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Review
. 2020 Jan;16(1):23-31.
doi: 10.1016/j.hfc.2019.08.001.

The Gut Axis Involvement in Heart Failure: Focus on Trimethylamine N-oxide

Andrea Salzano  1 , Shabana Cassambai  2 , Yoshiyuki Yazaki  2 , Muhammad Zubair Israr  2 , Dennis Bernieh  2 , Max Wong  2 , Toru Suzuki  3
Affiliations
Review

The Gut Axis Involvement in Heart Failure: Focus on Trimethylamine N-oxide

Andrea Salzano et al. Heart Fail Clin. 2020 Jan.

Abstract

A novel pathophysiological model of interest is the association between heart failure (HF) and the gastrointestinal system, the 'gut hypothesis'. The choline and carnitine metabolic by-product, Trimethylamine N-oxide (TMAO) is one of the more prominent molecules associated with the link between HF and the gut. Indeed, TMAO levels are increased in HF populations and higher TMAO levels are associated with poor prognosis, whereas low TMAO levels either at baseline/follow up confer better prognosis. Considering that TMAO levels seem not to be affected by guideline-HF treatment, this model could represent a novel and independent therapeutic target for HF.

Keywords: Cardiovascular disease; Gut; Heart failure; Prognosis; Risk stratification; TMAO.

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