Chronic heart failure is associated with a huge increase in levels of pathogenic bacteria and fungi in the gut, as well as increases in intestinal permeability, right atrial pressure, and inflammation. These findings come from a study conducted in Italy and now published in JACC Heart Failure.

Chronic systemic inflammation is known to occur in patients with heart failure, and this inflammatory state has been associated with alterations in the morphology, function, and bacterial flora of the intestine. Flourishing of bacterial populations coupled with increased gut permeability might result in bacteria and their toxins entering the bloodstream and causing inflammation. Accordingly, Evasio Pasini and colleagues set out to identify and quantify the colonies of pathogenic bacteria in the gut, and to determine whether there was a correlation with the severity of heart failure.