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Clinical and echocardiographic phenotype of cardiac wasting in patients with advanced cancer

Aims Cardiac wasting-associated cardiomyopathy in patients with advanced cancer is characterized by loss of left ventricular (LV) mass and independently associated with poor prognosis. Better understanding of this very prevalent cardiomyopathy is urgently needed. Methods and results Overall, 398 pat...

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Main Authors: Anker, Markus (Author) , Khan, Muhammad Shahzeb (Author) , Nikolski, Anja (Author) , Porthun, Jan (Author) , Arshad, Muhammad Sameer (Author) , Hadzibegovic, Sara (Author) , Lena, Alessia (Author) , Kretzler, Lucie (Author) , Hella, Jonathan L. (Author) , Witkowski, Marco (Author) , Rieger, Kathrin (Author) , Ahn, Johann (Author) , Modest, Dominik Paul (Author) , Keller, Ulrich (Author) , Bullinger, Lars (Author) , Totzeck, Matthias (Author) , Mahabadi, Amir A. (Author) , Rassaf, Tienush (Author) , Buchmann, Nikolaus (Author) , Attanasio, Philipp (Author) , Zeller, Tanja (Author) , Karakas, Mahir (Author) , Tocchetti, Carlo G. (Author) , Wilkenshoff, Ursula (Author) , Cleland, John G. F. (Author) , von Haehling, Stephan (Author) , Butler, Javed (Author) , Landmesser, Ulf (Author)
Format: Article (Journal)
Language:English
Published: 06 August 2025
In: European journal of heart failure
Year: 2025, Volume: 27, Issue: 11, Pages: 2130-2140
ISSN:1879-0844
DOI:10.1002/ejhf.3744
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/ejhf.3744
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.3744
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Author Notes:Markus S. Anker, Muhammad Shahzeb Khan, Anja Nikolski, Jan Porthun, Muhammad Sameer Arshad, Sara Hadzibegovic, Alessia Lena, Lucie Kretzler, Jonathan L. Hella, Marco Witkowski, Kathrin Rieger, Johann Ahn, Dominik P. Modest, Ulrich Keller, Lars Bullinger, Matthias Totzeck, Amir A. Mahabadi, Tienush Rassaf, Nikolaus Buchmann, Philipp Attanasio, Tanja Zeller, Mahir Karakas, Carlo G. Tocchetti, Ursula Wilkenshoff, John G. F. Cleland, Stephan von Haehling, Javed Butler, and Ulf Landmesser
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Summary:Aims Cardiac wasting-associated cardiomyopathy in patients with advanced cancer is characterized by loss of left ventricular (LV) mass and independently associated with poor prognosis. Better understanding of this very prevalent cardiomyopathy is urgently needed. Methods and results Overall, 398 patients with active, mostly advanced cancer without significant cardiovascular disease (mean LV ejection fraction [LVEF] 64.3 ± 0.2%) or active infection were prospectively examined (mean age 60 ± 1 years, 50% women, body mass index 25.0 ± 0.2 kg/m2, 26% cachectic). Patients were categorized and compared by quartiles of LV mass/height2. LVEF, global longitudinal strain (GLS), and anticancer therapy naive status were similar across quartiles. Patients in Q1 (lowest LV mass quartile) were younger, more likely cachectic, had lower: BMI, 10-step stair-climbing power, tricuspid annular plane systolic excursion (TAPSE), stroke volume, cardiac output, and higher heart rate. In repeat follow-up assessments after 140 ± 8 days (n = 143), LVEF, TAPSE, LV mass, left atrial volume, and GLS were found reduced (all p ≤ 0.002). Only in those with above-median LV mass at baseline, cardiac output and heart rate increased during follow-up - in those with below-median LV mass, mitral E/A decreased. Conclusions Patients with advanced cancer with low LV mass have a distinct phenotype characterized by lower cardiac chamber volumes, stroke volume, and cardiac output, but normal LVEF and GLS that may be the distinct feature of cardiac wasting-associated cardiomyopathy.
Item Description:Gesehen am 17.12.2025
Physical Description:Online Resource
ISSN:1879-0844
DOI:10.1002/ejhf.3744

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