Endotoxemia in Acute Heart Failure and Cardiogenic Shock: Evidence, Mechanisms and Therapeutic Options

Nguyen, Maxime; Gautier, Thomas; Masson, David; Bouhemad, Bélaïd; Guinot, Pierre-Grégoire

doi:10.3390/jcm12072579

Cited by 6 publications

(2 citation statements)

References 90 publications

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“…LPS-mediated inflammation can promote plaque instability and thrombus formation due to the damaging effect that low-grade endotoxemia has on the integrity of leukocytes, platelets, and endothelial cells [31]. Thrombus formation and consequently reduced cardiac output can result in inadequate oxygen and nutrient delivery to tissues and organs, cellular death and multiple organ failure [32]. Understandably, if endotoxemia is left unaddressed and progresses into thrombus formation, subsequent cellular death, and multiple organ failure, then the risk of septic shock and/or mortality is drastically enhanced [33,34].…”

Section: Exercise-induced Gastrointestinal Syndrome and Gastrointesti...mentioning

confidence: 99%

Exertional Stress-induced Pathogenic Luminal Content Translocation – Friend or Foe?

Henningsen,

Martinez,

Costa

2024

Int J Sports Med

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The incidence of perturbed gastrointestinal integrity, as well as resulting systemic immune responses and gastrointestinal symptoms, otherwise known as exercised-induced gastrointestinal syndrome (EIGS), is common among individuals who partake in prolonged exercise. EIGS may cause the translocation of pathogenic material, including whole bacteria and bacterial endotoxins, from the lumen into circulation, which may progress into clinical consequences such as sepsis, and potentially subsequent fatality. However, further investigation is warranted to assess the possibility of food allergen and/or digestive enzyme luminal to circulatory translocation in response to exercise, and the clinical consequences. Findings from this narrative literature review demonstrate evidence that whole bacteria and bacterial endotoxins translocation from the gastrointestinal lumen to systemic circulation occurs in response to exercise stress, with a greater propensity of translocation occurring with accompanying heat exposure. It has also been demonstrated that food allergens can translocate from the lumen to systemic circulation in response to exercise stress and initiate anaphylaxis. To date, no research investigating the effect of exercise on the translocation of digestive enzymes from the lumen into systemic circulation exists. It is evident that EIGS and consequential pathogenic translocation presents life-threatening clinical implications, warranting the development and implementation of effective management strategies in at-risk populations.

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Section: Exercise-induced Gastrointestinal Syndrome and Gastrointesti...mentioning

confidence: 99%

Exertional Stress-induced Pathogenic Luminal Content Translocation – Friend or Foe?

Henningsen,

Martinez,

Costa

2024

Int J Sports Med

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“…Finally, inflammation is thought to extend myocardial injury ( 13 ) and promote recurrent cardiovascular (CV) events ( 14 ), so endotoxemia might also have negative effects on long-term recovery. Despite these potentially harmful effects, data regarding acute endotoxemia and MI are scarce and further evidence is needed ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Risk factors and prognostic value of endotoxemia in patients with acute myocardial infarction

Nguyen,

Putot,

Masson

et al. 2024

Front. Cardiovasc. Med.

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BackgroundThere is increasing evidence regarding the association between endotoxemia and the pathogenesis of atherosclerosis and myocardial infarction (MI). During the acute phase of MI, endotoxemia might increase inflammation and drive adverse cardiovascular (CV) outcomes. We aimed to explore the risk factors and prognostic value of endotoxemia in patients admitted for acute MI.MethodsPatients admitted to the coronary care unit of Dijon University Hospital for type 1 acute MI between 2013 and 2015 were included. Endotoxemia, assessed by plasma lipopolysaccharide (LPS) concentration, was measured by mass spectrometry. Major adverse CV events were recorded in the year following hospital admission.ResultsData from 245 consecutive MI patients were analyzed. LPS concentration at admission markedly increased with age and diabetes. High LPS concentration was correlated with metabolic biomarkers (glycemia, triglyceride, and total cholesterol) but not with CV (troponin Ic peak and N-terminal pro-brain natriuretic peptide) or inflammatory biomarkers (C-reactive protein, IL6, IL8, and TNFα). LPS concentration was not associated with in-hospital or 1-year outcomes.ConclusionsIn patients admitted for MI, higher levels of endotoxins were related to pre-existing conditions rather than acute clinical severity. Therefore, endotoxins measured on the day of MI could reflect metabolic chronic endotoxemia rather than MI-related acute gut translocation.

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Cardiogenic shock and infection: A lethal combination

Cherbi,

Merdji,

Labbé

et al. 2024

Archives of Cardiovascular Diseases

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Endotoxemia in Acute Heart Failure and Cardiogenic Shock: Evidence, Mechanisms and Therapeutic Options

Cited by 6 publications

References 90 publications

Exertional Stress-induced Pathogenic Luminal Content Translocation – Friend or Foe?

Exertional Stress-induced Pathogenic Luminal Content Translocation – Friend or Foe?

Risk factors and prognostic value of endotoxemia in patients with acute myocardial infarction

Cardiogenic shock and infection: A lethal combination

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