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The TMAO treatment induced the hypertrophy of cultured cardiomyocytes and expression of hypertrophic markers such as atrial natriuretic peptide (ANP) and beta-myosin heavy chain (-MHC) that was demonstrated to be mediated via TGF-/Smad3 signaling that had been identified in the development of cardiac hypertrophy and fibrosis

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1 Now, in 2022, we know his astute instinct was likely correct as we continue to learn how the gut microbiome and the numerous compounds it produces play a critical role in the prevention of many chronic diseases

in rare cases, dose adjustment or medication pause may be needed