The Role of Intestinal Flora and Its Metabolites in Heart Failure

Abstract

Intestinal flora is a complex collection of microbial communities that participate in the physiological and pathological activities of the human body through various pathways. In recent years, numerous studies have reported that intestinal flora are involved in the occurrence and development of heart failure (HF) and its metabolic products could play an important role in this progression, suggesting a great value in the clinical treatment of this condition. This study reported the interaction between intestinal flora and HF, and with intestinal flora metabolites, such as short-chain fatty acids, trimethylamine N-oxide and bile acids and urotoxins, considered as the starting point, the mechanism of the roles in HF was summarized. Additionally, the current research status and the development prospects of applying flora and metabolites to the clinical therapeutic decision of HF were discussed.

The Implication of the Gut Microbiome in Heart Failure

“…Therefore, as HF evolves into advanced stages, levels of endotoxinemia and systemic inflammation increase and the gut diversity of bacterial communities decreases [ 43 ]. Several studies of the intestinal bacterial profile in patients with acute decompensated or stable HFrEF have reported that HF patients have a significantly reduced alpha and beta diversity compared to healthy individuals, providing evidence for the HF-induced community composition shifting of the gut microbiota [ 5 , 13 , 53 , 54 , 55 , 56 , 57 ]. Similarly, another small study on HF patients reported a different microbiota composition between individuals with congestive heart failure and healthy volunteers, although between ischemic and dilated cardiomyopathy no noticeable differences could be identified [ 58 ].…”

“…The SCFAs are represented by acetate, propionate and butyrate, and they are generated by gut bacteria including Bacteroides , Bifidobacterium and Faecalibacterium spp. [ 53 ]. They are the most important metabolites produced through colon bacteria fermentation of resistant starch and dietary fibers [ 101 ].…”

Research progress of dietary fiber and its regulation of intestinal flora to improve type 2 diabetes mellitus

“…The intestinal flora transforms the nutrients in the food such as dietary fiber, sugar, fat, protein and other substances into vitamins, amino acids, folic acid, lactic acid and other substances, participating in some metabolic activities of the human body [5]. Among them, the metabolites of short-chain fatty acids (SCFAs), bile acids (BAs) and lipopolysaccharide (LPS) are closely related to the T2DM.…”

Research progress on the relationship between intestinal flora and liver cirrhosis

“…Most of the dominating flora, which is crucial to sustaining the bodily processes between the host and determining the physiopathological relevance from the host to the flora, is found in these four primary groupings of flora. 90 percent of all the microorganisms in a healthy gut belongs to the phyla Bacteroidetes and Firmicutes [6]. Gut homeostasis is also significantly maintained by the intestinal flora.…”