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Fat malabsorption in elderly patients with cardiac cachexia

D King1, M L Smith, T J Chapman

  • 1Department of Geriatric Medicine, Royal Liverpool University Hospital, Liverpool.

Age and Ageing
|March 1, 1996
PubMed
Summary
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Malnutrition in heart failure patients (cardiac cachexia) is linked to impaired fat absorption. This fat malabsorption is not caused by small-bowel bacterial overgrowth, requiring further investigation into its origins.

Area of Science:

  • Gerontology
  • Gastroenterology
  • Cardiology

Background:

  • Cardiac cachexia (CC), a form of malnutrition in chronic heart failure, significantly increases mortality and morbidity, particularly in the elderly.
  • The underlying causes of CC are believed to be multifactorial, with malabsorption being a potential contributor.

Purpose of the Study:

  • To investigate the association between impaired fat absorption and cardiac cachexia.
  • To determine if small-bowel bacterial overgrowth is the cause of fat malabsorption in patients with CC.

Main Methods:

  • The study compared three groups: patients with CC, patients with heart failure but no weight loss (NON-CC), and healthy controls.
  • Fat absorption was assessed using the 14C-triolein breath test, and small-bowel bacterial overgrowth was evaluated with the 14C-glycocholic acid breath test.

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Main Results:

  • Patients with cardiac cachexia exhibited significantly reduced cumulative 6-hour 14CO2 exhalation in the 14C-triolein breath test, indicating impaired fat absorption (p = 0.001).
  • No evidence of small-bowel bacterial overgrowth was found in any of the study groups.
  • The degree of impaired fat absorption correlated with the clinical severity and duration of heart failure.

Conclusions:

  • Impaired fat absorption is associated with cardiac cachexia in patients with chronic heart failure.
  • Small-bowel bacterial overgrowth does not appear to be the cause of this fat malabsorption.
  • Further research is needed to elucidate the etiology of fat malabsorption in the context of heart failure.