The effect of Piboserod a 5-HT4-receptor antagonist on left ventricular function in patients with symptomatic heart failure

Abstract

Standard therapy: ACEI, diuretics, cardiac glycosides, β-blockers. All patients underwent a 6-min test; evaluation of EF (echoCG); measurement of CRP in blood (EIA method); endotoxin (LAL); faeces plating on growth media; colonoscopy with fecal biopsy with subsequent histological and histochemical (OLA, Muc5, staining for CD8+ cells; Ki67) evaluation of tissue samples at 1 and 14 day of treatment. Results: At first day patients of both groups had plethoric blood vessels in the mucosal proper lamina and focal, dense lymphoid cellular infiltration corresponding to the picture of pronounced chronic inflammation. Lymphocytes were represented primarily by CD8+ cells. Also the number of mucin 5-producing glandular cells was increased. In addition, histological examination revealed abundant siderophages indicating a chronic congestive process in large intestinal blood vessels. At 1 group on 14 day – we found decreasing of chronic inflammation and edema of mucosal proper lamina. In group 2 decreasing of edema was significantly less and increasing of chronic inflammation was finding. Analyses of blood revealed significant (p<0.05) differences between two groups at 14 day: CRP 1.89±0.03 U/l and endotoxin 0.39±0.01 EU/ml in group 1 and CRP 4.6±0.07 U/l and endotoxin 1.3±0.08 EU/ml in group 2. No significant changes in faecal level of enterobacteria were finding. Conclusions: Patients with high FC CHF have chronic inflammation of large intestine, which is probably one of causes for the increased blood endotoxin and development of systemic inflammation. Additional prescription of diuretics, especially diacarb may be helpful in treatment of systemic inflammation in patients with high FC CHF.