UNHEALTHY LIFESTYLE, GUT MICROBIOME, AND FCVD
Clinical studies showed that the gut microbiota play a pivotal role in human vascular physiology, and they may be potential therapeutic and preventive targets for CVD, such as atherosclerosis (107), heart failure with preserved ejection fraction (HFpEF) (108). Morevover, gut-related metabolites, L-carnitine, acetyl-L-carnitine, and Trimethylamine N-oxide (TMAO), show associations with adverse short-term and long-term outcomes in acute HF (109), respectively. And the gut microbiome is a vital mediator of age-related arterial endothelial dysfunction, arterial stiffening, vascular oxidative stress and inflammation (110), therefore may be a promising therapeutic target for preserving arterial function with ageing and reducing the risk of CVD.
As we known, the gut microbiome is associated with human diseases. A recent study found that lifestyle (socioeconomic factors, genetics, current exposome, diet and medication), particular early life shape the microbiome in health and disease due to significant association with microbiome function and composition (111). Risk factors related to unhealthy lifestyle may disrupt the “brain-heart-gut” axis by negative regulations of the gut microbiome and induce fCVD, but a healthy lifestyle intervention (brain and physical activities and diet) among older adults is effective in preventing MACCE (112). And current the microbiome-based “brain-heart-gut” axis explains the vital mechanisms of fCVD (Figure 2), since the microbiome contributes to many cardiometabolic traits by modulating human inflammation and metabolism (113). Herein, healthy E(e)SEEDi lifestyle plays a vital role in the “brain-heart-gut” axis and novel mechanisms of fCVD.
All in all, there is indeed a direct association between the gut microbiota and host aging, diseases, and health by changes in mitochondrial dynamics (114). And currently, fecal microbiota transplantation is a novel method and an effective strategy against age-related human diseases (115, 116). And there is also a definite association between major risk factors in early life (117) and fCVD. Developments in artificial intelligence and big data will help us to setup a population-based risk algorithm (118, 119) or a scoring algorithm linking to unhealthy E(e)SEEDi lifestyle for evaluation, prediction, and prevention of fCVD.
With the development of cellular and molecular biology in brain and cardiovascular system and new tools of biomedicine (120-122), the scientist will further disclose the mechanisms of eCVD and fCVD under the help of this novel theory of “brain-heart-gut axis”. And it is believed that with the further understanding of new origins and novel mechanisms, there will be better prospects in healthy aging and longevity due to better protection of brain and cardiovascular system. Here, wish everyone health, peace and happiness when the World Heart Day in this September is coming.