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Gut Microbiota as a Potential Treatment Target in Patient with Chronic Heart Failure

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Abstract

Chronic heart failure (CHF) is a pandemic with a high mortality rate and a high economic burden. The complexity of heart failure clinical syndromes requires approaches through different therapeutic targets. Intestinal dysbiosis is a condition in the human intestinal tract characterized by an imbalance of bacteria, causing various adverse effects. It has been linked with more than 20 diseases and clinical syndromes, including chronic heart failure. The composition of intestinal microbiota is influenced by structural and functional changes of the intestine, which happens in patients with CHF, through a complex network of cytokines, metabolic products, and numerous regulatory molecules. This condition provides exciting new fields for searching for a novel treatment for chronic heart failure. Several interventions, including diet, probiotic, prebiotic, antibiotic, even fecal microbial transplant, have previously been studied. This article discusses the reciprocal relationship between the heart and the gut microbiota through various changes in the gut microbiota composition, intestinal dysfunction, and altered bacterial metabolites and the potential therapies for modulating gut microbiota composition as a target of therapy for CHF.

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Abbreviations

CHF:

Chronic heart failure

IBD:

Inflammatory bowel disease

IBS:

Irritable bowel syndrome

IL-10:

Interleukin 10

IFN-Y:

Interferon gamma

IL-17:

Interleukin 17

IL-22:

Interleukin 22

LPS:

Lipopolysaccharides

TNF-α:

Tumor necrosis factor-α

LPS:

Lipopolysaccharides

TMAO:

Trimethylamine-N-oxide

SCFA:

Short-chain fatty acids

NT-proBNP:

N terminal pro brain natriuretic peptide

eGFR:

Estimated glomerular filtration rate

NYHA:

New York Heart Association

TMA:

Trimethylamine

FMO-3:

Flavin mono oxygenase-3

Gpr43:

G protein-coupled receptor 43

Th1:

T helper 1

Th17:

T helper 17

MI:

Myocardial infarction

Olfr78:

Olfactory receptors 78

Gpr41:

G protein-coupled receptor 41

BAs:

Bile acids

LC:

Lithocholic acid

GLC:

Glycine conjugated lithocholic acid

TLC:

Taurine conjugated lithocholic acid

GUDCA:

Glycine conjugated ursodeoxycholic acid

DCA:

Deoxycholic acid

UDCA:

Ursodeoxycholic acid

MAPK:

Mitogen-activated protein kinase

AMPK/UCP:

AMP-activated protein kinase/uncoupling protein 2

DASH:

Dietary approach to stop hypertension

AHA/ACC:

American Heart Association/American College of Cardiology

WHI:

Women Health Initiatives

6 MWT:

6-minute walking test

HFpEF:

Heart failure with preserved ejection fraction

MACE:

Major adverse cardiovascular events

ISAPP:

The International Scientific Association for Probiotics and Prebiotics

FAO/WHO:

Food and Agriculture Organization of the United Nations/World Health Organizations

GABA:

γ-Aminobutyric acid

SHR:

Spontaneously hypertensive rats

PSPY:

Purple sweet potato yogurt

MSP-1:

Major secreted protein-1

IGF1R:

Insulin-growth factor I receptor

Treg :

Regulatory T cells

EF:

Ejection fractions

RCTs:

Randomized controlled trials

FDA:

Food and Drug Administration

GRAS:

Generally recognized as safe

SDD:

Selective decontamination of digestive tract

GNB:

Gram-negative Bacillus

FMT:

Fecal microbial transplantation

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Acknowledgements

The authors are grateful to Quinta Febryani Handoyono, MD for her assistance on figure design

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Authors and Affiliations

  1. Siloam Heart Institute, Siloam Hospitals Kebon Jeruk, Jl. Perjuangan No.8, RT.14/RW.10, Kb. Jeruk, Kec. Kb. Jeruk, Kota Jakarta Barat, Daerah Khusus Ibukota Jakarta, 11530, Indonesia

    Joshua Henrina, Irvan Cahyadi, Hoo Felicia Hadi Gunawan & Leonardo Paskah Suciadi

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  1. Joshua Henrina
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  2. Irvan Cahyadi
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  3. Hoo Felicia Hadi Gunawan
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  4. Leonardo Paskah Suciadi
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JH, IC, and HFHG contributed to conception and design, literature research, and drafting the manuscript. JH also provides revision of the manuscript. LPS contributed in revision of the manuscript, supervision, and final approval of the manuscript. All authors apporoved the final manuscript

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Correspondence to Joshua Henrina.

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Henrina, J., Cahyadi, I., Hadi Gunawan, H.F. et al. Gut Microbiota as a Potential Treatment Target in Patient with Chronic Heart Failure. SN Compr. Clin. Med. 2, 1614–1627 (2020). https://doi.org/10.1007/s42399-020-00436-4

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