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Sarcopenia and Heart Failure

1
Department of Translational Medical Sciences, University of Naples Federico II Naples, 80131 Naples, Italy
2
Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
3
IRCCS Salvatore Maugeri Foundation, Scientific Institute of Veruno, 28010 Novara, Italy
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Department of Systems Medicine, University of Rome Tor Vergata, 00100 Rome, Italy
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San Raffaele Roma Open University, School of Medicine, 00100 Rome, Italy
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Division of Internal Medicine, AOU San Giovanni di Dio e Ruggi di Aragona, 84121 Salerno, Italy
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Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, 00100 Rome, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(1), 211; https://doi.org/10.3390/nu12010211
Received: 5 December 2019 / Revised: 25 December 2019 / Accepted: 8 January 2020 / Published: 14 January 2020
(This article belongs to the Special Issue Sarcopenia and Nutritional Status)
Modifications of lean mass are a frequent critical determinant in the pathophysiology and progression of heart failure (HF). Sarcopenia may be considered one of the most important causes of low physical performance and reduced cardiorespiratory fitness in older patients with HF. Sarcopenia is frequently misdiagnosed as cachexia. However, muscle wasting in HF has different pathogenetic features in sarcopenic and cachectic conditions. HF may induce sarcopenia through common pathogenetic pathways such as hormonal changes, malnutrition, and physical inactivity; mechanisms that influence each other. In the opposite way, sarcopenia may favor HF development by different mechanisms, including pathological ergoreflex. Paradoxically, sarcopenia is not associated with a sarcopenic cardiac muscle, but the cardiac muscle shows a hypertrophy which seems to be “not-functional.” First-line agents for the treatment of HF, physical activity and nutritional interventions, may offer a therapeutic advantage in sarcopenic patients irrespective of HF. Thus, sarcopenia is highly prevalent in patients with HF, contributing to its poor prognosis, and both conditions could benefit from common treatment strategies based on pharmacological, physical activity, and nutritional approaches. View Full-Text
Keywords: sarcopenia; heart failure; elderly; cachexia; malnutrition; physical activity sarcopenia; heart failure; elderly; cachexia; malnutrition; physical activity
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Curcio, F.; Testa, G.; Liguori, I.; Papillo, M.; Flocco, V.; Panicara, V.; Galizia, G.; Della-Morte, D.; Gargiulo, G.; Cacciatore, F.; Bonaduce, D.; Landi, F.; Abete, P. Sarcopenia and Heart Failure. Nutrients 2020, 12, 211.

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