The interplay between dietary flavonoids and gut microbiota in protecting against heart failure

Background: Heart failure (HF) is a global health issue that affects over 64 million people worldwide. Numerous recent epidemiological and experimental studies have revealed that the supplementation of dietary flavonoids and modulation of gut microbiota can independently or dependently impact the progression of heart failure. However, there are currently rare systematic review of the interplay between dietary flavonoids, gut microbiota, and heart failure. Scope and approach: This article reviews a selection of experimental and clinical studies from PubMed during 2014-2023, which explore the anti-HF effects and respective molecular mechanisms of dietary flavonoids and highlights the interplay between flavonoids, gut microbiota, and heart failure. In this review, we first summarized the pathogenesis and emerging intervention strategies for heart failure. Then, we reviewed the cardioprotective function of flavonoids and the roles of gut microbiota in the pathogenesis of heart failure. Finally, we reviewed the intricate interplay between flavonoids, gut microbiota, and heart failure. Key findings and conclusions: Flavonoids have the potential to modulate the gut microbiota composition and function, while the gut microbiota can metabolize flavonoids into bioactive compounds that may offer cardioprotective effects. Moreover, heart failure conditions also could affect the composition and function of gut microbiota. In the future, collaborative endeavors across disciplines encompassing nutrition, medicine, epidemiology, and microbiology will advance the understanding of the complicated interplay between dietary flavonoids, gut microbiota, and heart failure, and ultimately facilitate the development of gut microbiota- and dietary flavonoids-based therapeutic strategies for heart failure.