STUDY OF THE GUT MICROBIOTA COMPOSITION ROLE IN THE CONTEXT OF CHRONIC HEART FAILURE DEVELOPMENT: REVIEW OF CURRENT DATA

Abstract

Background. Chronic heart failure (CHF) is a global health issue with high mortality rates. According to statistical data, 
in Kazakhstan, 4.7% of the population suffers from CHF, which amounts to approximately 320,000 people. In the United 
States, 6.7 million individuals are affected, with projections rising to 8.5 million by 2030. Despite advancements in treatment, 
mortality rates remain high. Recent studies highlight the role of gut microbiota in systemic inflammation, a key factor in 
cardiovascular diseases. Exploring the gut microbiota offers a novel perspective for understanding CHF pathogenesis and 
potential therapeutic interventions. 
Aim. The review aims to explore the role of gut microbiota in the development and progression of CHF and examine new 
methods to improve the clinical status of patients through gut microbiota modulation. 
Search strategy. A literature review was conducted using PubMed, Medline, Cochrane Central register of Controlled 
Trials database, Web of Science, Scopus, https://elibrary.ru, and Google Scholar over the past 10 years, providing 
information on the role of the gut microbiota in the development and progression of CHF. The review includes works 
published in Russian and English  
Results. Disruption of the intestinal barrier allows endotoxins and microbial metabolites to enter systemic circulation, 
triggering systemic inflammation and endothelial dysfunction, exacerbating CHF. Gut hypoperfusion and increased 
permeability further contribute to the disease's progression. Microbial metabolites, such as trimethylamine-N-oxide (TMAO) 
and short-chain fatty acids (SCFAs), influence systemic inflammation. Elevated TMAO levels are linked to cardiovascular 
events, while SCFAs have protective effects but are reduced in CHF patients. Gut dysbiosis is prevalent in CHF, marked by 
altered microbiota composition, including decreased beneficial bacteria and increased pathogenic species. These changes 
correlate with systemic inflammation and disease severity. 
Conclusions. The gut microbiota significantly impacts CHF pathogenesis through its influence on systemic inflammation 
and metabolic pathways. Modulating gut microbiota presents promising therapeutic opportunities, including dietary 
adjustments, probiotics, prebiotics, and fecal microbiota transplantation. Further research is essential to optimize 
interventions and explore the gut-heart axis's role in CHF progression and comorbidities.