Incidence and impact of cardiac cachexia in valvular surgery

Asian Cardiovasc Thorac Ann. 2009 Dec;17(6):617-21. doi: 10.1177/0218492309349093.

Abstract

Cardiac cachexia is a wasting feature of advanced heart failure, which is due to several etiologies and associated with a poor prognosis. This study assessed the incidence and impact of cardiac cachexia retrospectively in 353 patients who underwent valve surgery from June 2005 to June 2006. Using 80% of ideal body weight as a cut-off point, 46 (13%) of these patients were considered to have cardiac cachexia. Patients with cachexia were predominantly male with more underlying diseases and a lower body mass index than those without cachexia. The New York Heart Association functional class was significantly worse in patients with cachexia (class III/IV: 54.4% vs. 21.2%) and they had greater incidences of active infective endocarditis (21.7% vs. 5.2%) and tricuspid regurgitation (41.3% vs. 21.8%) compared to those with normal body weight. The cachexia group had significantly longer postoperative hospitalization and more complications (37% vs. 21.5%); perioperative mortality tended to be higher (6.5% vs. 2.3%) although not statistically significant. Cardiac cachexia remains an important problem in patients undergoing valve surgery, which indicates end-staged disease, and contributes to poor perioperative outcomes. Special care and attention are needed in this particular group of patients.

MeSH terms

  • Adult
  • Body Mass Index
  • Body Weight
  • Cachexia / etiology*
  • Cachexia / mortality
  • Cachexia / physiopathology
  • Cardiac Surgical Procedures* / adverse effects
  • Cardiac Surgical Procedures* / mortality
  • Disease Progression
  • Endocarditis / complications
  • Endocarditis / surgery
  • Female
  • Heart Failure / etiology*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Heart Valve Diseases / complications
  • Heart Valve Diseases / mortality
  • Heart Valve Diseases / physiopathology
  • Heart Valve Diseases / surgery*
  • Hospital Mortality
  • Humans
  • Incidence
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thailand / epidemiology
  • Time Factors
  • Treatment Outcome
  • Tricuspid Valve Insufficiency / complications
  • Tricuspid Valve Insufficiency / surgery