Evidence map›Paper›PMID 41378248›Full record

ArticleWorld journal of biological chemistry2025

Gut microbiome and chemotherapy-induced cardiotoxicity: A systematic review of evidence and emerging therapies.

Razan Abdulaal, Imad Afara, Ali Harajli, Ehab Al Mashtoub, Alaa Tarchichi, Karim Hassan, Ali Afara, Jana Abou Fakher, Sethrida Salhab, Issam Fassih and 1 more

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In one paragraph

Article in World journal of biological chemistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. The gut-heart axis in cardio-oncology.Cardiovascular research · 2026
    Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Razan AbdulaalDepartment of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon.
Imad AfaraDepartment of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon.
Ali HarajliDepartment of Cardiology, Lebanese American University, Beirut 1100, Beyrouth, Lebanon.
Ehab Al MashtoubDepartment of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon.
Alaa TarchichiDepartment of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon.
Karim HassanDepartment of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon.
Ali AfaraDepartment of Cardiology, Saint Georges University of Beirut, Beirut 1100, Beyrouth, Lebanon.
Jana Abou FakherDepartment of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon.
Sethrida SalhabDepartment of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon.
Issam FassihDepartment of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon.
Mohamad TlaisDepartment of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon. mmtlaiss22@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChemotherapy-induced cardiotoxicity is a significant complication in cancer therapy, limiting treatment efficacy and worsening patient outcomes. Recent studies have implicated the gut microbiome and its key metabolites, such as short-chain fatty acids (SCFAs) and trimethylamine-N-oxide (TMAO), in mediating inflammation, oxidative stress, and cardiac damage. The gut-heart axis is increasingly recognized as a pivotal pathway linking microbiota dysregulation to chemotherapy-related cardiac dysfunction.

aimTo systematically review existing evidence on the role of gut microbiome alterations in chemotherapy-induced cardiotoxicity and evaluate emerging microbiome-based therapeutic strategies aimed at mitigating cardiovascular risk in cancer patients.

methodsA systematic literature search was conducted in PubMed, Scopus, and Web of Science for studies published between January 2013 and December 2024. Studies were included if they examined chemotherapy-induced cardiotoxicity in relation to gut microbiota composition, microbial metabolites (

resultsEighteen studies met the inclusion criteria. Chemotherapy was consistently associated with gut dysbiosis characterized by reduced SCFA-producing bacteria and increased TMAO-producing strains. This imbalance contributed to gut barrier disruption, systemic inflammation, and oxidative stress, all of which promote myocardial damage. SCFA depletion weakened anti-inflammatory responses, while elevated TMAO levels exacerbated cardiac fibrosis and dysfunction. Preclinical studies showed promising cardioprotective effects from probiotics, prebiotics, dietary interventions, and fecal microbiota transplantation, though human data remain limited.

conclusionGut microbiome dysregulation plays a crucial role in the development of chemotherapy-induced cardiotoxicity. Altered microbial composition and metabolite production trigger systemic inflammation and cardiac injury. Microbiome-targeted therapies represent a promising preventive and therapeutic approach in cardio-oncology, warranting further clinical validation through well-designed trials.

Indexed as

Chemotherapy-induced cardiotoxicityGut-heart axisGut microbiomeMicrobiome-targeted therapiesShort-chain fatty acidsTrimethylamine-N-oxide

Identifiers

PMID41378248
PMCPMC12687065

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.