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From heart to gut: Exploring the gut microbiome in congenital heart disease
Yuze Liu1, Yuan Huang1, Qiyu He1
1Pediatric Cardiac Surgery Centre, Fuwai Hospital, National Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences Peking Union Medical College Beijing China.
Insights
Congenital heart disease (CHD) is linked to gut microbiome changes. Understanding this gut-heart axis can improve treatment for children with CHD.
Area of Science:
- Microbiology
- Cardiology
- Immunology
Background:
- Congenital heart disease (CHD) is a common birth defect impacting childhood mortality.
- CHD involves cardiovascular issues but also affects other systems, including the gut microbiome.
- Gut microbiome dysbiosis is observed in CHD patients, influenced by hypoxia and inflammation.
Purpose of the Study:
- To review the multifaceted role of the gut microbiome in congenital heart disease.
- To explore the gut microbiome's influence on immunity, gut barrier function, neurodevelopment, and perioperative care in CHD.
- To highlight the clinical implications of the gut-heart axis in CHD.
Main Methods:
- Literature review synthesizing current research on CHD and the gut microbiome.
- Analysis of studies investigating microbial composition, metabolites, and host interactions.
- Discussion of evidence linking gut dysbiosis to CHD pathogenesis and outcomes.
Main Results:
- Chronic hypoxia and inflammation in CHD alter gut microbiome characteristics.
- Gut microbiome dysbiosis can lead to impaired gut barrier function and systemic inflammation.
- Microbial metabolites (e.g., SCFAs, TMAO) play significant roles in CHD development and prognosis.
Conclusions:
- The gut microbiome is a critical factor in CHD, influencing immune responses and overall health.
- Targeting the gut microbiome presents a potential therapeutic strategy for improving CHD management.
- Further research into the gut-heart axis is essential for advancing clinical outcomes in CHD patients.
Abstract:
Congenital heart disease (CHD) is a prevalent birth defect and a significant contributor to childhood mortality. The major characteristics of CHD include cardiovascular malformations and hemodynamical disorders. However, the impact of CHD extends beyond the circulatory system. Evidence has identified dysbiosis of the gut microbiome in patients with CHD. Chronic hypoxia and inflammation associated with CHD affect the gut microbiome, leading to alterations in its number, abundance, and composition. The gut microbiome, aside from providing essential nutrients, engages in direct interactions with the host immune system and indirect interactions via metabolites. The abnormal gut microbiome or its products can translocate into the bloodstream through an impaired gut barrier, leading to an inflammatory state. Metabolites of the gut microbiome, such as short-chain fatty acids and trimethylamine N-oxide, also play important roles in the development, treatment, and prognosis of CHD. This review discusses the role of the gut microbiome in immunity, gut barrier, neurodevelopment, and perioperative period in CHD. By fostering a better understanding of the cross-talk between CHD and the gut microbiome, this review aims to contribute to improve clinical management and outcomes for CHD patients.
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