The adverse effects of high-fat diet on intestinal microbiome and metabolites have been demonstrated in a host of diseases, and high fat aggravates pulmonary vascular abnormalities and right ventricular hypertrophy (RVH) in apolipoprotein E–null mice (Lawrie et al., 2011; Wallström et al., 2012). This evidence concerns the gene APOE and Right ventricular hypertrophy.