Patients with congestive heart failure (CHF) frequently suffer from cognitive deficits and depressive symptoms. Changes in intestinal microbiota composition have been suggested to promote those features in CHF via alterations in their metabolite release. We examined the association between reduced psychological well-being (including cognitive deficits, depressive symptoms, and quality of life) and changes in plasma concentrations of the short-chain fatty acids (SCFA) acetate (C2), propionate (C3), and butyrate (C4) as main metabolites of microbial fiber fermentation. We previously found a high correlation between colonic production and plasma concentration.
We recruited 15 clinically stable CHF patients (EF: 35.7 (2.6)%, NYHA class: 2.3 (0.2), BW: 100.1 (5.4) kg) and 17 healthy controls (BW: 77.9 (3.2) kg) matched for age and gender. After an overnight fast, venous plasma was collected, vital signs taken, and body composition measured by DXA. Cognitive function, quality of life and severity of depressive symptoms were assessed using questionnaires. SCFA concentrations (in μM) were measured by GC-MS. Stats by unpaired t-test and Pearson correlation coefficient. Data are mean (SE).
CHF patients showed lower C3 (2.75 (0.13) vs. 3.12 (0.12), P = 0.0498) and C4 (1.18 (0.06) vs. 1.44 (0.09), P = 0.031) while C2 was similar between the groups (50.0 (12.2) vs. 62.0 (9.79), P = 0.203). CHF patients with lower C3 and C4 reported a lower quality of life (C3-MLHFQ score, r: −0.637, P = 0.014) and higher depression (C3-HADS depression score, r: −0.622, P = 0.013; C4-depression: r: −0.474, P = 0.087) and anxiety rates (C3-HADS anxiety score, r: −0.647, P = 0.009). Additionally, lower C2 was associated with a higher systolic blood pressure (r: −0.618, P = 0.024). CHF patients with lower C4 had a higher BMI (r: −0.608, P = 0.021) and fat mass index (r: −0.553, P = 0.040). No correlations with cognitive function were found.
Plasma propionate and butyrate concentrations are decreased in mainly obese CHF patients and higher SCFA concentrations are associated with less psychological symptoms, lower fat mass and BMI, as well as improved blood pressure. More research is required to test whether fiber supplementation can improve psychological and overall well-being in CHF.
NIH; Huffines Institute for Sports Medicine and Human Performance.