Reversibility of cardiac cachexia after heart transplantation

Dirk Habedank, Manfred Hummel, Roland Hetzer, Stefan Anker

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

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] ≤21 kg/m2, n = 15), normal weight (BMI 21 to 27 kg/m2, n = 64) and obese (BMI 2, 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 ≤ 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 ≤ 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.

Original languageEnglish
Pages (from-to)1757-1762
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume24
Issue number11
DOIs
Publication statusPublished - Nov 2005

Fingerprint

Cachexia
Heart Transplantation
Body Mass Index
Thinness
Weights and Measures
Weight Gain
Mortality
Weight Loss
Heart Failure
Transplants
Cardiomyopathies
Population
Coronary Disease
Transplantation
Body Weight

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Reversibility of cardiac cachexia after heart transplantation. / Habedank, Dirk; Hummel, Manfred; Hetzer, Roland; Anker, Stefan.

In: Journal of Heart and Lung Transplantation, Vol. 24, No. 11, 11.2005, p. 1757-1762.

Research output: Contribution to journalArticle

Habedank, Dirk ; Hummel, Manfred ; Hetzer, Roland ; Anker, Stefan. / Reversibility of cardiac cachexia after heart transplantation. In: Journal of Heart and Lung Transplantation. 2005 ; Vol. 24, No. 11. pp. 1757-1762.
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abstract = "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] ≤21 kg/m2, n = 15), normal weight (BMI 21 to 27 kg/m2, n = 64) and obese (BMI 2, 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 ≤ 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 ≤ 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.",
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AB - 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] ≤21 kg/m2, n = 15), normal weight (BMI 21 to 27 kg/m2, n = 64) and obese (BMI 2, 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 ≤ 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 ≤ 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.

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