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慢性心力衰竭中肌肉减少症发病机制和治疗的新见解。

New insights into the pathogenesis and treatment of sarcopenia in chronic heart failure.

机构信息

Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.

Department of Geriatrics, Sir Run Run Hospital Affiliated to Nanjing Medical University, Nanjing, China.

出版信息

Theranostics. 2019 May 31;9(14):4019-4029. doi: 10.7150/thno.33000. eCollection 2019.

Abstract

Sarcopenia is an age-related geriatric syndrome that is characterized by a progressive loss of muscle mass, strength and function. Chronic heart failure (CHF), the final stage of various cardiovascular diseases, may be closely correlated with the occurrence of sarcopenia. Accumulating evidence has demonstrated that CHF can promote the development of sarcopenia through multiple pathophysiological mechanisms, including malnutrition, inflammation, hormonal changes, oxidative stress, autophagy, and apoptosis. Additionally, CHF can aggravate the adverse outcomes associated with sarcopenia, including falls, osteoporosis, frailty, cachexia, hospitalization, and mortality. Sarcopenia and CHF are mutually interacting clinical syndromes. Patients with these two syndromes seem to endure a double burden, with no particularly effective way to hinder their progression. However, the combination of physical exercise, nutritional supplements, and drug therapy may counteract the development of these maladies. In this review, we will summarize the latest progress in the pathogenesis and treatment of sarcopenia in patients with CHF.

摘要

肌肉减少症是一种与年龄相关的老年综合征,其特征是肌肉质量、力量和功能逐渐丧失。慢性心力衰竭(CHF)是各种心血管疾病的终末期,可能与肌肉减少症的发生密切相关。越来越多的证据表明,CHF 可以通过多种病理生理机制促进肌肉减少症的发展,包括营养不良、炎症、激素变化、氧化应激、自噬和细胞凋亡。此外,CHF 会加重与肌肉减少症相关的不良后果,包括跌倒、骨质疏松症、虚弱、恶病质、住院和死亡。肌肉减少症和 CHF 是相互作用的临床综合征。患有这两种综合征的患者似乎承受着双重负担,目前尚无特别有效的方法来阻止其进展。然而,结合身体运动、营养补充和药物治疗可能会抑制这些疾病的发展。在这篇综述中,我们将总结 CHF 患者肌肉减少症发病机制和治疗的最新进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d065/6592172/51ea45f93d54/thnov09p4019g001.jpg

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