New Study worth the reading. I suggest to open the link to see the images as well.
Therapeutic Implications
Despite the current lack of human studies to support interventions aimed at modifying the gut microbiota in the prevention and management of AF, recent preclinical animal studies have highlighted the potential impact of gut microbiota modification on AF susceptibility.62,63 Zhang et al. showed that transplantation of young faecal microbiota into AF-susceptible aged rats led to a reduction in LPS concentration, suppression of NLRP3 activity, decreased atrial fibrosis and AF inducibility.63 Moreover, several studies have shown promise towards managing AF risk factors. Probiotics rich in Lactobacillus spp. and Bifidobacterium spp. have been shown to be effective in the management of AF risk factors such as atherosclerosis, dyslipidaemia and hypertension.71–73 Supplementation with SCFAs (propionate) is associated with improved insulin sensitivity and blood pressure control.74,75 Faecal microbial transplantation in humans has been associated with improved insulin sensitivity in patients with metabolic syndrome.76 Future studies are required to determine whether the aforementioned interventions have an impact on AF pathogenesis.
Future Directions
Although an extensive body of evidence is present to support differences in gut microbiota in AF patients compared with healthy controls, direct evidence linking gut-associated metabolites to AF susceptibility is still lacking. Large studies comparing individuals with and without gut dysbiosis and adjusted AF risk factors are needed.
In addition, although current interventions such as probiotics, faecal microbial transplantation and diet have shown promise in the management of AF risk factors, there is no clear evidence to support their role in the prevention or treatment of AF. Randomised clinical studies to study the impact of each component are required to answer that question.
Last, elevated blood concentrations of gut-associated metabolites have been associated with recurrence following AF catheter ablation in small observational studies. Large studies are required to determine whether using such metabolites would add to the current clinical recurrence prediction algorithms to assist in choosing patients who are likely to benefit from AF ablation.
Conclusion
With advancements in the molecular assessment of the gut microbiota, there is an emerging body of evidence to suggest that there is a link between gut dysbiosis and AF. Animal and human experimental studies are required to determine the mechanistic link between gut dysbiosis and arrhythmogenesis in AF. This would pave the way towards conducting clinical interventional studies to determine whether the gut dysbiosis is a modifiable AF risk factor.
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Edited 2 time(s). Last edit at 09/05/2023 11:40PM by Marco.
