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Gut Microbial Metabolism in Heart Failure

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Gut Microbiome, Microbial Metabolites and Cardiometabolic Risk

Part of the book series: Endocrinology ((ENDOCR))

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Abstract

Despite significant advances in drug development and therapeutic strategies, heart failure (HF) continues to have a high burden of morbidity and mortality. Current treatment options for advanced HF are limited to cardiac replacement therapies such as heart transplantation and left ventricular assist devices, but even these therapies pose restrictions of related complications and high rehospitalization rates. There remains a strong need for novel insight into the pathophysiology of HF to develop more precise, personalized, and complementary therapeutics. Recent evidence has demonstrated that alterations in the gut microbiome could play a role in HF progression and development. Changes in gut microbiota composition and metabolism, or gut dysbiosis, has been linked to HF’s pathogenic disease outcomes. While understanding of the specific mechanisms behind HF-related gut dysbiosis is limited, research has illustrated the effects of several gut microbial metabolites such as short-chain fatty acids, bile acids, trimethylamine N-oxide, amino acid metabolites, and phenylacetylglutamine and their implications in HF pathogenesis and overall cardiac health. The use of gut microbial metabolites as diagnostic biomarkers and therapeutic targets for HF demonstrates great clinical potential. Further insight into the complex gut microbiome–host interactions opens the door to improved treatment options and more comprehensive and personalized HF care.

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Disclosure

Ms. Aiyer has no relationships to disclose. Dr. Tang served as consultant for Sequana Medical, Cardiol Therapeutics, Genomics plc, Zehna Therapeutics, Renovacor, WhiteSwell, Kiniksa, Boston Scientific, and CardiaTec Biosciences and has received honorarium from Springer Nature and American Board of Internal Medicine.

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Authors and Affiliations

  1. Center for Microbiome and Human Health, Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA

    Sahana Aiyer & W. H. Wilson Tang

  2. Kaufman Center for Heart Failure Treatment and Recovery, Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA

    W. H. Wilson Tang

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  1. Sahana Aiyer
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Correspondence to W. H. Wilson Tang .

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Editors and Affiliations

  1. Department of Systems Medicine, University of Tor Vergata, Rome, Italy

    Massimo Federici

  2. Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

    Rossella Menghini

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Aiyer, S., Tang, W.H.W. (2024). Gut Microbial Metabolism in Heart Failure. In: Federici, M., Menghini, R. (eds) Gut Microbiome, Microbial Metabolites and Cardiometabolic Risk. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-031-35064-1_11

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  • DOI: https://doi.org/10.1007/978-3-031-35064-1_11

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