title: Intersections Between Microbiome and Heart Failure: Revisiting the Gut Hypothesis.
abstract: Microbes play an important role in human health and disease. In the setting of heart failure (HF), substantial hemodynamic changes, such as hypoperfusion and congestion in the intestines, can alter gut morphology, permeability, function, and possibly the growth and composition of gut microbiota. These changes can disrupt the barrier function of the intestines and exacerbate systemic inflammation via microbial or endotoxin translocation into systemic circulation. Furthermore, cardiorenal alterations via metabolites derived from gut microbiota can potentially mediate or modulate HF pathophysiology. Recently, trimethylamine N-oxide (TMAO) has emerged as a key mediator that provides a mechanistic link between gut microbiota and multiple cardiovascular diseases, including HF. Potential intervention strategies which may target this microbiota-driven pathology include dietary modification, prebiotics/probiotics, and selective binders of microbial enzymes or molecules, but further investigations into their safety and efficacy are warranted.
authors.affiliation: Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nagatomo
authors.affiliation: Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: tangw@ccf.org.
authors.forename: W H Wilson
authors.initials: WH
authors.lastname: Tang
mesh_terms: D005260:Female; D000069196:Gastrointestinal Microbiome / Q000187:drug effects* / Q000502:physiology; D006333:Heart Failure / Q000378:metabolism* / Q000503:physiopathology; D006706:Homeostasis / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008297:Male; D008744:Methylamines / Q000378:metabolism*; D064307:Microbiota / Q000502:physiology; D019936:Probiotics / Q000008:administration & dosage*; D012680:Sensitivity and Specificity
chemical_list: D008744:Methylamines; C005855:trimethyloxamine
keywords: Microbiome; TMAO; heart failure