Collagen accumulation and dysfunctional mucosal barrier of the small intestine in patients with chronic heart failure

Arutyunov, G. P.; Kostyukevich, O I; Серов, Р. А.; Рылова, Н. В.; Bylova, Nadezda

doi:10.1016/j.ijcard.2007.11.103

Cited by 87 publications

(62 citation statements)

References 19 publications

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“…Bisoprolol is assigned to class 3 of the biopharmaceutics classification system (low permeability, high solubility) [32]; thus, lower bioavailability is more likely to be associated with declining gut function in HF patients. Reduced intestinal blood flow, mucosal oedema and increased thickness of bowel tissue from the terminal ileus to the colon have been observed in such patients [32][33][34][35]. Assumption of decreased F a is further supported by the fact that in our group of patients we observed a significant decline in the absorption rate constant during follow-up.…”

Section: Discussionsupporting

confidence: 80%

Bisoprolol pharmacokinetics and body composition in patients with chronic heart failure: a longitudinal study

Trobec

Grabnar

Kos

et al. 2016

Eur J Clin Pharmacol

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In patients with chronic heart failure, bisoprolol clearance was associated with estimated renal function; thus, in moderately and severely decreased renal function, patients may need to have their dose adjusted. Patients with low body weight or low SMI have greater fluctuations and higher maximal plasma concentrations of bisoprolol because of the lower volume of distribution. Longitudinal changes of bisoprolol pharmacokinetics were not associated with changes in body composition.

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Section: Discussionsupporting

confidence: 80%

Bisoprolol pharmacokinetics and body composition in patients with chronic heart failure: a longitudinal study

Trobec

Grabnar

Kos

et al. 2016

Eur J Clin Pharmacol

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“…They showed that intestinal inflammation based on high erythrocyte sedimentation rate was correlated with increased intestinal permeability, but not PEW, defined by <90% ideal body weight, <90% of the ideal fat free mass index and >10% weight loss. In line with the hypothesis that inflammation plays a major role in epithelial alterations, several diseases that are often associated with PEW are also associated with an alteration of tight junction proteins [53], increased intestinal permeability [54,55] and reduced absorptive capacity [38,56].…”

Section: Function Of Gut Epithelium In Depleted Nutritional States Inmentioning

confidence: 67%

Alterations of gut barrier and gut microbiota in food restriction, food deprivation and protein-energy wasting

2015

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“…48 Such mechanisms include edematous changes in the intestinal wall, increased thickness of the bowel tissues as a result of collagen deposition, and intestinal damage from chronic hypoperfusion. 22,49 The proinflammatory cytokine milieu can also alter the expression of various drugmetabolizing enzymes and transporters. 50,51 Drugs are transported from intestinal lumen to epithelial cells through either transcellular or paracellular tight junctions.…”

Section: Alteration In the Pharmacokinetics And Pharmacodynamics Of Hmentioning

confidence: 99%

Gastrointestinal and Liver Issues in Heart Failure

2016

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Abstract-Heart failure affects ≈23 million people worldwide and continues to have a high mortality despite advancements in modern pharmacotherapy and device therapy. HF is a complex clinical syndrome that can result in the impairment of endocrine, hematologic, musculoskeletal, renal, respiratory, peripheral vascular, hepatic, and gastrointestinal systems. Although gastrointestinal involvement and hepatic involvement are common in HF and are associated with increased morbidity and mortality, their bidirectional association with HF progression remains poorly fathomed. The current understanding of multiple mechanisms, including proinflammatory cytokine milieu, hormonal imbalance, and anabolic/ catabolic imbalance, has been used to explain the relationship between the gut and HF and has been the basis for many novel therapeutic strategies. However, the failure of these novel therapies such as anti-tumor necrosis factor-α has resulted in further complexity. Key Words: gastrointestinal tract ◼ heart failure H eart failure (HF) is a systemic disorder caused by the inability of the heart to accommodate the venous return and to maintain sufficient cardiac output to meet the body's metabolic needs.1 These hemodynamic perturbations result in a state of systemic inflammation with well-described and well-studied consequences in a variety of other organ systems, including the renal, cerebral, musculoskeletal, and immune systems. In contrast, the gastrointestinal and hepatic systems have received less attention, although gastrointestinal symptoms are common. With increasing clinical efforts to resuscitate the advanced HF patient, a greater appreciation and a better understanding of the gastrointestinal and hepatic manifestations of HF are needed. 2,3With some notable exceptions, gastrointestinal and hepatic involvement in heart disease has historically received little attention from cardiologists. 4 Mechanisms of gastrointestinal and hepatic dysfunction remain poorly understood despite the common presence of gastrointestinal-related symptoms and the increased morbidity and mortality associated with their presence. The specific involvement of the gastrointestinal system in HF results in a bidirectional relationship that has been called the cardiointestinal syndrome.5 For example, the systemic volume overload characteristic of HF is generally accompanied by concomitant gut edema, which can lead to bacterial translocation into the systemic circulation. Consequent monocyte activation and excessive cytokine release result in systemic inflammation, increased symptoms, and disease progression. In this review, we describe the current state of understanding of the gastrointestinal and hepatic systems in HF. Although nutritional status is also relevant in this discussion, we refer the reader to other excellent reviews of nutritional aspects of chronic disease. 7,8The Gut in HF Gastrointestinal System as a Venous ReservoirStudies of implantable hemodynamic monitors to manage HF patients document that acute decompensated HF was not associ...

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Collagen accumulation and dysfunctional mucosal barrier of the small intestine in patients with chronic heart failure

Cited by 87 publications

References 19 publications

Bisoprolol pharmacokinetics and body composition in patients with chronic heart failure: a longitudinal study

Bisoprolol pharmacokinetics and body composition in patients with chronic heart failure: a longitudinal study

Alterations of gut barrier and gut microbiota in food restriction, food deprivation and protein-energy wasting

Gastrointestinal and Liver Issues in Heart Failure

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