Cellular and Molecular Mechanisms Explaining the Link Between Inflammatory Bowel Disease and Heart Failure

Area of Science:

• Gastroenterology
• Cardiology
• Immunology

Background:

• Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is a systemic condition with growing recognition of its cardiovascular impact.
• Heart failure is a significant complication observed in IBD patients, highlighting a critical link between gut health and cardiac function.

Purpose of the Study:

• To explore the cellular and molecular pathways connecting IBD and heart failure.
• To examine how IBD promotes cardiac dysfunction through various biological mechanisms.

Main Methods:

• Narrative review synthesizing findings from epidemiologic studies, experimental models, and clinical research.
• Analysis of chronic systemic inflammation, intestinal barrier integrity, gut microbiome composition, and metabolic byproducts in IBD.

Main Results:

• Chronic inflammation (e.g., TNF-α, IL-1β) in IBD impairs myocardial structure and function.
• Intestinal dysfunction and gut dysbiosis lead to translocation of inflammatory metabolites and depletion of cardioprotective compounds, increasing heart failure risk.
• Other factors include endothelial dysfunction, autonomic dysregulation, nutritional deficits, genetic factors, and medication side effects.

Conclusions:

• IBD contributes to heart failure through multifactorial and interconnected mechanisms.
• The gut-heart axis plays a crucial role in IBD-associated heart failure.
• Recognizing this link is vital for early cardiovascular risk identification, integrated care, and developing targeted therapies to mitigate heart failure risk in IBD patients.