Excessive growth of intestinal microflora (SIBO) increases the risk of heart failure (HF) in re-hospitalization in patients with heart failure with reduced ejection fraction (HFrEF), as well as the risk of death with cardiovascular disease (CV) in people with failure Cardiac retention fracture ejaculation (HFpEF), according to study results published in Journal of the American Heart Association.
The researchers sought to evaluate the prevalence of SIBO and its potential to predict adverse outcomes in hospitalized patients with different types of HF. The study prospectively enrolled patients admitted to hospital from July 2017 to May 2019. Complex CV death and HF resettlement was the primary endpoint.
The analysis included patients who were tested for SIBO using the lactulose-hydrogen-methane breath test. Patients who met 1 of the following criteria were considered SIBO positive:
- Fasting hydrogen level of 20 ppm or a 20 ppm increase in hydrogen by 90 minutes SIBO (H) was considered2)-positive
- Methane levels were considered to be 10 ppm at any SIBO (CH4)-positive
Of the total 287 patients tested for SIBO, 128 tested positive (mean age, 58.3 ± 15 years; 73% male), and 159 patients were negative (mean age, 56.5 ± 14.1 years; 79% male). Among people with HFrEF, 78/189 (41%) tested positive for SIBO, and 50/98 (51%) with HFpEF tested positive for SIBO (s =. 115).
Patients with HFrEF who were SIBO positive were at increased risk for re-hospitalization of HF (risk ratio [HR] 2.77 [95% CI, 1.62-4.74]; s <.001), and no difference was observed in CV death (HR 1.66.2) [95% CI, 0.4-6.94]; s = .467). SIBO-positive patients with HFpEF had an increased risk of CV death (HR 7.34 [95% CI, 1.58-34.13]; s = .011) compared to HF resettlement (HR 3.03.1) [95% CI, 0.98-9.38]; s = .077).
Univariate Cox regression analysis showed that bacterial overgrowth in the small intestine was associated with primary endpoint risk (HR 2.91.1) [95% CI, 1.81-4.68]; s <.001). After adjusting for variables, including BMI, Class III-IV of the New York Heart Association, use of beta-blockers and aldosterone antagonists, among others, the researchers found that SIBO independently correlates with the primary endpoint in all patients with HF (modified heart rate). 2.13 [95% CI, 1.26-3.58]; s = .005).
SIBO (CH4) Had a significant predictive value with respect to the primary endpoint of the study (HR 2.35.1) [95% CI, 1.38-4.02]; s <.001), and this association remained after modification (HR 2.19.1) [95% CI, 1.39-3.48]; s = .001). Patients with SIBO (H.2 And CH4It had similar outcomes for patients with SIBO (H.2) Or SIBO (CH4And they had a higher risk of the primary endpoint compared to patients without SIBO.
The researchers noted several limitations to their findings, including the small sample size from a single center. Also, the hydrogen and methane breath test is not the gold standard for diagnosing SIBO, and age and gender control participants were not included.
SIBO (CH4) May have a better predictive value than SIBO (H.2), “The study authors state.” Given the high prevalence and prognostic association of SIBO in patients with HF“Proactive treatment for patients with HF and SIBO may improve prognosis and quality of life.”
Song Y, Liu Y, Qi B, et al. Association of intestinal microflora overgrowth with heart failure and prognosis for short-term outcomes. J Am Heart Assoc. 2021; 10 (7): e015292. Doi: 10.1161 / JAHA.119.015292
This article originally appeared Heart advisor