Gut Microbiome Interactions in Pediatric Cardiac Health

The gut microbiome comprises a vast community of bacteria, viruses and fungi that interact with host metabolism, immunity and barrier integrity. In children with congenital or acquired cardiac conditions, these microbial populations can become imbalanced, a state known as dysbiosis, contributing to systemic inflammation and impaired mucosal defence. Metabolites such as short-chain fatty acids and trimethylamine N-oxide modulate vascular tone, immune cell function and myocardial development, while an impaired gut barrier may permit translocation of bacterial products into the circulation, exacerbating postoperative complications. Hypoxaemia, altered perfusion and perioperative factors such as cardiopulmonary bypass further perturb microbial communities. Emerging evidence suggests that targeted modulation of the gut microbiome through probiotics, prebiotics or dietary interventions could support immune homeostasis, preserve gut barrier function and ultimately improve surgical recovery and long-term cardiac outcomes in paediatric patients worldwide.

Research from Nature Portfolio

Recent studies have revealed that chronic systemic hypoxia in cyanotic congenital heart disease leads to marked gut dysbiosis, characterised by loss of beneficial Lactobacilli and accumulation of d-galactose, which drives premature senescence of bone marrow mesenchymal stem cells. Restoration of specific probiotic strains in animal models reversed these effects, highlighting a mechanistic gut–bone marrow axis. In a maternal cohort, altered gut microbial diversity and distinct metabolomic profiles were identified in mothers of infants with congenital heart disease, with particular bacterial genera correlating with lipid-metabolite shifts. These findings implicate maternal microbiota as an environmental factor influencing foetal cardiac development and suggest opportunities for early intervention.

Gut Microbiome Interactions in Pediatric Cardiac Health publication trend

The graph below shows the total number of articles in gut microbiome interactions in pediatric cardiac health across all publications each year (not limited to Nature Index journals).

Technical terms

Gut microbiome: The community of microorganisms residing in the gastrointestinal tract.

Dysbiosis: An imbalance in the composition or function of the gut microbiome.

Short-chain fatty acids (SCFAs): Metabolites produced by microbial fermentation of dietary fibres that regulate host immunity and barrier integrity.

Trimethylamine N-oxide (TMAO): A molecule derived from microbial metabolism of dietary choline, implicated in vascular and cardiac health.

Cardiopulmonary bypass (CPB): The use of an extracorporeal circuit to oxygenate and circulate blood during cardiac surgery.

Gut barrier: The epithelial lining and associated immune components that prevent translocation of bacteria and toxins.

References

1. From heart to gut: Exploring the gut microbiome in congenital heart disease. iMeta (2023).
2. Hypoxia induces senescence of bone marrow mesenchymal stem cells via altered gut microbiota. Nature Communications (2018).
3. Association of maternal gut microbiota and plasma metabolism with congenital heart disease in offspring: a multi-omic analysis. Scientific Reports (2021).
4. Mapping the early life gut microbiome in neonates with critical congenital heart disease: multiomics insights and implications for host metabolic and immunological health. Microbiome (2022).
5. Piglet cardiopulmonary bypass induces intestinal dysbiosis and barrier dysfunction associated with systemic inflammation. Disease Models & Mechanisms (2023).