Modulating gut microbial metabolism in heart failure: Opportunities and challenges

Alterations in gut microbial composition and metabolism have been mechanistically linked to the development of heart failure (HF) [1]. However, the promise of targeting the gut microbiome to prevent or even reverse disease progression remains somewhat unfulfilled despite the exponential growth of technological advances that have allowed us to gain insights and deliver therapeutic interventions to modulate gut microbial metabolism [2]. In a recent issue of EBioMedicine, an esteemed group of clinical investigators from Norway and Brazil reported their primary findings of the GutHeart trial, a prospective multicenter study that demonstrated that short-term treatment of either rifaximin or Saccharomyces boulardii did not improve cardiac function in patients with HF with reduced ejection fraction [3].