PMID- 26682791
OWN - NLM
STAT- MEDLINE
DCOM- 20161223
LR  - 20220408
IS  - 2213-1787 (Electronic)
IS  - 2213-1779 (Linking)
VI  - 4
IP  - 3
DP  - 2016 Mar
TI  - Pathogenic Gut Flora in Patients With Chronic Heart Failure.
PG  - 220-7
LID - S2213-1779(15)00698-8 [pii]
LID - 10.1016/j.jchf.2015.10.009 [doi]
AB  - OBJECTIVES: The goal of this study was to measure the presence of pathogenic gut 
      flora and intestinal permeability (IP) and their correlations with disease 
      severity, venous blood congestion, and inflammation in patients with chronic 
      heart failure (CHF). BACKGROUND: Evidence suggests that translocation of gut 
      flora and/or their toxins from the intestine to the bloodstream is a possible 
      trigger of systemic CHF inflammation. However, the relation between pathogenic 
      gut flora and CHF severity, as well as IP, venous blood congestion as right 
      atrial pressure (RAP), and/or systemic inflammation (C-reactive protein [CRP]), 
      is still unknown. METHODS: This study analyzed 60 well-nourished patients in 
      stable condition with mild CHF (New York Heart Association [NYHA] functional 
      class I to II; n = 30) and moderate to severe CHF (NYHA functional class III to 
      IV; n = 30) and matched healthy control subjects (n = 20). In all subjects, the 
      presence and development in the feces of bacteria and fungi (Candida species) 
      were measured; IP according to cellobiose sugar test results was documented. The 
      study data were then correlated with RAP (echocardiography) and systemic 
      inflammation. RESULTS: Compared with normal control subjects, the entire CHF 
      population had massive quantities of pathogenic bacteria and Candida such as 
      Campylobacter (85.3 +/- 3.7 CFU/ml vs. 1.0 +/- 0.3 CFU/ml; p < 0.001), Shigella (38.9 
      +/- 12.3 CFU/ml vs. 1.6 +/- 0.2 CFU/ml; p < 0.001), Salmonella (31.3 +/- 9.1 CFU/ml vs 
      0 CFU/ml; p < 0.001), Yersinia enterocolitica (22.9 +/- 6.3 CFU/ml vs. 0 CFU/ml; p 
      < 0.0001), and Candida species (21.3 +/- 1.6 CFU/ml vs. 0.8 +/- 0.4 CFU/ml; p < 
      0.001); altered IP (10.2 +/- 1.2 mg vs. 1.5 +/- 0.8 mg; p < 0.001); and increased RAP 
      (12.6 +/- 0.6 mm Hg) and inflammation (12.5 +/- 0.6 mg/dl). These variables were more 
      pronounced in patients with moderate to severe NYHA functional classes than in 
      patients with the mild NYHA functional class. Notably, IP, RAP, and CRP were 
      mutually interrelated (IP vs. RAP, r = 0.55; p < 0.0001; IP vs. CRP, r = 0.78; p 
      < 0.0001; and RAP vs. CRP, r = 0.78; p < 0.0001). CONCLUSIONS: This study showed 
      that patients with CHF may have intestinal overgrowth of pathogenic bacteria and 
      Candida species and increased IP associated with clinical disease severity, 
      venous blood congestion, and inflammation.
CI  - Copyright (c) 2016 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Pasini, Evasio
AU  - Pasini E
AD  - Fondazione "Salvatore Maugeri," IRCCS, Medical Centre of Lumezzane, Brescia, 
      Italy.
FAU - Aquilani, Roberto
AU  - Aquilani R
AD  - Department of Biology and Biotechnology "L. Spallanzani," University of Pavia, 
      Pavia, Italy.
FAU - Testa, Cristian
AU  - Testa C
AD  - Laboratory of Clinical Microbiology and Virology Functional Point, Bergamo, 
      Italy.
FAU - Baiardi, Paola
AU  - Baiardi P
AD  - Direzione Scientifica Centrale, Fondazione Salvatore Maugeri, IRCCS, Pavia, 
      Italy.
FAU - Angioletti, Stefania
AU  - Angioletti S
AD  - Laboratory of Clinical Microbiology and Virology Functional Point, Bergamo, 
      Italy.
FAU - Boschi, Federica
AU  - Boschi F
AD  - Department of Drug Science, University of Pavia, Pavia, Italy. Electronic 
      address: federica.boschi@unipv.it.
FAU - Verri, Manuela
AU  - Verri M
AD  - Department of Biology and Biotechnology "L. Spallanzani," University of Pavia, 
      Pavia, Italy.
FAU - Dioguardi, Francesco
AU  - Dioguardi F
AD  - Department of Clinical Science and Community Health, University of Milano, Milan, 
      Italy.
LA  - eng
PT  - Journal Article
DEP - 20151209
PL  - United States
TA  - JACC Heart Fail
JT  - JACC. Heart failure
JID - 101598241
RN  - 16462-44-5 (Cellobiose)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
CIN - Nat Rev Cardiol. 2016 Feb;13(2):61. PMID: 26701213
CIN - JACC Heart Fail. 2016 Mar;4(3):228-9. PMID: 26874394
MH  - Aged
MH  - C-Reactive Protein/metabolism
MH  - Case-Control Studies
MH  - Cellobiose/metabolism
MH  - Chronic Disease
MH  - Feces/microbiology
MH  - Female
MH  - Gastroenteritis/*microbiology
MH  - Gastrointestinal Microbiome/*physiology
MH  - Gastrointestinal Tract/microbiology
MH  - Heart Failure/*microbiology
MH  - Humans
MH  - Hyperemia/*microbiology
MH  - Intestinal Absorption/physiology
MH  - Male
MH  - Permeability
OTO - NOTNLM
OT  - chronic heart failure
OT  - gut flora
OT  - inflammation
OT  - intestinal permeability
EDAT- 2015/12/20 06:00
MHDA- 2016/12/24 06:00
CRDT- 2015/12/20 06:00
PHST- 2015/03/09 00:00 [received]
PHST- 2015/10/05 00:00 [revised]
PHST- 2015/10/19 00:00 [accepted]
PHST- 2015/12/20 06:00 [entrez]
PHST- 2015/12/20 06:00 [pubmed]
PHST- 2016/12/24 06:00 [medline]
AID - S2213-1779(15)00698-8 [pii]
AID - 10.1016/j.jchf.2015.10.009 [doi]
PST - ppublish
SO  - JACC Heart Fail. 2016 Mar;4(3):220-7. doi: 10.1016/j.jchf.2015.10.009. Epub 2015 
      Dec 9.