Abstract

Aim: Heart failure (HF) is a systemic syndrome affecting multiple organ systems, and increasing evidence highlights the role of the gut–heart axis in its pathophysiology. Intestinal barrier dysfunction, chronic inflammation, and immune dysregulation in HF patients may increase susceptibility to intestinal parasitic infections. This study aimed to investigate the prevalence and types of intestinal parasites in patients with heart failure.
Materials and Methods: This case–control study included 130 patients aged ≥18 years diagnosed with HF who presented to the Cardiology Outpatient Clinic of Ordu University Faculty of Medicine. A control group without HF was also evaluated. Patients with malignancy, immunosuppressive diseases, immunosuppressive therapy, or recent antibiotic or antiparasitic drug use were excluded. Stool samples were examined using a combination of parasitological methods, including the cellophane tape method, native–Lugol direct microscopy, sedimentation technique, and modified Kinyoun acid-fast staining.
Results: Intestinal parasites were detected in 61.4% of HF patients and 64.7% of the control group, with no statistically significant difference between groups (p>0.05). The most frequently detected parasites in both groups were Cryptosporidium spp. and Blastocystis spp. In HF patients, Cryptosporidium spp. was detected in 36.4% of cases, followed by Blastocystis spp. (30.3%), Entamoeba coli (12.9%), Giardia intestinalis (4.5%), and Dientamoeba fragilis (5.3%). Although overall parasite prevalence did not differ significantly, opportunistic coccidian parasites were commonly detected, particularly in patients with multiple comorbidities such as diabetes mellitus.
Conclusion: In conclusion, intestinal parasite prevalence was high in both HF patients and controls, suggesting that regional environmental and socio-epidemiological factors play a more prominent role than heart failure itself. However, the high frequency of opportunistic parasites in HF patients highlights the importance of comprehensive parasitological evaluation and careful clinical monitoring in this vulnerable population. Further multicenter studies are needed to clarify the clinical impact of intestinal parasitic infections on HF progression.

Key words: Heart failure, circulatory disorders, intestinal parasites