Key points: Inflammation, pathogenic gut bacteria, and Candida species and markers of disease severity where analyzed in adults with stable mild, moderate and severe congestive heart failure (CHF). High levels of pathogenic bacteria including Campylobacter, Shigella, Salmonella, Yersinia enterocolitica, and Candida species were discovered in CHF patients when compared to normal control. Intestinal permeability (IP), right arterial pressure (RAP) and markers of inflammation, including C-reactive protein (CRP) was also greater in the CHF group. These results suggest that people with CHF have higher levels of gut dysbiosis and inflammation, which may contribute to increased congestion of venous blood and cardiac disease severity.

Research subjects were organized based on their New York Heart Association (NYHA) functional class for CHF disease severity. Researchers analyzed the results from 30 adults with mild CHF (class I-II), 30 adults with moderate to severe CHF (class III-IV), and compared the results to 20 healthy control subjects. Statistically significant increases in pathogenic bacteria were found in all CHF patients when compared to the control. Increased IP (10.2 mg vs 1.5 mg, p<0.0001), increased RAP (12.6mmHg), and increased inflammation, CRP levels (12.5mg/dl), were seen in all CHF groups when compared to the control group.

Why is this Clinically Relevant?

Pathogenic gut bacteria may contribute to inflammation and thus impact cardiac health and blood flow. These results suggest that pathogenic gut bacterial, and gut health may be contributing factors for CHF disease risk and severity. Treatments aimed at normalizing and rebalancing gut flora, and reducing inflammation, are promising strategies for reducing CHF disease severity and risk


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