Cardiac cachexia: A scientific statement from the American Association of Heart Failure Nurses (AAHFN)

Cardiac cachexia is a complex and multifactorial syndrome in patients with heart failure (HF). Cardiac cachexia is associated with poor functional status, symptoms, increased hospitalizations, and psychosocial effects. Despite its significant association with morbidity and mortality, cardiac cachexia remains under-recognized and undertreated. This scientific statement provides a comprehensive overview of the contemporary understanding of cardiac cachexia by detailing the definition, prevalence, prognostic implications, mechanisms, clinical manifestations, diagnostic strategies, treatment modalities, and recommendations for future clinical and research considerations. The development of cardiac cachexia is an indication of advanced serious illness. Diagnostic challenges persist due to the heterogeneous condition of HF, fluid imbalances that may mask or mimic weight changes, and the lack of definitive diagnostic evaluation. While no standard treatment exists, a multidisciplinary approach combining nutritional support, physical activity, and pharmacologic management is recommended. Greater clinical awareness and early identification of cardiac cachexia are essential for improving outcomes in patients with HF. Future research recommendations include prioritizing clinical trials that specifically evaluate cardiac cachexia within the context of HF to develop comprehensive treatment strategies targeting catabolic and anabolic pathways, and the associated psychosocial manifestations of the conditions.

Duke Scholars

Author Carolyn Louise Lekavich Medicine, Cardiology