TISSUE WASTING IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE, THE ACQUIRED IMMUNE DEFICIENCY SYNDROME, AND CONGESTIVE HEART FAILURE
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THE WASTING SYNDROME IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Malnutrition is common among hypoxemic patients with chronic obstructive pulmonary disease (COPD): 40%–50% weigh less than 90% of ideal body weight.24, 68, 99 Although increased mortality and morbidity have been associated with weight loss, 24, 68, 97, 99, 109, 115 the pathophysiology of malnutrition remains unclear.5 The primary postulated mechanism is hypermetabolism resulting in elevated total caloric expenditure, which arises from a number of perturbations. When contrasted with normally
THE AIDS WASTING SYNDROME
The tissue-wasting syndrome associated with AIDS is a significant public health problem in the United States because it ultimately affects most patients with AIDS. Insights into its pathogenesis are important because the loss of lean tissue mass, one of the hallmarks of the syndrome, is associated with increased mortality and morbidity.18, 62 The cause of lean tissue-wasting in AIDS is poorly understood, but the operative mechanisms may include inadequate nutrient intake (including
THE CONGESTIVE HEART FAILURE WASTING SYNDROME
The state of undernutrition that often accompanies chronic congestive heart failure (CHF) has long been recognized as a significant clinical problem; it was first characterized by Hippocrates as a disorder in which the flesh is consumed and the feet and ankles swell93 and was recognized later by Withering in the late 18th century as a malady in which significant amounts of fat and skeletal muscle are lost.116 This tissue wasting syndrome, which has been termed cardiac cachexia, may be present
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Cited by (35)
Inflammation induced loss of skeletal muscle
2015, BoneCitation Excerpt :In dystrophic muscle, elevated levels of TNF-α inhibit the regenerative potential of satellite cells by epigenetically silencing Notch 1 [164]. TNF-α has been attributed to a number of inflammatory diseases like COPD and is associated with loss of muscle mass in COPD patients [165]. The cytokine tumor necrosis factor like weak inducer of apoptosis (TWEAK) is a member of the TNF superfamily.
The role of exercise training in heart failure
2011, Journal of the American College of CardiologyCitation Excerpt :Catecholamine levels rise with exercise in patients with HF, but it is not clear whether this is a contributor to exercise intolerance or an indication of advanced disease (32). The role of inflammatory mediators, such as tumor necrosis factor and interleukin-6, in the pathogenesis of skeletal muscle wasting and fatigue in numerous clinical settings—including HF—is an area of active investigation (33–35). Elevated cytokines have been documented in HF patients with reduced lower limb muscle mass and strength (36) and functional class (37).
No effects of human ghrelin on cardiac function despite profound effects on body composition in a rat model of heart failure
2009, International Journal of CardiologyCitation Excerpt :Cachexia is a process of muscle and fat tissue wasting and subsequent weight loss that occurs in several different chronic disorders and is also part of the process of aging, being almost always associated with a very poor prognosis [1–4].
ESPEN Guidelines on Parenteral Nutrition: On Cardiology and Pneumology
2009, Clinical NutritionCitation Excerpt :There is limited information regarding nutritional status and metabolic abnormalities in these conditions. The causes of cachexia in COPD are thought to be multifactorial, and include tissue hypoxia, ageing, physical inactivity, increased resting metabolic rate, chronic inflammatory processes,38 and certain drugs, resulting in net catabolism and muscle wasting.39,40 Endogenous protective anabolic mechanisms are insufficiently effective, due possibly to hormonal resistance syndromes.41
ESPEN Guidelines on Enteral Nutrition: Cardiology and Pulmonology
2006, Clinical NutritionCachexia: Pathophysiology and clinical relevance
2006, American Journal of Clinical Nutrition
Address reprint requests to Mark O. Farber, MD, Veterans Affairs Medical Center, 1481 W Tenth Street, Indianapolis, IN 46202
Partial support provided by The AIDS Clinical Trials Group at Indiana University School of Medicine, NIH grant #AI 25859.