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Salt and Gut Microbiota in Heart Failure

  • Inflammation and Cardiovascular Diseases (A Kirabo, Section Editor)
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Abstract

Purpose of Review

The role and underlying mechanisms mediated by dietary salt in modulating the gut microbiota and contributing to heart failure (HF) are not clear. This review summarizes the mechanisms of dietary salt and the gut-heart axis in HF.

Recent Findings

The gut microbiota has been implicated in several cardiovascular diseases (CVDs) including HF. Dietary factors including high consumption of salt play a role in influencing the gut microbiota, resulting in dysbiosis. An imbalance of microbial species due to a reduction in microbial diversity with accompanying immune cell activation has been implicated in the pathogenesis of HF via several mechanisms.

Summary

The gut microbiota and gut-associated metabolites contribute to HF by reducing gut microbiota biodiversity and activating several signaling pathways. High dietary salt modulates the gut microbiota composition and exacerbate or induce HF by increasing the expression of the epithelial sodium/hydrogen exchanger isoform 3 in the gut, cardiac expression of beta myosin heavy chain, activation of the myocyte enhancer factor/nuclear factor of activated T cell, and salt-inducible kinase 1. These mechanisms explain the resulting structural and functional derangements in patients with HF.

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Funding

This work was supported by the Fogarty International Center of the National Institutes of Health grants R03HL155041, R01HL147818 and R01HL144941 (AK) and 2D43TW009744, D43 TW009744 and D43 TW009337 (SKM). The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health.

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  1. HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Zambia

    Sepiso K. Masenga

  2. Department of Medicine, Vanderbilt University Medical Center, Room 536 Robinson Research Building, Nashville, TN, 37232-6602, USA

    Sepiso K. Masenga & Annet Kirabo

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  1. Sepiso K. Masenga
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SKM conceptualized the study and wrote the draft manuscript. SKM and AK wrote and edited different sections of the manuscript. SKM created all the figures. AK conceptualized the framework and finalized the manuscript and obtained funding for the manuscript. All authors contributed to article reviews, edited, and approved the final version of this manuscript.

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Correspondence to Annet Kirabo.

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Masenga, S.K., Kirabo, A. Salt and Gut Microbiota in Heart Failure. Curr Hypertens Rep 25, 173–184 (2023). https://doi.org/10.1007/s11906-023-01245-5

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