Intestinal microbiota disorders in chronic heart failure patients
Abstract. Chronic heart failure (CHF) remains a pressing public health problem due to its associated high morbidity and mortality. Current data highlight the influence of intestinal microbiota (IM) on CHF via “intestine – heart” axis; however, most relevant studies are based on relative new-generation sequencing data, which does not allow for the estimation of absolute changes in microbial abundance. The aim: to evaluate absolute changes in the microbial abundance in IM of patients with CHF comparatively to healthy individuals using gas chromatography-mass spectrometry (GC-MS). Material and methods. The study included 25 patients with CHF (18 male and 7 female individuals, mean age 75 ± 9.4 years) hospitalized in a multidisciplinary hospital. Of these, 60.0% (n = 15) had a low left ventricular ejection fraction (LVEF), 16.0% (n = 4) had a moderately reduced LVEF, and 24.0% (n = 6) had a preserved LVEF. The control group consisted of 23 healthy volunteers. IM composition was determined using GC-MS methodic. Patients with CHF underwent LVEF testing, bioimpedance vector analysis, liver fibroscanning, blood biochemistry, also nutritional status assessment (MNA), and sarcopenia screening (SARC-F, MSRA-7). Results. In patients with CHF, comparatively to healthy controls, changes in the absolute numbers of a number of microorganisms were detected: an increase in the number of opportunistic proinflammatory microorganisms (in particular, Campylobacter mucosalis, Candida spp., Alcaligenes spp. / Klebsiella spp., Clostridium difficile; in all cases, p <0.05), Cytomegalovirus HHV-5 viruses, as well as a decrease in the number of bacteria producing short-chain fatty acids (SCFAs), in particular, Clostridium ramosum, Propionibacterium jensenii, Blautia coccoides, Bacteroides fragilis, Eubacterium spp. (in all cases, p <0.05). Associations between the number of microorganisms and clinical and functional parameters of CHF were also identified. Conclusion. Signs of intestine microbiota disturbances with an increase in the absolute number of opportunistic proinflammatory microorganisms and a decrease in SCFAs producers in case of CHF were identified. These changes are also associated with the clinical and functional parameters of CHF. Taken together, the obtained results confirm the pathogenetic role of intestine microbiota in CHF and expand our understanding of the “intestine – heart” axis with new data that can be used to identify microbial markers to assess the severity of dysbiosis and develop microbiotherapy for this disease.N.V. Sturov, V.A. Zhukov, A. Yu. Moiseeva, I.V. Zelensky, Zh.D. Kobalava
Keywords
intestinal microbiota
chronic heart failure
gas chromatography-mass spectrometry
“intestine – heart” axis
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About the Authors
Nikolay V. Sturov, MD, PhD (Medicine), associate professor, head of the Department of general medical practice, deputy director for academic affairs of the Medical institute, RUDN University, Moscow, Russian Federation.Email: sturov-nv@rudn.ru
ORCID: https://orcid.org/0000-0002-3138-8410
Vladimir A. Zhukov, MD, PhD (Medicine), associate professor of the Department of general medical practice of the Medical institute, RUDN University, Moscow, Russian Federation.
Email: zhukov-vlan@rudn.ru
ORCID: https://orcid.org/0000-0001-9995-264X
Alexandra Yu. Moiseeva, MD, PhD (Medicine), assistant professor of the Department of internal medicine with a course in cardiology and functional diagnostics named after academician V.S. Moiseyev of the Institute of clinical medicine of the Medical institute, RUDN University, Moscow, Russian Federation.
E-mail: moiseeva-ayu@rudn.ru
ORCID: https://orcid.org/0000-0003-0718-5258
Ilya V. Zelensky, MD, laboratory assistant of the Department of general medical practice of the Medical institute, RUDN University, Moscow, Russian Federation.
E-mail: zelenskiy-iv@rudn.ru
ORCID: https://orcid.org/0009-0004-9603-0067
Zhanna D. Kobalava, MD, Dr. Sci. (Medicine), professor, corresponding member of RAS, head of the Department of internal medicine with a course in cardiology and functional diagnostics named after academician V.S. Moiseyev of the Medical Institute, head of the Institute of clinical medicine, RUDN University, vice-president of RSMSIM, Moscow, Russian Federation.
E-mail: kobalava-zhd@rudn.ru
ORCID: https://orcid.org/0000-0002-5873-1768
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