Gut Microbiota Composition and Cardiovascular Disease: A Potential New Therapeutic Target?

Abstract

A great deal of evidence has revealed an important link between gut microbiota and the heart. In particular, the gut microbiota plays a key role in the onset of cardiovascular (CV) disease, including heart failure (HF). In HF, splanchnic hypoperfusion causes intestinal ischemia resulting in the translocation of bacteria and their metabolites into the blood circulation. Among these metabolites, the most important is Trimethylamine N-Oxide (TMAO), which is responsible, through various mechanisms, for pathological processes in different organs and tissues. In this review, we summarise the complex interaction between gut microbiota and CV disease, particularly with respect to HF, and the possible strategies for influencing its composition and function. Finally, we highlight the potential role of TMAO as a novel prognostic marker and a new therapeutic target for HF.

Keywords: atherosclerosis; cardiovascular diseases; gut microbiota; heart failure; trimethylamine N-Oxide.

Figure 1

The 3 mechanisms responsible for bacterial translocation and systemic inflammation. LPS = lipopolysaccharide.

Figure 2

TMA produced by the gut microbiota enters the circulatory system and is oxidized to TMAO by FMO3 in the liver. Circulating TMAO causes endothelial dysfunction, platelet hyperreactivity, heart failure, and the progression of renal disease.

Figure 3

Different high-throughput-sequencing techniques performed at the level of microbes, DNA, mRNA, proteins, and metabolites.