Abstract
Fructose is a main dietary sugar involved in the excess sugar intake-mediated progression of cardiovascular diseases and cardiac arrhythmias. Chronic intake of fructose has been the focus on the possible contributor to the metabolic diseases and cardiac inflammation. Recently, the small intestine was identified to be a major organ in fructose metabolism. The overconsumption of fructose induces dysbiosis of the gut microbiota, which, in turn, increases intestinal permeability and activates host inflammation. Endotoxins and metabolites of the gut microbiota, such as lipopolysaccharide, trimethylamine N-oxide, and short-chain fatty acids, also influence the host inflammation and cardiac biofunctions. Thus, high-fructose diets cause heart–gut axis disorders that promote cardiac arrhythmia. Understanding how gut microbiota dysbiosis-mediated inflammation influences the pathogenesis of cardiac arrhythmia may provide mechanisms for cardiac arrhythmogenesis. This narrative review updates our current understanding of the roles of excessive intake of fructose on the heart-gut axis and proposes potential strategies for inflammation-associated cardiac vascular diseases.
Highlights
These findings have suggested that excess fructose intake mediates metabolic syndrome (MetS)-promoting and cardiovascular diseases (CVD)-inducing by gut microbiota dysbiosis
Patient groups with persistent atrial fibrillation (AF) lasting 12 months shared many features of disordered gut microbiota and metabolism in common, which may happen in the early stage of the disease, whereas a prolonged persistent AF duration was connected to certain unique alterations [69]
The targeting of inflammation can potentially reduce the risk of cardiac arrhythmia, and the blocking of gut microbiota-mediated inflammation by reducing fructose intake, inhibiting inflammation signaling, and administering probiotics and dietary short-chain fatty acid (SCFA) may reduce the risk of CVDs
Summary
Epidemiological studies have suggested a possible link between the intake of fructose, including high-fructose corn sugar, with CVDs [3,4,5,6]. Excess fructose intake may be associated with risk factors for heart disease, such as non-alcoholic fatty liver disease (NAFLD), obesity, diabetes, kidney dysfunction, and dyslipidemia [13,14,15,16,17,18]. Low carbohydrate diet can reduce inflammation, blood pressure, and fasting blood glucose and enhance insulin sensitivity.
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