Cardiac cachexia (CC) is the unintentional non-oedematous weight loss of >5% over at least 6 months. CC is associated with older age and can result in longer length of hospital stay and higher costs. CC (19%) is among the most common comorbidities of HF together with malignancies (34%) and chronic obstructive pulmonary disease (29%). Pathophysiological mechanisms of CC include metabolic and neurohormonal abnormalities [100]. However, the preoperative health status Kansas City Cardiomyopathy Questionnaire has limited association with outcomes after ventricular assist device (VAD) implantation [101]. For assessment of nutritional status, the prognostic nutritional index [serum (pre-) albumin and total lymphocyte count] might be used as an indicator of a worse outcome [102].