The microbiome\u2019s relationship with congenital heart disease: more than a gut feeling

Dan Feng,Anji T. Yetman,Jeffrey D. Salomon,Amar B. Singh,Merry L. Lindsey,Jason T. Christensen

doi:10.1186/s40949-021-00060-4

Abstract

Patients with congenital heart disease (CHD) are at risk for developing intestinal dysbiosis and intestinal epithelial barrier dysfunction due to abnormal gut perfusion or hypoxemia in the context of low cardiac output or cyanosis. Intestinal dysbiosis may contribute to systemic inflammation thereby worsening clinical outcomes in this patient population. Despite significant advances in the management and survival of patients with CHD, morbidity remains significant and questions have arisen as to the role of the microbiome in the inflammatory process. Intestinal dysbiosis and barrier dysfunction experienced in this patient population are increasingly implicated in critical illness. This review highlights possible CHD-microbiome interactions, illustrates underlying signaling mechanisms, and discusses future directions and therapeutic translation of the basic research.

Highlights

Congenital heart disease (CHD) remains an important risk for morbidity and mortality in the pediatric population, accounting for up to 50 % of mortality due to birth defects[1]
The intestinal microbiome is important in regulating health and homeostasis [15–18], and its dysregulation has been well studied in critical illness [19–21] and the cardiac surgical population [22–24]
In this review we examine the composition of the intestinal microbiome, discuss the evidence of the microbiota’s relationship with CHD, and discuss future directions for research and therapeutic interventions to improve outcomes

Summary

Introduction

Congenital heart disease (CHD) remains an important risk for morbidity and mortality in the pediatric population, accounting for up to 50 % of mortality due to birth defects[1]. Pre- and post-operative inflammatory responses can lead to abnormalities in the intestinal microbiome and contribute to worse outcomes following cardiac surgery. Elevations of pro-inflammatory bacteria, Proteobacteria, in the blood have been associated with an increased risk of developing cardiovascular diseases [45].

Results

Conclusion