Skeletal myopathy in patients with chronic heart failure: significance of anabolic‐androgenic hormones

Abstract

In heart failure, impairment of cardiac muscle function leads to numerous neurohormonal and metabolic disorders, including an imbalance between anabolic and catabolic processes, in favour of the latter. These disorders cause loss of muscle mass with structural and functional changes within the skeletal muscles, known as skeletal myopathy. This phenomenon constitutes an important mechanism that participates in the pathogenesis of chronic heart failure. both its clinical symptoms and the progression of the disease. Attempts to reverse the above-mentioned pathologic processes by exploiting the anabolic action of androgenic hormones could provide a potentially attractive treatment option. The current concepts of anabolic androgen deficiency and resultant skeletal myopathy in patients with heart failure are reviewed, and the potential role of anabolic-androgenic hormones as an emerging therapeutic option for targeting heart failure is discussed.

Muscle wasting in young patients with dilated cardiomyopathy

“…This prevalence is increased in elderly with a chronic disease such as heart failure. However, there is no consensus with regard to the precise age range for this syndrome 1, 2, 3, 6, 9, 12, 13, 14, 15, 16…”

“…Although muscle wasting was first introduced as a phenomenon secondary to ageing, it is more prevalent in patients with a chronic illness such as heart failure, chronic renal failure, and chronic lung disease 1, 6, 7, 8. In most studies regarding muscle wasting in heart failure, elderly patients have been selected 2, 3, 4, 5, 9. The results of these studies indicate a higher prevalence of muscle wasting in older patients with heart failure compared with healthy subjects who are at the same age 2, 3, 4, 5, 9.…”

“…In most studies regarding muscle wasting in heart failure, elderly patients have been selected 2, 3, 4, 5, 9. The results of these studies indicate a higher prevalence of muscle wasting in older patients with heart failure compared with healthy subjects who are at the same age 2, 3, 4, 5, 9. There are only scant data regarding the presence of muscle wasting in younger patients with heart failure,3 and it is not known whether heart failure could possibly be a risk factor for muscle wasting regardless of ageing process or not.…”

Cardiac cachexia: hic et nunc

“…20,21 Anabolic deficiency in HF patients induce loss of skeletal muscle mass and function. 22 Men with HF showed reduced circulating testosterone and dehydroepiandrosterone sulfate, and its relation with decreased exercise capacity. 23,24 It is well known that anabolic steroids have a significant role in the quantitative and qualitative regulation of muscle fibre content, leading to increases in muscle mass and strength, as well as improvement in physical performance.…”

Searching for a relevant definition of sarcopenia: results from the cross-sectional EPIDOS study

“…Nonetheless, loss of muscle mass has been observed beyond mere ageing‐related changes in a number of acute and chronic diseases. Evaluation of sarcopenia prevalence in specific cohorts of patients, for example, suffering from chronic kidney disease,9, 10 chronic heart failure,11 hip fractures,1 or hemiparetic stroke,12 is difficult because of lack of an appropriate disease‐related sarcopenia definition. Thus, in the present paper, the patients with walking or femoral neck fracture disabilities were excluded.…”