Loncar Goran, Springer Jochen, Anker Markus, Doehner Wolfram, Lainscak Mitja
Int J Cardiol. 2015 Dec 15;201:e1-12. doi: 10.1016/j.ijcard.2015.10.115. Epub 2015 Oct 23.
Cardiac cachexia (CC) is the clinical entity at the end of chronic natural course of heart failure (HF). Despite the efforts, even the most recent definition of cardiac cachexia has been challenged, more precisely the addition of new criteria on top of obligatory weight loss. The pathophysiology of CC is complex and multifactorial. Better understanding of pathophysiological pathways in body wasting will contribute to establish potentially novel treatment strategies. The complex biochemical network related with CC and HF pathophysiology underlines that a single biomarker cannot reflect all of the features of the disease. Biomarkers that could pick-up the changes in body composition before they convey into clinical manifestations of CC would be of great importance. The development of preventive and therapeutic strategies against cachexia, sarcopenia and wasting disorders is perceived as an urgent need by healthcare professionals. The treatment of body wasting remains an unresolved challenge to this day. As CC is a multifactorial disorder, it is unlikely that any single agent will be completely effective in treating this condition. Among all investigated therapeutic strategies, aerobic exercise training in HF patients is the most proved to counteract skeletal muscle wasting and is recommended by treatment guidelines for HF.
心脏恶病质（CC）是心力衰竭（HF）慢性自然病程末期的临床实体。尽管做出了努力，但即使是心脏恶病质的最新定义也受到了挑战，更确切地说是在强制性体重减轻之外增加新的标准受到了挑战。CC的病理生理学复杂且具有多因素性。更好地理解身体消瘦的病理生理途径将有助于建立潜在的新治疗策略。与CC和HF病理生理学相关的复杂生化网络强调，单一生物标志物无法反映该疾病的所有特征。能够在CC的临床表现出现之前检测到身体成分变化的生物标志物将非常重要。医疗保健专业人员认为，开发针对恶病质、肌肉减少症和消瘦性疾病的预防和治疗策略迫在眉睫。时至今日，身体消瘦的治疗仍然是一个未解决的挑战。由于CC是一种多因素疾病，不太可能有任何单一药物能完全有效地治疗这种疾病。在所有研究的治疗策略中，HF患者的有氧运动训练最被证明可以对抗骨骼肌消瘦，并且被HF治疗指南推荐。
