Malnutrition and Cachexia in Heart Failure

JPEN J Parenter Enteral Nutr. 2016 May;40(4):475-86. doi: 10.1177/0148607114566854. Epub 2015 Jan 29.

Abstract

Heart failure is a growing public health concern. Advanced heart failure is frequently associated with severe muscle wasting, termed cardiac cachexia This process is driven by systemic inflammation and tumor necrosis factor in a manner common to other forms of disease-related wasting seen with cancer or human immunodeficiency virus. A variable degree of malnutrition is often superimposed from poor nutrient intake. Cardiac cachexia significantly decreases quality of life and survival in patients with heart failure. This review outlines the evaluation of nutrition status in heart failure, explores the pathophysiology of cardiac cachexia, and discusses therapeutic interventions targeting wasting in these patients.

Keywords: cardiac disease; critical care; internal medicine; minerals/trace elements; nutrition; nutrition assessment; nutrition support practice; organ transplantation; outcomes research/quality; proteins; research and diseases; vitamins.

Publication types

  • Review

MeSH terms

  • Appetite
  • Cachexia / complications*
  • Cachexia / therapy
  • Energy Metabolism
  • Heart Failure / complications*
  • Heart Failure / physiopathology
  • Heart Failure / therapy
  • Humans
  • Inflammation / drug therapy
  • Inflammation / physiopathology
  • Insulin Resistance
  • Malnutrition / complications*
  • Malnutrition / epidemiology
  • Myocardium / metabolism
  • Nutritional Status
  • Quality of Life
  • Tumor Necrosis Factor-alpha / physiology
  • Wasting Syndrome / complications
  • Wasting Syndrome / physiopathology
  • Wasting Syndrome / therapy

Substances

  • Tumor Necrosis Factor-alpha