ArticleFrontiers of medicine2022
FMO3-TMAO axis modulates the clinical outcome in chronic heart-failure patients with reduced ejection fraction: evidence from an Asian population.
Article in Frontiers of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 31 citations in OpenAlex.
- Marine-Derived Proteins: Individual Variability in Health Effects Across Protein Structure, Host Genetics, and Gut Microbiota.Comprehensive reviews in food science and food safety · 2026Review
- Gut Microbiota-Derived Trimethylamine N-Oxide and NT-proBNP in Heart Failure: A Critical Review of Diagnostic and Prognostic Value.Biomedicines · 2026Review
- The gut-heart axis in heart failure: from bidirectional pathophysiological mechanisms to integrative therapeutic strategies.Frontiers in microbiology · 2026Review
- The role of the gut microbiota and metabolites in heart failure and possible implications for treatment.Heart failure reviews · 2025Review
- From Gut to Heart: Targeting Trimethylamine N-Oxide as a Novel Strategy in Heart Failure Management.Biomolecules · 2025Review
- How the Microbiome Drives Cardiovascular Disease.The Surgical clinics of North America · 2025Review
- The oral-gut microbiota axis in cardiovascular diseases: mechanisms, therapeutic targets, and translational challenges.Frontiers in cellular and infection microbiology · 2025Review
- Carnitine is a friend in HFpEF and foe in HFrEF.iScience · 2024Article
- Low-Molecular-Weight Compounds Produced by the Intestinal Microbiota and Cardiovascular Disease.International journal of molecular sciences · 2024Review
- Trimethylamine N-oxide: a meta-organismal axis linking the gut and fibrosis.Molecular medicine (Cambridge, Mass.) · 2024Review
- Promising dawn in the management of pulmonary hypertension: The mystery veil of gut microbiota.iMeta · 2024Review
- Therapeutic applications of gut microbes in cardiometabolic diseases: current state and perspectives.Applied microbiology and biotechnology · 2024Review
- Mechanistic Review on the Role of Gut Microbiota in the Pathology of Cardiovascular Diseases.Cardiovascular & hematological disorders drug targets · 2024Review
- Choline induced cardiac dysfunction by inhibiting the production of endogenous hydrogen sulfide in spontaneously hypertensive rats.Physiological research · 2023Article
- Nutri-microbiome epidemiology, an emerging field to disentangle the interplay between nutrition and microbiome for human health.Protein & cell · 2023Review
- The Role of Phytochemicals and Gut Microbiome in Atherosclerosis in Preclinical Mouse Models.Nutrients · 2023Review
- Heart failure and trimethylamine N-oxide: time to transform a 'gut feeling' in a fact?ESC heart failure · 2023Article
- From heart failure and kidney dysfunction to cardiorenal syndrome: TMAO may be a bridge.Frontiers in pharmacology · 2023Review
- Association between the Changes in Trimethylamine N-Oxide-Related Metabolites and Prognosis of Patients with Acute Myocardial Infarction: A Prospective Study.Journal of cardiovascular development and disease · 2022Article
- The role of the gut microbiota in health and cardiovascular diseases.Molecular biomedicine · 2022Review
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Authors and funding
15 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The association among plasma trimethylamine-N-oxide (TMAO), FMO3 polymorphisms, and chronic heart failure (CHF) remains to be elucidated. TMAO is a microbiota-dependent metabolite from dietary choline and carnitine. A prospective study was performed including 955 consecutively diagnosed CHF patients with reduced ejection fraction, with the longest follow-up of 7 years. The concentrations of plasma TMAO and its precursors, namely, choline and carnitine, were determined by liquid chromatography-mass spectrometry, and the FMO3 E158K polymorphisms (rs2266782) were genotyped. The top tertile of plasma TMAO was associated with a significant increment in hazard ratio (HR) for the composite outcome of cardiovascular death or heart transplantation (HR = 1.47, 95% CI = 1.13-1.91, P = 0.004) compared with the lowest tertile. After adjustments of the potential confounders, higher TMAO could still be used to predict the risk of the primary endpoint (adjusted HR = 1.33, 95% CI = 1.01-1.74, P = 0.039). This result was also obtained after further adjustment for carnitine (adjusted HR = 1.33, 95% CI = 1.01-1.74, P = 0.039). The FMO3 rs2266782 polymorphism was associated with the plasma TMAO concentrations in our cohort, and lower TMAO levels were found in the AA-genotype. Thus, higher plasma TMAO levels indicated increased risk of the composite outcome of cardiovascular death or heart transplantation independent of potential confounders, and the FMO3 AA-genotype in rs2266782 was related to lower plasma TMAO levels.
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