Microbially Produced Imidazole Propionate Is Associated With Heart Failure and Mortality.

Abstract

BACKGROUND:

Over the past years, it has become clear that the microbial ecosystem in the gut has a profound capacity to interact with the host through the production of a wide range of bioactive metabolites. The microbially produced metabolite imidazole propionate (ImP) is clinically and mechanistically linked with insulin resistance and type 2 diabetes, but it is unclear how ImP is associated with heart failure.

OBJECTIVES:

The authors aimed to explore whether ImP is associated with heart failure and mortality.

METHODS:

ImP serum measurements in 2 large and independent clinical cohorts of patients (European [n = 1,985] and North American [n = 2,155]) with a range of severity of cardiovascular disease including heart failure. Univariate and multivariate Cox regression analyses were performed to delineate the impact of ImP on 5-year mortality in the North American cohort, independent of other covariates.

RESULTS:

ImP is independently associated with reduced ejection fraction and heart failure in both cohorts, even after adjusting for traditional risk factors. Elevated ImP was a significant independent predictor of 5-year mortality (for the highest quartile, adjusted HR: 1.85 [95% CI: 1.20-2.88]; P < 0.01).

CONCLUSIONS:

The gut microbial metabolite ImP is increased in individuals with heart failure and is a predictor of overall survival.

• Authors: Antonio Molinaro, Ina Nemet, Pierre Bel Lassen, Rima Chakaroun, Trine Nielsen, Judith Aron-Wisnewsky, Per-Olof Bergh, Lin Li, Marcus Henricsson, Lars Køber, Richard Isnard, Gerard Helft, Michael Stumvoll, Oluf Pedersen, J Gustav Smith, W H Wilson Tang, Karine Clément, Stanley L Hazen, Fredrik Bäckhed, MetaCardis Consortium
• Journal: JACC. Heart failure (JACC Heart Fail) Vol. 11 Issue 7 Pg. 810-821 (07 2023) ISSN: 2213-1787 [Electronic] United States
• PMID: 37115134 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• 5-imidazolepropionic acid
• Imidazoles

Topics

• Humans
• Heart Failure
• Diabetes Mellitus, Type 2
• Ecosystem
• Imidazoles (therapeutic use)
• Stroke Volume