Metabolomic analysis reveals the role of gut microbiota metabolic disorders in heart failure due to congenital heart disease

This study aimed to explore the effects of gut microbiota metabolic disorders caused by gut microbiota dysbiosis on heart failure due to congenital heart disease (CHD) through metabolomic analysis. Patients with congestive heart failure caused by left-to-right shunt CHD were selected as the subjects. Thirty infants with heart failure due to CHD admitted to the Department of Cardiovascular Surgery of our hospital from April 2022 to August 2022 were included in this study. Thirty healthy infants of the same age and sex who visited our hospital during the same period were selected as the control group. Faecal samples were collected from each participant and subjected to metabolomic analysis. Compared with those in the control group, the levels of 125 metabolites increased, whereas those of 147 metabolites decreased in the heart failure group. Compared with those in the control group, the levels of indoxyl, arachidonic acid, erucic acid, and DL-glycerol 1-phosphate were significantly increased in the heart failure group, whereas the level of 1-aminocyclopropanecarboxylic acid was significantly decreased. Pathway analysis of differentially abundant metabolites revealed that, compared with those in the control group, the metabolic pathways of linoleic acid metabolism, PPAR signalling, and arachidonic acid metabolism were significantly upregulated in the heart failure group. The NT-BNP level was significantly positively correlated with indoxyl, arachidonic acid and erucic acid (P < 0.05). There was a significant positive correlation between cardiac function scores and the levels of indoxyl and arachidonic acid (P < 0.05). In this exploratory study, infants with congestive heart failure due to CHD exhibited significant changes in gut microbiota metabolites and metabolic pathways. The gut metabolites of indoxyl and arachidonic acid significantly were increased, and the metabolic pathways of linoleic acid metabolism, the PPAR signalling pathway, and arachidonic acid metabolism were significantly upregulated in the heart failure infants. Increased gut metabolites of indoxyl and arachidonic acid were positively correlated with the severity of heart failure.