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Murine Cervical Heart Transplantation Model Using a Modified Cuff Technique
Published on: October 12, 2014
Reversibility of cardiac cachexia after heart transplantation
Dirk Habedank1, Manfred Hummel, Roland Hetzer
1Division of Applied Cachexia Research, Department of Cardiology, Charité Campus Virchow-Klinikum, Berlin, Germany. dirk.habedank@charite.de
Insights
Cardiac cachexia, a risk factor for mortality, is reversible after heart transplantation (HTx). Underweight patients experience significant weight gain post-transplant, indicating cachexia reversal independent of gender.
Area of Science:
- Cardiology
- Transplantation Medicine
- Metabolic Disorders
Background:
- Cardiac cachexia is a significant predictor of mortality in chronic heart failure patients.
- Cachexia can persist even after heart transplantation (HTx), impacting patient outcomes.
- The reversibility of cardiac cachexia and gender-specific differences post-HTx require investigation.
Purpose of the Study:
- To determine if cardiac cachexia is reversible following heart transplantation.
- To investigate potential gender-specific differences in cachexia reversal after HTx.
- To correlate pre-transplant nutritional status with post-transplant weight changes.
Main Methods:
- Prospective study of 106 patients before and up to 24 months after HTx.
- Patients categorized by body mass index (BMI): underweight (< or =21 kg/m2), normal (21-27 kg/m2), and obese (> or =27 kg/m2).
- Serial assessment of body weight and BMI changes at multiple time points post-transplant.
Main Results:
- Significant weight gain observed in underweight patients post-HTx, particularly up to 24 months.
- The overall heart transplant population experienced initial weight loss followed by gain at 6 and 12 months.
- Lower pre-HTx BMI strongly correlated with greater post-HTx weight increase; no gender differences noted.
Conclusions:
- Heart transplantation can reverse cardiac cachexia, especially in underweight individuals, due to improved cardiac function.
- Post-transplant weight gain in the general heart transplant population reflects partial cachexia reversibility.
- Cachexia reversibility after HTx is not influenced by gender.
Background:
Cachexia is an independent risk factor for mortality in patients with chronic heart failure and increases mortality even after heart transplantation (HTx). We aimed to determine whether cardiac cachexia is reversible after HTx, and investigated differences specific to gender.
Methods:
We prospectively examined 106 patients before and serially 3, 6, 12 and 24 months after HTx (18 women, 88 men; median age at transplantation 53.7 +/- 9.7 years; n = 68 dilative cardiomyopathy, n = 33 coronary heart disease, n = 5 other origin of heart failure). Patients were sub-grouped as underweight (body mass index [BMI] < or =21 kg/m2, n = 15), normal weight (BMI 21 to 27 kg/m2, n = 64) and obese (BMI > or =27 kg/m2, n = 27).
Results:
Body weight increase was restricted to underweight patients: at 3 months (+6.8% vs pre-transplant weight); at 6 months (+11.3%), at 12 months (+15.6%); and at 24 months (+17.7%, all p < or = 0.03). The entire population had weight loss at 3 months (-2.9%), but had weight gain at 6 (+2.5%), 12 (+6.1%, all p < or = 0.02) and 24 months (+1.3%, p = 0.44). A lower BMI before HTx correlated significantly with greater weight increase after HTx at every follow-up time-point (r = 0.55; p < 0.001). There were no gender-specific differences for BMI or weight change. Weight loss within 3 months after HTx was associated with higher mortality during 4 years of follow-up.
Conclusions:
Weight gain after HTx is particularly strong in underweight patients, and the increased cardiac function causes the cessation of cachexia. The weight increase of the entire heart transplant population is partially an effect of reversibility of cachexia and not affected by gender.
