Gut microbiota and cardiac arrhythmia.

Area of Science:

• Cardiology
• Microbiology
• Metabolomics

Background:

• Cardiac arrhythmia is a prevalent cardiovascular disease with incompletely understood causes.
• Gut microbiota (GM) and its metabolites are increasingly recognized for their significant influence on cardiovascular health.
• GM's intricate role in cardiac arrhythmia presents potential avenues for prevention, development, treatment, and prognosis.

Purpose of the Study:

• To review the mechanisms by which GM and its metabolites impact cardiac arrhythmia.
• To explore the relationship between GM-derived metabolites and established cardiac arrhythmia mechanisms.
• To summarize differences in GM and metabolites between arrhythmia populations and healthy individuals, and introduce therapeutic strategies.

Main Methods:

• Literature review focusing on microbial-host cross-talk in cardiac arrhythmia.
• Analysis of metabolites such as short-chain fatty acids (SCFA), Indoxyl sulfate (IS), trimethylamine N-oxide (TMAO), lipopolysaccharides (LPS), phenylacetylglutamine (PAGln), and bile acids (BA).
• Examination of mechanisms including structural and electrophysiological remodeling, nervous system regulation, immune regulation, inflammation, and programmed cell death.

Main Results:

• GM metabolites are linked to cardiac arrhythmia through diverse mechanisms, including immune and inflammatory pathways.
• Distinct alterations in GM composition and metabolite profiles are observed in atrial and ventricular arrhythmias compared to healthy controls.
• Potential therapeutic strategies involve modulating GM, such as probiotics, prebiotics, fecal microbiota transplantation (FMT), and immunomodulators.

Conclusions:

• GM plays a substantial role in cardiac arrhythmia via multiple pathways, offering a broad spectrum of potential therapeutic targets.
• Targeting GM and its metabolites represents a promising, albeit challenging, frontier for reducing cardiac arrhythmia risk.
• Further research is needed to fully elucidate these complex interactions and develop effective interventions.