Cardiac Cachexia: A Comprehensive Review
Access to this document is restricted. Some items have been embargoed at the request of the author, but will be made publicly available after the "No Access Until" date.
During the embargo period, you may request access to the item by clicking the link to the restricted file(s) and completing the request form. If we have contact information for a Cornell author, we will contact the author and request permission to provide access. If we do not have contact information for a Cornell author, or the author denies or does not respond to our inquiry, we will not be able to provide access. For more information, review our policies for restricted content.
Cardiac cachexia remains a phenomenon seen more particularly in New York Heart Association Classification class III or IV heart failure patients. This is frequently missed and written off as "old age." It has a mortality rate of 50% within 18 months of diagnosis, so it is imperative to diagnose cardiac cachexia promptly. It remains elusive in the complexity of its underlying pathophysiology, from cytokine release from both the endocardium and the gut, with systemic implications. This review provides an analysis of cardiac cachexia: (1) definition and diagnostic criteria; (2) prevalence and mortality outcomes; (3) pathophysiology: biomarkers, neurohormonal activation, inflammatory cytokines, involvement of the gut, and iron deficiency anemia; (4) potential of reversibility; (5) differentiating cardiac cachexia from sarcopenia and frailty; (6) treatment: both pharmacologic and nonpharmacologic. This complex disease remains underrecognized.