Mechanistic Study of Lingzao Jiaotai Formula in Regulating Gut Microbiota to Ameliorate Atrial Fibrillation via the TMAO-TGF-b1/Smad3 Axis

This study aimed to investigate the mechanism by which Lingzao Jiaotai Decoction (LZJT) alleviates atrial fibrillation (AF) through modulation of gut microbiota and inhibition of the trimethylamine N-oxide (TMAO)-TGF-b1/Smad3 signaling pathway. Fecal microbiota from three patients with isolated AF and three healthy donors were transplanted into antibiotic-treated mice for 14 days, followed by administration of different doses of LZJT or 3,3-dimethyl-1-butanol (DMB) as a positive control for six weeks. AF susceptibility was evaluated using transesophageal burst pacing, and cardiac function, plasma TMAO levels, myocardial fibrosis, inflammatory cytokines, and activation of the TGF-b1/Smad3 signaling pathway were assessed.