| Invasive assessment of bacterial endotoxin and inflammatory cytokines in patients with acute heart failure. | |
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MedLine Citation:
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PMID: 14607199 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Thomas Peschel; Martin Schönauer; Holger Thiele; Stefan D Anker; Gerhard Schuler; Josef Niebauer |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: European journal of heart failure Volume: 5 ISSN: 1388-9842 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2003 Oct |
Date Detail:
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Created Date: 2003-11-10 Completed Date: 2004-03-12 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 609-14 Citation Subset: IM |
Affiliation:
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Herzzentrum der Universität Leipzig, Strümpellstrasse 39, 04289 Leipzig, Germany. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antigens, CD14 / blood Bacterial Translocation* Blood Specimen Collection Case-Control Studies Cytokines / blood* Endotoxins / blood* Heart Failure / blood* Heart Ventricles Hepatic Veins Humans Inflammation Mediators / blood* Interleukin-6 / blood Tumor Necrosis Factor-alpha / analysis |
| Chemical | |
Reg. No./Substance:
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0/Antigens, CD14; 0/Cytokines; 0/Endotoxins; 0/Inflammation Mediators; 0/Interleukin-6; 0/Tumor Necrosis Factor-alpha |
| Comments/Corrections | |
Erratum In:
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Eur J Heart Fail. 2004 Mar 1;6(2):245 |
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