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Hydrogen- and Methane-Based Breath Testing and Outcomes in Patients With Heart Failure
- Source :
- JOURNAL OF CARDIAC FAILURE, r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA, instname, Journal of Cardiac Failure, r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol, J Card Fail
- Publication Year :
- 2019
- Publisher :
- CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 2019.
-
Abstract
- Background: Recent evidence endorses gut microbiota dysregulation in the pathophysiology of heart failure (HF). Small intestinal bacterial overgrowth (SIBO) might be present in HF and associated with poor clinical outcomes. Lactulose breath testing is a simple noninvasive test that has been advocated as a reliable indicator of SIBO. In patients with HF, we aimed to evaluate the association with clinical outcomes of the exhaled hydrogen (H-2) and methane (CH4) concentrations through the lactulose breath test. Methods and Results: We included 102 patients with HF in which lactulose SIBO breath tests were assessed. Cumulative gas was quantified by the area under the receiver operating characteristic curve of CH4 (AUC-CH4) and H-2 (AUC-H-2). Clinical end points included the composite of all-cause death with either all-cause or HF hospitalizations, recurrent all-cause hospitalizations, and recurrent HF hospitalizations. Medians (interquartile ranges) of AUC-H-2 and AUC-CH4 were 1290 U (520-2430) and 985 U (450-2120), respectively. In multivariable analysis, AUC-H-2 (per 1000 U) was associated with all-cause death/all-cause hospitalization (hazard ratio [HR] 1.21, 95% CI 1.04-1.40; P = .012), all-cause death/HF hospitalization (HR 1.20, 95% CI 1.03-1.40; P = .021), and an increase in the rate of recurrent all-cause (incidence rate ratio [IRR] 1.31, 95% CI 1.14-1.51; P < .001) and HF (IRR 1.41, 95% CI 1.15-1.72; P = .001) hospitalizations. AUC-CH4 was not associated with any of these end points. Conclusions: AUC-H-2, a safe and noninvasive method for SIBO estimation, is associated with higher risk of long-term adverse clinical events in patients with HF. In contrast, AUC-CH4 did not show any prognostic value.
- Subjects :
- Male
medicine.medical_specialty
heart failure
small intestinal bacterial overgrowth
030204 cardiovascular system & hematology
Rate ratio
Gastroenterology
Article
03 medical and health sciences
Lactulose
0302 clinical medicine
Interquartile range
Internal medicine
Intestine, Small
Small intestinal bacterial overgrowth
medicine
Humans
Gut
Prospective Studies
030212 general & internal medicine
Aged
Aged, 80 and over
Heart Failure
Breath test
Bacteria
medicine.diagnostic_test
Receiver operating characteristic
business.industry
Hazard ratio
medicine.disease
Gastrointestinal Microbiome
Hospitalization
Breath Tests
Exhalation
Heart failure
Female
breath tests
prognosis
Cardiology and Cardiovascular Medicine
business
Methane
Follow-Up Studies
Hydrogen
medicine.drug
Subjects
Details
- ISSN :
- 10719164
- Database :
- OpenAIRE
- Journal :
- JOURNAL OF CARDIAC FAILURE, r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA, instname, Journal of Cardiac Failure, r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol, J Card Fail
- Accession number :
- edsair.doi.dedup.....231ef5e0999dd3faf526b659a8f34d3f