Wasting of the left ventricle in patients with cardiac cachexia: A cardiovascular magnetic resonance study

Viorel G. Florea; James Moon; Dudley J. Pennell; Wolfram Doehner; Andrew J.S. Coats; Stefan D. Anker

doi:10.1016/j.ijcard.2003.05.050

Wasting of the left ventricle in patients with cardiac cachexia: A cardiovascular magnetic resonance study

Viorel G. Florea, James Moon, Dudley J. Pennell, Wolfram Doehner, Andrew J.S. Coats, Stefan D. Anker

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: The "cachectic heart" has been described as a pathologic decrease in the size and mass of the heart, but no in vivo studies have shown changes in cardiac dimensions or left ventricular (LV) mass over time in chronic heart failure (CHF) associated with body wasting (cardiac cachexia). Cardiovascular magnetic resonance (CMR) has high reproducibility and is more sensitive than other techniques. Methods: CMR studies of LV volumes and mass were performed at baseline and a mean of 15 months later in nine CHF patients with cardiac cachexia and 28 matched CHF controls without cachexia (mass index 23±1 vs. 29±5 kg/m², P=0.0005). Results: At baseline, LV end-diastolic volume (197±78 vs. 203±65 ml), end-systolic volume (131±75 vs. 126±63 ml), LV mass (213±44 vs. 222±62 g), and LV ejection fraction (38±19% vs. 40±16%) did not differ between cachectic patients and controls (all P>0.10). During follow-up, there was a significant decrease in LV mass in patients with cachexia (-16 g, P<0.05) and a trend to increase in LV mass in patients without cachexia (+7 g, P=0.12, comparison between groups: P=0.010). Conclusions: The direction of changes over time in LV mass differs in CHF patients with cachexia as compared with non-cachectic controls. A significant decrease in LV mass occurs in patients with cardiac cachexia. This study documents in vivo the occurrence of wasting of the left ventricle in patients with CHF who demonstrate general body wasting.

Original language	English (US)
Pages (from-to)	15-20
Number of pages	6
Journal	International Journal of Cardiology
Volume	97
Issue number	1
DOIs	https://doi.org/10.1016/j.ijcard.2003.05.050
State	Published - Oct 2004
Externally published	Yes

Bibliographical note

Funding Information:
Dr. Viorel G. Florea was supported by a research fellowship from the European Society of Cardiology. Dr. James Moon was supported by the British Heart Foundation. Professor Andrew J.S. Coats is supported by the Viscount Royston Trust, UK. Dr. Stefan D. Anker is supported by a Vandervelle Fellowship. This research was supported by CORDA, The Heart Charity and the Wellcome Trust.

Keywords

Cardiac cachexia
Heart failure
Left ventricular mass
Magnetic resonance imaging

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title = "Wasting of the left ventricle in patients with cardiac cachexia: A cardiovascular magnetic resonance study",

abstract = "Background: The {"}cachectic heart{"} has been described as a pathologic decrease in the size and mass of the heart, but no in vivo studies have shown changes in cardiac dimensions or left ventricular (LV) mass over time in chronic heart failure (CHF) associated with body wasting (cardiac cachexia). Cardiovascular magnetic resonance (CMR) has high reproducibility and is more sensitive than other techniques. Methods: CMR studies of LV volumes and mass were performed at baseline and a mean of 15 months later in nine CHF patients with cardiac cachexia and 28 matched CHF controls without cachexia (mass index 23±1 vs. 29±5 kg/m2, P=0.0005). Results: At baseline, LV end-diastolic volume (197±78 vs. 203±65 ml), end-systolic volume (131±75 vs. 126±63 ml), LV mass (213±44 vs. 222±62 g), and LV ejection fraction (38±19% vs. 40±16%) did not differ between cachectic patients and controls (all P>0.10). During follow-up, there was a significant decrease in LV mass in patients with cachexia (-16 g, P<0.05) and a trend to increase in LV mass in patients without cachexia (+7 g, P=0.12, comparison between groups: P=0.010). Conclusions: The direction of changes over time in LV mass differs in CHF patients with cachexia as compared with non-cachectic controls. A significant decrease in LV mass occurs in patients with cardiac cachexia. This study documents in vivo the occurrence of wasting of the left ventricle in patients with CHF who demonstrate general body wasting.",

keywords = "Cardiac cachexia, Heart failure, Left ventricular mass, Magnetic resonance imaging",

author = "Florea, {Viorel G.} and James Moon and Pennell, {Dudley J.} and Wolfram Doehner and Coats, {Andrew J.S.} and Anker, {Stefan D.}",

note = "Funding Information: Dr. Viorel G. Florea was supported by a research fellowship from the European Society of Cardiology. Dr. James Moon was supported by the British Heart Foundation. Professor Andrew J.S. Coats is supported by the Viscount Royston Trust, UK. Dr. Stefan D. Anker is supported by a Vandervelle Fellowship. This research was supported by CORDA, The Heart Charity and the Wellcome Trust.",

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T1 - Wasting of the left ventricle in patients with cardiac cachexia

T2 - A cardiovascular magnetic resonance study

AU - Florea, Viorel G.

AU - Moon, James

AU - Pennell, Dudley J.

AU - Doehner, Wolfram

AU - Coats, Andrew J.S.

AU - Anker, Stefan D.

N1 - Funding Information: Dr. Viorel G. Florea was supported by a research fellowship from the European Society of Cardiology. Dr. James Moon was supported by the British Heart Foundation. Professor Andrew J.S. Coats is supported by the Viscount Royston Trust, UK. Dr. Stefan D. Anker is supported by a Vandervelle Fellowship. This research was supported by CORDA, The Heart Charity and the Wellcome Trust.

PY - 2004/10

Y1 - 2004/10

N2 - Background: The "cachectic heart" has been described as a pathologic decrease in the size and mass of the heart, but no in vivo studies have shown changes in cardiac dimensions or left ventricular (LV) mass over time in chronic heart failure (CHF) associated with body wasting (cardiac cachexia). Cardiovascular magnetic resonance (CMR) has high reproducibility and is more sensitive than other techniques. Methods: CMR studies of LV volumes and mass were performed at baseline and a mean of 15 months later in nine CHF patients with cardiac cachexia and 28 matched CHF controls without cachexia (mass index 23±1 vs. 29±5 kg/m2, P=0.0005). Results: At baseline, LV end-diastolic volume (197±78 vs. 203±65 ml), end-systolic volume (131±75 vs. 126±63 ml), LV mass (213±44 vs. 222±62 g), and LV ejection fraction (38±19% vs. 40±16%) did not differ between cachectic patients and controls (all P>0.10). During follow-up, there was a significant decrease in LV mass in patients with cachexia (-16 g, P<0.05) and a trend to increase in LV mass in patients without cachexia (+7 g, P=0.12, comparison between groups: P=0.010). Conclusions: The direction of changes over time in LV mass differs in CHF patients with cachexia as compared with non-cachectic controls. A significant decrease in LV mass occurs in patients with cardiac cachexia. This study documents in vivo the occurrence of wasting of the left ventricle in patients with CHF who demonstrate general body wasting.

AB - Background: The "cachectic heart" has been described as a pathologic decrease in the size and mass of the heart, but no in vivo studies have shown changes in cardiac dimensions or left ventricular (LV) mass over time in chronic heart failure (CHF) associated with body wasting (cardiac cachexia). Cardiovascular magnetic resonance (CMR) has high reproducibility and is more sensitive than other techniques. Methods: CMR studies of LV volumes and mass were performed at baseline and a mean of 15 months later in nine CHF patients with cardiac cachexia and 28 matched CHF controls without cachexia (mass index 23±1 vs. 29±5 kg/m2, P=0.0005). Results: At baseline, LV end-diastolic volume (197±78 vs. 203±65 ml), end-systolic volume (131±75 vs. 126±63 ml), LV mass (213±44 vs. 222±62 g), and LV ejection fraction (38±19% vs. 40±16%) did not differ between cachectic patients and controls (all P>0.10). During follow-up, there was a significant decrease in LV mass in patients with cachexia (-16 g, P<0.05) and a trend to increase in LV mass in patients without cachexia (+7 g, P=0.12, comparison between groups: P=0.010). Conclusions: The direction of changes over time in LV mass differs in CHF patients with cachexia as compared with non-cachectic controls. A significant decrease in LV mass occurs in patients with cardiac cachexia. This study documents in vivo the occurrence of wasting of the left ventricle in patients with CHF who demonstrate general body wasting.

KW - Cardiac cachexia

KW - Heart failure

KW - Left ventricular mass

KW - Magnetic resonance imaging

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Wasting of the left ventricle in patients with cardiac cachexia: A cardiovascular magnetic resonance study

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