Intestinal microbiota in the pathogenesis of chronic heart failure

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Abstract

It is currently being discussed that the microbiota of the gastrointestinal tract and its metabolites affect the course of chronic heart failure (CHF). The purpose to summarize the available data on the role of the intestinal microbiota in the pathogenesis of CHF. Material and methods. A analysis of the main foreign and domestic sources on PubMed, MedLine, eLIBRARY databases over the last 20 years has been carried out. Results. In the course of the analysis of published works, the key links in the pathogenesis of CHF (imbalance of neurohumoral systems, inflammatory theory, metabolic disorders) and changes arising from disturbance of intestinal microbiota composition were compared. The results of studies where microbiota correction by prescribing antibiotics, probiotics and prebiotics resulted in positive effects on the course and prognosis in CHF are presented. Conclusion: Commonality in CHF pathogenesis (imbalance of neurohumoral systems, inflammatory theory and metabolic disorders) and changes in microbiota disturbances (including those mediated by microbial metabolites and inflammatory cytokines), the positive effects of pro- and prebiotics both on the microbial composition of the intestine and on course and prognosis in CHF, allow the consideration of microbiome as a marker and a possible target in CHF therapy. All of the above necessitates for further research in this area.

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About the authors

Maria Vadimovna Fadeeva

Sechenov First Moscow State University (Sechenov University)

Author for correspondence.
Email: maria.fad@yandex.ru
graduate student Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology Pogodinskaya str., 1, bld. 1., Moscow, Russian Federation, 119435

Manana Revazovna Skhirtladze

Sechenov First Moscow State University (Sechenov University)

Email: maria.fad@yandex.ru
Ph.D. Head of the Department of Cardiology of the Clinic for Propedeutics of Internal Diseases, Gastroenterology and Hepatology named after V.Kh. Vasilenko Pogodinskaya str., 1, bld. 1., Moscow, Russian Federation, 119435

Oxana Yuryevna Zolnikova

Sechenov First Moscow State University (Sechenov University)

Email: ks.med@mail.ru
Doctor of Medical Sciences, Associate Prof., Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology Pogodinskaya str., 1, bld. 1., Moscow, Russian Federation, 119435

Vladimir Trofimovich Ivashkin

Sechenov First Moscow State University (Sechenov University)

Email: kont07@yandex.ru
Doctor of Medical Sciences, RAS Academician, Prof., Departament Head, Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology Pogodinskaya str., 1, bld. 1., Moscow, Russian Federation, 119435

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Supplementary files

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2. Fig. 1. Effects of cell wall components of gram-positive and gram-negative intestinal bacteria

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3. Fig. 2. Changes in the structure and function of the intestinal wall in chronic heart failure

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4. Fig. 3. Violation of the gut barrier function in the inflammatory theory of chronic heart failure

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