Cardiac muscle wasting in individuals with cancer cachexia

• Published in: ESC Heart Failure Vol. 4; no. 4; pp. 458 - 467
• Main Authors: Barkhudaryan, Anush, Scherbakov, Nadja, Springer, Jochen, Doehner, Wolfram
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.11.2017; John Wiley and Sons Inc
• Subjects: Adult; Aged; Aged, 80 and over; Anorexia; Body Mass Index; Cachexia - complications; Cachexia - epidemiology; Cachexia - metabolism; Cancer cachexia; Cancer therapies; Cardiac function; Chemotherapy; Drug therapy; Family medical history; Female; Fitness training programs; Germany - epidemiology; Heart; Heart Failure - epidemiology; Heart Failure - etiology; Heart Failure - metabolism; Heart weight; Humans; Laboratories; Lung cancer; Male; Medical prognosis; Middle Aged; Morbidity - trends; Muscle, Skeletal - metabolism; Muscle, Skeletal - physiopathology; Musculoskeletal system; Myocardium - metabolism; Neoplasms - complications; Neoplasms - epidemiology; Original; Original s; Pancreatic cancer; Pathology; Proteins; Pulmonary arteries; Quality of life; Retrospective Studies; Studies; Survival Rate - trends; Tumor necrosis factor-TNF; Weight loss; Young Adult; Cancer cachexia; Heart weight; Cardiac function; Weight loss
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.12184

Aims Cachexia is a severe complication of cancer that adversely affects the course of the disease and is associated with high rates of mortality. Patients with cancer manifest symptoms, such as fatigue, shortness of breath, and impaired exercise tolerance, which are clinical signs of chronic heart failure. The aim of this study was to evaluate cardiac muscle wasting in cancer individuals. Methods and results We retrospectively analysed 177 individuals who died of cancer, including 58 lung, 60 pancreatic, and 59 gastrointestinal (GI) cancers, and 42 cancer‐free controls who died of other, non‐cardiovascular reasons. Cancer cachexia (CC) was defined based on clinical and/or pathological diagnosis, body mass index (BMI) <20.0 kg/m2 and/or oedema‐free body weight loss of 5.0% during the previous year or less. The pathology reports were analysed for BMI, heart weight (HW), and left and right ventricular wall thicknesses (LVWT and RVWT, respectively). The analysis of clinical data included recording of biochemical parameters and medication data of study patients. CC was detected in 54 (30.5%) subjects. Individuals with CC had a significantly lower HW than non‐cachectic subjects (363.1 ± 86.2 vs. 447.0 ± 128.9 g, P < 0.001) and control group (412.9 ± 75.8 g, P < 0.05). BMI correlated with HW in cases with GI cancer (r = 0.44, P < 0.001), lung cancer (r = 0.53, P < 0.0001), and pancreatic cancer (r = 0.39, P < 0.01). Conclusions Body weight loss in individuals with lung, pancreatic, and GI cancers is accompanied by a decrease in HW. In patients with CC who receive cancer treatment, screening for cardiac muscle wasting may have clinical importance.