Aims: The aim of this study was to investigate mesenteric ischaemia by determining intragastric PCO (iPCO ) with gastric 2 2 tonometry during rest and exercise stress testing in patients with chronic heart failure (CHF). In CHF inflammatory immune activation is hypothesized to result from a chronic endotoxin challenge due to bacterial translocation of hypoperfused intestinal mucosa. Methods and Results: In 10 patients with CHF and ten healthy controls a tonometry catheter was inserted into the stomach. IPCO was measured at rest and during bicycle exercise every 5 min. At rest arterial pCO (aPCO ), intragastric pCO 12"2% vs. 1"0.4%, P-0.001). In CHF, iPCO during peak exercise was 25"3% higher than at rest, compared to controls 2 (increase 2"1, P-0.0001). Conclusions: Patients with CHF already at low level exercise develop an increase in iPCO . This is 2 likely to reflect hypoperfusion of the intestinal mucosa, which may contribute to the development of bacterial translocation.
Plasma leptin concentrations correlate with the NYHA functional class suggesting anabolic metabolism in NYHA class II and catabolic metabolism in advanced heart failure which might be of prognostic relevance.
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