Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Urology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Front Cell Infect Microbiol. 2023 Apr 25;13:1147687. doi: 10.3389/fcimb.2023.1147687. eCollection 2023.
One of the most prevalent cardiac diseases is cardiac arrhythmia, however the underlying causes are not entirely understood. There is a lot of proof that gut microbiota (GM) and its metabolites have a significant impact on cardiovascular health. In recent decades, intricate impacts of GM on cardiac arrythmia have been identified as prospective approaches for its prevention, development, treatment, and prognosis. In this review, we discuss about how GM and its metabolites might impact cardiac arrhythmia through a variety of mechanisms. We proposed to explore the relationship between the metabolites produced by GM dysbiosis including short-chain fatty acids(SCFA), Indoxyl sulfate(IS), trimethylamine N-oxide(TMAO), lipopolysaccharides(LPS), phenylacetylglutamine(PAGln), bile acids(BA), and the currently recognized mechanisms of cardiac arrhythmias including structural remodeling, electrophysiological remodeling, abnormal nervous system regulation and other disease associated with cardiac arrythmia, detailing the processes involving immune regulation, inflammation, and different types of programmed cell death etc., which presents a key aspect of the microbial-host cross-talk. In addition, how GM and its metabolites differ and change in atrial arrhythmias and ventricular arrhythmias populations compared with healthy people are also summarized. Then we introduced potential therapeutic strategies including probiotics and prebiotics, fecal microbiota transplantation (FMT) and immunomodulator etc. In conclusion, the GM has a significant impact on cardiac arrhythmia through a variety of mechanisms, offering a wide range of possible treatment options. The discovery of therapeutic interventions that reduce the risk of cardiac arrhythmia by altering GM and metabolites is a real challenge that lies ahead.
一种最常见的心脏疾病是心律失常，然而其根本原因尚未完全了解。有大量证据表明，肠道微生物群（GM）及其代谢物对心血管健康有重大影响。近几十年来，GM 对心律失常的复杂影响已被确定为预防、发展、治疗和预后的潜在方法。在这篇综述中，我们讨论了 GM 及其代谢物如何通过多种机制影响心律失常。我们建议探讨 GM 失调产生的代谢物与目前公认的心律失常机制之间的关系，包括短链脂肪酸（SCFA）、吲哚硫酸（IS）、三甲胺 N-氧化物（TMAO）、脂多糖（LPS）、苯乙酰谷氨酰胺（PAGln）、胆汁酸（BA）等，以及心律失常的结构重塑、电生理重塑、异常神经系统调节等，详细描述涉及免疫调节、炎症和不同类型程序性细胞死亡等过程，这是微生物-宿主相互作用的关键方面。此外，还总结了 GM 及其代谢物在与健康人相比的心房性心律失常和心室性心律失常人群中的差异和变化。然后我们介绍了一些潜在的治疗策略，包括益生菌和益生元、粪便微生物群移植（FMT）和免疫调节剂等。总之，GM 通过多种机制对心律失常有重大影响，提供了广泛的可能治疗选择。通过改变 GM 和代谢物来降低心律失常风险的治疗干预的发现是一个真正的挑战。
