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ORIGINAL ARTICLE

Incidence and Impact of Cardiac Cachexia in Valvular Surgery

Thitipong Tepsuwan, MD, Suphachai Schuarattanapong, MD, Surin Woragidpoonpol, MD, Supap Kulthawong, BSc, Anong Chaiyasri, MSc, Weerachai Nawarawong, MD

Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Thitipong Tepsuwan, MD, Tel: +66 53 94 5533, Fax: +66 53 94 6139, Email: Thitipong_tepsuwan{at}yahoo.com, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.

ABSTRACT

Cardiac cachexia is a wasting feature of advanced heart failure, which is due to several etiologies and associated with a poor prognosis. This study assessed the incidence and impact of cardiac cachexia retrospectively in 353 patients who underwent valve surgery from June 2005 to June 2006. Using 80% of ideal body weight as a cut-off point, 46 (13%) of these patients were considered to have cardiac cachexia. Patients with cachexia were predominantly male with more underlying diseases and a lower body mass index than those without cachexia. The New York Heart Association functional class was significantly worse in patients with cachexia (class III/IV: 54.4% vs. 21.2%) and they had greater incidences of active infective endocarditis (21.7% vs. 5.2%) and tricuspid regurgitation (41.3% vs. 21.8%) compared to those with normal body weight. The cachexia group had significantly longer postoperative hospitalization and more complications (37% vs. 21.5%); perioperative mortality tended to be higher (6.5% vs. 2.3%) although not statistically significant. Cardiac cachexia remains an important problem in patients undergoing valve surgery, which indicates end-staged disease, and contributes to poor perioperative outcomes. Special care and attention are needed in this particular group of patients.

Key Words: Cachexia • Heart Failure • Heart Valve Diseases

Asian Cardiovasc Thorac Ann 2009; 17:617-621
© 2009 by SAGE Publications
DOI: 10.1177/0218492309349093




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