Portal congestion and intestinal edema in hospitalized patients with heart failure

  • Yuki Ikeda
  • Shunsuke Ishii
  • Mayu Yazaki
  • Teppei Fujita
  • Yuichiro Iida
  • Toyoji Kaida
  • Takeru Nabeta
  • Eiji Nakatani
  • Emi Maekawa
  • Tomoyoshi Yanagisawa
  • Toshimi Koitabashi
  • Takayuki Inomata
  • Junya Ako
Original Article

Abstract

An interaction between the intestine and cardiovascular disease has been suggested. We thought to clarify the association between intestinal conditions and clinical outcomes in patients with heart failure (HF). Hemodynamic parameters in intestinal vessels [superior mesenteric artery (SMA), inferior mesenteric artery (IMA), and portal vein (PV)] and average colon wall thickness (aCWT) from the ascending colon to sigmoid colon were evaluated in 224 hospitalized HF patients. Echocardiographic parameters and composite event rates (all-cause mortality, readmission for HF deterioration, major ventricular arrhythmias) were also examined. Higher PV congestion index (CI) and aCWT were observed in patients with New York Heart Association (NYHA) class III/IV. Higher PVCI [hazard ratio (HR) per + 1 standard deviation (SD) 1.50, p < 0.01] and aCWT (HR per + 1 SD 1.45, p < 0.01) were independently associated with higher composite event rates during the follow-up of 122 ± 68 days. None of SMA/IMA hemodynamic parameters were associated with NYHA class or composite event rates. Higher right ventricular end-diastolic dimension (38 ± 7 vs 34 ± 9 mm, p < 0.01) and lower tricuspid annual plane systolic excursion (15 ± 5 vs 19 ± 5 mm, p < 0.001) were observed in patients with higher PVCI (> 0.031 cm s) and aCWT (> 2.8 mm) relative to those in others. In conclusion, increased portal congestion and intestinal edema were associated with severe HF symptoms and poor outcomes in hospitalized HF patients, in addition to being associated with impaired right-sided cardiac function.

Keywords

Heart failure Congestion Right ventricular function Intestinal dysbiosis 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to disclose.

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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Yuki Ikeda
    • 1
  • Shunsuke Ishii
    • 1
  • Mayu Yazaki
    • 1
  • Teppei Fujita
    • 1
  • Yuichiro Iida
    • 1
  • Toyoji Kaida
    • 1
  • Takeru Nabeta
    • 1
  • Eiji Nakatani
    • 2
  • Emi Maekawa
    • 1
  • Tomoyoshi Yanagisawa
    • 1
  • Toshimi Koitabashi
    • 1
  • Takayuki Inomata
    • 3
  • Junya Ako
    • 1
  1. 1.Department of Cardiovascular MedicineKitasato University School of MedicineSagamiharaJapan
  2. 2.Translational Research Informatics CenterFoundation for Biomedical Research and InnovationKobeJapan
  3. 3.Department of Cardiovascular MedicineKitasato Institute HospitalTokyoJapan

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