Gut microbiota, dysbiosis and atrial fibrillation. Arrhythmogenic mechanisms and potential clinical implications

Research output: Contribution to journalReviewResearchpeer-review

  • Monika Gawalko
  • Thomas A. Agbaedeng
  • Saljic, Arnela
  • Dominik N. Mueller
  • Nicola Wilck
  • Renate Schnabel
  • John Penders
  • Michiel Rienstra
  • Isabelle van Gelder
  • Jespersen, Thomas
  • Ulrich Schotten
  • Harry J. G. M. Crijns
  • Jonathan M. Kalman
  • Prashanthan Sanders
  • Stanley Nattel
  • Dobromir Dobrev
  • Dr Linz, Dominik Karl

Recent preclinical and observational cohort studies have implicated imbalances in gut microbiota composition as a contributor to atrial fibrillation (AF). The gut microbiota is a complex and dynamic ecosystem containing trillions of microorganisms, which produces bioactive metabolites influencing host health and disease development. In addition to host-specific determinants, lifestyle-related factors such as diet and drugs are important determinants of the gut microbiota composition. In this review, we discuss the evidence suggesting a potential bidirectional association between AF and gut microbiota, identifying gut microbiota-derived metabolites as possible regulators of the AF substrate. We summarize the effect of gut microbiota on the development and progression of AF risk factors, including heart failure, hypertension, obesity, and coronary artery disease. We also discuss the potential anti-arrhythmic effects of pharmacological and diet-induced modifications of gut microbiota composition, which may modulate and prevent the progression to AF. Finally, we highlight important gaps in knowledge and areas requiring future investigation. Although data supporting a direct relationship between gut microbiota and AF are very limited at the present time, emerging preclinical and clinical research dealing with mechanistic interactions between gut microbiota and AF is important as it may lead to new insights into AF pathophysiology and the discovery of novel therapeutic targets for AF.

Original languageEnglish
JournalCardiovascular Research
Volume118
Issue number11
Pages (from-to)2415–2427
ISSN0008-6363
DOIs
Publication statusPublished - 2022

    Research areas

  • Arrhythmia, Atrial fibrillation, Cardiometabolic, Gut microbiota, Metabolites, TRIMETHYLAMINE-N-OXIDE, LIFE-STYLE INTERVENTION, BILE-ACID METABOLISM, INTESTINAL MICROBIOTA, HEART-FAILURE, L-CARNITINE, DIET, INFLAMMATION, ANTIBIOTICS, OVERWEIGHT

ID: 317957921