Rahman Adam, Jafry Syed, Jeejeebhoy Khursheed, Nagpal A Dave, Pisani Barbara, Agarwala Ravi
University of Western Ontario, London, Ontario, Canada Lawson Health Research Institute Program of Experimental Medicine (POEM), London, Ontario, Canada.
University of Western Ontario, London, Ontario, Canada.
JPEN J Parenter Enteral Nutr. 2016 May;40(4):475-86. doi: 10.1177/0148607114566854. Epub 2015 Jan 29.
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.
心力衰竭正日益成为一个公共卫生问题。晚期心力衰竭常伴有严重的肌肉萎缩,即心源性恶病质。这一过程由全身炎症和肿瘤坏死因子驱动,其方式与癌症或人类免疫缺陷病毒所致的其他形式的疾病相关性消瘦相同。营养摄入不足常常会叠加不同程度的营养不良。心源性恶病质显著降低心力衰竭患者的生活质量和生存率。本综述概述了心力衰竭患者营养状况的评估,探讨了心源性恶病质的病理生理学,并讨论了针对这些患者消瘦问题的治疗干预措施。