Pathophysiological role of trimethylamine oxide in heart failure

The aim of the project is to investigate the biological effects of trimethylamine oxide (TMAO), which is produced by intestinal bacteria and may affect the normal function of the heart and the entire circulatory system. Heart failure is one of the most important cardiological causes of death, numerous hospitalizations, disability and reduced quality of life. Recent studies indicate that TMAO, a metabolite of intestinal bacteria, may play an important role in cardiovascular disease. In recent years, there have been reports that an increase in the concentration of trimethylamine oxide (TMAO) in the blood is associated with a higher risk of myocardial infarction, stroke and death. The increase in TMAO levels may be due to diet, impaired gut function, or changes in the composition of the gut flora. It is known that the concentration of TMAO in the blood increases after eating foods containing L-carnitine and phosphatidocholine, which are found in large amounts, for example, in red meat. It has been proposed that TMAO may constitute a long-sought link between diet and cardiovascular disease. On the other hand, a large number of previous studies on the role of TMAO in the biology of marine animals and physicochemical studies on the effects of TMAO on proteins indicate the protective effect of TMAO. Therefore, it can be assumed that the increase in the concentration of TMAO in the blood is not the cause, but the body's defense action, which is a protective mechanism against factors disturbing the proper functioning of the circulatory system. Another argument pointing to the beneficial effects of TMAO may be the fact that TMAO is found in very high concentrations in fish, especially marine fish, which are an important part of many diets considered beneficial to the circulatory system, such as the Mediterranean diet.