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Heart failure is associated with depletion of core intestinal microbiota

机译：心力衰竭与核心肠道菌群耗竭有关

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Abstract Aims In spite of current medical treatment approaches, mortality of chronic heart failure (HF) remains high and novel treatment modalities are thus urgently needed. A recent theory proposes a possible impact of the intestinal microbiome on the incidence and clinical course of heart failure. This study sought to systematically investigate, if there are specific changes of the intestinal microbiome in heart failure patients. Methods and results The intestinal microbiome of 20 patients with heart failure with reduced ejection fraction due to ischemic or dilated cardiomyopathy was investigated by applying high-throughput sequencing of the bacterial 16S rRNA gene. Microbial profiles were compared to those of matched controls in which heart failure was ruled out by clinical assessment and NT-proBNP serum levels ( n = 20) . According to the Shannon diversity index (which measures the intra-individual alpha-diversity) based on the distribution of operational taxonomic units (OTUs), HF cases showed a nominally significantly lower diversity index compared to controls ( P nom. = 0.01), and testing for genera abundance showed a tendency towards a decreased alpha diversity of HF patients. Beta-diversity measures (inter-individual diversity) revealed a highly significant separation of HF cases and controls, (e.g. P weighted UniFracv = 0.004). Assessing the individual abundance of core measurable microbiota (CMM), a significant decrease of Coriobacteriaceae , Erysipelotrichaceae and Ruminococcaceae was observed on the family level. In line with that, Blautia , Collinsella , uncl. Erysipelotrichaceae and uncl. Ruminococcaceae showed a significant decrease in HF cases compared to controls on the genus level. Conclusions Heart failure patients showed a significantly decreased diversity of the intestinal microbiome as well as a downregulation of key intestinal bacterial groups. Our data point to an altered intestinal microbiome as a potential player in the pathogenesis and progression of heart failure.
机译：摘要目的尽管有当前的治疗方法，但慢性心力衰竭（HF）的死亡率仍然很高，因此迫切需要新颖的治疗方法。最近的理论提出肠道微生物组对心力衰竭的发生率和临床过程可能产生影响。这项研究试图系统地调查心力衰竭患者肠道微生物组是否有特定变化。方法和结果通过对细菌16S rRNA基因进行高通量测序，研究了20例因缺血性或扩张型心肌病而导致射血分数降低的心力衰竭患者的肠道微生物组。通过临床评估和NT-proBNP血清水平（n = 20），将微生物谱与匹配的对照组进行了比较，在对照组中，心力衰竭被排除。根据基于操作分类单位（OTU）分布的Shannon多样性指数（用于衡量个体内部alpha多样性），与对照组相比，HF病例的名义多样性指数明显低（P nom = 0.01），并且属丰富度的测试表明，HF患者的alpha多样性有降低的趋势。 Beta多样性指标（个体间多样性）表明，HF病例和对照之间的分离非常显着（例如，P加权UniFracv = 0.004）。评估核心可测量菌群（CMM）的个体丰度，在家庭水平上观察到了Coriobacteriaceae，Erysipelotrichaceae和Ruminococcaceae的显着减少。与此相对应的是Blautia，Collinsella和uncl。丹参科和Uncl。与属水平的对照相比，Ruminococcaceae在HF病例中显示出明显减少。结论心力衰竭患者肠道微生物组多样性显着降低，关键肠道细菌群表达下调。我们的数据表明，肠道微生物组的改变是心力衰竭发病机理和进展的潜在因素。

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