Division of Cardiology, Hygeia Hospital, Erithrou Stavrou 4, 15123 Athens, Greece.
Heart Failure Subdivision, Department of Clinical Therapeutics, Alexandra Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Vassilisis Sofias 80, 11528 Athens, Greece.
Int J Mol Sci. 2024 Jan 31;25(3):1716. doi: 10.3390/ijms25031716.
Regardless of the currently proposed best medical treatment for heart failure patients, the morbidity and mortality rates remain high. This is due to several reasons, including the interaction between oral cardiac drug administration and gut microbiota. The relation between drugs (especially antibiotics) and gut microbiota is well established, but it is also known that more than 24% of non-antibiotic drugs affect gut microbiota, altering the microbe's environment and its metabolic products. Heart failure treatment lies mainly in the blockage of neuro-humoral hyper-activation. There is debate as to whether the administration of heart-failure-specific drugs can totally block this hyper-activation, or whether the so-called intestinal dysbiosis that is commonly observed in this group of patients can affect their action. Although there are several reports indicating a strong relation between drug-gut microbiota interplay, little is known about this relation to oral cardiac drugs in chronic heart failure. In this review, we review the contemporary data on a topic that is in its infancy. We aim to produce scientific thoughts and questions and provide reasoning for further clinical investigation.
无论目前针对心力衰竭患者提出的最佳医疗方法是什么，其发病率和死亡率仍然很高。这有几个原因，包括口服心脏药物和肠道微生物群之间的相互作用。药物（尤其是抗生素）和肠道微生物群之间的关系已经得到很好的证实，但也有研究表明，超过 24%的非抗生素药物会影响肠道微生物群，改变微生物的环境及其代谢产物。心力衰竭的治疗主要在于阻断神经体液的过度激活。对于心力衰竭特异性药物的给药是否可以完全阻断这种过度激活，或者在这组患者中常见的所谓肠道菌群失调是否会影响其作用，存在争议。尽管有几项报告表明药物-肠道微生物群相互作用之间存在很强的关系，但对于慢性心力衰竭患者口服心脏药物与这种关系知之甚少。在这篇综述中，我们回顾了这一处于起步阶段的主题的最新数据。我们旨在产生科学的想法和问题，并为进一步的临床研究提供推理。
