Gut-microbe derived TMAO and its association with more progressed forms of AF: Results from the AF-RISK study

Nguyen, Bao-Oanh; Meems, L. M. G.; Faassen, Martijn van; Crijns, Harry J.G.M.; Gelder, Isabelle C. Van; Kuipers, Folkert; Rienstra, Michiel

doi:10.1016/j.ijcha.2021.100798

Cited by 10 publications

(13 citation statements)

References 9 publications

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“…38 Further support of a link between TMAO and AF was demonstrated by Nguyen et al, who detected a significant association between TMAO levels and AF clinical phenotype. 39 In a cohort of 78 patients, TMAO levels were significantly higher in 22 patients with persistent AF compared with 56 patients with paroxysmal AF. However, that study did not adjust for the traditional risk factors of AF that are known to cause AF and which are more prevalent in persistent AF than paroxysmal AF.…”

Section: Trimethylamine N-oxidementioning

confidence: 87%

Gut Microbiota and Atrial Fibrillation: Pathogenesis, Mechanisms and Therapies

Al‐Kaisey

Figgett

Hawson

et al. 2023

Arrhythm Electrophysiol Rev

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Over the past decade there has been an interest in understanding the role of gut microbiota in the pathogenesis of AF. A number of studies have linked the gut microbiota to the occurrence of traditional AF risk factors such as hypertension and obesity. However, it remains unclear whether gut dysbiosis has a direct effect on arrhythmogenesis in AF. This article describes the current understanding of the effect of gut dysbiosis and associated metabolites on AF. In addition, current therapeutic strategies and future directions are discussed.

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Section: Trimethylamine N-oxidementioning

confidence: 87%

Gut Microbiota and Atrial Fibrillation: Pathogenesis, Mechanisms and Therapies

Al‐Kaisey

Figgett

Hawson

et al. 2023

Arrhythm Electrophysiol Rev

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show abstract

“…47 In the AF-RISK study, higher TMAO levels were associated with progression to permanent AF. 48 Finally, the proarrhythmic and prothrombotic effects of TMAO can result in increased risk of thrombus formation in patients with AF. 49…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Trimethylamine N-oxide in cardiovascular disease

Konieczny¹,

Kuliczkowski²

2022

Adv Clin Exp Med

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Although traditional cardiovascular risk factors are well established and understood, mortality and morbidity in patients with cardiovascular disease (CVD) remains high. Exploring new pathophysiological pathways enables a better understanding of CVD at both the molecular and clinical levels. Gut microbiota as a potential modulator of CVD are the subject of extensive research. In recent years, trimethylamine N-oxide (TMAO), a biologically active molecule generated by the gut microbiota, has been widely tested in studies on various populations of patients. The ultimate TMAO levels depend on individual features and gut microbiota composition. Most of the research on TMAO has focused on atherosclerotic CVD and heart failure (HF). Studies conducted so far support the use of TMAO as a prognostic marker in CVD. Several studies describe diverse interventions aimed at reducing the concentration of TMAO and its harmful effects. This article summarizes the findings from research, discusses the major insights into TMAO metabolism and related pathophysiological processes, as well as indicates the directions for future research.

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“…27,28 At present, more and more studies, including preclinical and clinical research, have found that TMAO was associated with the occurrence, progression, recurrence 1976 after ablation, embolism events and may serve as a potential therapeutic target of AF. 15,29,30 Many observations have provided positive evidence for the relationship between TMAO and AF and explored the underlying mechanisms. However, some findings on the relationship between TMAO and AF come from small clinical observational studies with conflicting outcomes, which is unable to reveal the cause-and-effect and interactive relationship between TMAO and AF.…”

Section: Tmao and Afmentioning

confidence: 99%

“…Lastly, patients with persistent AF have more underlying diseases, such as coronary heart disease, hypertension, and cardiac insufficiency, which will affect the results of TMAO. 29 Strikingly, a study also revealed that intestinal microbiota disorder was a predictor of recurrence after AF ablation. The study recommended that intestinal microbiota disorder be included in the model for predicting AF recurrence.…”

Section: Tmao May Serve As a Potential Biomarker In Afmentioning

confidence: 99%

The Gut Microbial-Derived Metabolite Trimethylamine N-Oxide and Atrial Fibrillation: Relationships, Mechanisms, and Therapeutic Strategies

Huang¹,

Li²,

Lei³

2021

CIA

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Accumulating evidence has demonstrated that gut microbial-derived metabolite trimethylamine N-oxide (TMAO) plays a crucial role in the pathogenesis of many diseases and can be served as a prognostic biomarker for several cardiovascular disorders, including arrhythmia. Recently, some studies have documented that TMAO was associated with the occurrence, progression, recurrence, and embolism risk of atrial fibrillation (AF). The activation of related inflammatory signal pathways and the cardiac sympathetic nervous system (CSNS) caused by elevated TAMO may be the underlying mechanism. It is worth noting that intervention in the metabolic pathway of TMAO may be an underlying therapeutic target of AF. In addition, standardized and individualized treatment strategies in clinical practice may be of great significance for AF patients, particularly those with high serum TMAO concentrations. However, there are also contradictions in the current research on TMAO and AF. Moreover, notwithstanding the positive preclinical and clinical findings, data supporting a direct association between TMAO and AF is a paucity. Thus, conclusive evidence from preclinical studies and multi-center randomized controlled trials to reveal the essential relationship between TMAO and AF is needy. In this review, we have attempted to summarize recent studies on TMAO and AF, highlighted the potential therapeutic strategies for AF patients, followed by a discussion on directions for future research in this field.

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Gut-microbe derived TMAO and its association with more progressed forms of AF: Results from the AF-RISK study

Cited by 10 publications

References 9 publications

Gut Microbiota and Atrial Fibrillation: Pathogenesis, Mechanisms and Therapies

Gut Microbiota and Atrial Fibrillation: Pathogenesis, Mechanisms and Therapies

Trimethylamine N-oxide in cardiovascular disease

The Gut Microbial-Derived Metabolite Trimethylamine N-Oxide and Atrial Fibrillation: Relationships, Mechanisms, and Therapeutic Strategies

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