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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Sarcopaenia complicating heart failure.

Guilherme Wesley Peixoto da Fonseca1,2, Stephan von Haehling2,3

  • 1Cardiovascular Rehabilitation and Exercise Physiology Unit, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 - Cerqueira Cesar, 05403-900 São Paulo, Brazil.

European Heart Journal Supplements : Journal of the European Society of Cardiology
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Sarcopaenia, or reduced muscle mass, significantly impacts heart failure patients, worsening exercise capacity. Further research is needed to understand this link and develop effective treatments for both conditions.

Keywords:
Clinical managementHeart failureMechanismsSarcopaenia

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Area of Science:

  • Gerontology
  • Cardiology
  • Muscle Physiology

Background:

  • Sarcopaenia, characterized by reduced skeletal muscle mass, impacts strength and physical performance.
  • It affects 17.5% globally, with over 20% prevalence in heart failure (HF) patients.
  • Sarcopaenia severely impacts mortality, physical capacity, and quality of life.

Purpose of the Study:

  • To explore the intricate relationship between sarcopaenia and heart failure progression.
  • To investigate the underlying mechanisms driving the exacerbation of HF by sarcopaenia and vice versa.
  • To highlight the need for further research into the interaction of proposed pathogenic mechanisms.

Main Methods:

  • Review of proposed mechanisms including autonomic imbalance, reduced muscle blood flow, inflammation, hormonal changes, apoptosis, and autophagy.
  • Assessment of the impact of sarcopaenia on HF progression and vice versa.
  • Evaluation of current treatment strategies, including resistance training and nutritional protein intake.

Main Results:

  • Sarcopaenia is significantly associated with heart failure, leading to diminished exercise capacity.
  • The prevalence of sarcopaenia is notably high in heart failure populations.
  • Existing pharmacotherapies have not been extensively studied for their effect on sarcopaenia in HF.

Conclusions:

  • Sarcopaenia and heart failure are interconnected conditions, with sarcopaenia worsening outcomes for HF patients.
  • The precise mechanisms underlying the bidirectional relationship between sarcopaenia and HF require further elucidation.
  • Effective therapeutic strategies addressing both cardiac and skeletal muscle health are needed.