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Relationship between heart failure and intestinal inflammation in infants with congenital heart disease
Qi-Liang Zhang1,2, Xiu-Hua Chen3,4, Si-Jia Zhou3,4
1Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China. zhangqiliang2020@163.com.
Insights
Infants with congenital heart disease (CHD) and heart failure (HF) show altered gut bacteria, with lower diversity and increased Enterococcus. This may worsen intestinal inflammation and heart failure progression.
Area of Science:
- Pediatric Cardiology
- Gastroenterology
- Microbiome Research
Background:
- Congenital heart disease (CHD) is often associated with heart failure (HF) in infants.
- The gut microbiota's role in infant health, particularly in complex conditions like CHD-HF, is an emerging area of research.
Purpose of the Study:
- To investigate the association between heart failure (HF) and intestinal inflammation in infants with congenital heart disease (CHD).
- To analyze the gut microbial composition and its correlation with inflammatory markers and heart function in infants with CHD-HF.
Main Methods:
- Faecal samples were collected from 20 infants with HF and CHD and 20 age/sex-matched controls.
- Enzyme-linked immunoassay and 16S rDNA sequencing were used to assess inflammatory factors and gut microbiota.
Main Results:
- Infants with HF and CHD exhibited significantly increased levels of pro-inflammatory cytokines (IL-1β, IL-4, IL-6, TNF-α) and decreased IL-10.
- Reduced intestinal microbial diversity and a higher abundance of Enterococcus, with a decrease in Bifidobacterium, were observed in the HF group.
- Microbial diversity and Enterococcus abundance correlated with inflammatory markers and negatively with IL-10 levels.
Conclusions:
- Infants with CHD-related HF present with a disordered intestinal microbiota, characterized by reduced diversity and an imbalance favoring pathogenic bacteria like Enterococcus.
- This dysbiosis and associated intestinal inflammation may contribute to the exacerbation and progression of heart failure in these infants.
Objective:
The association between heart failure (HF) and intestinal inflammation caused by a disturbed intestinal microbiota in infants with congenital heart disease (CHD) was investigated.
Methods:
Twenty infants with HF and CHD who were admitted to our hospital between October 2021 and March 2022 were included in this study. Twenty age- and sex-matched infants without HF at our hospital were selected as the control group. Faecal samples were obtained from each participant and analysed by enzyme-linked immunoassay and 16 S rDNA sequencing to assess intestinal inflammatory factors and the microbiota.
Results:
The levels of intestinal inflammatory factors, including IL-1β, IL-4, IL-6, IL-17 A and TNF-α, were greatly increased, while the levels of IL-10 were significantly decreased in the HF group compared to the control group (p < 0.05). The intestinal microbial diversity of patients in the HF group was markedly lower than that in the control group (p < 0.05). The abundance of Enterococcus was significantly increased in the HF group compared to the control group (p < 0.05), but the abundance of Bifidobacterium was significantly decreased in the HF group compared to the control group (p < 0.05). The diversity of the intestinal microbiota was negatively correlated with the levels of IL-1β, IL-4, IL-6 and TNF-α in the intestinal tract but was positively correlated with that of IL-10. The abundance of Enterococcus was positively associated with the levels of IL-1β, IL-4, IL-6 and TNF-α in the intestinal tract but was negatively correlated with that of IL-10. NT-proBNP was positively associated with the levels of IL-1β, IL-4, IL-6 and TNF-α in the HF group but was negatively correlated with that of IL-10. The heart function score was positively associated with the levels of IL-1β, IL-4, IL-6 and TNF-α in the HF group but was negatively correlated with that of IL-10.
Conclusions:
Infants with CHD-related HF had a disordered intestinal microbiota, decreased diversity of intestinal microbes, increased levels of pathogenic bacteria and decreased levels of beneficial bacteria. The increased abundance of Enterococcus and the significant decrease in the diversity of the intestinal microbiota may exacerbate the intestinal inflammatory response, which may be associated with the progression of HF.
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