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Gustav Smith, MD, PhD

Gustav Smith

Associate professor

Gustav Smith, MD, PhD

Microbially Produced Imidazole Propionate Is Associated With Heart Failure and Mortality

Author

  • 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
Show all

Summary, in English

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.

Department/s

  • WCMM-Wallenberg Centre for Molecular Medicine
  • Heart Failure and Mechanical Support
  • Cardiovascular Epigenetics
  • Cardiology
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Molecular Epidemiology and Cardiology

Publishing year

2023-07

Language

English

Pages

810-821

Publication/Series

JACC: Heart Failure

Volume

11

Issue

7

Document type

Journal article

Publisher

Elsevier

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • heart failure
  • histidine
  • imidazole propionate
  • microbiota

Status

Published

Research group

  • Heart Failure and Mechanical Support
  • Cardiovascular Epigenetics
  • Molecular Epidemiology and Cardiology

ISBN/ISSN/Other

  • ISSN: 2213-1779