In recent years, research has indicated that the composition of the gut microbiome is influential on long-term heath and the progression of aging and age-related conditions, perhaps to a similar degree as the better studied influences of weight and exercise. The scientific community has made inroads into correlating specific microbial species and metabolites with specific conditions, and has demonstrated that altering the balance of populations making up the gut microbiome can improve health and extend life in aged animals. Here, researchers review what is known of the ways in which age-related changes in the composition of the gut microbiome can contribute to the progression of heart failure.
Heart failure (HF) occurs in the end stage of various cardiovascular diseases (CVDs), such as hypertension, myocardial infarction, and myocarditis. It is characterized by cardiac remodeling, which involves various structural and functional changes in the myocardium that develop in response to chronic stress or injury to the heart. These changes help maintain heart function to some extent. However, in the long term, they tend to accelerate the progression of CVDs and ultimately lead to HF.
Recently, the role of the gut microbiota in HF has received extensive attention. In HF patients, substantial changes occur in the gut microbiota, characterized by a decline in beneficial bacteria and an overgrowth of potentially harmful bacteria. These changes indicate that gut dysbiosis plays an important role in the development of HF, and therapy targeting the gut microbiota may become a new treatment approach. Furthermore, increasing evidence suggests that microbiota-derived metabolites, such as trimethylamine N-oxide (TMAO), bile acids (BAs), short-chain fatty acids (SCFAs), and amino acids (AAs), may influence the development of myocardial remodeling. Modulating the composition of the gut microbiota appears to help ameliorate myocardial fibrosis and delay the development of HF.
In the past few years, there has been an explosion of reports regarding gut microbiota, and many excellent review articles have summarized the interactions between the gut microbiota and various organs in the body. Here, we focus on the role of gut microbiota in HF and its significance in cardiac remodeling. Although emerging evidence suggests that gut dysbiosis significantly influences the progression of HF, the specific mechanisms remain unclear. We discuss the potential advantages and challenges of novel therapeutic approaches targeting the gut microbiota, aiming to bridge the knowledge gap between gut health and HF, thereby laying a foundation for future research and clinical advancements.
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