 |
 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 December 1994 | Volume 121 Issue 11 | Pages 860-862
Objective: To examine resting metabolic rate in patients with congestive heart failure as a cause of cardiac cachexia and associated weight loss.
Design: Cross-sectional study.
Setting: Baltimore Veterans Affairs Medical Center.
Patients: 20 men with heart failure (mean age ±SD, 69 ±7 years) and reduced ejection fraction (mean, 0.24 ±0.10) and 40 healthy men (mean age, 69 ±7 years).
Results: Patients with heart failure had smaller fat-free mass than did controls (53 ±8 kg compared with 56 ±6 kg; P < 0.09), but no difference in fat mass existed (21 ±8 kg compared with 19 ±8 kg). Measured resting metabolic rate was 18% higher in patients with heart failure than in controls (1828 ±275 kcal/d compared with 1543 ±219 kcal/d; P < 0.01); no difference in caloric intake existed (2144 ±479 kcal/d compared with 2174 ±826 kcal/d). The difference in resting metabolic rate between the two groups was even more striking when indexed per kilogram of fat-free mass.
Conclusions: Higher resting metabolic rate in patients with heart failure at least partially accounts for otherwise unexplained weight loss. Present caloric guidelines, which were established in healthy elderly persons, substantially underestimate the resting caloric needs of elderly persons with heart failure.
Author and Article Information
From the University of Maryland, the Baltimore Veterans Affairs Medical Center, the Geriatric Research Education and Clinical Center, and University of Maryland Claude D. Pepper Older Americans Independence Center, Baltimore, Maryland.
BRIEF COMMUNICATION
Increased Resting Metabolic Rate in Patients with Congestive Heart Failure
Requests for Reprints: Eric T. Poehlman, PhD, Baltimore Veterans Affairs Medical Center, Geriatrics (Ref. 18), 10 North Greene Street, Baltimore, MD 21201.
Acknowledgments: The authors thank Philip A. Ades, MD, Andrew P. Goldberg, MD, and Michael J. Toth, BS, for critiques of this paper.
Grant Support: In part by a grant from the National Institute of Aging (AG-07857), a Research Career and Development Award from the National Institute of Aging (AG-05564), the Office of the Dean at the University of Maryland, and the Geriatric Research Education and Clinical Center (GRECC), Department of Veterans Affairs.
This article has been cited by other articles:
|
|
 |
|
  S. von Haehling, W. Doehner, and S. D Anker Nutrition, metabolism, and the complex pathophysiology of cachexia in chronic heart failure Cardiovasc Res, January 15, 2007; 73(2): 298 - 309. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Ruggiero and L. Ferrucci The endeavor of high maintenance homeostasis: resting metabolic rate and the legacy of longevity. J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2006; 61(5): 466 - 473. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Kistorp, J. Faber, S. Galatius, F. Gustafsson, J. Frystyk, A. Flyvbjerg, and P. Hildebrandt Plasma Adiponectin, Body Mass Index, and Mortality in Patients With Chronic Heart Failure Circulation, September 20, 2005; 112(12): 1756 - 1762. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Yee-Moon Wang, M. Man-Mei Sea, N. Tang, J. E. Sanderson, S.-F. Lui, P. Kam-Tao Li, and J. Woo Resting Energy Expenditure and Subsequent Mortality Risk in Peritoneal Dialysis Patients J. Am. Soc. Nephrol., December 1, 2004; 15(12): 3134 - 3143. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Heidland, K Sebekova, A Frangiosa, L S De Santo, M Cirillo, F Rossi, M Cotrufo, A Perna, A Klassen, R Schinzel, et al. Paradox of circulating advanced glycation end product concentrations in patients with congestive heart failure and after heart transplantation Heart, November 1, 2004; 90(11): 1269 - 1274. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rauchhaus, A. L. Clark, W. Doehner, C. Davos, A. Bolger, R. Sharma, A. J. S. Coats, and S. D. Anker The relationship between cholesterol and survival in patients with chronic heart failure J. Am. Coll. Cardiol., December 3, 2003; 42(11): 1933 - 1940. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A.G.N. Agusti, A. Noguera, J. Sauleda, E. Sala, J. Pons, and X. Busquets Systemic effects of chronic obstructive pulmonary disease Eur. Respir. J., February 1, 2003; 21(2): 347 - 360. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Hambrecht, P. C. Schulze, S. Gielen, A. Linke, S. Mobius-Winkler, J. Yu, J.u. Kratzsch, G. Baldauf, M. W. Busse, A. Schubert, et al. Reduction of insulin-like growth factor-I expression in the skeletal muscle of noncachectic patients with chronic heart failure J. Am. Coll. Cardiol., April 3, 2002; 39(7): 1175 - 1181. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Akner and T. Cederholm Treatment of protein-energy malnutrition in chronic nonmalignant disorders Am. J. Clinical Nutrition, July 1, 2001; 74(1): 6 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. K. A. Witte, A. L. Clark, and J. G. F. Cleland Chronic heart failure and micronutrients J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1765 - 1774. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. P. Kotler Cachexia Ann Intern Med, October 17, 2000; 133(8): 622 - 634. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Berry and A.L Clark Catabolism in chronic heart failure Eur. Heart J., April 1, 2000; 21(7): 521 - 532. [PDF]
|
|
|
|
|
|
D.R. Murdoch and J.J.V. McMurray Cardiac cachexia--lean and mean Eur. Heart J., November 2, 1999; 20(22): 1609 - 1611. [PDF]
|
|
|
|
|
|
P. Ponikowski, M. Piepoli, T.P. Chua, W. Banasiak, D. Francis, S.D. Anker, and A.J.S. Coats The impact of cachexia on cardiorespiratory reflex control in chronic heart failure Eur. Heart J., November 2, 1999; 20(22): 1667 - 1675. [Abstract] [PDF]
|
|
|
|
|
|
D R Murdoch, E Rooney, H J Dargie, D Shapiro, J J Morton, and J J V McMurray Inappropriately low plasma leptin concentration in the cachexia associated with chronic heart failure Heart, September 1, 1999; 82(3): 352 - 356. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.D. Anker, P.P. Ponikowski, A.L. Clark, F. Leyva, M. Rauchhaus, M. Kemp, M.M. Teixeira, P.G. Hellewell, J. Hooper, P.A. Poole-Wilson, et al. Cytokines and neurohormones relating to body composition alterations in the wasting syndrome of chronic heart failure Eur. Heart J., May 1, 1999; 20(9): 683 - 693. [Abstract] [PDF]
|
|
|
|
 |
|
 S. D. Anker and A. J. S. Coats Cardiac Cachexia: A Syndrome With Impaired Survival and Immune and Neuroendocrine Activation Chest, March 1, 1999; 115(3): 836 - 847. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. T. Poehlman Special Considerations in Design of Trials with Elderly Subjects: Unexplained Weight Loss, Body Composition and Energy Expenditure J. Nutr., January 1, 1999; 129(1): 260S - 260S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Niebauer, C.-D. Pflaum, A. L. Clark, C. J. Strasburger, J. Hooper, P. A. Poole-Wilson, A. J. S. Coats, and S. D. Anker Deficient insulin-like growth factor I in chronic heart failure predicts altered body composition, anabolic deficiency, cytokine and neurohormonal activation J. Am. Coll. Cardiol., August 1, 1998; 32(2): 393 - 397. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D. Anker, T. P. Chua, P. Ponikowski, D. Harrington, J. W. Swan, W. J. Kox, P. A. Poole-Wilson, and A. J. S. Coats Hormonal Changes and Catabolic/Anabolic Imbalance in Chronic Heart Failure and Their Importance for Cardiac Cachexia Circulation, July 15, 1997; 96(2): 526 - 534. [Abstract] [Full Text]
|
|
Article
