Cardiac Failure Review (May 2019)
Diet, the Gut Microbiome and Heart Failure
Abstract
The collection of microorganisms that live in coexistence within or on the host body has been referred to as the microbiota. In humans, such cohabitation is mostly seen in the gut, mainly in the colon. The gut microbiome is acquired from the environment and is modified mostly by the diet. There are preliminary data to show that gut microbia can directly influence the pathogenetic disease processes in heart failure (HF). HF leads to bowel wall oedema and regional hypoxia, causing a change in the microbial flora of the gut, which can initiate or perpetuate certain pathogenetic process in HF. The structural component of the microbiota itself, such as lipopolysaccharides or the substances produced by the bacteria, such as trimethylamine N-oxide, is implicated in the pathogenesis of HF. This process is termed as the ‘heart–gut axis’ in HF. Manipulating the gut microbia or targeting products from the microbia may become treatment options for HF in future.