Pathogenic Gut Flora (“Leaky Gut”) Tied to Heart-Failure Severity

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Pathogenic Gut Flora (“Leaky Gut”) Tied to Heart-Failure Severity


BRESCIA, ITALY — Patients with chronic heart failure (CHF) are likely to have “intestinal overgrowth” of pathogenic gut flora and permeability that is associated with disease severity, new research suggests[1].
A study of 80 total participants showed that the CHF patients had “massive quantities” of pathogenic bacteria and candida vs a group of healthy controls. Specific types of the increased pathogens found in stool samples included Campylobacter, Shigella, Salmonella, Yersinia enterocolitica, and Candidaspecies. Those with CHF also had significantly increased inflammation, intestinal permeability, and right atrial pressure (RAP), which is a signal of venous blood congestion.
In addition, most associations were stronger in those with moderate-severe HF (NYHA 3-4) vs those with mild HF (NYHA 1-2).
“Our study suggests gut microbiota need to be continually investigated as soon as CHF is diagnosed,” note the investigators, led by Dr Evasio Pasini (Salvatore Maugeri Foundation, IRCCS, Medical Center of Lumezzane, Brescia, Italy). They add that using simple, noninvasive, reproducible methods to measure gut-flora development could provide “important clinical information to treat complicated multiorgan syndromes.”
The study reaffirms earlier research “in a very nice, single packet,” commented Dr Stanley L Hazen (Cleveland Clinic, OH) to heartwire from Medscape. “It’s well-known that with heart failure, you have enhanced intra-abdominal pressure and vasculature that has poor edema and intra-abdominal lymph flow. As a consequence, you get bowel-wall edema, and there’s a breakdown in the barrier of the gut,” he said.
“This concept of a ‘leaky gut’ in heart failure has been out there for quite some time.” But this study nicely shows, through several different measures, that impairment in intestinal bowel-wall function is associated with severity of HF, said Hazen, who was not involved with this research.
The findings were published online December 9, 2015 in JACC: Heart Failure.

References

  1. Pasini E, Aquilani R, Testa C, et al. Pathogenic gut flora in patients with chronic heart failure. JACC: Heart Fail.2015; DOI:10.1016/j.jchf.2015.10.009. Article
  2. Wang Z, Roberts AB, Buffa JA, et al. Non-lethal inhibition of gut microbial trimethylamine production for the treatment of atherosclerosis. Cell 2015; DOI:10.1016/j.cell.2015.11.055. Article

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