Relationship Between Serum Anti-Lipopolysaccharide Immunoglobulin a and Inflammation in Acute Heart Failure: A Preliminary Study

Background and Aims: Translocation of endotoxin (lipopolysaccharide, LPS) across intestinal wall is thought to be one of the origins of systemic inflammation in patients with heart failure (HF). However, the relationship between LPS and inflammation has not been well examined in Japanese acute HF patients. In this preliminary study, we hypothesized that serum antibody to LPS level was associated with systemic inflammation in acute HF patients. Methods: We retrospectively analyzed 40 patients (28 males, 68 years) hospitalized due to acute HF. We measured serum anti-LPS immunoglobulin A (IgA) level on admission and investigated the correlations between anti-LPS IgA level and demographic characteristics, laboratory measurements, echocardiographic data and nutritional state. Results: The mean values of body mass index, left ventricular ejection fraction, brain natriuretic peptide, and anti-LPS IgA level were 23.7 kg/m², 35%, 872 pg/mL and 61.8 AMU/mL, respectively. Anti-LPS IgA level was negatively correlated with high sensitivity C-reactive protein (hs-CRP) level (r = −0.38, P = .02) and Controlling Nutritional Status score (r = −0.33, P = .04), and positively correlated with serum albumin level (r = 0.32, P = .04). Conclusions: Contrary to our hypothesis, anti-LPS IgA level did not show a positive correlation with hs-CRP level, implying that the LPS may not be a causal factor for systemic inflammation in acute heart failure exacerbation in this study.