Current diagnostic criteria for cardiac cachexia lack standardization and accuracy, complicated by comorbidities and overlapping pathogenic mechanisms in heart failure patients.
Current diagnostic criteria for cardiac cachexia lack standardization and accuracy, highlighting the need for a novel clinical definition to improve risk stratification and management in heart failure.
Abstract Background Cardiac cachexia is a multifactorial wasting syndrome characterized by unintentional weight loss, altered body composition, and disrupted inflammatory processes that affect people with heart failure across different NYHA classes. Although various definitions of cardiac cachexia exist across the literature, there is still a lack of a universally standardized definition for cardiac cachexia to clearly differentiate it from other types of cachexia, which impedes the recognition and risk stratification of chronic heart failure (CHF). Purpose This study investigates the clinical definitions of cardiac cachexia (diagnostic criteria) found in the literature and examines the strengths and weaknesses associated with each definition. Methods A scoping review was conducted in accordance with the PRISMA-Sc guidelines. We systematically searched for eligible papers published in English across the literature that reported using the diagnostic criteria of cardiac cachexia among people with heart failure through various databases. Results Current definitions of cardiac cachexia showed a lack of accuracy of diagnostic tools and the invalidity in certain criteria to identify heart failure patients who have cachexia. Body composition measurements and the cutoff point for weight loss proportion were neither standardized nor specified, making it difficult to accurately determine cachectic patients. The inclusion of comorbidities in patients with chronic heart failure have significantly affected the diagnosis of cardiac cachexia considering the presence of multiple illnesses that could conceal the accurate measurement of the patient's ideal body weight (dry weight). The overlapping of the same pathogenic mechanisms (some biomarkers and cytokines) between cardiac cachexia and different conditions further complicates the recognition of patients who have cardiac cachexia. Conclusion Prospective efforts are critical to develop a novel clinical definition for cardiac cachexia with an evident approach that effectively manages the current weaknesses and strengths to enhance the long-term prognosis and promote the outcomes for patients with chronic heart failure. The importance of early identification could play a key role in facilitating timely therapeutic decisions, responding to the needs of patients, building personalized care plans, and reducing the rates of hospitalization and institutionalization.Cardiac Cachexia Fig 1
Alrfooh et al. (Wed,) conducted a review in Cardiac cachexia in heart failure. Diagnostic criteria for cardiac cachexia was evaluated on Clinical definitions of cardiac cachexia and their strengths and weaknesses. Current diagnostic criteria for cardiac cachexia lack standardization and accuracy, complicated by comorbidities and overlapping pathogenic mechanisms in heart failure patients.