Abstract
Emerging evidence positions the gut microbiome and its metabolites (e.g., TMAO, SCFAs) as pivotal regulators of cardiovascular disease (CVD) pathogenesis. This review synthesizes current knowledge on the molecular mechanisms linking dysbiosis to atherosclerosis and evaluates the preventive potential of microbiome-targeted, precision nutritional interventions (including specific fibers, prebiotics, and postbiotics) in pre-clinical and early clinical studies. We argue that integrating microbial signatures into CVD risk stratification and developing personalized, microbiome-informed nutritional strategies could herald a new era in cardiovascular primary prevention.
Proposed Structure
- Introduction: The global CVD burden, limitations of current prevention, and the “gut-heart axis” hypothesis.
- Mechanistic Pathways: Detailed analysis of how microbial metabolites (TMAO, butyrate, etc.) influence endothelial function, inflammation, and immunity.
- Potential for Intervention:
- Precision Fiber: Supplementation tailored to individual microbial baselines.
- Probiotics/Prebiotics: The role of specific strains (e.g., Akkermansia muciniphila).
- Pharmacological Approaches: Repurposing of non-absorbable antibiotics (e.g., MAC-MoA).
- Challenges in Translation: Inter-individual variability, dietary adherence, long-term safety, regulatory pathways.
- Conclusion & Future Directions: Call for large-scale, long-term, multi-omics RCTs to integrate microbiome medicine into public health guidelines.
Key References
- Tang, W. H. W., et al. (2013). Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. New England Journal of Medicine, 368(17), 1575-1584.
- Witkowski, M., et al. (2020). The gut microbiome and cardiovascular disease. Journal of the American College of Cardiology, 75(10), 1190-1202.
- Menni, C., et al. (2018). Gut microbiome diversity is associated with lower arterial stiffness in women. European Heart Journal, 39(25), 2390-2397.
