ABSTRACT Cardiac cachexia affects mainly advanced chronic heart failure patients and is characterized by body weight loss, including muscle, adipose tissue and bone mass reduction. The development of cardiac cachexia is linked to a poor prognosis in chronic heart failure. There are emerging clinical observations that indicate that adipose tissue mass is a major determinant of survival in chronic heart failure patients and that fat mass is more closely related to mortality compared to lean tissue mass. A particular interest has developed in the last decade on research on adipose tissue metabolism regulatory mechanisms in physiologic condition but also in pathologic clinical situations, especially cachexia related diseases. This review focuses on adipose white tissue specific physiological and physio-pathological importance in heath condition and in heart failure both in clinical and experimental situations. It will also evaluate the regulation of the major established pathways involved in adipose tissue metabolism (stimulation or inhibition of lipolysis), and cellular physiology (differentiation) and the known and potentially involved mechanisms in altered adipose regulatory control during heart failure progression. A better understanding of the mechanisms involved in the altered fat mass metabolism in cardiac cachexia could lead to the development of efficacious treatments, with a better management of heart failure clinical condition preventing such a complication with a worst prognosis.
Buy this Article
|