The gut microbial-derived metabolite trimethylamine N-oxide: A missing link between lifestyle-components and atrial fibrillation?

Gawałko, Monika; Jespersen, Thomas; Dobrev, Dobromir; Linz, Dominik

doi:10.1016/j.ijcha.2020.100581

Cited by 1 publication

(1 citation statement)

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“…41 In a standard scenario, TMAO levels are affected by numerous factors such as diet, underlying diseases, lifestyles, and basic studies have found that TMAO may also be the causative agent of certain other cardiovascular diseases and neurological diseases, and these covariates may mask the authentic relationship between TMAO and AF as well as arrhythmia. [42][43][44][45] In addition, most of the current studies did not consider the complexity and diversity of the structure of the intestinal microbes, such as other bacteria, viruses, and fungi, which may interfere with this association. Overall, despite an extensive body of evidence, whether TMAO is a risk factor, mediator, or bystander in the arrhythmia process remains largely unknown.…”

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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