INS and hydrops fetalis: Lipopolysaccharides consisting of a hydrophobic domain known as lipid A (or endotoxin), a non-repeating “core” oligosaccharide, and a distal polysaccharide (or O-antigen) are elevated in decompensated HF [137] and play a crucial role in gut barrier function, inflammation, cardiac contractility, insulin resistance, and endothelial function.