Gut microbiome in heart failure and aortic stenosis

The gut microbiome is linked to the development of individual diseases. Patients with congestive heart failure (HF) develop intestinal wall edema due to venous congestion, which impairs absorption function and allows bacterial overgrowth. Consequently, the pathogenous bacterial strains produce many harmful substances, including trimethylamine N-oxide (TMAO) and endotoxin (LPS - lipopolysaccharide), which lead to deterioration of HF. These discoveries led to hypothesis about the heart-bowel axis. High levels of TMAO present in patients with HF predispose to higher long-term mortality, even after correlation with traditional risk factors and cardiorenal indices. Most LPS is generated by the intestinal microbiome, and the osteogenic response in aortic stenosis to LPS stimulation of valve interstitial cells (VIC) is closely linked to inflammation and immunity. Thus, the concentration of intestinal microbiome research may provide new insights into the investigation of new therapeutic targets for HF and aortic stenosis.