Konsep Aksis Jantung dan Saluran Cerna: Hubungan Gangguan Keseimbangan Mikrobiota Saluran Cerna dan Gagal Jantung
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gagal jantung, aksis jantung saluran cerna, gangguan mikrobiota saluran cerna, probiotik
Abstract
Diperkirakan sekitar 64,3 juta pasien di dunia mengalami penyakit gagal jantung. Di negara berkembang, diperkirakan prevalensi orang yang diketahui menderita gagal jantung sebesar 1-2% dari populasi orang dewasa. Sampai saat ini sudah banyak penelitian yang membahas tentang tatalaksana gagal jantung sejak bertahun-tahun yang lalu. Namun prognosis penderita gagal jantung masih terbilang kurang baik dan Quality of Life (QoL) mereka menurun. Studi studi beberapa dekade terakhir menunjukan bahwa keseimbangan mikrobiota di saluran pencernaan turut serta dalam patogenesis dari aterosklerosis, penyakit jantung koroner, dan gagal jantung. Penulisan ini bertujuan untuk memberikan gambaran hubungan antara gagal jantung dengan keseimbangan mikrobiota saluran cerna serta tatalaksana yang dapat diberikan sebagai alternatif yang dapat memberikan hasil optimal terhadap pasien.
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References
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12. Fuke N, Nagata N, Suganuma H, Ota T. Regulation of Gut Microbiota and Metabolic Endotoxemia with Dietary Factors. Nutrients. 2019;11(10):2277.
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14. Zhao P, Zhao S, Tian J, Liu X. Significance of Gut Microbiota and Short-Chain Fatty Acids in Heart Failure. Nutrients. 2022;14(18):3758.
15. Yuzefpolskaya M, Bohn B, Nasiri M, Zuver AM, Onat DD, Royzman EA, et al. Gut microbiota, endotoxemia, inflammation, and oxidative stress in patients with heart failure, left ventricular assist device, and transplant. Journal of Heart and Lung Transplantation. 2020 Sep 1;39(9):880–90.
16. Madan S, Mehra MR. The heart-gut microbiome axis in advanced heart failure. J Heart Lung Transplant. 2020;39(9):891-893.
17. Doenst T, Nguyen TD, Abel ED. Cardiac metabolism in heart failure: Implications beyond atp production. Circ Res. 2013;113(6):709–24.
18. Carley AN, Maurya SK, Fasano M, Wang Y, Selzman CH, Drakos SG, et al. Short-Chain Fatty Acids Outpace Ketone Oxidation in the Failing Heart. Circulation. 2021 May 4;143(18):1797–808.
19. Palm CL, Nijholt KT, Bakker BM, Westenbrink BD. Short-Chain Fatty Acids in the Metabolism of Heart Failure - Rethinking the Fat Stigma. Front Cardiovasc Med. 2022;9:915102.
20. Ohira H, Tsutsui W, Fujioka Y. Are Short Chain Fatty Acids in Gut Microbiota Defensive Players for Inflammation and Atherosclerosis?. J Atheroscler Thromb. 2017;24(7):660-672.
21. Bartolomaeus H, Balogh A, Yakoub M, Homann S, Markó L, Höges S, et al. Short-Chain Fatty Acid Propionate Protects from Hypertensive Cardiovascular Damage. Circulation. 2019 Mar 12;139(11):1407–21.
22. Xu M, Jiang Z, Wang C, Li N, Bo L, Zha Y, et al. Acetate attenuates inflammasome activation through GPR43-mediated Ca2+-dependent NLRP3 ubiquitination. Exp Mol Med. 2019 Jul 1;51(7).
23. Yukino-Iwashita M, Nagatomo Y, Kawai A, et al. Short-Chain Fatty Acids in Gut-Heart Axis: Their Role in the Pathology of Heart Failure. J Pers Med. 2022;12(11):1805.
24. Bean LD, Wing JJ, Harris RE, Smart SM, Raman SV, Milks MW. Transferrin predicts trimethylamine-N-oxide levels and is a potential biomarker of cardiovascular disease. BMC Cardiovasc Disord. 2022;22(1):209.
25. Zhang Y, Wang Y, Ke B, Du J. TMAO: how gut microbiota contributes to heart failure. Transl Res. 2021;228:109-125.
26. Crisci G, Israr MZ, Cittadini A, Bossone E, Suzuki T, Salzano A. Heart failure and trimethylamine N-oxide: time to transform a 'gut feeling' in a fact?. ESC Heart Fail. 2023;10(1):1-7.
27. Li X, Geng J, Zhao J, Ni Q, Zhao C, Zheng Y, et al. Trimethylamine N-oxide exacerbates cardiac fibrosis via activating the NLRP3 inflammasome. Front Physiol. 2019;10(JUL).
28. Zhen J, Zhou Z, He M, et al. The gut microbial metabolite trimethylamine N-oxide and cardiovascular diseases. Front Endocrinol (Lausanne). 2023;14:1085041.
29. Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document: The international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506–514.
30. Gibson GR, Scott KP, Rastall RA, Tuohy KM, Hotchkiss A, Dubert-Ferrandon A, et al. Dietary prebiotics: current status and new definition. Food Science & Technology Bulletin: Functional Foods. 2010 May;7(1):1–19.
31. Moludi J, Alizadeh M, Davari M, Golmohammadi A, Maleki V. The efficacy and safety of probiotics intervention in attenuating cardiac remodeling following myocardial infraction: Literature review and study protocol for a randomized, double-blinded, placebo controlled trial. Contemp Clin Trials Commun. 2019;15:100364.
32. Gan XT, Ettinger G, Huang CX, Burton JP, Haist J V., Rajapurohitam V, et al. Probiotic administration attenuates myocardial hypertrophy and heart failure after myocardial infarction in the rat. Circ Heart Fail. 2014;7(3):491–499.
33. Tenorio-Jiménez C, Martínez-Ramírez MJ, Tercero-Lozano M, Arraiza-Irigoyen C, Del Castillo-Codes I, Olza J, et al. Evaluation of the effect of Lactobacillus reuteri V3401 on biomarkers of inflammation, cardiovascular risk and liver steatosis in obese adults with metabolic syndrome: A randomized clinical trial (PROSIR). BMC Complement Altern Med. 2018 Nov 20;18(1).
34. Hofeld BC, Puppala VK, Tyagi S, Ahn KW, Anger A, Jia S, et al. Lactobacillus plantarum 299v probiotic supplementation in men with stable coronary artery disease suppresses systemic inflammation. Sci Rep. 2021 Dec 1;11(1).
35. Moludi J, Khedmatgozar H, Nachvak SM, Abdollahzad H, Moradinazar M, Sadeghpour tabaei A. The effects of co-administration of probiotics and prebiotics on chronic inflammation, and depression symptoms in patients with coronary artery diseases: a randomized clinical trial. Nutr Neurosci. 2022 Aug 3;25(8):1659–1668.
36. Costanza AC, Moscavitch SD, Faria Neto HCC, Mesquita ET. Probiotic therapy with Saccharomyces boulardii for heart failure patients: A randomized, double-blind, placebo-controlled pilot trial. Int J Cardiol. 2015 Jan 20;179:348–350.
37. Wu H, Chiou J. Potential benefits of probiotics and prebiotics for coronary heart disease and stroke. Nutrients. 2021 Aug 1;13(8).
38. Farias D de P, de Araújo FF, Neri-Numa IA, Pastore GM. Prebiotics: Trends in food, health and technological applications. Trends Food Sci Technol. 2019 Nov;93:23–35.
39. Wickman BE, Enkhmaa B, Ridberg R, et al. Dietary Management of Heart Failure: DASH Diet and Precision Nutrition Perspectives. Nutrients. 2021;13(12):4424.
40. Challa HJ, Ameer MA, Uppaluri KR. DASH Diet To Stop Hypertension. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 23, 2023.
41. Mayerhofer CCK, Kummen M, Holm K, Broch K, Awoyemi A, Vestad B, et al. Low fibre intake is associated with gut microbiota alterations in chronic heart failure. ESC Heart Fail. 2020 Apr 1;7(2):456–466.
42. Bailén M, Bressa C, Martínez-López S, González-Soltero R, Montalvo Lominchar MG, San Juan C, et al. Microbiota Features Associated With a High-Fat/Low-Fiber Diet in Healthy Adults. Front Nutr. 2020 Dec 18;7.
43. Thomson C, Garcia AL, Edwards CA. Interactions between dietary fibre and the gut microbiota [published online ahead of print, 2021 Sep 23]. Proc Nutr Soc. 2021;1-11.
44. Cronin P, Joyce SA, O'Toole PW, O'Connor EM. Dietary Fibre Modulates the Gut Microbiota. Nutrients. 2021;13(5):1655.
45. Alasmre FA, Alotaibi HA. Plant-Based Diet: A Potential Intervention for Heart Failure. Cureus. 2020;12(5):e8282.
46. Laksono S dan Fiyani N. Defisiensi Mikronutrien pada Gagal Jantung: Disfungsi Mitokondrial sebagai Patofisiologi. UMI Medical Journal. 2022; 7(2): 141-51.
2. Groenewegen A, Rutten FH, Mosterd A, Hoes AW. Epidemiology of heart failure. Eur J Heart Fail. 2020;22(8):1342-1356.
3. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure [published correction appears in Eur Heart J. 2021 Oct 14;:]. Eur Heart J. 2021;42(36):3599-3726.
4. Beale AL, O’Donnell JA, Nakai ME, Nanayakkara S, Vizi D, Carter K, et al. The gut microbiome of heart failure with preserved ejection fraction. J Am Heart Assoc. 2021;10(13).
5. Forkosh E, Ilan Y. The heart-gut axis: New target for atherosclerosis and congestive heart failure therapy. Open Heart. 2019 Apr 1;6(1).
6. Matsiras D, Bezati S, Ventoulis I, Verras C, Parissis J, Polyzogopoulou E. Gut Failure: A Review of the Pathophysiology and Therapeutic Potentials in the Gut-Heart Axis. J Clin Med. 2023;12(7):2567.
7. Richards LB, Li M, van Esch BCAM, Garssen J, Folkerts G. The effects of short-chain fatty acids on the cardiovascular system. PharmaNutrition [Internet]. 2016;4(2):68–111. Available from: https://www.sciencedirect.com/science/article/pii/S2213434416300135
8. Zhang Y, Wang Y, Ke B, Du J. TMAO: how gut microbiota contributes to heart failure. Transl Res. 2021;228:109-125.
9. Reina-Couto M, Pereira-Terra P, Quelhas-Santos J, Silva-Pereira C, Albino-Teixeira A, Sousa T. Inflammation in Human Heart Failure: Major Mediators and Therapeutic Targets. Front Physiol. 2021;12:746494.
10. Schwinger RHG. Pathophysiology of heart failure. Cardiovasc Diagn Ther. 2021;11(1):263-276.
11. Chen L, Li S, Ai L, Zhou J, Huang J, Xu F, et al. The Correlation Between Heart Failure and Gut Microbiome Metabolites. Infectious Microbes and Diseases. 2020 Dec;2(4):136–143.
12. Fuke N, Nagata N, Suganuma H, Ota T. Regulation of Gut Microbiota and Metabolic Endotoxemia with Dietary Factors. Nutrients. 2019;11(10):2277.
13. Moludi J, Maleki V, Jafari‐Vayghyan H, Vaghef‐Mehrabany E, Alizadeh M. Metabolic endotoxemia and cardiovascular disease: A systematic review about potential roles of prebiotics and probiotics. Clin Exp Pharmacol Physiol. 2020 Jun 24;47(6):927–939.
14. Zhao P, Zhao S, Tian J, Liu X. Significance of Gut Microbiota and Short-Chain Fatty Acids in Heart Failure. Nutrients. 2022;14(18):3758.
15. Yuzefpolskaya M, Bohn B, Nasiri M, Zuver AM, Onat DD, Royzman EA, et al. Gut microbiota, endotoxemia, inflammation, and oxidative stress in patients with heart failure, left ventricular assist device, and transplant. Journal of Heart and Lung Transplantation. 2020 Sep 1;39(9):880–90.
16. Madan S, Mehra MR. The heart-gut microbiome axis in advanced heart failure. J Heart Lung Transplant. 2020;39(9):891-893.
17. Doenst T, Nguyen TD, Abel ED. Cardiac metabolism in heart failure: Implications beyond atp production. Circ Res. 2013;113(6):709–24.
18. Carley AN, Maurya SK, Fasano M, Wang Y, Selzman CH, Drakos SG, et al. Short-Chain Fatty Acids Outpace Ketone Oxidation in the Failing Heart. Circulation. 2021 May 4;143(18):1797–808.
19. Palm CL, Nijholt KT, Bakker BM, Westenbrink BD. Short-Chain Fatty Acids in the Metabolism of Heart Failure - Rethinking the Fat Stigma. Front Cardiovasc Med. 2022;9:915102.
20. Ohira H, Tsutsui W, Fujioka Y. Are Short Chain Fatty Acids in Gut Microbiota Defensive Players for Inflammation and Atherosclerosis?. J Atheroscler Thromb. 2017;24(7):660-672.
21. Bartolomaeus H, Balogh A, Yakoub M, Homann S, Markó L, Höges S, et al. Short-Chain Fatty Acid Propionate Protects from Hypertensive Cardiovascular Damage. Circulation. 2019 Mar 12;139(11):1407–21.
22. Xu M, Jiang Z, Wang C, Li N, Bo L, Zha Y, et al. Acetate attenuates inflammasome activation through GPR43-mediated Ca2+-dependent NLRP3 ubiquitination. Exp Mol Med. 2019 Jul 1;51(7).
23. Yukino-Iwashita M, Nagatomo Y, Kawai A, et al. Short-Chain Fatty Acids in Gut-Heart Axis: Their Role in the Pathology of Heart Failure. J Pers Med. 2022;12(11):1805.
24. Bean LD, Wing JJ, Harris RE, Smart SM, Raman SV, Milks MW. Transferrin predicts trimethylamine-N-oxide levels and is a potential biomarker of cardiovascular disease. BMC Cardiovasc Disord. 2022;22(1):209.
25. Zhang Y, Wang Y, Ke B, Du J. TMAO: how gut microbiota contributes to heart failure. Transl Res. 2021;228:109-125.
26. Crisci G, Israr MZ, Cittadini A, Bossone E, Suzuki T, Salzano A. Heart failure and trimethylamine N-oxide: time to transform a 'gut feeling' in a fact?. ESC Heart Fail. 2023;10(1):1-7.
27. Li X, Geng J, Zhao J, Ni Q, Zhao C, Zheng Y, et al. Trimethylamine N-oxide exacerbates cardiac fibrosis via activating the NLRP3 inflammasome. Front Physiol. 2019;10(JUL).
28. Zhen J, Zhou Z, He M, et al. The gut microbial metabolite trimethylamine N-oxide and cardiovascular diseases. Front Endocrinol (Lausanne). 2023;14:1085041.
29. Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document: The international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506–514.
30. Gibson GR, Scott KP, Rastall RA, Tuohy KM, Hotchkiss A, Dubert-Ferrandon A, et al. Dietary prebiotics: current status and new definition. Food Science & Technology Bulletin: Functional Foods. 2010 May;7(1):1–19.
31. Moludi J, Alizadeh M, Davari M, Golmohammadi A, Maleki V. The efficacy and safety of probiotics intervention in attenuating cardiac remodeling following myocardial infraction: Literature review and study protocol for a randomized, double-blinded, placebo controlled trial. Contemp Clin Trials Commun. 2019;15:100364.
32. Gan XT, Ettinger G, Huang CX, Burton JP, Haist J V., Rajapurohitam V, et al. Probiotic administration attenuates myocardial hypertrophy and heart failure after myocardial infarction in the rat. Circ Heart Fail. 2014;7(3):491–499.
33. Tenorio-Jiménez C, Martínez-Ramírez MJ, Tercero-Lozano M, Arraiza-Irigoyen C, Del Castillo-Codes I, Olza J, et al. Evaluation of the effect of Lactobacillus reuteri V3401 on biomarkers of inflammation, cardiovascular risk and liver steatosis in obese adults with metabolic syndrome: A randomized clinical trial (PROSIR). BMC Complement Altern Med. 2018 Nov 20;18(1).
34. Hofeld BC, Puppala VK, Tyagi S, Ahn KW, Anger A, Jia S, et al. Lactobacillus plantarum 299v probiotic supplementation in men with stable coronary artery disease suppresses systemic inflammation. Sci Rep. 2021 Dec 1;11(1).
35. Moludi J, Khedmatgozar H, Nachvak SM, Abdollahzad H, Moradinazar M, Sadeghpour tabaei A. The effects of co-administration of probiotics and prebiotics on chronic inflammation, and depression symptoms in patients with coronary artery diseases: a randomized clinical trial. Nutr Neurosci. 2022 Aug 3;25(8):1659–1668.
36. Costanza AC, Moscavitch SD, Faria Neto HCC, Mesquita ET. Probiotic therapy with Saccharomyces boulardii for heart failure patients: A randomized, double-blind, placebo-controlled pilot trial. Int J Cardiol. 2015 Jan 20;179:348–350.
37. Wu H, Chiou J. Potential benefits of probiotics and prebiotics for coronary heart disease and stroke. Nutrients. 2021 Aug 1;13(8).
38. Farias D de P, de Araújo FF, Neri-Numa IA, Pastore GM. Prebiotics: Trends in food, health and technological applications. Trends Food Sci Technol. 2019 Nov;93:23–35.
39. Wickman BE, Enkhmaa B, Ridberg R, et al. Dietary Management of Heart Failure: DASH Diet and Precision Nutrition Perspectives. Nutrients. 2021;13(12):4424.
40. Challa HJ, Ameer MA, Uppaluri KR. DASH Diet To Stop Hypertension. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 23, 2023.
41. Mayerhofer CCK, Kummen M, Holm K, Broch K, Awoyemi A, Vestad B, et al. Low fibre intake is associated with gut microbiota alterations in chronic heart failure. ESC Heart Fail. 2020 Apr 1;7(2):456–466.
42. Bailén M, Bressa C, Martínez-López S, González-Soltero R, Montalvo Lominchar MG, San Juan C, et al. Microbiota Features Associated With a High-Fat/Low-Fiber Diet in Healthy Adults. Front Nutr. 2020 Dec 18;7.
43. Thomson C, Garcia AL, Edwards CA. Interactions between dietary fibre and the gut microbiota [published online ahead of print, 2021 Sep 23]. Proc Nutr Soc. 2021;1-11.
44. Cronin P, Joyce SA, O'Toole PW, O'Connor EM. Dietary Fibre Modulates the Gut Microbiota. Nutrients. 2021;13(5):1655.
45. Alasmre FA, Alotaibi HA. Plant-Based Diet: A Potential Intervention for Heart Failure. Cureus. 2020;12(5):e8282.
46. Laksono S dan Fiyani N. Defisiensi Mikronutrien pada Gagal Jantung: Disfungsi Mitokondrial sebagai Patofisiologi. UMI Medical Journal. 2022; 7(2): 141-51.
Published
2025-06-05
How to Cite
Laksono, S., & Surya Angkasa, I. (2025). Konsep Aksis Jantung dan Saluran Cerna: Hubungan Gangguan Keseimbangan Mikrobiota Saluran Cerna dan Gagal Jantung . Keluwih: Jurnal Kesehatan Dan Kedokteran, 6(2). Retrieved from https://journal.ubaya.ac.id/index.php/kesdok/article/view/5633
Section
Article Review
Copyright (c) 2025 Sidhi Laksono, Irwan Surya Angkasa (Author)
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