NFKB1 and cardiac hypertrophy: Cell culture studies showed that TMAO promotes chronic kidney disease (CKD) by activation of NF-κB. Non-lethal inhibitor of gut microbial TMA production attenuated CKD and cardiac hypertrophy, in adenine induced CKD mouse model [104].Increased TMAO concentration in cardiac mitochondria impairs pyruvate and fatty acid oxidation [105]. The same group, later reported a protective role of elevated TMAO, by restoration of fatty acid oxidation and cardiac functionality in the experimental model of right ventricular heart failure [106].