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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