title: Prognostic impact of intestinal wall thickening in hospitalized patients with heart failure.
abstract: BACKGROUND
  Intestine-cardiovascular relationship has been increasingly recognized as a key factor in patients with heart disease. We aimed to identify the relationships among intestinal wall edema, cardiac function, and adverse clinical events in hospitalized heart failure (HF) patients.
  
  
  RESULTS
  Abdominal computed tomographic images of 168 hospitalized HF patients were retrospectively investigated for identification of average colon wall thickness (CWT) from the ascending to sigmoid colon. Relationships between average CWT and echocardiographic parameters, blood sampling data, and primary outcomes including readmission for deteriorated HF and all-cause mortality were evaluated. Among the echocardiographic parameters, lower left ventricular diastolic function was correlated with higher average CWT. In multivariate analysis, higher logarithmic C-reactive protein level, lower estimated glomerular filtration rate, lower peripheral blood lymphocyte count, higher E/E' ratio, and extremely higher/lower defecation frequency were independently correlated with higher average CWT. Multivariate Cox-hazard analysis demonstrated that higher average CWT was independently related to higher incidence of primary outcomes.
  
  
  CONCLUSIONS
  In hospitalized HF patients, increased CWT was associated with lower cardiac performance, and predicted poorer long-term clinical outcomes.
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. Electronic address: sishii@med.kitasato-u.ac.jp.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Ishii
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Fujita
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Iida
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Toyoji
authors.initials: T
authors.lastname: Kaida
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Takeru
authors.initials: T
authors.lastname: Nabeta
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Maekawa
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Yanagisawa
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Koitabashi
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takeuchi
authors.affiliation: Department of Cardiovascular Medicine, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Inomata
authors.affiliation: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
mesh_terms: D000368:Aged; D003106:Colon / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007297:Inpatients; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013318:Stroke Volume; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Diastolic dysfunction; Heart failure; Intestine; Prognosis