The gut microbiota-inflammation-HFpEF axis: deciphering the role of gut microbiota dysregulation in the pathogenesis and management of HFpEF

Heart failure with preserved left ventricular ejection fraction (HFpEF) is a disease that affects multiple organs throughout the body, accounting for over 50% of heart failure cases. HFpEF has a significant impact on individuals’ life expectancy and quality of life, but the exact pathogenesis remain...

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Main Authors: Shenghua Zhou, Xuan Zhou, Panpan Zhang, Wei Zhang, Jinli Huang, Xuzhao Jia, Xiaole He, Xin Sun, Hui Su
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1537576/full
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author Shenghua Zhou
Xuan Zhou
Panpan Zhang
Wei Zhang
Jinli Huang
Xuzhao Jia
Xiaole He
Xin Sun
Hui Su
author_facet Shenghua Zhou
Xuan Zhou
Panpan Zhang
Wei Zhang
Jinli Huang
Xuzhao Jia
Xiaole He
Xin Sun
Hui Su
author_sort Shenghua Zhou
collection DOAJ
description Heart failure with preserved left ventricular ejection fraction (HFpEF) is a disease that affects multiple organs throughout the body, accounting for over 50% of heart failure cases. HFpEF has a significant impact on individuals’ life expectancy and quality of life, but the exact pathogenesis remains unclear. Emerging evidence implicates low-grade systemic inflammation as a crucial role in the onset and progression of HFpEF. Gut microbiota dysregulation and associated metabolites alteration, including short-chain fatty acids, trimethylamine N-oxides, amino acids, and bile acids can exacerbate chronic systemic inflammatory responses and potentially contribute to HFpEF. In light of these findings, we propose the hypothesis of a “gut microbiota-inflammation-HFpEF axis”, positing that the interplay within this axis could be a crucial factor in the development and progression of HFpEF. This review focuses on the role of gut microbiota dysregulation-induced inflammation in HFpEF’s etiology. It explores the potential mechanisms linking dysregulation of the gut microbiota to cardiac dysfunction and evaluates the therapeutic potential of restoring gut microbiota balance in mitigating HFpEF severity. The objective is to offer novel insights and strategies for the management of HFpEF.
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spelling doaj-art-b169a648eda94d67b8bd402b4e8ec2282025-08-20T02:52:52ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-03-011510.3389/fcimb.2025.15375761537576The gut microbiota-inflammation-HFpEF axis: deciphering the role of gut microbiota dysregulation in the pathogenesis and management of HFpEFShenghua Zhou0Xuan Zhou1Panpan Zhang2Wei Zhang3Jinli Huang4Xuzhao Jia5Xiaole He6Xin Sun7Hui Su8Department of Geriatrics, Xijing Hospital, the Fourth Military Medical University, Xi’an, ChinaDepartment of Geriatrics, Xijing Hospital, the Fourth Military Medical University, Xi’an, ChinaDepartment of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi’an, ChinaDepartment of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi’an, ChinaDepartment of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi’an, ChinaDepartment of Geriatrics, Xijing Hospital, the Fourth Military Medical University, Xi’an, ChinaDepartment of General Practice, Xijing Hospital, the Fourth Military Medical University, Xi’an, ChinaDepartment of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi’an, ChinaDepartment of Geriatrics, Xijing Hospital, the Fourth Military Medical University, Xi’an, ChinaHeart failure with preserved left ventricular ejection fraction (HFpEF) is a disease that affects multiple organs throughout the body, accounting for over 50% of heart failure cases. HFpEF has a significant impact on individuals’ life expectancy and quality of life, but the exact pathogenesis remains unclear. Emerging evidence implicates low-grade systemic inflammation as a crucial role in the onset and progression of HFpEF. Gut microbiota dysregulation and associated metabolites alteration, including short-chain fatty acids, trimethylamine N-oxides, amino acids, and bile acids can exacerbate chronic systemic inflammatory responses and potentially contribute to HFpEF. In light of these findings, we propose the hypothesis of a “gut microbiota-inflammation-HFpEF axis”, positing that the interplay within this axis could be a crucial factor in the development and progression of HFpEF. This review focuses on the role of gut microbiota dysregulation-induced inflammation in HFpEF’s etiology. It explores the potential mechanisms linking dysregulation of the gut microbiota to cardiac dysfunction and evaluates the therapeutic potential of restoring gut microbiota balance in mitigating HFpEF severity. The objective is to offer novel insights and strategies for the management of HFpEF.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1537576/fullHFpEFinflammationgut microbiotametabolitesprobioticsfecal microbial transplantation
spellingShingle Shenghua Zhou
Xuan Zhou
Panpan Zhang
Wei Zhang
Jinli Huang
Xuzhao Jia
Xiaole He
Xin Sun
Hui Su
The gut microbiota-inflammation-HFpEF axis: deciphering the role of gut microbiota dysregulation in the pathogenesis and management of HFpEF
Frontiers in Cellular and Infection Microbiology
HFpEF
inflammation
gut microbiota
metabolites
probiotics
fecal microbial transplantation
title The gut microbiota-inflammation-HFpEF axis: deciphering the role of gut microbiota dysregulation in the pathogenesis and management of HFpEF
title_full The gut microbiota-inflammation-HFpEF axis: deciphering the role of gut microbiota dysregulation in the pathogenesis and management of HFpEF
title_fullStr The gut microbiota-inflammation-HFpEF axis: deciphering the role of gut microbiota dysregulation in the pathogenesis and management of HFpEF
title_full_unstemmed The gut microbiota-inflammation-HFpEF axis: deciphering the role of gut microbiota dysregulation in the pathogenesis and management of HFpEF
title_short The gut microbiota-inflammation-HFpEF axis: deciphering the role of gut microbiota dysregulation in the pathogenesis and management of HFpEF
title_sort gut microbiota inflammation hfpef axis deciphering the role of gut microbiota dysregulation in the pathogenesis and management of hfpef
topic HFpEF
inflammation
gut microbiota
metabolites
probiotics
fecal microbial transplantation
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1537576/full
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