Association of gut microbiome dysbiosis with the progression of atrial fibrillation: A systematic review

Abstract

Objective: Many clinical and preclinical studies have implicated an association between atrial fibrillation (AF) and its progression to imbalances in the gut microbiome composition. The gut microbiome is a diverse and complex ecosystem containing billions of microorganisms that produce biologically active metabolites influencing the host disease development.Methods: For this review, a literature search was conducted using digital databases to systematically identify the studies reporting the association of gut microbiota with AF progression.Results: In a total of 14 studies, 2479 patients were recruited for the final analysis.More than half (n = 8) of the studies reported alterations in alpha diversity in atrial fibrillation. As for the beta diversity, 10 studies showed significant alterations. Almost all studies that assessed gut microbiota alterations reported major taxa associated with atrial fibrillation. Most studies focused on short-chain fatty acids (SCFAs), whereas three studies evaluated TMAO levels in the blood, which is the breakdown product of dietary l-carnitine, choline, and lecithin. Moreover, an independent cohort study assessed the relationship between phenylacetylglutamine (PAGIn) and AF. Conclusion:Intestinal dysbiosis is a modifiable risk factor that might provide newer treatment strategies for AF prevention. Well-designed research and prospective randomized interventional studies are required to target the gut dysbiotic mechanisms and determine the gut dysbiotic-AF relationship.

Transcriptomic analysis reveals the potential crosstalk genes and immune relationship between Crohn’s disease and atrial fibrillation

“…These cells can infiltrate the atrial tissue and produce pro-inflammatory cytokines, ultimately leading to the development of atrial fibrosis and electrical remodeling ( 29 , 30 ). Additionally, the gut-heart axis has emerged as a potential mechanism linking the gut microbiota to the development of AF, whereby gut dysbiosis can result in increased levels of circulating inflammatory markers and subsequent atrial remodeling ( 31 ). In conclusion, the MHC-related pathway plays a crucial role in immune response by presenting antigens to T cells, which are a fundamental component of the immune system.…”

Putative causal relations among gut flora, serums metabolites and arrhythmia: a Mendelian randomization study

“…The lack or disorder of gut flora seriously affects the body's decomposition of polysaccharides in food and absorption of lipids, leading to dysfunction of the liver and adipose tissue, and inducing a series of metabolic diseases, such as obesity, fatty liver, type 2 diabetes, and cardio-cerebral vascular disease [ 12 ]. Recently, several studies have proposed a new concept of the cardio-intestinal axis, suggesting a role for the gut microbiota in the development of various cardiovascular diseases such as coronary artery disease, hypertension and heart failure [ 13 ]. It has been noted that a wide range of bacteria have been identified in atherosclerotic plaques, and reduced diversity of the gut microbiota has been observed in patients with heart failure, but studies on gut microbial profiles and various types of arrhythmias are unclear [ 14 ].…”

Platelet amino acid spectrum and gut microbiota, their links in patients with coronary artery disease and atrial fibrillation

“…Gut microbiota acts at the heart health through its metabolites toxicity: increasing plasma lipopolysaccharides (LPS), trimethylamine (TMA), trimethylamine-N-oxide (TMAO), bile acids, indole sulfate and decreasing fecal short chain fatty acids (SCFA) due to impaired intestinal barrier function [9]. That leads for autonomic remodeling (increasing sympathetic activity in heart innervation), structural remodeling (cardiac fibrosis, sell apoptosis, increasing conduction velocity) and electrical remodeling (reduction effective refractory period and increase after depolarizations) [10].…”