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The Role of Gut Microbiota and Trimethylamine N-oxide in Cardiovascular Diseases

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Abstract

Changes in the intestinal flora and its metabolites have been associated with cardiovascular disease (CVD). Short-chain fatty acids, bile acids, and especially trimethylamine N-oxide (TMAO), an endothelial toxic factor produced by gut microbiota from phosphatidylcholine in meat, have been identified to be closely related to endothelial cell dysfunction as well as tightly affiliated with CVD, the two main types being coronary artery disease (CAD) and coronary microvascular disease (CMVD). We discuss how changes in the gut flora and the metabolite TMAO contribute to the development of CAD and CMVD. The above insight might serve as a stepping stone for novel CAD and CMVD diagnostics and therapies centered on microbiota.

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Abbreviations

CVD:

Cardiovascular diseases

CAD:

Coronary artery diseases

CMVD:

Coronary microvascular diseases

TMAO:

Trimethylamine N-oxide

ROS:

Reactive oxygen species

AS:

Atherosclerosis

NO:

Nitric oxide

HDL:

High-density lipoprotein

LDL:

Low-density lipoprotein

LPS:

Lipopolysaccharide

ADP:

Adenosine diphosphate

CFR:

Coronary flow reserve

MACEs:

Major adverse vascular events

TF:

Tissue factor

FMO:

Flavin-containing monooxygenase

FMT:

Fecal microbiota transplant

DMB:

3,3-Dimethyl-1-Butanol

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Funding

This research was funded by Clinical Research Plan of SHDC, grant number 2020CR4065; National Natural Science Foundation of China, grant number 82071956.

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Author notes

  1. Yan Huang and Han Zhang have equal contribution to this study as first co-author.

Authors and Affiliations

  1. Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Yanchang RD. 301, Shanghai, 200072, China

    Yan Huang, Han Zhang, Xin Fan, Yuzhen Yin, Yu Zhang & Fei Yu

  2. Medical College, Anhui University of Science and Technology, Huainan, China

    Yan Huang & Junpeng Wang

  3. Department of Informatics, Technical University of Munich, München, Germany

    Kuangyu Shi

  4. Department of Nuclear Medicine, University of Bern, Bern, Switzerland

    Kuangyu Shi

  5. Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China

    Fei Yu

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Contributions

F.Y. and H.Z. had the idea for the article; Y.H. performed the literature search and initial writing; H.Z. and X.F. critically revised the work. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Fei Yu.

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Huang, Y., Zhang, H., Fan, X. et al. The Role of Gut Microbiota and Trimethylamine N-oxide in Cardiovascular Diseases. J. of Cardiovasc. Trans. Res. 16, 581–589 (2023). https://doi.org/10.1007/s12265-022-10330-0

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