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Increased secondary/primary bile acid ratio in chronic heart failure

Permanent link
https://hdl.handle.net/10037/13143
DOI
https://doi.org/10.1016/j.cardfail.2017.06.007
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Accepted manuscript version (PDF)
Date
2017-09-09
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Author
Mayerhofer, Christiane Caroline; Ueland, Thor; Broch, Kaspar; Vincent, Royce P.; Cross, Gemma F.; Dahl, Christen Peder; Aukrust, Pål; Gullestad, Lars; Hov, Johannes Espolin Roksund; Trøseid, Marius
Abstract

Objective Bile acids (BAs) are now recognized as signaling molecules and emerging evidence suggests that BAs affect cardiovascular function. The gut microbiota has recently been linked to the severity of heart failure (HF), and microbial metabolism has a major impact on BA homeostasis. We aimed to investigate the pattern of BAs, and particularly microbiota-transformed (secondary) BAs, in patients with chronic HF.

Methods and Results This was a prospective, observational, single-center study including 142 patients with chronic HF and 20 age- and sex-matched healthy control subjects. We measured plasma levels of primary, secondary, and total BAs, and explored their associations with clinical characteristics and survival. Plasma levels of primary BAs were lower (P < .01) and the ratios of secondary to primary BAs higher (P < .001) in patients with HF compared with control subjects. Approximately 40% of patients in the upper tertile of the ratio of secondary to primary BAs died during 5.6 years of follow-up (unadjusted Cox regression: hazard ratio 1.93, 95% confidence interval 1.01–3.68, compared with the lower tertiles). However, this association was attenuated and no longer significant in multivariate analyses.

Conclusions Levels of primary BAs were reduced and specific secondary BAs increased in patients with chronic HF. This pattern was associated with reduced overall survival in univariate analysis, but not in multivariate analyses. Future studies should assess the regulation and potential role of BA metabolism in HF.

Description
Accepted manuscript version. Published version available at https://doi.org/10.1016/j.cardfail.2017.06.007.
Publisher
Elsevier
Citation
Mayerhofer, C.C., Ueland, T., Broch, K., Vincent, R.P., Cross, G.F., ... Trøseid, M. (2017). Increased secondary/primary bile acid ratio in chronic heart failure. Journal of Cardiac Failure, 23(9), 666-671. https://doi.org/10.1016/j.cardfail.2017.06.007
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