Microbially produced imidazole propionate is associated with heart failure and mortality
Open access article online, JACC Heart Failure, April 2023
This article, by first author Antonio Molinaro, was recently published online in JACC Heart Failure and shows how the gut microbial metabolite ImP is increased in individuals with heart failure and is a predictor of overall survival.
Over the past years, it has become clear that the microbial ecosystem in the gut has a profound capacity to interact with the host through the production of a wide range of bioactive metabolites. The microbially produced metabolite imidazole propionate (ImP) is clinically and mechanistically linked with insulin resistance and type 2 diabetes, but it is unclear how ImP is associated with heart failure.
In this study, ImP serum was measurements in 2 large and independent clinical cohorts of patients (European [n = 1,985] and North American [n = 2,155]) with a range of severity of cardiovascular disease including heart failure. ImP is independently associated with reduced ejection fraction and heart failure in both cohorts, even after adjusting for traditional risk factors. This article shows that elevated ImP was a significant independent predictor of 5-year mortality.