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@ARTICLE{Lena:275459,
      author       = {A. Lena and U. Wilkenshoff and S. Hadzibegovic and J.
                      Porthun and L. Rösnick and A.-K. Fröhlich and T. Zeller
                      and M. Karakas and U. Keller$^*$ and J. Ahn and L.
                      Bullinger$^*$ and H. Riess and S. D. Rosen and A. R. Lyon
                      and T. F. Lüscher and M. Totzeck and T. Rassaf and D.
                      Burkhoff and M. R. Mehra and J. J. Bax and J. Butler and F.
                      Edelmann and W. Haverkamp and S. D. Anker and M. Packer and
                      A. J. S. Coats and S. von Haehling and U. Landmesser and M.
                      S. Anker},
      title        = {{C}linical and {P}rognostic {R}elevance of {C}ardiac
                      {W}asting in {P}atients {W}ith {A}dvanced {C}ancer},
      journal      = {Journal of the American College of Cardiology},
      volume       = {81},
      number       = {16},
      issn         = {0735-1097},
      address      = {New York, NY},
      publisher    = {American College of Cardiology},
      reportid     = {DKFZ-2023-00774},
      pages        = {1569 - 1586},
      year         = {2023},
      abstract     = {Background:Body wasting in patients with cancer can affect
                      the heart.Objectives:The frequency, extent, and clinical and
                      prognostic importance of cardiac wasting in cancer patients
                      is unknown.Methods:This study prospectively enrolled 300
                      patients with mostly advanced, active cancer but without
                      significant cardiovascular disease or infection. These
                      patients were compared with 60 healthy control subjects and
                      60 patients with chronic heart failure (ejection fraction
                      $<40\%)$ of similar age and sex distribution.Results:Cancer
                      patients presented with lower left ventricular (LV) mass
                      than healthy control subjects or heart failure patients
                      (assessed by transthoracic echocardiography: 177 ± 47 g vs
                      203 ± 64 g vs 300 ± 71 g, respectively; P < 0.001). LV
                      mass was lowest in cancer patients with cachexia (153 ± 42
                      g; P < 0.001). Importantly, the presence of low LV mass was
                      independent of previous cardiotoxic anticancer therapy. In
                      90 cancer patients with a second echocardiogram after 122 ±
                      71 days, LV mass had declined by $9.3\%$ ± $1.4\%$ (P <
                      0.001). In cancer patients with cardiac wasting during
                      follow-up, stroke volume decreased (P < 0.001) and resting
                      heart rate increased over time (P = 0.001). During follow-up
                      of on average 16 months, 149 patients died (1-year all-cause
                      mortality $43\%;$ $95\%$ CI: $37\%-49\%).$ LV mass and LV
                      mass adjusted for height squared were independent prognostic
                      markers (both P < 0.05). Adjustment of LV mass for body
                      surface area masked the observed survival impact. LV mass
                      below the prognostically relevant cutpoints in cancer was
                      associated with reduced overall functional status and lower
                      physical performance.Conclusions:Low LV mass is associated
                      with poor functional status and increased all-cause
                      mortality in cancer. These findings provide clinical
                      evidence of cardiac wasting–associated cardiomyopathy in
                      cancer.},
      cin          = {BE01},
      ddc          = {610},
      cid          = {I:(DE-He78)BE01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37076211},
      doi          = {10.1016/j.jacc.2023.02.039},
      url          = {https://inrepo02.dkfz.de/record/275459},
}