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Review
. 2023 May 2;81(17):1729-1739.
doi: 10.1016/j.jacc.2023.02.045.

Gut Microbiome-Based Management of Patients With Heart Failure: JACC Review Topic of the Week

Petra Mamic  1 , Michael Snyder  2 , W H Wilson Tang  3
Affiliations
Free article
Review

Gut Microbiome-Based Management of Patients With Heart Failure: JACC Review Topic of the Week

Petra Mamic et al. J Am Coll Cardiol. .
Free article

Abstract

Despite therapeutic advances, chronic heart failure (HF) is still associated with significant risk of morbidity and mortality. The course of disease and responses to therapies vary widely among individuals with HF, highlighting the need for precision medicine approaches. Gut microbiome stands to be an important aspect of precision medicine in HF. Exploratory clinical studies have revealed shared patterns of gut microbiome dysregulation in this disease, with mechanistic animal studies providing evidence for active involvement of the gut microbiome in development and pathophysiology of HF. Deeper insights into gut microbiome-host interactions in patients with HF promise to deliver novel disease biomarkers, preventative and therapeutic targets, and improve disease risk stratification. This knowledge may enable a paradigm shift in how we care for patients with HF, and pave the path toward improved clinical outcomes through personalized HF care.

Keywords: cardiomyopathy; gut microbiome; heart failure; personalized medicine; precision medicine.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Snyder is a co-founder and member of the scientific advisory boards of Personalis, SensOmics, Filtricine, Qbio, January, Mirvie, and Oralome; and is on the scientific advisory boards of Danaher, Genapsys, and Jupiter. Dr Tang has been supported by NIH 1R01HL126827; has served as a consultant for Sequana Medical, Cardiol Therapeutics, Genomics plc, Zehna Therapeutics, Renovacor, WhiteSwell, Kiniksa, Boston Scientific, and CardiaTec Biosciences; and has received honoraria from Springer Nature and American Board of Internal Medicine. Dr Mamic has reported that he has no relationships relevant to the contents of this paper to disclose.