Abstract
Lipopolysaccharide of gram-negative bacteria associated with a more severe course and poor prognosis of patients with chronic heart failure. However, its origin and relation to the functional status of patients remains unclear. Goal. To determine the origin and the severity of endotoxemia, and to establish its correlation with parameters of functional status of patients with acute decompensated heart failure. Materials and methods. Examined 20 in-patients with acute decompensated heart failure with reduced ejection fraction of the left ventricle at the age of 61±1,7 years. With the help of the standard tests in the first 3 days of treatment was assessed the functional status of patients, level and origin of endotoxin was determined using the method of mass spectrometry microbial markers. Results. The total level of endotoxin in the blood were 0,27±0,026 nmol/ml, exceeding the reference values only 10% of patients. The main sources of endotoxemia in the study sample were Prevotella spp. Kingella spp. Helicobacter pylori. Also defined components of endotoxin Fusobacterium spp./Haemophilus spp., Campylobacter mucosalis, Alcaligenes spp., Acinetobacter spp. Flavo spp. The identified significant medium-strength connection between the number of Prevotella spp. Kingella spp. level of endotoxin and indicators of functional status: the number of points on the scale of assessment of clinical status and distance test six-minute walk. Revealed a moderate increase in aspartate aminotransferase, also correlated with the level of microbial markers. Conclusion. In patients with acute decompensated heart failure failure in 90% of cases the level of endotoxin is in the range of normal values, thus there is a relationship of the level of endotoxin in the blood and the number of gram-negative microorganisms in the jejunum intestine with functional status of patients. Further accumulation of facts for a more accurate understanding of the role of the er in heart failure. The use of methods modespecific display may help to explain the diversity of biological effects of endotoxin.
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