Fountoulakis Petros N, Theofilis Panagiotis, Vlachakis Panayotis K, Karakasis Paschalis, Pamporis Konstantinos, Sagris Marios, Dimitroglou Yannis, Tsioufis Panagiotis, Oikonomou Evangelos, Tsioufis Konstantinos, Tousoulis Dimitris
1st Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.
2nd Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.
Biomedicines. 2025 Apr 9;13(4):911. doi: 10.3390/biomedicines13040911.
Heart failure (HF) has become an immense health concern affecting almost 1-2% of the population globally. It is a complex syndrome characterized by activation of the sympathetic nervous system and the Renin-Angiotensin-Aldosterone (RAAS) axis as well as endothelial dysfunction, oxidative stress, and inflammation. The recent literature points towards the interaction between the intestinal flora and the heart, also called the gut-heart axis. The human gastrointestinal tract is naturally inhabited by various microbes, which are distinct for each patient, regulating the functions of many organs. Alterations of the gut microbiome, a process called dysbiosis, may result in systemic diseases and have been associated with heart failure through inflammatory and autoimmune mechanisms. The disorder of intestinal permeability favors the translocation of microbes and many metabolites capable of inducing inflammation, thus further contributing to the deterioration of normal cardiac function. Besides diet modifications and exercise training, many studies have revealed possible gut microbiota targeted treatments for managing heart failure. The aim of this review is to demonstrate the impact of the inflammatory environment induced by the gut microbiome and its metabolites on heart failure and the elucidation of these novel therapeutic approaches.
心力衰竭（HF）已成为一个重大的健康问题，全球近1%-2%的人口受其影响。它是一种复杂的综合征，其特征为交感神经系统和肾素-血管紧张素-醛固酮（RAAS）轴的激活，以及内皮功能障碍、氧化应激和炎症。最近的文献指出肠道菌群与心脏之间存在相互作用，即所谓的肠-心轴。人类胃肠道自然栖息着各种微生物，每个患者的微生物各不相同，这些微生物调节着许多器官的功能。肠道微生物群的改变，即所谓的生态失调，可能导致全身性疾病，并通过炎症和自身免疫机制与心力衰竭相关。肠道通透性紊乱有利于微生物和许多能够诱导炎症的代谢产物的易位，从而进一步导致正常心脏功能恶化。除了饮食调整和运动训练外，许多研究还揭示了针对肠道微生物群治疗心力衰竭的可能性。本综述的目的是证明肠道微生物群及其代谢产物诱导的炎症环境对心力衰竭的影响，并阐明这些新的治疗方法。
