Gut Microbiota and Derived Short-Chain Fatty Acids Are Linked to Evolution of Heart Failure Patients

Abstract

There is a lack of direct evidence regarding gut microbiota dysbiosis and changes in short-chain fatty acids (SCFAs) in heart failure (HF) patients. We sought to assess any association between gut microbiota composition, SCFA production, clinical parameters, and the inflammatory profile in a cohort of newly diagnosed HF patients. In this longitudinal prospective study, we enrolled eighteen newly diagnosed HF patients. At admission and after 12 months, blood samples were collected for the assessment of proinflammatory cytokines, monocyte populations, and endothelial dysfunction, and stool samples were collected for analysis of gut microbiota composition and quantification of SCFAs. Twelve months after the initial HF episode, patients demonstrated improved clinical parameters and reduced inflammatory state and endothelial dysfunction. This favorable evolution was associated with a reversal of microbiota dysbiosis, consisting of the increment of health-related bacteria, such as genus Bifidobacterium, and levels of SCFAs, mainly butyrate. Furthermore, there was a decrease in the abundance of pathogenic bacteria. In vitro, fecal samples collected after 12 months of follow-up exhibited lower inflammation than samples collected at admission. In conclusion, the favorable progression of HF patients after the initial episode was linked to the reversal of gut microbiota dysbiosis and increased SCFA production, particularly butyrate. Whether restoring butyrate levels or promoting the growth of butyrate-producing bacteria could serve as a complementary treatment for these patients deserves further studies.

The Role of Gut Microbiota and Its Metabolites in Patients with Heart Failure

“…A negative correlation was also observed between acetate and NT-proBNP, and a positive correlation was observed with left ventricular ejection fraction (LVEF) and endothelial progenitor cells. Propionate correlated positively with anti-inflammatory activity [39].…”

“…Furthermore, they also demonstrated the positive impact of this phylum of bacteria. They showed that higher levels of Bifidobacterium were associated with lower levels of pro-inflammatory markers and N-terminal pro-Btype natriuretic peptides (NTpro-BNP) and were positively correlated with markers of endothelial function and improved intestinal barrier function [39].…”

“…After this treatment period, levels of pro-inflammatory factors such as ICAM-1, IL-6, IL-18, CRP, sCD163, tumor necrosis factor alfa (TNF-α), and VCAM-1 were significantly reduced. Meanwhile, the levels of classical non-activated monocytes and circulating endothelial progenitor cells, which may be responsible for replacing dysfunctional endothelium, significantly increased [39].…”

The Role of Gut Microbiota and the Potential Effects of Probiotics in Heart Failure

“…Some of these bacteria have been associated with the severity of the disease as expressed by the New York Heart Association (NYHA) functional classes [16]. With respect to controls, HF patients are also characterized by less abundance of short-chain fatty acid (SCFA)-producing bacteria such as Blautia, Erysipelotrichaceae, Collinsella, Ruminococcaceae, Lachnospiraceae, Faecalibacterium, Eubacterium rectale, and Dorea Longicatena [17][18][19].…”