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Collectively, these studies suggest that SCFAs play a pivotal role in preventing the development of HFpEF by cutting off the connection between inflammation and the metabolic syndrome, suggesting their significant potential in the prevention and management of HFpEF ( 5.3 Trimethylamine N-oxide TMAO is the oxygenated metabolite of trimethylamine, generated by gut microbiota catabolism of choline and L-carnitine, followed by hepatic enzymatic oxidation (Janeiro et al., 2018)