. 2021 Sep 23;9(10):2013. doi: 10.3390/microorganisms9102013

Table 2.

Summary of trials explored connections between gut microbiota and CVDs.

Clinical Studies
CVD	No. of Patients	Change in Gut Microbiota Composition/Metabolites	Outcome	Reference
Atherosclerosis	332	Increased LBP	Increased carotid intima media thickness	[46]
Atherosclerosis	4144	Increased TMAO	Increased atherosclerotic risk	[47]
CAD	2255	Increased TMAO	Increased risk of artery infarction	[48]
	59	Increased L-carnitine	Increased TMAO in CAD patients	[49]
	126	Increased LPS	Increased inflammatory cytokines	[50]
	30	Reduced Bacteroides vulgatus and B. dorei and LPS	Increased lesions	[51]
CAD and artery stenosis	169	Increased TMAO	Increased risk of CAD and artery stenosis	[17]
Heart failure	122	Increased LPS	LPS translocation through leaky gut, resulting in inflammation	[52]
Heart failure	452	Increased LPS	Endotoxemia inflammation and oxidative stress	[52]
Heart attack	38	Increased proteobacteria LPS and leaky gut	Increased endotoxemia	[53]
Atrial fibrillation	912	Increased LPS	Increased platelet activation	[54]
Animal studies
CVD	Animal	Change in gut microbiota composition/metabolites	Outcome	Reference
Atherosclerosis	Mice	Increased LPS	Activation of NF-κB and JNK pathways	[55]
	Mice		Increased size of atherosclerotic lesions	[56]
	Mice		Increased proinflammatory cytokines	[57]
	Mice	Increased TMAO	Nlrp3 inflammasome stimulation and endothelial dysfunction	[58]
	Mice		Increased plague area	[48]
			Increased expression of inflammatory genes	[48]
	Mice	Butyrate supplementation	Reduced cholesterol absorption and atherosclerotic lesion	[59]
	Mice	Reduced SCFAs and Akkermansia, Clostridium, and Odoribacter	Increased plague size	[60]
	Mice	Reduced Bacteroidetes and Clostridia	Increased dyslipidaemia	[61]
Heart failure	Mice	Increased TMAO	Increased severity of heart failure	[48]
Hypertension	Rat	Increased TMAO	Increased osmotic pressure and water reabsorption	[62]
Cardiomyopathy	Mice	Increased LPS	Increased inflammatory markers	[63]

CAD: Coronary artery disease; LPS: Lipopolysaccharides; TMAO: Trimethylamine N-oxide; LBP: Lipopolysaccharide binding protein; SCFAs: Short chain fatty acids; NF-κB: Nuclear factor kappa beta.