Gastrointestinal “mask” of heart failure: from symptoms to laboratory diagnostics

Given the high prevalence of cardiovascular pathologies, heart failure, as their common outcome, becomes a priority target for therapy and fundamental research. In recent years, increasing attention has been paid to the role of the microbiome in the pathogenesis of cardiovascular events. Under normal conditions, the gut flora and its metabolites are involved in maintaining the body’s homeostasis and represent an important component of immunological defense. In contrast, an imbalance of microorganisms leads to systemic inflammation and metabolic disorders. Gut dysbiosis is found in 90% of patients with cardiovascular diseases and is characterized by reduced microbiome diversity, an increase in pathogenic bacteria, and a decrease in the number of Lactobacillus and Bifidobacterium [8]. These changes can lead to increased levels of toxic metabolites, such as lipopolysaccharides and TMAO, resulting in inflammation, impaired cardiac function, and the realization of an atherogenic effect. The aim of the study was to assess the correlation between the severity of gastrointestinal symptoms and the degree of chronic heart failure (CHF) in cardiology patients. The study involved 159 patients from the cardiology department. The diagnosis of CHF was confirmed clinically, through laboratory tests, and instrumentally. The standard Gastrointestinal Symptom Rating Scale (GSRS) questionnaire was used to assess the severity of gastrointestinal complaints. The result is to reveal “cardiointestinal syndrome” as a new independent term. The study revealed a direct correlation between the severity of gastrointestinal symptoms and the NYHA functional class of CHF, but there were no correlation between EF and functional class of HF.