PDF(Pubmed)
Abstract：
Heart failure (HF) is a sophisticated syndrome with structural or functional impairment of ventricular filling or ejection of blood, either causing symptoms and signs or being asymptomatic. HF is a major global health issue affecting about 64.3 million people worldwide. The gut microbiota refers to the complex ecosystem of microorganisms, mainly bacteria, in the gut. Studies have revealed that the gut microbiota is associated with many diseases ranging from neurodegenerative diseases to inflammatory bowel disease and cardiovascular diseases. The gut hypothesis of HF suggests that low cardiac output and systemic circulation congestion would cause insufficient intestinal perfusion, leading to ischemia and intestinal barrier dysfunction. The resulting bacterial translocation would contribute to inflammation. Recent studies have refined the hypothesis that changes of metabolites in the gut microbiota have a close relationship with HF. Thus, the gut microbiota has emerged as a potential therapeutic target for HF due to both its critical role in regulating host physiology and metabolism and its pivotal role in the development of HF. This review article aims to provide an overview of the current understanding of the gut microbiota\'s involvement in HF, including the introduction of the gut hypothesis of HF, its association with HF progression, the potential mechanisms involved mediated by the gut microbiota metabolites, and the impact of various interventions on the gut microbiota, including dietary interventions, probiotic therapy, fecal microbiota transplantation, antibiotics, and so on. While the gut hypothesis of HF is refined with up-to-date knowledge and the gut microbiota presents a promising target for HF therapy, further research is still needed to further understand the underlying mechanisms between gut microbiota and HF, the efficacy of these interventions, and contribute to the health of HF patients.
摘要：
心力衰竭（HF）是一种复杂的综合征，具有心室充盈或射血的结构或功能损害，要么引起症状和体征，要么无症状。HF是一个主要的全球健康问题，影响全球约6430万人。肠道微生物群是指微生物的复杂生态系统，主要是细菌,在肠子里.研究表明，肠道微生物群与许多疾病有关，从神经退行性疾病到炎症性肠病和心血管疾病。HF的肠道假说表明，低心输出量和体循环充血会导致肠道灌注不足，导致缺血和肠屏障功能障碍。所产生的细菌易位将有助于炎症。最近的研究完善了肠道微生物群中代谢物的变化与HF密切相关的假设。因此，由于其在调节宿主生理和代谢中的关键作用以及在HF发展中的关键作用，肠道微生物群已成为HF的潜在治疗靶标。这篇综述文章旨在概述目前对肠道微生物群参与HF的理解。包括引入HF的肠道假说，它与HF进展有关，肠道微生物代谢产物介导的潜在机制，以及各种干预措施对肠道微生物群的影响，包括饮食干预，益生菌疗法,粪便微生物移植，抗生素,等等。虽然HF的肠道假说得到了最新知识的完善，并且肠道微生物群提出了HF治疗的有希望的目标，仍需要进一步的研究来进一步了解肠道微生物群和HF之间的潜在机制，这些干预措施的有效性，并有助于HF患者的健康。
