Gut microbiota and heart failure: bacterial metabolites role in cardiomyopathy.

The gut microbiota is a complex entity living in symbiosis with our organism, sometimes the symbiosis gets shattered by life events with detrimental consequences for human health. The gut microbiota can be associated to an endogenous organ since it can produce a wide range of metabolites that has beneficial or deleterious effects on the host. Recently, many researchers are trying to understand the complex interactions existing between the gut microbiota, its metabolites and the host organism, as those interactions showed to regulate the onset of several pathologies. One of the latest suggestions concern the involvement of dysbiosis (alterations in the composition of the gut microbiota) in the onset and progression of heart failure (HF), a multifactorial disease with a high mortality rate that every year affects millions of people in the word. The trimethylamine is a bacterial metabolite, it derives from foods rich in choline and L-carnitine, and it is transformed by the liver in trimethylamine n-oxide (TMAO). The TMAO has been found to cause, and affects, all the feature that characterize the heart during heart failure (hypertrophy, fibrosis, inflammation). Due to its harmful effects, higher circulating concentrations of TMAO exhibit to worsens the prognosis of patients with heart failure, highlighting its relevant role in the pathology.