Gastro-intestinal protein loss in elderly patients with cardiac cachexia

Undernutrition resulting from chronic congestive heart failure (cardiac cachexia, CC) increases morbidity and mortality particularly in elderly people. The aetiology of CC is thought to be multifactorial. We have assessed the presence of gastro-intestinal protein loss in a group of patients with CC and a group of healthy age-and sex-matched controls. Gastro-intestinal protein loss was measured using the (51)chromic chloride test in 29 patients with CC [mean age 76.1(SD 4.4) years] and 29 healthy controls [mean age 74.9(SD 4.8) years]. The patients were undernourished in terms of anthropometric measurements compared to controls. The patients had a significantly lower mean ejection fraction [41.5(18.3)% vs. 65.5(2.2)%] and higher mean pulmonary artery pressure [89.4(19.9) mmHg vs. 19.3(8.1) mmHg]. The recovery of radioactivity in a 5-day stool collection was similar in the two groups [patients vs. controls: 1.0(0.7)% vs. 0.98(0.6)%, p = 0.9]. These values are within the expected normal range. We conclude that gastro-intestinal protein loss is not a significant factor in the production of cardiac cachexia.