Exploring the prevalence, impact and experience of cardiac cachexia in patients with advanced heart failure and their caregivers: A sequential phased study

Abstract

Background: Cardiac Cachexia is a wasting syndrome that has a significant impact on patient mortality and quality of life world-wide, although it is poorly understood in clinical practice. Aim: Identify the prevalence of cardiac cachexia in patients with advanced New York Heart Association (NYHA) functional class and explore its impact on patients and caregivers. Design: An exploratory cross-sectional study. The sequential approach had two phases, with phase 1 including 200 patients with NYHA III-IV heart failure assessed for characteristics of cardiac cachexia. Phase 2 focussed on semi-structured interviews with eight cachectic patients and five caregivers to ascertain the impact of the syndrome. Setting/participants: Two healthcare trusts within the United Kingdom. Results: Cardiac Cachexia was identified in 30 out of 200 participants, giving a prevalence rate of 15%. People with cachexia had a significantly reduced average weight and anthropometric measures ( p < 0.05). Furthermore, individuals with cachexia experienced significantly more fatigue, had greater issues with diet and appetite, reduced physical wellbeing and overall reduced quality of life. C-reactive protein was significantly increased, whilst albumin and red blood cell count were significantly decreased in the cachectic group ( p < 0.05). From qualitative data, four key themes were identified: (1) ‘Changed relationship with food and eating’, (2) ‘Not me in the mirror’, (3) ‘Lack of understanding regarding cachexia’ and (4) ‘Uncertainty regarding the future’. Conclusions: Cardiac cachexia has a debilitating effect on patients and caregivers. Future work should focus on establishing a specific definition and clinical pathway to enhance patient and caregiver support.

Prevalence of cardiac cachexia among congestive heart failure patients

“…The hemoglobin counts in the cachectic groups were much lower, according to Mathew A. Carson et al (2022). Therefore, the current study is consistent with the earlier study.…”

Protein–Energy Malnutrition Is Associated with Worse Outcomes in Patients with Atrial Fibrillation: A Nationwide Analysis

“… 23 Another potential explanation of our findings could be attributed to the association between being underweight, a surrogate of frailty, and the severity of cardiac dysfunction. This theory was validated in a cross-sectional study by Carson et al 24 They observed cardiac cachexia as a predominant finding in advanced heart failure patients with a poor functional status and high odds of mortality.…”

Cardiac Cachexia in Left Ventricular Assist Device Recipients and the Implications of Weight Gain Early After Implantation

“… 15 For example, a 10.5% to 16% cachexia prevalence has been reported per >5% unintentional edema‐free weight loss criteria (n=238, mean age 71 years; n=11 712 clinical trial participants, mean age 65 years). 2 , 16 A recent study of 200 inpatients and outpatients with New York Heart Association class III–IV heart failure in the United Kingdom used consensus cachexia criteria incorporating weight loss, anthropometrics, strength, symptoms, and biochemistry, and found a 15% prevalence, 17 whereas a US analysis of heart failure inpatient diagnostic codes yielded 7% cachexia. 18 Rates ranging from 19.5% to 52% are reported using dual x‐ray absorptiometry appendicular lean mass criteria (n=200, mean age 70 years; n=38, mean age 75 years).…”