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. 2023 Apr;10(2):1250-1257.
doi: 10.1002/ehf2.14156. Epub 2023 Jan 28.

Intestinal permeability evaluation in patients with chronic Chagas heart failure

Angela Braga Rodrigues  1 , Henrique Oswaldo da Gama Torres  2 , Maria do Carmo Pereira Nunes  1   2 , Juliana de Assis Silva Gomes  3 , Aline Braga Rodrigues  4 , Laura Lopes Nogueira Pinho  2 , Manoel Otavio da Costa Rocha  1   2 , Fernando Antonio Botoni  1   2
Affiliations

Intestinal permeability evaluation in patients with chronic Chagas heart failure

Angela Braga Rodrigues et al. ESC Heart Fail. 2023 Apr.

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.

Keywords: Chagasic heart failure; Intestinal dysfunction; Intestinal permeability.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Difference of lactulose/mannitol urinary excretion ratio between patients with peripheral oedema, patients with no oedema, and healthy controls.
Figure 2
Figure 2
Difference of lactulose/mannitol urinary excretion ratio between patients with clinical sings of right heart failure (RHF), patients with no clinical signs of right heart failure (RHF), and healthy controls.
See this image and copyright information in PMC

References

    1. World Health Organization . Chagas disease in Latin America: an epidemiological update based on 2010 estimates = Maladie de Chagas en Amérique latine: le point épidémiologique basé sur les estimations de 2010. Wkly Epidemiol Rec 2015; 90: 33–44. - PubMed
    1. Benziger CP, do Carmo GA, Ribeiro AL. Chagas cardiomyopathy. Cardiol Clin 2017; 35: 31–47. - PubMed
    1. Rassi A, Rassi SG. Predictors of mortality in chronic Chagas disease. Circulation 2007; 115: 1101–1108. - PubMed
    1. Nunes MC, Carmo AA, Rocha MO, Ribeiro AL. Mortality prediction in Chagas heart disease. Expert Rev Cardiovasc Ther 2012; 10: 1173–1184. - PubMed
    1. Botoni FA, Poole‐Wilson PA, Ribeiro AL, Okonko DO, Oliveira BM, Pinto AS, Teixeira MM, Teixeira AL, Reis AM, Dantas JB, Ferreira CS. A randomized trial of carvedilol after renin‐angiotensin system inhibition in chronic Chagas cardiomyopathy. Am Heart J 2007; 153: 544‐e1. - PubMed

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