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Published on: May 26, 2023

Investigating the gut microbiota in advanced heart failure and cardiac cachexia

Mansimran Singh Dulay1,2, Despoina Chrysostomou3, Monica Campos4,5

  • 1King's College London School of Cardiovascular Medicine and Sciences, London, UK.

Gut Microbes Reports
|June 10, 2026
PubMed

Insights

Cardiac cachexia (CC), linked to advanced heart failure (AHF) and unintentional weight loss (UWL), may involve subtle gut microbiota (GM) changes. Further research is needed to confirm these findings in CC patients.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Microbiology

Background:

  • Cardiac cachexia (CC) is characterized by unintentional weight loss (UWL) in advanced heart failure (AHF) and can be worsened by right ventricular systolic dysfunction (RVSD).
  • The role of gut microbiota (GM) in CC pathogenesis remains largely unexplored.

Purpose of the Study:

  • To investigate potential alterations in gut microbiota composition and diversity in patients with AHF and CC/UWL.
  • To compare GM between patients with and without CC/UWL, and across different stages of heart failure (HF) and in healthy controls (HCs).

Main Methods:

  • Fecal samples were collected from patients with AHF (with or without CC/UWL), stable HF, and HCs.
  • 16S rRNA gene sequencing was used to analyze GM composition and diversity.
  • Statistical analyses compared GM between groups, including CC/UWL-AHF and the rest of the cohort (ROC), and explored associations with RVSD.

Main Results:

  • No significant taxonomic differences in GM were found between CC/UWL-AHF patients and the ROC.
  • A non-significant trend towards compositional differences in GM was observed between CC/UWL-AHF and ROC (beta diversity R² = 0.016, p = 0.071).
  • Significant GM alterations were identified across the HF spectrum, notably involving *Streptococcus spp.*, *Alistipes*, and *Bacteroides*, but no differences were linked to RVSD.

Conclusions:

  • Cardiac cachexia associated with AHF and UWL may be linked to subtle changes in gut microbiota composition.
  • Larger-scale studies are warranted to further elucidate the relationship between GM and CC/UWL in AHF.

Keywords:
Advanced heart failurecardiac cachexiagut microbiotaprognosisunintentional weight loss

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