Rodrigues AB, da Gama Torres HO, do Carmo Pereira Nunes M, de Assis Silva Gomes J, Rodrigues AB, Pinho LLN, da Costa Rocha MO, Botoni FA. Intestinal permeability evaluation in patients with chronic Chagas heart failure.
ESC Heart Fail 2023;
10:1250-1257. [PMID:
36708272 PMCID:
PMC10053184 DOI:
10.1002/ehf2.14156]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 01/29/2023] Open
Abstract
AIMS
We analysed intestinal permeability in patients with chronic Chagas cardiomyopathy (CCC) and evaluated its association with clinical manifestations, haemodynamic parameters measured by echocardiogram, and disease outcome. Intestinal permeability was compared between CCC patients and a group of healthy controls.
BACKGROUND
Intestinal dysfunction may contribute to a more severe disease presentation with worse outcome in patients with CCC and heart failure.
METHODS
Fifty patients with CCC and left ventricular ejection fraction (LVEF) of less than 55% were prospectively selected and followed for a mean period of 18 ± 8 months. A group of 27 healthy volunteers were also investigated. One patient was excluded from the analysis since he died before completing the intestinal permeability test. Intestinal permeability was evaluated with the sugar probe drink test. It consists in the urinary recovery of previously ingested sugar probes: mannitol, a monosaccharide, and lactulose, a disaccharide.
RESULTS
Patient's mean age was 53.4 ± 10.4 years, and 31(63%) were male. Differential urinary excretion of lactulose/mannitol ratio did not differ significantly between healthy controls and CCC patients, regardless of clinical signs of venous congestion, haemodynamic parameters, and severity of presentation and outcome.
CONCLUSIONS
The present study could not show a disturbance of the intestinal barrier in CCC patients with LVEF <55%, measured by lactulose/mannitol urinary excretion ratio. Further investigations are needed to verify if in patients with LVEF <40% intestinal permeability is increased.
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