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Jarrad M Scarlett Department of Pediatrics, Oregon Health and Science University, Mailcode L481, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA

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Darren D Bowe Department of Pediatrics, Oregon Health and Science University, Mailcode L481, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA

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Xinxia Zhu Department of Pediatrics, Oregon Health and Science University, Mailcode L481, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA

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Ayesha K Batra Department of Pediatrics, Oregon Health and Science University, Mailcode L481, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA

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Wilmon F Grant Department of Pediatrics, Oregon Health and Science University, Mailcode L481, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA

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Daniel L Marks Department of Pediatrics, Oregon Health and Science University, Mailcode L481, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA

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The central melanocortin system plays a key role in the regulation of food intake and energy homeostasis. We investigated whether genetic or pharmacologic blockade of central melanocortin signaling attenuates cardiac cachexia in mice and rats with heart failure. Permanent ligation of the left coronary artery (myocardial infarction (MI)) or sham operation was performed in wild-type (WT) or melanocortin-4 receptor (MC4R) knockout mice. Eight weeks after surgery, WT-Sham mice had significant increases in lean body mass (LBM; P<0.05) and fat mass (P<0.05), whereas WT-MI did not gain significant amounts of LBM or fat mass. Resting basal metabolic rate (BMR) was significantly lower in WT-Sham mice compared to WT-MI mice (P<0.001). In contrast, both MC4-Sham and MC4-MI mice gained significant amounts of LBM (P<0.05) and fat mass (P<0.05) over the study period. There was no significant difference in the BMR between MC4-Sham and MC4-MI mice. In the second experiment, rats received aortic bands or sham operations, and after recovery received i.c.v. injections of either artificial cerebrospinal fluid (aCSF) or the melanocortin antagonist agouti-related protein (AGRP) for 2 weeks. Banded rats receiving AGRP gained significant amount of LBM (P<0.05) and fat mass (P<0.05) over the treatment period, whereas banded rats receiving aCSF did not gain significant amounts of LBM or fat mass. These results demonstrated that genetic and pharmacologic blockade of melanocortin signaling attenuated the metabolic manifestations of cardiac cachexia in murine and rat models of heart failure.

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