its development. We assessed how cachexia conditions in CHF reflect cardiac and laboratory parameters in comparison with non-cachectic patients. Methods: 66 women were enrolled to the study group and underwent meticulous screening, according to recent clinical guidelines, in order to enable CHF and cachexia detection. Body composition was evaluated by bioelectrical impedance analysis (BIA) and laboratory tests were supplemented by analysis of plasma circulating irisin. Results: A negative correlation between irisin concentration and both CRP and TNF-α was recorded (R = −0.362 and R = −0.243; p < 0.05). Irisin concentration positively correlated with EF% (R = 0.253; p = 0.046) and negatively with LVESd, LVEDd and NT-proBNP (R = −0.326, −0.272, and −0.320; p < 0.05). Both low levels of circulating irisin and Capacitance of membrane (Cm) were selected as unfavorable factors affecting cachexia in CHF patients (OR = 1.39 and 34.49; p < 0.05). Combination of Cm, irisin, CRP and albumin demonstrated sensitivity of 93.3% and specificity of 85.3% (AUC = 0.949) for distinguishing between cachectic and non-cachectic CHF patients. Conclusions: Selected parameters reliably reflect cachectic conditions in CHF, and the proposed approach for cachexia based on the combined analysis of at least a few non-invasive markers could offer new opportunities for improving clinical outcomes in CHF patients.

Myokines and Heart Failure: Challenging Role in Adverse Cardiac Remodeling, Myopathy, and Clinical Outcomes

“…Irisin levels demonstrated positive correlation with brain natriuretic peptide (BNP) levels and New York Heart Association (NYHA) class of HF and inverse correlation with body mass index (BMI) and catabolic state including cachexia in HFrEF [ 69 ]. Yet, FNDC5 expression in skeletal muscles is related to aerobic performance in patients with HFrHF [ 70 , 71 ]. Thus, irisin plays a protective role in myocardial ischemia, cardiac myocyte apoptosis, and skeletal myopathy preserving energy homeostasis, attenuating mitochondrial function, and regulating muscle atrophy.…”

Role of Irisin in Myocardial Infarction, Heart Failure, and Cardiac Hypertrophy

“…Cachexia is caused by muscle wasting and the exacerbation of heart failure decompensation. A low level of circulating irisin was noted in female patients with heart failure with cachexia [69]. By contrast, another study showed a high level of irisin in heart failure with cachexia [70].…”

“…Higher irisin might enhance the energy demand and produce more oxidative stress. In the chronic heart failure stage, lower irisin might represent muscle loss and cachexia [69]. However, we need a large cohort study to prove this observation in the future.…”

Clinical Significance of TNFRSF1A36T/C Polymorphism in Cachectic Patients with Chronic Heart Failure

“…Chronic heart failure (CHF) is a clinical syndrome characterized by systemic inflammation and immune system activation [ 1 ]. The increase in the number of newly diagnosed CHF cases is related to a rising life expectancy (patient’s age >70 years) and diastolic heart failure [ 2 , 3 ]. Inflammation plays a crucial role in chronic heart failure.…”