Doctoral Program in Medical Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile 8331010, Chile.
Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile 7820436, Chile.
Int J Mol Sci. 2024 Nov 20;25(22):12465. doi: 10.3390/ijms252212465.
Myocardial infarction (MI) remains the leading cause of death globally, imposing a significant burden on healthcare systems and patients. The gut-heart axis, a bidirectional network connecting gut health to cardiovascular outcomes, has recently emerged as a critical factor in MI pathophysiology. Disruptions in this axis, including gut dysbiosis and compromised intestinal barrier integrity, lead to systemic inflammation driven by gut-derived metabolites like lipopolysaccharides (LPSs) and trimethylamine N-oxide (TMAO), both of which exacerbate MI progression. In contrast, metabolites such as short-chain fatty acids (SCFAs) from a balanced microbiota exhibit protective effects against cardiac damage. This review examines the molecular mediators of the gut-heart axis, considering the role of factors like sex-specific hormones, aging, diet, physical activity, and alcohol consumption on gut health and MI outcomes. Additionally, we highlight therapeutic approaches, including dietary interventions, personalized probiotics, and exercise regimens. Addressing the gut-heart axis holds promise for reducing MI risk and improving recovery, positioning it as a novel target in cardiovascular therapy.
心肌梗死（MI）仍然是全球范围内的主要死亡原因，给医疗保健系统和患者带来了巨大负担。肠道-心脏轴，即连接肠道健康和心血管结局的双向网络，最近已成为 MI 病理生理学的一个关键因素。该轴的中断，包括肠道菌群失调和肠道屏障完整性受损，导致由肠道衍生代谢物如脂多糖（LPS）和三甲胺 N-氧化物（TMAO）驱动的全身炎症，这两者都加剧了 MI 的进展。相比之下，来自平衡微生物组的代谢物如短链脂肪酸（SCFAs）对心脏损伤具有保护作用。本综述探讨了肠道-心脏轴的分子介质，同时考虑了性别特异性激素、衰老、饮食、体力活动和酒精摄入等因素对肠道健康和 MI 结局的影响。此外，我们还强调了治疗方法，包括饮食干预、个性化益生菌和运动方案。解决肠道-心脏轴问题有望降低 MI 风险并改善恢复，使其成为心血管治疗的一个新靶点。
