Kaufman Center for Heart Failure Treatment and Recovery, Heart Vascular and Thoracic Institute, Cleveland Clinic.
Center for Microbiome and Human Health, Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Curr Opin Clin Nutr Metab Care. 2023 Mar 1;26(2):195-200. doi: 10.1097/MCO.0000000000000897. Epub 2022 Dec 14.
The importance of amino acid metabolism in heart failure has often been overlooked, especially in advanced stages. Metabolism of dietary compounds by gut microbiota generates a wide range of metabolites that can directly or indirectly modulate end-organ functions in their hosts. Herein, we describe recently discovered mechanistic links between various gut microbial metabolic pathways of amino acids and their derivatives in the pathophysiology of heart failure.
Growing evidence points to incremental prognostic value in amino acid profiling in patients with heart failure. Reducing branched-chain amino acid levels in the failing heart may have a cardioprotective role. Gut microbiome-related amino acid, including amino acid supplementation, dietary interventions, or microbial enzyme inhibition, can be targeted to modify cardiovascular risks.
Interplay between the gut microbiome and amino acid metabolism may contribute to disease progression in heart failure. Further investigations are warranted to uncover opportunities for intervention.
氨基酸代谢在心力衰竭中的重要性经常被忽视,尤其是在疾病的晚期阶段。肠道微生物群通过对膳食化合物的代谢产生了广泛的代谢物,这些代谢物可以直接或间接地调节宿主的终末器官功能。在此,我们描述了最近发现的各种氨基酸及其衍生物的肠道微生物代谢途径与心力衰竭病理生理学之间的机制联系。
越来越多的证据表明,心力衰竭患者的氨基酸谱分析具有递增的预后价值。减少心力衰竭心脏中的支链氨基酸水平可能具有心脏保护作用。与肠道微生物群相关的氨基酸,包括氨基酸补充、饮食干预或微生物酶抑制,可以作为靶点来改变心血管风险。
肠道微生物群和氨基酸代谢之间的相互作用可能导致心力衰竭的疾病进展。需要进一步的研究来发现干预的机会。