Effect of Rifaximin and a Multi-Strain Probiotic on the Intestinal Microbiome and Cardiovascular Risk Indicators in Patients with Coronary Heart Disease

Кашух, Е. А.; Полуэктова, Е. А.; Кудрявцева, А. В.; Krasnov, George S.; Казей, В. И.; Соболев, П. Д.; Гремякова, П. В.; Ивашкин, В. Т.

doi:10.22416/1382-4376-2019-29-4-38-49

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…В одних исследованиях установлена корреляция пролиферации рода Escherichia / Shigella с концентрацией ТМАО [58], другие свидетельствуют о способности кишечной палочки (более выраженной у тонкокишечных изолятов, чем у толстокишечных) осуществлять обратное превращение ТМАО в триметиламин (ТМА) [59]. Исходя только из этих фактов, причинно-следственные взаимоотношения дисбиоза и повышения ТМАО становятся неоднозначными, а возможность управления сердечно-сосудистыми рисками при помощи антибактериальной терапии требует продолжения исследований [60]. При этом прогностическая роль ТМАО для больных ХСН имеет серьезные доказательства [57].…”

Section: роль микрофлоры кишечника и ее метаболитов в патогенезе хронической сердечной недостаточностиunclassified

Intestinal Microbial-tissue Complex and Chronic Heart Failure (part 1): Pathogenesis

Власов¹,

Саликова

Golovkin³

et al. 2021

Racionalʹnaâ farmakoterapiâ v kardiologii

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Antigenic and metabolic integration of the intestinal microbiota into the homeostasis of the human body is a factor that claims to play a key role in the pathogenesis of cardiovascular diseases. It acquires special significance against the background of the decrease in blood circulation and congestion in the digestive system during chronic heart failure. Aim of the review is analysis and synthesis of studies results on the role of intestinal microbiocenosis in the pathogenesis of heart remodeling and chronic heart failure. The search for articles was conducted in databases eLIBRARY.RU and Medline for the key terms "gut microbiota (microbiome, microbiocenosis)", "dysbiosis (dysbacteriosis)", "excessive bacterial growth syndrome", "lipopolysaccharide (endotoxin)", "trimethylamine-N-oxide" in combination with the terms "heart failure", "myocardial remodeling", "myocardium" in Russian and English, respectively. We selected articles containing the results of clinical and experimental studies published from 1995 to 2020. Review articles were considered only on the subject of the cited original publications. Most researchers have established the relationship between chronic heart failure and dysfunction and changes in the qualitative and quantitative composition of intestinal microbiocenosis. As negative changes, it is customary to note the proliferation of gram-negative opportunistic bacteria with concomitant endotoxinemia and a decrease in the pool of commensal microbiota. The available data suggest that the participation of the intestinal microbial-tissue complex in the pathogenesis of chronic heart failure and heart remodeling is realized through the activation of a local and then systemic inflammatory response, accompanied by cardiodepressive action of pro-inflammatory cytokines and universal proliferation factors, an imbalance of matrix metalloproteinases and their inhibitors, the initiation of apoptosis, fibrosis, and loss of contractile myocardium. Besides, a decrease in the production of short-chain and polyunsaturated fatty acids and vitamins by the commensal microbiota may be associated with changes in the electrical properties of cardiomyocyte membranes, a decrease in the systolic function of the left ventricle of the heart, and an increase in the risk of sudden cardiac death. It's also shown that the direct cardiotoxic effect of microbial molecules (lipopolysaccharides, peptidoglycans, trimethylamine-N-oxide, etc.), which interact with the receptors of cardiomyocytes and microenvironment cells, can cause the development of myocardial remodeling and its dysfunction. Recent studies have established mechanisms of myocardial remodeling mediated by microbial molecules, which may be associated with new strategies for the treatment and prevention of heart failure.

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Intestinal Microbial-tissue Complex and Chronic Heart Failure (part 1): Pathogenesis

Власов¹,

Саликова

Golovkin³

et al. 2021

Racionalʹnaâ farmakoterapiâ v kardiologii

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The role of trimethylamine-N-oxide in the development of cerebrovascular disease (brief review)

Kutlubaev

Rakhmatullin

Kutlubaeva

2023

RJTAO

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Trimethylamine-N-oxide (TMO) is one of the best studied metabolites of the gut microbiota. It increases the risk of stroke and dyscirculatory encephalopathy, independent of traditional cardiovascular risk factors. The mechanisms of the negative effects of TMO on the cardiovascular system are related to the acceleration of atherosclerosis progression, platelet activation, and the development of aseptic inflammation. Currently, elevated TMO levels are an indication for a strict diet with restriction of foods rich in TMO precursors. Future research should clarify the role of TMO in the development of cerebrovascular disease (CVD). It is necessary to continue the investigation of new compounds that can reduce TMO levels in patients at high risk for developing CVD.

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Microbiota and Cardiovascular Diseases: Mechanisms of Influence and Correction Possibilities

Gorbenko

Skirdenko

Andreev

et al. 2023

Racionalʹnaâ farmakoterapiâ v kardiologii

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The term "microbiota" refers to the microbial community occupying a specific habitat with defined physical and chemical properties and forming specific ecological niches. The adult intestinal microbiota is diverse. It mainly consists of bacteria of Bacteroidetes and Firmicutes types. The link between the gut microbiota and cardiovascular disease (CVD) is being actively discussed. Rapid progress in this field is explained by the development of new generation sequencing methods and the use of sterile gut mice in experiments. More and more data are being published about the influence of microbiota on the development and course of hypertension, coronary heart disease (IHD), myocardial hypertrophy, chronic heart failure (CHF) and atrial fibrillation (AF). Diet therapy, antibacterial drugs, pro- and prebiotics are successfully used as tools to correct the structure of the gut microbiota of the macroorganism. Correction of gut microbiota in an experiment on rats with coronary occlusion demonstrates a significant reduction in necrotic area. A study involving patients suffering from CHF reveals a significant reduction in the level of uric acid, highly sensitive C-reactive protein, and creatinine. In addition to structural and laboratory changes in patients with CVD when modifying the microbiota of the gut, also revealed the effect on the course of arterial hypertension. Correction of gut microbiota has a beneficial effect on the course of AF. We assume that further active study of issues of influence and interaction of gut microbiota and macroorganism may in the foreseeable future make significant adjustments in approaches to treatment of such patients.

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Effect of Rifaximin and a Multi-Strain Probiotic on the Intestinal Microbiome and Cardiovascular Risk Indicators in Patients with Coronary Heart Disease

Cited by 3 publications

References 13 publications

Intestinal Microbial-tissue Complex and Chronic Heart Failure (part 1): Pathogenesis

Intestinal Microbial-tissue Complex and Chronic Heart Failure (part 1): Pathogenesis

The role of trimethylamine-N-oxide in the development of cerebrovascular disease (brief review)

Microbiota and Cardiovascular Diseases: Mechanisms of Influence and Correction Possibilities

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