Gut microbiome - A potential mediator of pathogenesis in heart failure and its comorbidities: State-of-the-art review

Interactions between the Gut Microbiome, Lung Conditions, and Coronary Heart Disease and How Probiotics Affect These

The importance of a healthy microbiome cannot be overemphasized. Disturbances in its composition can lead to a variety of symptoms that can extend to other organs. Likewise, acute or chronic conditions in other organs can affect the composition and physiology of the gut microbiome. Here, we discuss interorgan communication along the gut–lung axis, as well as interactions between lung and coronary heart diseases and between cardiovascular disease and the gut microbiome. This triangle of organs, which also affects the clinical outcome of COVID-19 infections, is connected by means of numerous receptors and effectors, including immune cells and immune-modulating factors such as short chain fatty acids (SCFA) and trimethlamine–N–oxide (TMAO). The gut microbiome plays an important role in each of these, thus affecting the health of the lungs and the heart, and this interplay occurs in both directions. The gut microbiome can be influenced by the oral uptake of probiotics. With an improved understanding of the mechanisms responsible for interorgan communication, we can start to define what requirements an ‘ideal’ probiotic should have and its role in this triangle.

Gut Microbiota and Subclinical Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus

Type 2 diabetes (T2D) is associated with an increased risk of cardiovascular disease (CVD). The gut microbiota may contribute to the onset and progression of T2D and CVD. The aim of this study was to evaluate the relationship between the gut microbiota and subclinical CVD in T2D patients. This cross-sectional study used echocardiographic data to evaluate the cardiac structure and function in T2D patients. We used a quantitative polymerase chain reaction to measure the abundances of targeted fecal bacterial species that have been associated with T2D, including Bacteroidetes, Firmicutes, Clostridium leptum group, Faecalibacterium prausnitzii, Bacteroides, Bifidobacterium, Akkermansia muciniphila, and Escherichia coli. A total of 155 subjects were enrolled (mean age 62.9 ± 10.1 years; 57.4% male and 42.6% female). Phyla Bacteroidetes and Firmicutes and genera Bacteroides were positively correlated with the left ventricular ejection fraction. Low levels of phylum Firmicutes were associated with an increased risk of left ventricular hypertrophy. High levels of both phylum Bacteroidetes and genera Bacteroides were negatively associated with diastolic dysfunction. A high phylum Firmicutes/Bacteroidetes (F/B) ratio and low level of genera Bacteroides were correlated with an increased left atrial diameter. Phyla Firmicutes and Bacteroidetes, the F/B ratio, and the genera Bacteroides were associated with variations in the cardiac structure and systolic and diastolic dysfunction in T2D patients. These findings suggest that changes in the gut microbiome may be the potential marker of the development of subclinical CVD in T2D patients.

Modulation of gelatinized wheat starch digestion and fermentation profiles by young apple polyphenols in vitro

To evaluate the effect of young apple polyphenols (YAP) on starch digestion and gut microbiota, complexes of native wheat starch (NWS) with YAP, and their main components chlorogenic acid (CA) and phlorizin (P) were fabricated and gelatinized. Through XRD and FTIR analysis, it was found that the partial crystalline structure of NWS was destroyed during gelatinization, and the addition of P decreased the extent of destruction. Then, the gelatinized starchy samples were subjected to in vitro digestion. The wheat starch (WS)-phenolic compound complexes significantly suppressed the digestion rate and increased the proportion of resistant starch (RS) in WS. Furthermore, the residual starchy components after digestion were fermented by human fecal samples for 24 h. The WS-YAP complex greatly increased the concentration of short-chain fatty acids (SCFAs), especially acetic and propionic acids, and enhanced the growth of health-promoting gut microbiota such as Prevotella. Conclusively, YAP was shown to play a positive role in maintaining blood glucose balance and intestinal health.