Background: Body weight loss or cardiac cachexia is associated with poor prognosis. Although
the causes of cardiac cachexia are not fully determined, sympathetic overactivation
might be implicated in the development of muscle wasting. Recently, it has been shown
that beta blocker treatment attenuated the development and promoted a partial reversal
of body weight loss in patients with heart failure (HF). Methods: We prospectively evaluated changes in body weight in 108 nonedematous patients with
HF and reduced ejection fraction (EF <0.45) who were measured muscle sympathetic nerve
activity (MSNA). Any data of body weights during follow-up were excluded from analyses
if edema were present. Patients were divided into 3 groups according to MSNA level
(low, middle and high groups). Significant weight loss was defined as follow: weight
loss of at least 5% in 12 months. Results: Usage and dose of beta blockers were similar in 3 groups. Mean left ventricular ejection
fraction were 34%, 32%, 30% in low, middle and high MSNA groups, respectively. Interestingly,
significant weight loss was frequently observed in high MSNA groups (33%) in compared
to middle and low MSNA groups (6% and 3%, respectively, P < .001 for χ test). Conclusion: Sympathetic overactivation might promote cachexia in patients with HF and reduced
ejection fraction.
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