Role of Intestinal Inflammation and Permeability in Patients with Acute Heart Failure
Marcello Covino,
Antonella Gallo,
Noemi Macerola,
Erika Pero,
Francesca Ibba,
Sara Camilli,
Laura Riccardi,
Francesca Sarlo,
Grazia De Ninno,
Silvia Baroni,
Francesco Landi,
Massimo Montalto
Affiliations
Marcello Covino
Department of Emergency Medicine, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy
Antonella Gallo
Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
Noemi Macerola
Division of Internal Medicine, San Carlo di Nancy Hospital, GVM Care and Research, Via Aurelia, 275, 00165 Rome, Italy
Erika Pero
Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
Francesca Ibba
Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
Sara Camilli
Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
Laura Riccardi
Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
Francesca Sarlo
Department of Chemistry, Biochemistry and Clinical Molecular Biology, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
Grazia De Ninno
Department of Chemistry, Biochemistry and Clinical Molecular Biology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy
Silvia Baroni
Department of Chemistry, Biochemistry and Clinical Molecular Biology, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
Francesco Landi
Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
Massimo Montalto
Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
Background and Objectives: Heart failure (HF) represents a major health burden. Although several treatment regimens are available, their effectiveness is often unsatisfactory. Growing evidence suggests a pivotal role of the gut in HF. Our study evaluated the prognostic role of intestinal inflammation and permeability in older patients with acute HF (AHF), and their correlation with the common parameters traditionally used in the diagnostic-therapeutic management of HF. Materials and Methods: In a single-center observational, prospective, longitudinal study, we enrolled 59 patients admitted to the Emergency Department (ED) and then hospitalized with a diagnosis of AHF, from April 2022 to April 2023. Serum routine laboratory parameters and transthoracic echocardiogram were assayed within the first 48 h of ED admission. Fecal calprotectin (FC) and both serum and fecal levels of zonulin were measured, respectively, as markers of intestinal inflammation and intestinal permeability. The combined clinical outcome included rehospitalizations for AHF and/or death within 90 days. Results: Patients with increased FC values (>50 µg/g) showed significantly worse clinical outcomes (p p p 50 µg/g resulted as independent predictors of a worse clinical outcome. Conclusions: Our preliminary finding supports the hypothesis of a close relationship between the gut and heart, recognizing in a specific marker of intestinal inflammation such as FC, an independent predictive prognostic role in patients admitted for AHF. Further studies are needed to confirm these results, as well as investigate the reliability of new strategies targeted at modulation of the intestinal inflammatory response, and which are able to significantly impact the course of diseases, mainly in older and frail patients.
