Florea Viorel G, Henein Michael Y, Rauchhaus Mathias, Koloczek Veronika, Sharma Rakesh, Doehner Wolfram, Poole-Wilson Philip A, Coats Andrew J S, Anker Stefan D
Department of Cardiac Medicine, National Heart and Lung Institute, London, United Kingdom.
Am Heart J. 2002 Jul;144(1):45-50. doi: 10.1067/mhj.2002.123314.
Recent evidence suggests the importance of noncardiac mechanisms in the genesis of the syndrome of cardiac cachexia. This raises the question of the relative role of the heart itself in this syndrome. This study sought to assess the cardiac dimensions, mass, and function and changes in these parameters over time in patients with chronic heart failure with and without cachexia.
Doppler echocardiography was performed in 28 patients with nonedematous weight loss (>7.5% over a period of >6 months) compared with 56 matched patients without weight loss in a ratio of 1:2 (age 71 +/- 13 vs 67 +/- 8 years, P =.07; New York Heart Association class 2.9 +/- 0.7 vs 2.6 +/- 0.6, P =.08). In 18 cachectic and 35 noncachectic patients with previous echocardiographic recordings, we analyzed the changes in left ventricular (LV) dimensions and mass over time.
Cardiac dimensions including LV diastolic (69 +/- 9 mm vs 67 +/- 13 mm) and systolic cavity diameter (58 +/- 11 mm vs 55 +/- 15 mm), LV mass (480 +/- 180 g vs 495 +/- 190 g), and LV systolic and diastolic function including fractional shortening (16% +/- 10% vs 18% +/- 10%), isovolumic relaxation time (29 +/- 22 ms vs 36 +/- 27 ms), and E/A ratio (2.7 +/- 1.6 vs 3.3 +/- 2.9) did not differ between cachectic and noncachectic patients (all P >.1). By analyzing changes in LV mass over time, we found an increase (>20%) in 2 (11%) cachectic and 14 (40%) noncachectic patients and a decrease in LV mass (>20%) in 9 (50%) cachectic and 8 (23%) noncachectic patients (chi2 test, P <.05).
Although no specific cardiac abnormality could be detected echocardiographically in cachectic patients compared with patients with noncachectic chronic heart failure in a cross-sectional study, over time a significant loss of LV mass (>20%) occurs more frequently in patients with cardiac cachexia.
近期证据表明非心脏机制在心脏恶病质综合征发生过程中具有重要作用。这就引出了心脏本身在该综合征中相对作用的问题。本研究旨在评估伴有和不伴有恶病质的慢性心力衰竭患者的心脏大小、质量和功能，以及这些参数随时间的变化情况。
对28例体重非水肿性减轻（超过6个月减轻>7.5%）的患者进行多普勒超声心动图检查，并与56例体重未减轻的匹配患者进行比较，比例为1:2（年龄71±13岁对67±8岁，P = 0.07；纽约心脏协会心功能分级2.9±0.7对2.6±0.6，P = 0.08）。在18例恶病质患者和35例有既往超声心动图记录的非恶病质患者中，我们分析了左心室（LV）大小和质量随时间的变化。
恶病质患者与非恶病质患者的心脏大小，包括左心室舒张末期内径（69±9mm对67±13mm）和收缩末期内径（58±11mm对55±15mm）、左心室质量（480±180g对495±190g），以及左心室收缩和舒张功能，包括缩短分数（16%±10%对18%±10%）、等容舒张时间（29±22ms对
