Host-microbiota interactions involving inflammatory and metabolic pathways have been linked to the pathogenesis of multiple immune-mediated diseases and metabolic conditions like diabetes and obesity. Accumulating evidence suggests that alterations in the gut microbiome could play a role in cardiovascular disease. This review focuses on recent advances in our understanding of the interplay between diet, gut microbiota and cardiovascular disease, with emphasis on heart failure and coronary artery disease. Whereas much of the literature has focused on the circulating levels of the diet- and microbiota-dependent metabolite trimethylamine-N-oxide (TMAO), several recent sequencing-based studies have demonstrated compositional and functional alterations in the gut microbiomes in both diseases. Some microbiota characteristics are consistent across several study cohorts, such as a decreased abundance of microbes with capacity for producing butyrate. However, the published gut microbiota studies generally lack essential covariates like diet and clinical data, are too small to capture the substantial variation in the gut microbiome, and lack parallel plasma samples, limiting the ability to translate the functional capacity of the gut microbiomes to actual function reflected by circulating microbiota-related metabolites. This review attempts to give directions for future studies in order to demonstrate clinical utility of the gut-heart axis.

中文翻译：

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冠状动脉疾病和心力衰竭中的肠道微生物组：当前知识和未来方向。

涉及炎症和代谢途径的宿主菌群相互作用已与多种免疫介导的疾病和诸如糖尿病和肥胖症等代谢疾病的发病机理相关。越来越多的证据表明，肠道微生物组的改变可能在心血管疾病中起作用。这篇综述着重于我们对饮食，肠道菌群和心血管疾病之间相互作用的理解的最新进展，重点是心力衰竭和冠状动脉疾病。尽管许多文献集中在饮食和微生物群依赖的代谢物三甲胺-N-氧化物（TMAO）的循环水平上，但最近一些基于测序的研究表明，两种疾病中肠道微生物群的组成和功能均发生了变化。在一些研究队列中，某些微生物群特征是一致的，例如具有丁酸生产能力的微生物数量减少。然而，已发表的肠道微生物群研究通常缺乏必要的协变量，如饮食和临床数据，太小而无法捕获肠道微生物组的实质性变化，并且缺乏平行的血浆样品，从而限制了将肠道微生物群功能转化为实际的能力。循环微生物群相关代谢产物反映的功能。这篇综述试图为今后的研究提供指导，以证明肠心轴的临床实用性。已发表的肠道菌群研究通常缺乏基本的协变量，如饮食和临床数据，太小而无法捕获肠道菌群的实质性变化，并且缺乏平行的血浆样本，从而限制了将肠道菌群的功能转化为实际功能的能力通过循环微生物相关的代谢产物。这篇综述试图为今后的研究提供指导，以证明肠心轴的临床实用性。已发表的肠道菌群研究通常缺乏基本的协变量，如饮食和临床数据，太小而无法捕获肠道菌群的实质性变化，并且缺乏平行的血浆样本，从而限制了将肠道菌群的功能转化为实际功能的能力通过循环微生物相关的代谢产物。这篇综述试图为将来的研究提供指导，以证明肠心轴的临床实用性。