Studies on bacterial endotoxin and intestinal absorption function in patients with chronic heart failure

Abstract Background Small intestinal function may be altered in decompensated chronic heart failure (CHF) and translocating LPS may contribute to systemic inflammation observed in CHF. Methods We measured intestinal permeability (melibiose and rhamnose), active (3-O-methyl-d-glucose (3-OMG)) and passive (d-xylose) carrier-mediated absorption in 20 CHF patients (12 edematous and 8 non-edematous) and 8 controls by saccharide absorption technique assessing urinary recovery of orally administered sugars. We additionally measured LPS concentrations in 42 patients with decompensated heart failure and after recompensation. Results CHF patients had a 54% reduction of active carrier-mediated intestinal transport compared to controls (p Edematous patients had highest blood concentrations of LPS, TNF and sTNF-R1 (p 0.50EU/mL (n=7) had the highest concentrations of TNF (7.0±1.6 vs. 3.1±0.3pg/mL, p Conclusion Active carrier-mediated intestinal transport is reduced in decompensated CHF indicating epithelial dysfunction possibly as a consequence of intestinal ischemia. Higher LPS concentrations in edematous CHF relate to inflammation. LPS decreased after recompensation. This suggests a cause/effect relationship between edematous gut wall, epithelial dysfunction and translocating LPS.