The importance of the gastrointestinal system in the pathogenesis of heart failure

Chronic heart failure (CHF) is a multi-organ disease with increasing evidence for the involvement of the gastrointestinal (GI) system in this syndrome. In recent research, the gut has received very little attention from cardiologists as its role in the pathogenesis of cardiovascular disease is poorl...

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Bibliographic Details
Published in:European heart journal 2005-11, Vol.26 (22), p.2368-2374
Main Authors: Krack, Andreas, Sharma, Rakesh, Figulla, Hans R., Anker, Stefan D.
Format: Article
Language:English
Subjects:
Bacterial Translocation
Biological and medical sciences
Bowel
Cardiology. Vascular system
Chronic Disease
Chronic heart failure
Endotoxin
Endotoxins - physiology
Exercise - physiology
Forecasting
Gastrointestinal Diseases - complications
Gastrointestinal Tract - blood supply
Gut
Heart
Heart Failure - etiology
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Inflammation
Medical sciences
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Summary:Chronic heart failure (CHF) is a multi-organ disease with increasing evidence for the involvement of the gastrointestinal (GI) system in this syndrome. In recent research, the gut has received very little attention from cardiologists as its role in the pathogenesis of cardiovascular disease is poorly understood. Intestinal ischaemia may play an important role in bacterial translocation by increasing bowel permeability. Decreased cardiac function can reduce bowel perfusion and so clearly impairs the function of the intestinal barrier. There is an increasing evidence to suggest that a ‘leaky’ bowel wall may lead to translocation of bacteria and/or endotoxin, which may be an important stimulus for inflammatory cytokine activation in CHF. Impaired functioning of the GI system may also contribute to malnutrition and cachexia in CHF. It is hoped that by improving our understanding of the role of the gut in cardiac disease will lead to the development of novel therapeutic strategies in the future.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehi389