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

Eur Heart J. 2005 Nov;26(22):2368-74. doi: 10.1093/eurheartj/ehi389. Epub 2005 Jun 24.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bacterial Translocation
  • Chronic Disease
  • Endotoxins / physiology
  • Exercise / physiology
  • Forecasting
  • Gastrointestinal Diseases / complications*
  • Gastrointestinal Tract / blood supply*
  • Heart Failure / etiology*
  • Humans


  • Endotoxins