The Pathogenesis of Cardiac Cachexia

Pittman, Joseph G.; Cohen, Phin

doi:10.1056/nejm196408272710908

Cited by 89 publications

(37 citation statements)

References 57 publications

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“…Many of the acyanotic children in the previous study by Kennaird (1976) were, however, in congestive heart failure requiring both digitalis and diuretics. Infants and children with a failing heart function have a higher oxygen consumption and metabolic rate than those who have normal heart functions (Pittman & Cohen 1964;Lees 1966). In the present series no child, cyanotic or acyanotic, had clinical signs of congestive heart failure which therefore may explain that there was no difference in metabolic rate between the groups.…”

Section: Discussioncontrasting

confidence: 44%

Gas exchange, metabolic rate and fluid requirements during anaesthesia of acyanotic and cyanotic infants and children with congenital heart malformations

Grigsby

Beynen

Lindahl³

1991

Pediatric Anesthesia

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Summa yIn order to study gas exchange and metabolic rate in anaesthetized children scheduled for corrective cardiac surgery and to find out if chronic hypoxaemia influenced gas exchange and energy expenditure, oxygen consumption (VOZ) and carbon dioxide elimination (Vco,) were measured and energy expenditure ( E ) was calculated. Infants and children whose haematocrit (Hct) was less than 44% and arterial oxygen saturation (Saoz) on room-air was greater than 93% were classified as acyanotic (group AC, n = 11, weight range 3.7 to 20 kg), and those whose Hct was higher than 44% and Saoz less than 93% as cyanotic (group C, n = 14, weight range 3.4 to 24.3 kg). The majority of children in both groups weighed less than the 50th percentile for normal children. There was no difference in Voz, Vcoz and E between the groups. These variables were related to weight according to the following expressions: Vo2 (ml min-I) = 6.1 x kg + 21.6, r = 0.95; Vco, (ml min-') = 5.7 x kg + 2.9, r = 0.96, and E (kcal h-') 1.8 x kg + 5.3; E (J h-') = 7.6 x kg + 22.3, r = 0.96. Fluid volumes (FV) could be calculated according to the expression: FV (ml h-l) = 3.0 x kg + 8.7; r = 0.96. Oxygen consumption was 15 to 20% higher in anaesthetized infants and children with congenital heart malformations than in anaesthetized infants and children with normal cardiopulmonary function. Accordingly, energy expenditure and fluid requirements were also higher. This difference was most probably due to an undernutrition in children with congenital heart malformations which resulted in a compensatory hypermetabolism.

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Section: Discussioncontrasting

confidence: 44%

Gas exchange, metabolic rate and fluid requirements during anaesthesia of acyanotic and cyanotic infants and children with congenital heart malformations

Grigsby

Beynen

Lindahl³

1991

Pediatric Anesthesia

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“…Cardiac cachexia is not infrequent pre-transplant. 26,27 Resolution of cachexia after transplant may contribute to the observed weight gain. Neurohormonal and immune abnormalities may play an important role in the pathophysiology of cardiac cachexia, and a catabolic/anabolic hormone imbalance is likely to be responsible for the development of the wasting process.…”

Section: Discussionmentioning

confidence: 99%

“…28 In addition, appetite and hunger may be diminished in cachetic patients by gastrointestinal hypomotility, with delayed gastric emptying resulting from edema of the stomach and bowel. 27 It is possible that resolution of the many factors post-transplant could contribute to weight gain. Compensatory mechanisms, such as stimulation of orexigenic hormones in an effort to up-regulate energy intake during cachexia may also play a role if the stimulation persists post-transplant.…”

Section: Discussionmentioning

confidence: 99%

Excessive Weight Gain in Cardiac Transplant Recipients

Williams

Lund

LaManca

et al. 2006

The Journal of Heart and Lung Transplantation

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“…The causes of cardiac cachexia in CHF patients and the precise pathophysiological mechanisms remain unclear. Four mechanisms, however, appear to enhance muscle wasting: these include anorexia, malabsorption, hypermetabolism and possibly a dysfunctional uptake of nutrients into the cell [9][10][11]. Another possible explanation has recently emerged.…”

Section: Introductionmentioning

confidence: 99%