The importance of the gastrointestinal system in the pathogenesis of heart failure

Andreas Krack, Rakesh Sharma, Hans R. Figulla, Stefan D. Anker

Research output: Contribution to journalArticlepeer-review


Chronic heart failure (CHF) is a multi-organ disease with increasing evidence for the involvement of the gastrointestinal (GI) system in this syndrome. In recent research, the gut has received very little attention from cardiologists as its role in the pathogenesis of cardiovascular disease is poorly understood. Intestinal ischaemia may play an important role in bacterial translocation by increasing bowel permeability. Decreased cardiac function can reduce bowel perfusion and so clearly impairs the function of the intestinal barrier. There is an increasing evidence to suggest that a 'leaky' bowel wall may lead to translocation of bacteria and/or endotoxin, which may be an important stimulus for inflammatory cytokine activation in CHF. Impaired functioning of the GI system may also contribute to malnutrition and cachexia in CHF. It is hoped that by improving our understanding of the role of the gut in cardiac disease will lead to the development of novel therapeutic strategies in the future.

Original languageEnglish
Pages (from-to)2368-2374
Number of pages7
JournalEuropean Heart Journal
Issue number22
Publication statusPublished - Nov 2005


  • Bowel
  • Chronic heart failure
  • Endotoxin
  • Gut
  • Inflammation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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