Gut Microbiota in Cardiovascular Diseases. From Mechanistic Insights to Therapeutic Perspectives

Cardiovascular diseases remain the leading cause of death worldwide, prompting continuous efforts to understand and treat their pathogenesis. In recent years, increasing attention has been paid to the role of the gut microbiome as a potential factor influencing the functioning of the cardiovascular system. The gut microbiota produces numerous bioactive metabolites, such as short-chain fatty acids (SCFAs) and trimethylamine N-oxide (TMAO), which affect lipid metabolism, modulate systemic inflammation, and regulate blood pressure. SCFAs exhibit anti-inflammatory properties, whereas TMAO is associated with an increased risk of cardiovascular events. Gut dysbiosis, defined as an imbalance in the intestinal microbiome, promotes chronic inflammation, increased intestinal barrier permeability, and activation of mechanisms that contribute to the development of atherosclerosis. This paper discusses the role of the gut microbiome in the pathogenesis of selected cardiovascular diseases, such as atherosclerosis, arterial hypertension, heart failure, and cardiac arrhythmias. Findings from observational and cohort studies reported in numerous scientific publications indicate characteristic alterations in the gut microbiota of patients with these conditions, although these relationships are primarily associative in nature. The paper also presents potential strategies for modulating the gut microbiota through the use of a properly balanced diet, as well as probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT). Despite the growing body of evidence supporting a strong link between alterations in the gut microbiota and the development of cardiovascular diseases, there are still limitations in therapeutic approaches, including the lack of standardized research methods, high interindividual variability in microbiota composition, and a limited number of causal studies. Future research directions should therefore include the development of personalized medicine, the application of multi-omics techniques, and the use of postbiotics. A better understanding of the interactions between the gut microbiota and the development and progression of cardiovascular diseases may contribute to the development of more effective treatment strategies.