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The underlying mechanisms seem to be related to the increase of both ubiquitin-proteasome and authophagy pathways in heart, resulting in cardiac derangements that finally lead to an increase in oxygen consumption and consequently energy expenditure, contributing to the negative energy balance, one of the hallmarks of cachexia syndrome ( In conclusion, skeletal muscle wasting, including heart weight loss, is not the first sign of cachexia development, although it is one of the main hallmarks