Gut microbiota in patients with pulmonary hypertension

Pulmonary arterial hypertension (PAH) secondary to congenital left-to-right shunt heart disease (CL-RSHD) involves vascular remodeling, metabolic dysregulation, chronic inflammation, immune dysfunction, and oxidative stress. This study explored gut microbiota composition and plasma metabolomic profiles in CL-RSHD-induced PAH patients compared to those with CL-RSHD alone and healthy controls. A total of 87 participants were included: 47 with CL-RSHD, 27 with CL-RSHD+PAH, and 13 healthy individuals. Gut microbiota was analyzed via 16S rRNA sequencing, while plasma metabolomics was assessed using untargeted LC-MS. Significant differences in microbial species and metabolites were observed in CL-RSHD+PAH patients compared to both CL-RSHD and healthy groups. Microbes linked to immune-inflammatory responses and metabolites related to oxidative stress and metabolic dysregulation were identified, potentially contributing to PAH progression. These findings suggest novel biomarkers and therapeutic targets for PAH in the context of CL-RSHD, offering new perspectives on the disease's pathogenesis and intervention strategies.