Hormonal changes and catabolic/anabolic imbalance in chronic heart failure and their importance for cardiac cachexia
Abstract
BACKGROUND: The role of hormonal and cytokine abnormalities in the development of cardiac cachexia remains obscure. METHODS AND RESULTS: Healthy control subjects (n=16) and patients with chronic heart failure (CHF), classified clinically as cachectic (8% to 35% weight loss over > or = 6 months before study, n=16) or noncachectic (n=37), were assessed for markers of disease severity (maximal oxygen consumption, left ventricular ejection fraction, NYHA functional class). These markers were compared with plasma concentrations of potentially important anabolic and catabolic factors. The degree of neurohormonal activation and catabolic/anabolic imbalance was closely related to wasting but not to conventional measures of the severity of heart failure. Compared with control subjects and noncachectic patients, cachectic patients had reduced plasma sodium and increased norepinephrine, epinephrine (all P<.0001), cortisol, tumor necrosis factor (TNF)-alpha (both P<.002), and human growth hormone (P<.05). Insulin-like growth factor-1, testosterone, and estrogen were similar in all groups. Insulin was increased only in the noncachectic patients (P<.005 versus control subjects). Dehydroepiandrosterone was reduced in the cachectic patients (P<.02 versus control subjects). Insulin, cortisol, TNF-alpha, and norepinephrine correlated independently with wasting in CHF (P<.05; multiple regression of these four factors versus percent ideal weight, R2=.50, P<.0001). CONCLUSIONS: Cachexia is more closely associated with hormonal changes in CHF than conventional measures of the severity of CHF. This study suggests that the syndrome of heart failure progresses to cardiac cachexia if the normal metabolic balance between catabolism and anabolism is altered.
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Anabolic hormones such as testosterone are under-expressed in heart failure.
“Anabolic hormones such as testosterone are under expressed in heart failure [3,4]”
From The Effect of Testosterone on Insulin Sensitivity in Men with Heart Failure (2007) · cites this paper as [4]
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- Authors
- Anker, S. D., Chua, T. P., Ponikowski, P., Harrington, D., Swan, J. W., Kox, W. J., Poole-Wilson, P. A., & Coats, A. J. S.
- Affiliations
- Stiftung des öffentlichen Rechts an der Martin-Luther-Universität Halle-Wittenberg (DE)
- Venue
- Circulation
- Published
- 1997-07-15
- Volume
- 96
- Issue
- 2
- Pages
- 526-534
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2009066753
- Cited by
- 800
- References
- 35
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 15 · 2023: 9 · 2022: 21 · 2021: 18 · 2020: 21 · 2019: 24 · 2018: 25 · 2017: 20 · 2016: 19 · 2015: 23 · 2014: 30 · 2013: 37 · 2012: 25
- FWCI
- 15.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- cardiac cachexia, chronic heart failure, neurohormonal activation, weight loss, norepinephrine, epinephrine, cortisol, TNF-α, insulin, dehydroepiandrosterone, human growth hormone, disease severity markers
- MeSH terms
- Aged, Body Weight, Cachexia, Chronic Disease, Female, Heart Failure, Hormones, Humans, Male, Middle Aged, Cytokines
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