Abstract
Background
Heart failure (HF) is the end stage of cardiovascular disease and arises when there are structural or functional cardiac abnormalities leading to increased intracardiac pressures and insufficient cardiac output. This study aimed to determine whether HF patients with left ventricular ejection fraction ≤45% had changes in gut microbiome and associated bacterial metabolites compared with healthy individuals. It also looked at the inflammatory, metabolomic, and lipidomic profiles of HF patients and whether these were associated with disease severity or differed from healthy individuals.
Methods
This single-centre, non-interventional, cross-sectional study recruited 73 HF patients (mean age 59.8, 83.5% male) and 59 healthy volunteers (mean age 56.0, 18.6% male). Blood, dental plaque, and stool samples were collected at baseline and 6-month follow-up.
Results
There was higher differential abundance of Staphylococcus, Megasphaera, Limosilactobacillus, and Lactobacillus bacterial groups in HF patients at baseline compared with healthy controls. At follow-up there was a significant reduction in bacterial diversity in HF patients compared with healthy controls (p=0.0168). In an unadjusted analysis, at baseline, HF patients showed significantly elevated plasma acetate (p=0.006), trimethylamine N-oxide (p=0.0003), serum sCD14 (p=0.0019), and sCD163 (p=0.0005) levels when compared with healthy controls. Furthermore, HF patients were observed to have a different metabolomic and lipidomic profile when compared with healthy controls.
Conclusion
Changes in the microbiome and its metabolites are associated with HF. Further research is required to understand the associations between gut microbiome and HF, and their clinical implications.