Research Article

Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-morbidity or Consequle of ‘Gut-Heart Axis

Volume: 19 Number: 57 December 1, 2025

Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-morbidity or Consequle of ‘Gut-Heart Axis

Abstract

Small intestinal bacterial overgrowth (SIBO) is a clinical condition characterised by the presence of colon-derived bacteria in the small intestine at a density of ≥10⁵ CFU/mL. Congestive heart failure (CHF) causes structural and functional changes in the gastrointestinal tract and has been associated with increased bacterial colonisation, inflammation and malabsorption. A total of 7 dogs with different stages of mitral valve disease and congestive heart failure were included in the study. All dogs were evaluated by clinical examination, laboratory tests involving relevant cardiopulmonary biomarkers and echocardiography. Lactulose-based breath test (LBT) test was used for SIBO and 16S rRNA gene sequencing was used for intestinal microbiota analysis. In the result, Peptoclostridium sp. was identified as the most frequently detected species in the fecal microbiota of dogs with congestive heart failure due to mitral regurgitation. In all cases, an increase of ≥20 ppm compared to the baseline value was observed in the LBT, which was evaluated in favor of SIBO. The most significant increase in hydrogen levels was noted at 60 and 90 minutes. In conclusion, CHF is closely associated with gut microbiota and intestinal dysbiosis should be evaluated in cases of heart disease.

Keywords

Small intestinal bacterial overgrowth, Chronic heart failure, Myxoid mitral valve disease, Dysbiosis

References

  1. Adike, A., and DiBaise, J. K. (2018). Small intestinal bacterial overgrowth: Nutritional implications, diagnosis, and management. Gastroenterology Clinics, 47, 193–208.
  2. Anker, S. D., Ponikowski, P., Varney, S., et al. 1997. Wasting as independent risk factor for mortality in chronic heart failure. Lancet, 349, 1050–1053.
  3. Arutyunov, G. P., Kostyukevich, O. I., Serov, R. A., Rylova, N. V., and Bylova, N. A. 2008. Collagen accumulation and dysfunctional mucosal barrier of the small intestine in patients with chronic heart failure. International Journal of Cardiology, 125(2), 240–245.
  4. Borgarelli, M., and Buchanan, J. W. 2012. Historical review, epidemiology and natural history of degenerative mitral valve disease. Journal of Veterinary Cardiology, 14, 93–101.
  5. Boyd, O., Mackay, C., Lamb, G., Bland, J. M., Grounds, R. M., and Bennett, E. D. 1993. Comparison of clinical information gained from routine blood-gas analysis and from gastric tonometry for intramural pH. Lancet, 341, 142–146.
  6. Buchanan, J. 1999. Prevalence of cardiovascular disorders. In D. Sisson, P. R. Fox, & M. Sydney (Eds.), Textbook of canine and feline cardiology (2nd ed., pp. 457–470). Saunders, Philadelphia, PA.
  7. Fialho, A., Fialho, A., Schenone, A., Thota, P., McCullough, A., and Shen, B. 2016. Association between small intestinal bacterial overgrowth and deep vein thrombosis. Gastroenterology Report, 4, 299–303. https://doi.org/10.1093/gastro/gow004
  8. Ghoshal, U. C. 2011. How to interpret hydrogen breath tests. Journal of Neurogastroenterology and Motility, 17, 312–317. https://doi.org/10.5056/jnm.2011.17.3.312
  9. He, Z., Ding, R., Wu, F., Wu, Z., and Liang, C. 2018. Excess alcohol consumption: A potential mechanism behind the association between small intestinal bacterial overgrowth and coronary artery disease. Digestive Diseases and Sciences, 63, 3516–3517. https://doi.org/10.1007/s10620-018-5279-x
  10. Johnston, J. D., Harvey, C. J., Menzies, I. S., and Treacher, D. F. 1996. Xylose and 3-O-methyl-D-glucose assumed marker for intestinal ischaemia. Gastrointestinal permeability and absorptive capacity in sepsis. Critical Care Medicine, 24, 1144–1149.
APA
Ural, K., Erdoğan, H., Paşa, S., Erdoğan, S., & Özalp, T. (2025). Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-morbidity or Consequle of ‘Gut-Heart Axis. Journal of Biological and Environmental Sciences, 19(57), 48-55. https://doi.org/10.5281/zenodo.17569130
AMA
1.Ural K, Erdoğan H, Paşa S, Erdoğan S, Özalp T. Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-morbidity or Consequle of ‘Gut-Heart Axis. JBES. 2025;19(57):48-55. doi:10.5281/zenodo.17569130
Chicago
Ural, Kerem, Hasan Erdoğan, Serdar Paşa, Songül Erdoğan, and Tahir Özalp. 2025. “Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-Morbidity or Consequle of ‘Gut-Heart Axis”. Journal of Biological and Environmental Sciences 19 (57): 48-55. https://doi.org/10.5281/zenodo.17569130.
EndNote
Ural K, Erdoğan H, Paşa S, Erdoğan S, Özalp T (December 1, 2025) Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-morbidity or Consequle of ‘Gut-Heart Axis. Journal of Biological and Environmental Sciences 19 57 48–55.
IEEE
[1]K. Ural, H. Erdoğan, S. Paşa, S. Erdoğan, and T. Özalp, “Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-morbidity or Consequle of ‘Gut-Heart Axis”, JBES, vol. 19, no. 57, pp. 48–55, Dec. 2025, doi: 10.5281/zenodo.17569130.
ISNAD
Ural, Kerem - Erdoğan, Hasan - Paşa, Serdar - Erdoğan, Songül - Özalp, Tahir. “Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-Morbidity or Consequle of ‘Gut-Heart Axis”. Journal of Biological and Environmental Sciences 19/57 (December 1, 2025): 48-55. https://doi.org/10.5281/zenodo.17569130.
JAMA
1.Ural K, Erdoğan H, Paşa S, Erdoğan S, Özalp T. Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-morbidity or Consequle of ‘Gut-Heart Axis. JBES. 2025;19:48–55.
MLA
Ural, Kerem, et al. “Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-Morbidity or Consequle of ‘Gut-Heart Axis”. Journal of Biological and Environmental Sciences, vol. 19, no. 57, Dec. 2025, pp. 48-55, doi:10.5281/zenodo.17569130.
Vancouver
1.Kerem Ural, Hasan Erdoğan, Serdar Paşa, Songül Erdoğan, Tahir Özalp. Mitral Regurgitation and Small Intestinal Bacterial Overgrowth in Dogs: A Co-morbidity or Consequle of ‘Gut-Heart Axis. JBES. 2025 Dec. 1;19(57):48-55. doi:10.5281/zenodo.17569130