Collagen accumulation and dysfunctional mucosal barrier of the small intestine in patients with chronic heart failure

Chronic heart failure is a systemic disease with a devastating prognosis, which affects many organ systems other than the cardiovascular system. A total of 45 Chronic heart failure patients of ischemic etiology and 18 control subjects aged 45-65 years were recruited. All subjects underwent a physical examination by a qualified physician, echocardiography, an evaluation of the trophological status (including height and weight assessment) and net-of-fat body mass (NFBM) determination, an evaluation of intestinal functional activity based on fat and protein excretion with feces, and biopsy examination from the small intestine (see below). For all of them were performed functional tests of the small intestine and morphological examination of the small intestine and biopsy collection. Staining for collagen content of the mucosal wall showed that collagen content differed significantly between the four cohorts studied. In fact, relative collagen content was highest in advanced stages of the disease. However, patients with cardiac cachexia displayed even higher relative amounts of collagen than those of the same functional class without cardiac cachexia. Both fat loss and protein loss with the feces correlated with relative collagen area. (C) 2008 Elsevier Ireland Ltd. All rights reserved.