Gut Microbiota Composition and Cardiovascular Disease: A Potential New Therapeutic Target?

Overview

Journal Int J Mol Sci

Publisher MDPI

Specialties Biochemistry
Chemistry
Molecular Biology

Date 2023 Aug 12

PMID 37569352

Authors

Martina Belli

Lucy Barone

Susanna Longo

Francesca Romana Prandi

Dalgisio Lecis

Rocco Mollace

Davide Margonato

Saverio Muscoli

Domenico Sergi

Massimo Federici

Francesco Barilla

Affiliations

Soon will be listed here.

Abstract

A great deal of evidence has revealed an important link between gut microbiota and the heart. In particular, the gut microbiota plays a key role in the onset of cardiovascular (CV) disease, including heart failure (HF). In HF, splanchnic hypoperfusion causes intestinal ischemia resulting in the translocation of bacteria and their metabolites into the blood circulation. Among these metabolites, the most important is Trimethylamine N-Oxide (TMAO), which is responsible, through various mechanisms, for pathological processes in different organs and tissues. In this review, we summarise the complex interaction between gut microbiota and CV disease, particularly with respect to HF, and the possible strategies for influencing its composition and function. Finally, we highlight the potential role of TMAO as a novel prognostic marker and a new therapeutic target for HF.

Citing Articles

Metagenomic Sequencing Combined with Metabolomics to Explore Gut Microbiota and Metabolic Changes in Mice with Acute Myocardial Infarction and the Potential Mechanism of Allicin.

Gao Y, Qin G, Liang S, Yin J, Wang B, Jiang H Drug Des Devel Ther. 2025; 19:771-791.

PMID: 39925879 PMC: 11806679. DOI: 10.2147/DDDT.S504884.

Exploring hypertension-linked diseases: a comprehensive review of innovative drug combinations with enhanced therapeutic potential.

Thakkar B, Dadhaniya H, Dudhat K Naunyn Schmiedebergs Arch Pharmacol. 2025; .

PMID: 39888363 DOI: 10.1007/s00210-025-03819-3.

Oxygenation and intestinal perfusion and its association with perturbations of the early life gut microbiota composition of children with congenital heart disease.

Renk H, Schoppmeier U, Muller J, Kuger V, Neunhoeffer F, Gille C Front Microbiol. 2025; 15:1468842.

PMID: 39881980 PMC: 11775010. DOI: 10.3389/fmicb.2024.1468842.

The impact of dietary patterns on gut microbiota for the primary and secondary prevention of cardiovascular disease: a systematic review.

Yu J, Wu Y, Zhu Z, Lu H Nutr J. 2025; 24(1):17.

PMID: 39875854 PMC: 11773984. DOI: 10.1186/s12937-024-01060-x.

Integrated Microbiome and Metabolome Analysis Reveals Correlations Between Gut Microbiota Components and Metabolic Profiles in Mice With Mitoxantrone-Induced Cardiotoxicity.

Zhang Q, Liang D, Zhang C, Ye L, Sun P, Zhu H Drug Des Devel Ther. 2025; 19:439-455.

PMID: 39867867 PMC: 11766154. DOI: 10.2147/DDDT.S479682.

References

Bunyavanich S, Shen N, Grishin A, Wood R, Burks W, Dawson P . Early-life gut microbiome composition and milk allergy resolution. J Allergy Clin Immunol. 2016; 138(4):1122-1130. PMC: 5056801. DOI: 10.1016/j.jaci.2016.03.041. View

Schiattarella G, Sannino A, Toscano E, Giugliano G, Gargiulo G, Franzone A . Gut microbe-generated metabolite trimethylamine-N-oxide as cardiovascular risk biomarker: a systematic review and dose-response meta-analysis. Eur Heart J. 2017; 38(39):2948-2956. DOI: 10.1093/eurheartj/ehx342. View

Salzano A, Israr M, Yazaki Y, Heaney L, Kanagala P, Singh A . Combined use of trimethylamine N-oxide with BNP for risk stratification in heart failure with preserved ejection fraction: findings from the DIAMONDHFpEF study. Eur J Prev Cardiol. 2019; 27(19):2159-2162. DOI: 10.1177/2047487319870355. View

Sedman P, MacFie J, Sagar P, Mitchell C, May J, Johnstone D . The prevalence of gut translocation in humans. Gastroenterology. 1994; 107(3):643-9. DOI: 10.1016/0016-5085(94)90110-4. View

Laterza L, Rizzatti G, Gaetani E, Chiusolo P, Gasbarrini A . The Gut Microbiota and Immune System Relationship in Human Graft-versus-Host Disease. Mediterr J Hematol Infect Dis. 2016; 8(1):e2016025. PMC: 4848019. DOI: 10.4084/MJHID.2016.025. View

Chen M, Wang S, Kuo C, Tsai I . Metabolome analysis for investigating host-gut microbiota interactions. J Formos Med Assoc. 2018; 118 Suppl 1:S10-S22. DOI: 10.1016/j.jfma.2018.09.007. View

Nagatomo Y, Tang W . Intersections Between Microbiome and Heart Failure: Revisiting the Gut Hypothesis. J Card Fail. 2015; 21(12):973-80. PMC: 4666782. DOI: 10.1016/j.cardfail.2015.09.017. View

Wen L, Duffy A . Factors Influencing the Gut Microbiota, Inflammation, and Type 2 Diabetes. J Nutr. 2017; 147(7):1468S-1475S. PMC: 5483960. DOI: 10.3945/jn.116.240754. View

Conraads V, Jorens P, De Clerck L, van Saene H, Ieven M, Bosmans J . Selective intestinal decontamination in advanced chronic heart failure: a pilot trial. Eur J Heart Fail. 2004; 6(4):483-91. DOI: 10.1016/j.ejheart.2003.12.004. View

10.

Tan J, McKenzie C, Potamitis M, Thorburn A, Mackay C, Macia L . The role of short-chain fatty acids in health and disease. Adv Immunol. 2014; 121:91-119. DOI: 10.1016/B978-0-12-800100-4.00003-9. View

11.

. Structure, function and diversity of the healthy human microbiome. Nature. 2012; 486(7402):207-14. PMC: 3564958. DOI: 10.1038/nature11234. View

12.

Sandek A, Swidsinski A, Schroedl W, Watson A, Valentova M, Herrmann R . Intestinal blood flow in patients with chronic heart failure: a link with bacterial growth, gastrointestinal symptoms, and cachexia. J Am Coll Cardiol. 2014; 64(11):1092-102. DOI: 10.1016/j.jacc.2014.06.1179. View

13.

Jandhyala S, Talukdar R, Subramanyam C, Vuyyuru H, Sasikala M, Reddy D . Role of the normal gut microbiota. World J Gastroenterol. 2015; 21(29):8787-803. PMC: 4528021. DOI: 10.3748/wjg.v21.i29.8787. View

14.

Longo S, Legramante J, Rizza S, Federici M . Vasovagal syncope: An overview of pathophysiological mechanisms. Eur J Intern Med. 2023; 112:6-14. DOI: 10.1016/j.ejim.2023.03.025. View

15.

Yazaki Y, Aizawa K, Israr M, Negishi K, Salzano A, Saitoh Y . Ethnic differences in association of outcomes with trimethylamine N-oxide in acute heart failure patients. ESC Heart Fail. 2020; 7(5):2373-2378. PMC: 7524106. DOI: 10.1002/ehf2.12777. View

16.

Dong Z, Zheng S, Shen Z, Luo Y, Hai X . Trimethylamine N-Oxide is Associated with Heart Failure Risk in Patients with Preserved Ejection Fraction. Lab Med. 2020; 52(4):346-351. DOI: 10.1093/labmed/lmaa075. View

17.

Krack A, Sharma R, Figulla H, Anker S . The importance of the gastrointestinal system in the pathogenesis of heart failure. Eur Heart J. 2005; 26(22):2368-74. DOI: 10.1093/eurheartj/ehi389. View

18.

Odamaki T, Kato K, Sugahara H, Hashikura N, Takahashi S, Xiao J . Age-related changes in gut microbiota composition from newborn to centenarian: a cross-sectional study. BMC Microbiol. 2016; 16:90. PMC: 4879732. DOI: 10.1186/s12866-016-0708-5. View

19.

Schuett K, Kleber M, Scharnagl H, Lorkowski S, Marz W, Niessner A . Trimethylamine-N-oxide and Heart Failure With Reduced Versus Preserved Ejection Fraction. J Am Coll Cardiol. 2017; 70(25):3202-3204. DOI: 10.1016/j.jacc.2017.10.064. View

20.

Just S, Mondot S, Ecker J, Wegner K, Rath E, Gau L . The gut microbiota drives the impact of bile acids and fat source in diet on mouse metabolism. Microbiome. 2018; 6(1):134. PMC: 6091023. DOI: 10.1186/s40168-018-0510-8. View