Skip to content
2000
Volume 5, Issue 1
  • ISSN: 0250-6882
  • E-ISSN: 0250-6882

Abstract

This literature review explores the correlation between atrial fibrillation (AF) and the gut microbiome by elucidating its significance in cardiovascular health. AF stands as a prevalent cardiac arrhythmia associated with increased morbidity and mortality rates worldwide. The gut microbiome, a complex ecosystem of microorganisms inhabiting the gastrointestinal tract, plays a crucial role in systemic health through its influence on immune modulation, metabolic processes, and host-microbe interactions. Emerging evidence suggests a potential link between AF and alterations in gut microbial composition, raising intriguing questions about underlying mechanisms and clinical implications.

Recent investigations have shed light on the potential interplay between AF and gut microbial composition. Alterations in gut microbiota diversity and abundance have been observed in AF patients compared to healthy controls, suggesting a possible link between gut dysbiosis and arrhythmia susceptibility. Mechanistic studies propose several pathways through which gut microbial metabolites and immune modulation may influence atrial electrophysiology and arrhythmogenesis.

The clinical implications of the AF-gut microbiome connection are profound. Microbiome-based biomarkers hold promise for risk stratification, enabling early identification of individuals at elevated risk of AF development or recurrence. Furthermore, interventions targeting the gut microbiome, such as probiotics, prebiotics, and dietary modifications, offer innovative therapeutic avenues for AF management, potentially augmenting traditional treatment modalities.

Despite significant progress, challenges such as methodological limitations and the need for further validation in diverse patient cohorts remain present. Longitudinal studies are warranted to elucidate the temporal relationship between gut microbiome alterations and AF onset or progression. Nevertheless, understanding the AF-gut microbiome connection provides a foundation for personalized medicine approaches, optimizing AF management and improving cardiovascular health outcomes.

This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Loading

Article metrics loading...

/content/journals/nemj/10.2174/0102506882332720241004072452
2024-01-01
2025-05-11
The full text of this item is not currently available.

References

  1. LiN. DurganD.J. WehrensX.H.T. Gut microbiota: A key regulator of ageing-associated atrial fibrillation?Cardiovasc. Res.118365765910.1093/cvr/cvab34634849621
    [Google Scholar]
  2. SagrisM. VardasE.P. TheofilisP. AntonopoulosA.S. OikonomouE. TousoulisD. Atrial fibrillation: Pathogenesis, predisposing factors, and genetics.Int. J. Mol. Sci.2021231610.3390/ijms2301000635008432
    [Google Scholar]
  3. PapandreouC. New evidence for the role of gut microbiota on atrial fibrillation development.EBioMedicine20239210462210.1016/j.ebiom.2023.10462237182267
    [Google Scholar]
  4. MaoM. ZhaiC. QianG. Gut microbiome relationship with arrhythmias and conduction blocks: A two-sample Mendelian randomization study.J. Electrocardiol.20238015516110.1016/j.jelectrocard.2023.06.00637422943
    [Google Scholar]
  5. AstudilloA.A. MayrovitzH.N. The gut microbiome and cardiovascular disease.Cureus2021134e1451910.7759/cureus.1451934007770
    [Google Scholar]
  6. ChughS.S. HavmoellerR. NarayananK. SinghD. RienstraM. BenjaminE.J. GillumR.F. KimY.H. McAnultyJ.H. ZhengZ.J. ForouzanfarM.H. NaghaviM. MensahG.A. EzzatiM. MurrayC.J.L. Worldwide epidemiology of atrial fibrillation: A Global Burden of Disease 2010 Study.Circulation2014129883784710.1161/CIRCULATIONAHA.113.00511924345399
    [Google Scholar]
  7. BenjaminE.J. LevyD. VaziriS.M. D’AgostinoR.B. BelangerA.J. WolfP.A. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study.JAMA19942711184084410.1001/jama.1994.035103500500368114238
    [Google Scholar]
  8. LauD.H. LinzD. SandersP. New findings in atrial fibrillation mechanisms.Card. Electrophysiol. Clin.201911456357110.1016/j.ccep.2019.08.00731706465
    [Google Scholar]
  9. JanuaryC.T. WannL.S. AlpertJ.S. CalkinsH. CigarroaJ.E. ClevelandJ.C. ContiJ.B. EllinorP.T. EzekowitzM.D. FieldM.E. MurrayK.T. SaccoR.L. StevensonW.G. TchouP.J. TracyC.M. YancyC.W. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation.J. Am. Coll. Cardiol.20146421e1e7610.1016/j.jacc.2014.03.02224685669
    [Google Scholar]
  10. AndradeJ. KhairyP. DobrevD. NattelS. The clinical profile and pathophysiology of atrial fibrillation: Relationships among clinical features, epidemiology, and mechanisms.Circ. Res.201411491453146810.1161/CIRCRESAHA.114.30321124763464
    [Google Scholar]
  11. HealeyJ.S. RobertsJ.D. FieldT.S. Who is at risk of atrial fibrillation?Heart Rhythm202118685385410.1016/j.hrthm.2021.02.01933639297
    [Google Scholar]
  12. XuH. YangF. BaoZ. Gut microbiota and myocardial fibrosis.Eur. J. Pharmacol.202394017535510.1016/j.ejphar.2022.17535536309048
    [Google Scholar]
  13. WolfP.A. AbbottR.D. KannelW.B. Atrial fibrillation as an independent risk factor for stroke: The Framingham Study.Stroke199122898398810.1161/01.STR.22.8.9831866765
    [Google Scholar]
  14. TakiishiT. FeneroC.I.M. CâmaraN.O.S. Intestinal barrier and gut microbiota: Shaping our immune responses throughout life.Tissue Barriers201754e137320810.1080/21688370.2017.137320828956703
    [Google Scholar]
  15. WeissG.A. HennetT. Mechanisms and consequences of intestinal dysbiosis.Cell. Mol. Life Sci.201774162959297710.1007/s00018‑017‑2509‑x28352996
    [Google Scholar]
  16. BidellM.R. HobbsA.L.V. LodiseT.P. Gut microbiome health and dysbiosis: A clinical primer.Pharmacotherapy2022421184985710.1002/phar.273136168753
    [Google Scholar]
  17. ThursbyE. JugeN. Introduction to the human gut microbiota.Biochem. J.2017474111823183610.1042/BCJ2016051028512250
    [Google Scholar]
  18. MłynarskaE. GadzinowskaJ. TokarekJ. The role of the microbiome-brain-gut axis in the pathogenesis of depressive disorder.Nutrients2022149192110.3390/nu1409192135565888
    [Google Scholar]
  19. Zysset-BurriD. MorandiS. HerzogE. The role of the gut microbiome in eye diseases.Prog. Retin. Eye Res.20229210111710.1016/j.preteyeres.2022.10111736075807
    [Google Scholar]
  20. MelnychukI. LizogubV.G. Gut microbiota composition and its metabolites changes in patients with atherosclerosis and atrial fibrillation.Wiad. Lek.202275122994299910.36740/WLek20221211736723316
    [Google Scholar]
  21. StrasserB. WoltersM. WeyhC. KrügerK. TicinesiA. The effects of lifestyle and diet on gut microbiota composition, inflammation and muscle performance in our aging society.Nutrients2021136204510.3390/nu1306204534203776
    [Google Scholar]
  22. FangC. ZuoK. LiuZ. LiuY. LiuL. WangY. YinX. LiJ. LiuX. ChenM. YangX. Disordered gut microbiota promotes atrial fibrillation by aggravated conduction disturbance and unbalanced linoleic acid/SIRT1 signaling.Biochem. Pharmacol.202321311559910.1016/j.bcp.2023.11559937196685
    [Google Scholar]
  23. PengJ. XiaoX. HuM. ZhangX. Interaction between gut microbiome and cardiovascular disease.Life Sci.201821415315710.1016/j.lfs.2018.10.06330385177
    [Google Scholar]
  24. CampanielloD. CorboM.R. SinigagliaM. SperanzaB. RacioppoA. AltieriC. BevilacquaA. How diet and physical activity modulate gut microbiota: Evidence, and perspectives.Nutrients20221412245610.3390/nu1412245635745186
    [Google Scholar]
  25. ZhangL. LiuY. SunY. ZhangX. Combined physical exercise and diet: Regulation of gut microbiota to prevent and treat of metabolic disease: A review.Nutrients20221422477410.3390/nu1422477436432462
    [Google Scholar]
  26. HuoL. LiH. ZhuM. LiuY. RenL. HuJ. WangX. Enhanced trimethylamine metabolism and gut dysbiosis in type 2 diabetes mellitus with microalbumin.Front. Endocrinol. (Lausanne)202314125745710.3389/fendo.2023.125745738075058
    [Google Scholar]
  27. Morwani-MangnaniJ. GiannosP. BelzerC. BeekmanM. Eline SlagboomP. ProkopidisK. Gut microbiome changes due to sleep disruption in older and younger individuals: A case for sarcopenia?Sleep20224512zsac23910.1093/sleep/zsac23936183306
    [Google Scholar]
  28. SassoJ.M. AmmarR.M. TenchovR. Gut microbiome-brain alliance: A landscape view into mental and gastrointestinal health and disorders.ACS Chem. Neurosci.202314101717176310.1021/acschemneuro.3c0012737156006
    [Google Scholar]
  29. TabataT. YamashitaT. HosomiK. ParkJ. HayashiT. YoshidaN. SaitoY. FukuzawaK. KonishiK. MurakamiH. KawashimaH. MizuguchiK. MiyachiM. KunisawaJ. HirataK. Gut microbial composition in patients with atrial fibrillation: effects of diet and drugs.Heart Vessels202136110511410.1007/s00380‑020‑01669‑y32683492
    [Google Scholar]
  30. AriasN. ArboleyaS. AllisonJ. KaliszewskaA. HigarzaS.G. GueimondeM. AriasJ.L. The relationship between choline bioavailability from diet, intestinal microbiota composition, and its modulation of human diseases.Nutrients2020128234010.3390/nu1208234032764281
    [Google Scholar]
  31. BrandsmaE. A proinflammatory gut microbiota increases systemic inflammation and accelerates atherosclerosis.Circ. Res.201912419410010.1161/CIRCRESAHA.118.31323430582442
    [Google Scholar]
  32. FanL. ChenJ. PanL. XinX. GengB. YangL. WangQ. MaW. LouY. BianJ. CuiX. LiJ. WangL. ChenZ. WangW. CuiC. LiS. GaoQ. SongQ. DengY. FanJ. YuJ. ZhangH. LiY. CaiJ. Alterations of gut microbiome, metabolome, and lipidome in takayasu arteritis.Arthritis Rheumatol.202375226627810.1002/art.4233136054683
    [Google Scholar]
  33. ChenL. ChenJ. HuangY. WuY. LiJ. NiW. LuY. LiZ. ZhaoC. KongS. ZhouH. QuX. Changes of the gut microbiota composition and short chain fatty acid in patients with atrial fibrillation.PeerJ202311e1622810.7717/peerj.1622838084144
    [Google Scholar]
  34. GuoY. LipG.Y.H. ApostolakisS. Inflammation in atrial fibrillation.J. Am. Coll. Cardiol.201260222263227010.1016/j.jacc.2012.04.06323194937
    [Google Scholar]
  35. SchoelerM. CaesarR. Dietary lipids, gut microbiota and lipid metabolism.Rev. Endocr. Metab. Disord.201920446147210.1007/s11154‑019‑09512‑031707624
    [Google Scholar]
  36. CandelliM. FranzaL. PignataroG. OjettiV. CovinoM. PiccioniA. GasbarriniA. FranceschiF. Interaction between lipopolysaccharide and gut microbiota in inflammatory bowel diseases.Int. J. Mol. Sci.20212212624210.3390/ijms2212624234200555
    [Google Scholar]
  37. FanY. OlufP. Gut microbiota in human metabolic health and disease.Nat. Rev. Microbiol.2021191557110.1038/s41579‑020‑0433‑932887946
    [Google Scholar]
  38. ManolisA.A. ManolisT.A. MelitaH. ManolisA.S. Gut microbiota and cardiovascular disease: Symbiosis versus dysbiosis.Curr. Med. Chem.202229234050407710.2174/092986732866621121311294934961453
    [Google Scholar]
  39. AkhtarM. ChenY. MaZ. ZhangX. ShiD. KhanJ.A. LiuH. Gut microbiota-derived short chain fatty acids are potential mediators in gut inflammation.Anim. Nutr.2022835036010.1016/j.aninu.2021.11.00535510031
    [Google Scholar]
  40. HaradaM. Van WagonerD.R. NattelS. Role of inflammation in atrial fibrillation pathophysiology and management.Circ. J.201579349550210.1253/circj.CJ‑15‑013825746525
    [Google Scholar]
  41. HuangR. YanL. LeiY. The gut microbial-derived metabolite trimethylamine n-oxide and atrial fibrillation: Relationships, mechanisms, and therapeutic strategies.Clin. Interv. Aging2021161975198610.2147/CIA.S33959034876810
    [Google Scholar]
  42. PalmuJ. BörschelC.S. Ortega-AlonsoA. MarkóL. InouyeM. JousilahtiP. SalidoR.A. SandersK. BrennanC. HumphreyG.C. SandersJ.G. GutmannF. LinzD. SalomaaV. HavulinnaA.S. ForslundS.K. KnightR. LahtiL. NiiranenT. SchnabelR.B. Gut microbiome and atrial fibrillation - Results from a large population-based study.EBioMedicine20239110458310.1016/j.ebiom.2023.10458337119735
    [Google Scholar]
  43. IharaK. SasanoT. Role of inflammation in the pathogenesis of atrial fibrillation.Front. Physiol.20221386216410.3389/fphys.2022.86216435492601
    [Google Scholar]
  44. XuF. FuY. SunT. JiangZ. MiaoZ. ShuaiM. GouW. LingC. YangJ. WangJ. ChenY. ZhengJ.S. The interplay between host genetics and the gut microbiome reveals common and distinct microbiome features for complex human diseases.Microbiome20208114510.1186/s40168‑020‑00923‑933032658
    [Google Scholar]
  45. Le ChatelierE. NielsenT. QinJ. PriftiE. HildebrandF. FalonyG. AlmeidaM. ArumugamM. BattoJ.M. KennedyS. LeonardP. LiJ. BurgdorfK. GrarupN. JørgensenT. BrandslundI. NielsenH.B. JunckerA.S. BertalanM. LevenezF. PonsN. RasmussenS. SunagawaS. TapJ. TimsS. ZoetendalE.G. BrunakS. ClémentK. DoréJ. KleerebezemM. KristiansenK. RenaultP. Sicheritz-PontenT. de VosW.M. ZuckerJ.D. RaesJ. HansenT. GuedonE. DelormeC. LayecS. KhaciG. van de GuchteM. VandemeulebrouckG. JametA. DervynR. SanchezN. MaguinE. HaimetF. WinogradskiY. CultroneA. LeclercM. JusteC. BlottièreH. PelletierE. LePaslierD. ArtiguenaveF. BrulsT. WeissenbachJ. TurnerK. ParkhillJ. AntolinM. ManichanhC. CasellasF. BoruelN. VarelaE. TorrejonA. GuarnerF. DenariazG. DerrienM. van Hylckama VliegJ.E.T. VeigaP. OozeerR. KnolJ. RescignoM. BrechotC. M’RiniC. MérieuxA. YamadaT. BorkP. WangJ. EhrlichS.D. PedersenO. Richness of human gut microbiome correlates with metabolic markers.Nature2013500746454154610.1038/nature1250623985870
    [Google Scholar]
  46. ZhangY. ZhangX. ChenD. LuJ. GongQ. FangJ. JiangJ. Causal associations between gut microbiome and cardiovascular disease: A Mendelian randomization study.Front. Cardiovasc. Med.2022997137610.3389/fcvm.2022.97137636110421
    [Google Scholar]
  47. GawałkoM. AgbaedengT.A. SaljicA. MüllerD.N. WilckN. SchnabelR. PendersJ. RienstraM. van GelderI. JespersenT. SchottenU. CrijnsH.J.G.M. KalmanJ.M. SandersP. NattelS. DobrevD. LinzD. Gut microbiota, dysbiosis and atrial fibrillation. Arrhythmogenic mechanisms and potential clinical implications.Cardiovasc. Res.2022118112415242710.1093/cvr/cvab29234550344
    [Google Scholar]
  48. LiJ. ZuoK. ZhangJ. HuC. WangP. JiaoJ. LiuZ. YinX. LiuX. LiK. YangX. Shifts in gut microbiome and metabolome are associated with risk of recurrent atrial fibrillation.J. Cell. Mol. Med.20202422133561336910.1111/jcmm.1595933058365
    [Google Scholar]
  49. YuL. MengG. HuangB. ZhouX. StavrakisS. WangM. LiX. ZhouL. WangY. WangM. WangZ. DengJ. PoS.S. JiangH. A potential relationship between gut microbes and atrial fibrillation: Trimethylamine N-oxide, a gut microbe-derived metabolite, facilitates the progression of atrial fibrillation.Int. J. Cardiol.2018255929810.1016/j.ijcard.2017.11.07129425570
    [Google Scholar]
  50. Al-KaiseyA.M. FiggettW. Gut microbiota and atrial fibrillation: Pathogenesis, mechanisms and therapies.Arrhythm. Electrophysiol. Rev.202312e1410.15420/aer.2022.3337427301
    [Google Scholar]
  51. RashidS. NoorT.A. SaeedH. AliA.S. MeheshwariG. MehmoodA. FatimaL. ZaidiS.M.J. MalikJ. MehmoodiA. HayatA. Association of gut microbiome dysbiosis with the progression of atrial fibrillation: A systematic review.Ann. Noninvasive Electrocardiol.2023284e1305910.1111/anec.1305936940225
    [Google Scholar]
  52. SitkinS.I. TkachenkoE.I. VakhitovT.Y. Metabolic dysbiosis of the gut microbiota and its biomarkers.Eksp. Klin. Gastroenterol.2016121262929889418
    [Google Scholar]
  53. HemmatiM. KashanipoorS. MazaheriP. AlibabaeiF. BabaeizadA. AsliS. MohammadiS. GorginA.H. GhodsK. YousefiB. EslamiM. Importance of gut microbiota metabolites in the development of cardiovascular diseases (CVD).Life Sci.202332912194710.1016/j.lfs.2023.12194737463653
    [Google Scholar]
  54. ZuoK. LiJ. LiK. HuC. GaoY. ChenM. HuR. LiuY. ChiH. WangH. QinY. LiuX. LiS. CaiJ. ZhongJ. YangX. Disordered gut microbiota and alterations in metabolic patterns are associated with atrial fibrillation.Gigascience201986giz05810.1093/gigascience/giz05831149718
    [Google Scholar]
  55. WangY. HeY. LiR. JiangH. TaoD. ZhaoK. YinZ. ZhangJ. WangH. Gut microbiota in patients with postoperative atrial fibrillation undergoing off-pump coronary bypass graft surgery.J. Clin. Med.2023124149310.3390/jcm1204149336836027
    [Google Scholar]
  56. MatsumotoN. ParkJ. TomizawaR. KawashimaH. HosomiK. MizuguchiK. HondaC. OzakiR. IwataniY. WatanabeM. KunisawaJ. Relationship between nutrient intake and human gut microbiota in monozygotic twins.Medicina (Kaunas)202157327510.3390/medicina5703027533809761
    [Google Scholar]
  57. HuangK. WangY. BaiY. LuoQ. LinX. YangQ. WangS. XinH. Gut microbiota and metabolites in atrial fibrillation patients and their changes after catheter ablation.Microbiol. Spectr.2022102e01077-2110.1128/spectrum.01077‑2135293804
    [Google Scholar]
  58. LuD. ZouX. ZhangH. The relationship between atrial fibrillation and intestinal flora with its metabolites.Front. Cardiovasc. Med.2022994875510.3389/fcvm.2022.94875535845042
    [Google Scholar]
  59. YooJ.Y. SniffenS. McGill PercyK.C. PallavalV.B. ChidipiB. Gut dysbiosis and immune system in atherosclerotic cardiovascular disease (ACVD).Microorganisms202210110810.3390/microorganisms1001010835056557
    [Google Scholar]
  60. FanH. LiuX. RenZ. FeiX. LuoJ. YangX. XueY. ZhangF. LiangB. Gut microbiota and cardiac arrhythmia.Front. Cell. Infect. Microbiol.202313114768710.3389/fcimb.2023.114768737180433
    [Google Scholar]
  61. ZhangY. ZhangS. LiB. LuoY. GongY. JinX. ZhangJ. ZhouY. ZhuoX. WangZ. ZhaoX. HanX. GaoY. YuH. LiangD. ZhaoS. SunD. WangD. XuW. QuG. BoW. LiD. WuY. LiY. Gut microbiota dysbiosis promotes age-related atrial fibrillation by lipopolysaccharide and glucose-induced activation of NLRP3-inflammasome.Cardiovasc. Res.2022118378579710.1093/cvr/cvab11433757127
    [Google Scholar]
  62. XingY. YanL. LiX. XuZ. WuX. GaoH. ChenY. MaX. LiuJ. ZhangJ. The relationship between atrial fibrillation and NLRP3 inflammasome: A gut microbiota perspective.Front. Immunol.202314127352410.3389/fimmu.2023.127352438077349
    [Google Scholar]
  63. LinzD. GawałkoM. SandersP. PendersJ. LiN. NattelS. DobrevD. Does gut microbiota affect atrial rhythm? Causalities and speculations.Eur. Heart J.202142353521352510.1093/eurheartj/ehab46734338744
    [Google Scholar]
  64. ChenY. ZhouJ. WangL. Role and mechanism of gut microbiota in human disease.Front. Cell. Infect. Microbiol.20211162591310.3389/fcimb.2021.62591333816335
    [Google Scholar]
  65. LuoQ. HuY. ChenX. LuoY. ChenJ. WangH. Effects of gut microbiota and metabolites on heart failure and its risk factors: A two-sample mendelian randomization study.Front. Nutr.2022989974610.3389/fnut.2022.89974635799593
    [Google Scholar]
  66. MorelliM.B. WangX. SantulliG. Functional role of gut microbiota and PCSK9 in the pathogenesis of diabetes mellitus and cardiovascular disease.Atherosclerosis201928917617810.1016/j.atherosclerosis.2019.07.02331431286
    [Google Scholar]
  67. Hoseini-TavassolZ. Hasani-RanjbarS. Targeting TMAO and its metabolic pathway for cardiovascular diseases treatment.J. Diabetes Metab. Disord.20212011095109710.1007/s40200‑021‑00819‑x34178875
    [Google Scholar]
  68. LiN. WangL. LiL. YangM.Z. WangQ.X. BaiX.W. GaoF. YuanY.Q. YuZ.J. RenZ.G. The correlation between gut microbiome and atrial fibrillation: Pathophysiology and therapeutic perspectives.Mil. Med. Res.20231015110.1186/s40779‑023‑00489‑137936201
    [Google Scholar]
  69. DaiH. HouT. WangQ. HouY. ZhuZ. ZhuY. ZhaoZ. LiM. LinH. WangS. ZhengR. XuY. LuJ. WangT. NingG. WangW. ZhengJ. BiY. XuM. The gut microbiota and inflammation: An overview.Int. J. Environ. Res. Public Health20201720761810.3390/ijerph17207618
    [Google Scholar]
  70. DaiH. HouT. WangQ. Roles of gut microbiota in atrial fibrillation: Insights from Mendelian randomization analysis and genetic data from over 430,000 cohort study participants.Cardiovasc. Diabetol.202322130610.1186/s12933‑023‑02045‑637940997
    [Google Scholar]
/content/journals/nemj/10.2174/0102506882332720241004072452
Loading
/content/journals/nemj/10.2174/0102506882332720241004072452
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test