Disorders of gut microbiota in children with Tetralogy of Fallot

Abstract

Background: Gut microbiota plays an important role in cardiovascular health and disease, including congenital heart disease (CHD). Tetralogy of Fallot (TOF) is the most common form of cyanotic CHD characterized by systemic chronic hypoxia and sustained pressure overload of the right ventricle. It is wellknown that hypoxia and pressure overload can affect gut microbiota. However, the effects of TOF on the gut microbiota remain little understood. This study explored the profile of the gut microbiota in children with unrepaired TOF.Methods: A total of 12 pediatric patients diagnosed with TOF and 9 healthy age-and gender-matched children were enrolled in this study. Fecal samples were collected from every participant and subjected to 16S rDNA gene sequencing. The raw sequencing data were processed using the Quantitative Insights Into Microbial Ecology pipeline.Results: A comparison of the gut microbiota revealed that pediatric patients with TOF had developed dysbiosis as reflected by the altered taxonomic composition and impaired functional profile. A total of 14 indicative bacterial genera were identified as differential biomarkers capable of distinguishing between healthy children and TOF patients. Furthermore, functional annotations revealed that the gut microbiota in TOF patients was characterized by increased levels of inflammatory, oxidative, and immune responses, and decreased activities of adaptation, synthesis, and metabolism.Conclusions: Pediatric patients with unrepaired TOF have intestinal dysbacteriosis that is characterized by altered taxonomic composition and impaired functional profile. These findings suggested that the interplay between gut microbiota and the host may be dysregulated in patients with TOF.

Early Empiric Antibiotic Treatment Among Neonates With Congenital Heart Defects: A Brief Report of an Integrative Review

“…Intestinal dysbiosis is characterized by an increased abundance of pathogenic bacterial species and decreased bacterial diversity and richness (13). Abnormal cardiac physiology and cardiopulmonary bypass are risk factors for intestinal dysbiosis and epithelial barrier dysfunction in CHD children and correspond with systemic inflammation (15)(16)(17)(18). Systemic inflammation in CHD neonates has been associated with stroke, low-cardiac output syndrome, prolonged hospitalization, and death (19)(20)(21).…”

Whole-exome sequencing revealed novel genetic alterations in patients with tetralogy of Fallot

“…Tetralogy of Fallot (TOF) is the most prevalent and complicated cyanotic CHD, and affects around one out of every 2,500 newborns ( 4 , 5 ). TOF is a condition that affects the heart’s outflow tract and is defined by four specific structural abnormalities identified postnatally: a ventricular septal defect, an anterocephalad deviation of the outflow septum with aortic override, a variable obstruction of the right ventricular outflow tract (RVOT) (pulmonary stenosis), and right ventricle hypertrophy ( 6 - 9 ). With the help of surgical procedures performed throughout childhood, 85–90% of TOF patients now live until the age of at least 30 years ( 10 ).…”