Malnutrition in heart failure is often referred to as cardiac cachexia. What is cardiac cachexia? What are the characteristic symptoms? Explain the role of the underlying heart disease in the development of malnutrition
What will be an ideal response?
• Cardiac cachexia is a wasting syndrome caused by heart failure that results in a metabolic imbalance favoring catabolism over anabolism. Losses in lean and fat tissue, in addition to bone mineral density, can be observed and is not always reversible upon feeding (like starvation).
• Signs and symptoms: increased plasma TNF-α, decreased GI tract perfusion (slowed peristalsis, early satiety, and impaired nutrition absorption), and endothelial dysfunction (leading to a reduction in skeletal muscle nutrient supply).
• Heart failure promotes the development of malnutrition through inflammatory pathways, elevated levels of B-type and atrial natriuretic peptides, aldosterone, and cortisol, and anorexia.
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