Morphology and Functional Changes of Intestine, Trophology Status and Systemic Inflammation in Patients with Chronic Heart Failure

Abstract

Current understanding prompts to view chronic heart failure (CHF) as a systemic condition. Traditionally, the following organs are considered the target organs of CHF: heart, kidneys, brain. However, low cardiac output and increased activity of the renin-angiotensinaldosterone system (RAAS), which lead to vasospasm and ischemia, are bound to have effect on functions of other organs, including small intestine, large intestine, and adipose tissue. The increased activity of RAAS is likely to have effect on morphological restructuring of the intestine as well. It can be assumed that accumulation of collagen in the intestinal wall, as well as development of edema and ischemia, decrease the functional activity of the intestinal wall and are a major factor of the malabsorption syndrome, which, in its turn, leads to progressive loss of body mass. This results in progression of certain clinical manifestations in patients with CHF, such as: weakness, fatigue, and progressive decrease of exercise tolerance, which cannot be explained by changes in peripheral circulation alone. The incidence of these complaints is known to increase as the NYHA class of the CHF grows, and it reaches its peak in patients with class IV (Harrington & Anker, 1997).