Abstract

Introduction: The “gut-heart axis” could explain the role of the human gut microbiota in the pathogenesis of heart failure (HF) by activation of host inflammation induced by a state of gut dysbiosis. This systematic review characterized the gut microbiota profile in HF patients compared to healthy subjects. Methods: Peer-reviewed human studies published in Ovid MEDLINE, Ovid EMBASE, SCOPUS, and the Cochrane Library up to April 18, 2022, were searched. Studies comparing the gut microbiota profile in adult HF patients and healthy controls (HCs) were eligible for inclusion. The alpha diversity (microbial richness and diversity), beta diversity (dissimilarity in microbiota composition between two groups), and the relative abundance of gut microbiota taxa were compared in adult HF patients and HCs. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of included studies. Results: A total of nine studies, including 317 HF patients and 510 HCs, were included in this systematic review. Decreased gut microbiota richness and similar microbial diversity and significantly different gut microbiota composition were observed between HF patients and HCs. HF patients had a greater abundance of Actinobacteria, Proteobacteria, and Synergistetes phyla; Enterococcus, Escherichia, Klebsiella, Lactobacillus, Ruminococcus, Streptococcus, and Veilonella genera; and Ruminococcus gnavus, Streptococcus sp., and Veilonella sp. Species compared to HCs. Decreased abundance of Firmicutes phylum; Blautia, Eubacterium, Faecalibacterium, Lachnospiraceae FCS020, and Sutterella genera; and Dorea longicatena, Eubacterium rectale, Faecalibacterium prausnitzii, Oscillibacter sp., and Sutterella wadsworthensis species were noted in HF patients. Conclusion: The gut microbiota diversity, richness, and composition in HF patients are significantly different from HCs. Overall, short-chain fatty acids-producing gut microbiota was depleted in HF patients.

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