Modulating the Gut Microbiome in Cardiovascular Diseases: Mechanisms Microbial Metabolites and Therapeutic Perspectives

Abstract

The gut microbial community, composed of trillions microorganisms residing within the gastrointestinal route, is increasingly recognized as a vital regulator of host physiology. It plays a pivotal role in digestion, immune system modulation, and systemic metabolism. Emerging evidence has established strong links between gut microbiota composition with cardiovascular health, suggesting that microbial imbalances may contribute to the development and development of heart diseases. This review article aims to provide an integrated overview of the mechanistic metabolic and immunological links between the gut microbiome and cardiovascular diseases. Unlike previous reviews, it synthesizes current knowledge regarding the relationship between the gut microbiome and cardiovascular disease, with a specific focus on microbial metabolites like trimethylamine-N-oxide (TMAO) and short-chain fatty acids (SCFAs), which affect systemic inflammation, lipid metabolism, endothelial function, and thrombosis, causing central and cardiovascular disease pathogenesis. The methodology involves a comprehensive analysis of peer-reviewed literature from multiple scientific databases used in the primary research, as well as targeted and untargeted mass spectrometry for metabolite quantification. Mechanistic insights from both clinical trials and preclinical studies—particularly those involving germ-free and antibiotic-treated animal models—are examined to understand causal pathways. Furthermore, the review evaluates intervention strategies aimed at modulating the gut microbiota to improve cardiovascular outcomes. These include dietary approaches like probiotics and prebiotics, and fecal microbiota transplantation (FMT). It also highlights the microbiome role for further therapeutic approaches. By integrating molecular, clinical, and experimental evidence, the gut microbiome considered as novel and promising target of cardiovascular diseases prevention and treatment.