Document Detail

Invasive assessment of bacterial endotoxin and inflammatory cytokines in patients with acute heart failure.
MedLine Citation:
PMID:  14607199     Owner:  NLM     Status:  MEDLINE    
AIMS: To test the hypothesis that during acute heart failure endotoxin might be increased in hepatic veins as a sign of bacterial or endotoxin translocation from the bowel into the blood stream.
METHODS AND RESULTS: In patients with acute heart failure (NYHA IV; n=17) levels of endotoxin, soluble (s) CD14, tumor necrosis factor alpha (TNFalpha and interleukin 6 (IL6)) were measured in blood drawn from an antecubital vein on admission and compared with age-matched patients with stable chronic heart failure (n=21) and healthy volunteers (n=9). All levels were systemically elevated during acute heart failure (all P<0.05); once patients were stable enough to undergo cardiac catheterization, endotoxin was found to be significantly higher in hepatic veins (0.62+/-0.05 EU/ml) than left ventricles (0.46+/-0.04 EU/ml; P<0.05), whereas sCD14, TNFalpha and IL6 were not different between these sites. At follow-up (29+/-6 days) endotoxin but not sCD14, TNFalpha or IL-6 was significantly lower as compared to baseline (P<0.05).
CONCLUSIONS: Higher levels of endotoxin in hepatic veins as compared to the left ventricle during acute heart failure are suggestive of bacterial or endotoxin translocation from the bowel into the blood stream. This may lead to new treatment strategies. The lack of difference in TNFalpha levels between the pulmonary artery and the left ventricle sheds doubt on the heart as a source of systemically elevated TNFalpha levels.
Thomas Peschel; Martin Schönauer; Holger Thiele; Stefan D Anker; Gerhard Schuler; Josef Niebauer
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of heart failure     Volume:  5     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-11-10     Completed Date:  2004-03-12     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  609-14     Citation Subset:  IM    
Herzzentrum der Universität Leipzig, Strümpellstrasse 39, 04289 Leipzig, Germany.
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MeSH Terms
Antigens, CD14 / blood
Bacterial Translocation*
Blood Specimen Collection
Case-Control Studies
Cytokines / blood*
Endotoxins / blood*
Heart Failure / blood*
Heart Ventricles
Hepatic Veins
Inflammation Mediators / blood*
Interleukin-6 / blood
Tumor Necrosis Factor-alpha / analysis
Reg. No./Substance:
0/Antigens, CD14; 0/Cytokines; 0/Endotoxins; 0/Inflammation Mediators; 0/Interleukin-6; 0/Tumor Necrosis Factor-alpha
Erratum In:
Eur J Heart Fail. 2004 Mar 1;6(2):245

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