Snelson Matthew, R Muralitharan Rikeish, Liu Chia-Feng, Markó Lajos, Forslund Sofia K, Marques Francine Z, Tang W H Wilson
Hypertension Research Laboratory, Department of Pharmacology, Biomedical Discovery Institute, Faculty of Medicine, Nursing and Health Sciences (M.S., R.R.M., F.Z.M.), Monash University, Melbourne, Australia.
Victorian Heart Institute (M.S., R.R.M., F.Z.M.), Monash University, Melbourne, Australia.
Circ Res. 2025 May 23;136(11):1382-1406. doi: 10.1161/CIRCRESAHA.125.325516. Epub 2025 May 22.
Heart failure is a global health issue with significant mortality and morbidity. There is increasing evidence that alterations in the gastrointestinal microbiome, gut epithelial permeability, and gastrointestinal disorders contribute to heart failure progression through various pathways, including systemic inflammation, metabolic dysregulation, and modulation of cardiac function. Moreover, several medications used to treat heart failure directly impact the microbiome. The relationship between the gastrointestinal tract and the heart is bidirectional, termed the gut-heart axis. It is increasingly understood that diet-derived microbial metabolites are key mechanistic drivers of the gut-heart axis. This includes, for example, trimethylamine -oxide and short-chain fatty acids. This review discusses current insights into the interplay between heart failure, its associated risk factors, and the gut microbiome, focusing on key metabolic pathways, the role of dietary interventions, and the potential for gut-targeted therapies. Understanding these complex interactions could pave the way for novel strategies to mitigate heart failure progression and improve patient outcomes.
心力衰竭是一个全球性的健康问题，具有较高的死亡率和发病率。越来越多的证据表明，胃肠道微生物群、肠道上皮通透性和胃肠道疾病的改变通过多种途径促进心力衰竭的进展，包括全身炎症、代谢失调和心脏功能调节。此外，几种用于治疗心力衰竭的药物会直接影响微生物群。胃肠道与心脏之间的关系是双向的，称为肠-心轴。人们越来越认识到，饮食衍生的微生物代谢产物是肠-心轴的关键机制驱动因素。这包括，例如，氧化三甲胺和短链脂肪酸。本综述讨论了目前对心力衰竭及其相关危险因素与肠道微生物群之间相互作用的见解，重点关注关键代谢途径、饮食干预的作用以及肠道靶向治疗的潜力。了解这些复杂的相互作用可能为减轻心力衰竭进展和改善患者预后的新策略铺平道路。
