The role of intestinal dysbiosis in endothelial dysfunction evolution in patients with microvascular angina


  • Mihail POPOVICI IMSP Institutul de Cardiologie
  • Loffredo LORENZO Sapienza University of Rome
  • Victoria IVANOV IMSP Institutul de Cardiologie
  • Ion POPOVICI IMSP Institutul de Cardiologie
  • Lucia CIOBANU IMSP Institutul de Cardiologie
  • Mihaela MUNTEANU IMSP Institutul de Cardiologie
  • Ion POPOVICI IMSP Institutul de Cardiologie
  • Valeriu COBEȚ IP Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”



Dysbiosis, microvascular angina, lipopolysaccharides, zonulin


Purpose. Evaluation of circulating levels of lipopolysaccharide and zonulin in conjunction with markers of endothelial dysfunction, inflammation, and oxidative stress in patients with microvascular angina (MА). Material and methods. The study was carried out in a group of 58 patients with MA hospitalized in the Institute of Cardiology. The determination of circulating levels of 20 biomarkers was carried out in cooperation with the laboratory investigation center of Sapienza University (Italy). All functional and biochemical markers were also determined in 48 apparently healthy people (control group) with the values of which the markers of MA patients were compared. Results. Endothelial dysfunction in patients with MA excelled by increasing the thickness of the intima-media complex of the carotid artery by 41%, as well as by reducing of flow-mediated brachial artery dilatation (FMD) by 31,6%. The presence of dysbiosis was manifested by an 80% increase in the serum content of lipopolysaccharides (LPS) and by doubling of zonulin (1,8±0,3 vs 3,6±0,7 ng/ml). Endothelial dysfunction and dysbiosis evolved in association with oxidative stress activation estimated by means of 6 markers and increased serum content of 6 important pro-inflammatory markers (hsCRP, IL-6, TNF-α, etc.) Conclusions. 1. In patients with MA, elevated circulating levels of LPS and zonulin more than twice compared to the control value were found, which indicates the presence of intestinal dysbiosis. 2. LPS and zonulin correlate robustly with morphofunctional and biochemical markers of endothelial dysfunction, as well as with markers of its main pathogenetic factors, inflammation and oxidative stress.

Author Biographies

Mihail POPOVICI, IMSP Institutul de Cardiologie

dr. hab. șt. medicale, prof. universitar, academician al AȘM

Loffredo LORENZO, Sapienza University of Rome

Doctor of Medical Sciences; Department of Clinical, Internistic, Anaesthetic and Cardiovascular Sciences

Victoria IVANOV, IMSP Institutul de Cardiologie

doctor habilitat în științe medicale, prof. cercetător

Ion POPOVICI, IMSP Institutul de Cardiologie

doctor habilitat în științe medicale, prof. cercetător

Lucia CIOBANU, IMSP Institutul de Cardiologie

doctor habilitat în științe medicale, conf. cercetător

Mihaela MUNTEANU, IMSP Institutul de Cardiologie

doctor în științe medicale, cercetător științific

Ion POPOVICI, IMSP Institutul de Cardiologie

student medicinist, anul VI

Valeriu COBEȚ, IP Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”

doctor habilitat în științe medicale, prof. universitar


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Research Article