最近的研究表明,肠道微生物组(GM)的改变在HF的病理生理学中起着综合作用。然而,这一领域的研究结果仍然存在争议。在这项研究中,我们关注HF患者和非HF患者之间的GM多样性和丰度差异,基于以前的16S核糖体RNA(16rRNA)基因测序。遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目,我们对PubMed进行了全面搜索,WebofScience,Embase,科克伦图书馆,和使用关键字“心力衰竭”和“胃肠道微生物组”的Ovid数据库。在HF患者中观察到α多样性的显著降低(Chao1,I2=87.5%,p<0.001;香农指数,I2=62.8%,p=0.021)。在门一级,HF组显示出更高的变形杆菌丰度(I2=92.0%,p=0.004)和放线菌(I2=82.5%,p=0.010),而拟杆菌(I2=45.1%,p=0.017)和F/B比(I2=0.0%,p<0.001)较低。Firmicutes呈下降趋势,但未达到统计学意义(I2=82.3%,p=0.127)。在属一级,链球菌的相对丰度,拟杆菌,Alistipes,双歧杆菌,大肠杆菌志贺氏菌,HF组肠球菌和克雷伯菌增多,而Ruminococus,粪杆菌,Dorea和Megamona的相对丰度下降。Dialister,布劳特氏菌和普雷沃氏菌呈下降趋势,但无统计学意义。这项观察性荟萃分析表明,GM变化与HF有关,表现为转基因丰度的改变,短链脂肪酸(SCFA)细菌生产的中断,和三甲胺N-氧化物(TMAO)产生细菌的增加。
Recent research has revealed that alterations of the gut microbiome (GM) play a comprehensive role in the pathophysiology of HF. However, findings in this field remain controversial. In this study, we focus on differences in GM diversity and abundance between HF patients and non-HF people, based on previous 16 S ribosomal RNA (16rRNA) gene sequencing. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive search of PubMed, Web of Science, Embase, Cochrane Library, and Ovid databases using the keyword \"Heart failure\" and \"Gastrointestinal Microbiome\". A significant decrease in alpha diversity was observed in the HF patients (Chao1, I2 = 87.5 %, p < 0.001; Shannon index, I2 = 62.8 %, p = 0.021). At the phylum level, the HF group exhibited higher abundances of Proteobacteria (I2 = 92.0 %, p = 0.004) and Actinobacteria (I2 = 82.5 %, p = 0.010), while Bacteroidetes (I2 = 45.1 %, p = 0.017) and F/B ratio (I2 = 0.0 %, p<0.001) were lower. The Firmicutes showed a decreasing trend but did not reach statistical significance (I2 = 82.3 %, p = 0.127). At the genus level, the relative abundances of Streptococcus, Bacteroides, Alistipes, Bifidobacterium, Escherichia-Shigella, Enterococcus and Klebsiella were increased in the HF group, whereas Ruminococcus, Faecalibacterium, Dorea and Megamona exhibited decreased relative abundances. Dialister, Blautia and Prevotella showed decreasing trends but without statistical significance. This observational meta-analysis suggests that GM changes are associated with HF, manifesting as alterations in GM abundance, disruptions in the production of short-chain fatty acids (SCFAs) bacteria, and an increase in trimethylamine N-oxide (TMAO) producing bacteria.