Gut microbiota, dysbiosis and atrial fibrillation. Arrhythmogenic mechanisms and potential clinical implications

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Item Type:	Review
Title:	Gut microbiota, dysbiosis and atrial fibrillation. Arrhythmogenic mechanisms and potential clinical implications
Creators Name:	Gawałko, M., Agbaedeng, T.A., Saljic, A., Mueller, D.N., Wilck, N., Schnabel, R., Penders, J., Rienstra, M., van Gelder, I., Jespersen, T., Schotten, U., Crijns, H.J.G.M., Kalman, J.M., Sanders, P., Nattel, S., Dobrev, D. and Linz, D.
Abstract:	Recent preclinical and observational cohort studies have implicated imbalances in gut microbiota composition as a contributor to atrial fibrillation (AF). The gut microbiota is a complex and dynamic ecosystem containing trillions of microorganisms, which produces bioactive metabolites influencing host health and disease development. In addition to host-specific determinants, lifestyle-related factors such as diet and drugs are important determinants of the gut microbiota composition. In this review, we discuss the evidence suggesting a potential bidirectional association between AF and gut microbiota, identifying gut microbiota-derived metabolites as possible regulators of the AF substrate. We summarize the effect of gut microbiota on the development and progression of AF risk-factors, including heart failure, hypertension, obesity and coronary artery disease. We also discuss the potential antiarrhythmic effects of pharmacological and diet-induced modifications of gut microbiota composition, which may modulate and prevent the progression to AF. Finally, we highlight important gaps in knowledge and areas requiring future investigation. Although data supporting a direct relationship between gut microbiota and AF are very limited at the present time, emerging preclinical and clinical research dealing with mechanistic interactions between gut microbiota and AF is important as it may lead to new insights into AF pathophysiology and the discovery of novel therapeutic targets for AF.
Keywords:	Arrhythmia, Atrial Fibrillation, Cardiometabolic, Gut Microbiota, Metabolites
Source:	Cardiovascular Research
ISSN:	0008-6363
Publisher:	Oxford University Press
Volume:	118
Number:	11
Page Range:	2415–2427
Date:	July 2022
Additional Information:	Published on behalf of the European Society of Cardiology. All rights reserved. Copyright © The Author(s) 2021.
Official Publication:	https://doi.org/10.1093/cvr/cvab292
External Fulltext:	View full text on PubMed Central
PubMed:	View item in PubMed

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