Paraskevaidis Ioannis, Xanthopoulos Andrew, Tsougos Elias, Triposkiadis Filippos
6th Department of Cardiology, Hygeia Hospital, 15123 Athens, Greece.
Department of Cardiology, University Hospital of Larissa, 41110 Larissa, Greece.
Biomedicines. 2023 Sep 19;11(9):2574. doi: 10.3390/biomedicines11092574.
There is a bidirectional relationship between the heart and the gut. The gut microbiota, the community of gut micro-organisms themselves, is an excellent gut-homeostasis keeper since it controls the growth of potentially harmful bacteria and protects the microbiota environment. There is evidence suggesting that a diet rich in fatty acids can be metabolized and converted by gut microbiota and hepatic enzymes to trimethyl-amine N-oxide (TMAO), a product that is associated with atherogenesis, platelet dysfunction, thrombotic events, coronary artery disease, stroke, heart failure (HF), and, ultimately, death. HF, by inducing gut ischemia, congestion, and, consequently, gut barrier dysfunction, promotes the intestinal leaking of micro-organisms and their products, facilitating their entrance into circulation and thus stimulating a low-grade inflammation associated with an immune response. Drugs used for HF may alter the gut microbiota, and, conversely, gut microbiota may modify the pharmacokinetic properties of the drugs. The modification of lifestyle based mainly on exercise and a Mediterranean diet, along with the use of pre- or probiotics, may be beneficial for the gut microbiota environment. The potential role of gut microbiota in HF development and progression is the subject of this review.
心脏与肠道之间存在双向关系。肠道微生物群，即肠道微生物本身的群落，是出色的肠道内环境稳定维持者，因为它能控制潜在有害细菌的生长并保护微生物群环境。有证据表明，富含脂肪酸的饮食可被肠道微生物群和肝脏酶代谢并转化为氧化三甲胺（TMAO），该产物与动脉粥样硬化、血小板功能障碍、血栓形成事件、冠状动脉疾病、中风、心力衰竭（HF）以及最终的死亡相关。心力衰竭通过引发肠道缺血、充血，进而导致肠道屏障功能障碍，促进微生物及其产物的肠道渗漏，使其易于进入循环系统，从而引发与免疫反应相关的低度炎症。用于治疗心力衰竭的药物可能会改变肠道微生物群，反之，肠道微生物群也可能改变药物的药代动力学特性。主要基于运动和地中海饮食的生活方式改变，以及使用益生元或益生菌，可能对肠道微生物群环境有益。肠道微生物群在心力衰竭发生发展中的潜在作用是本综述的主题。
