Leonov Georgy, Livantsova Elena, Varaeva Yurgita, Starodubova Antonina
Department of Cardiovascular Pathology and Diet Therapy, Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, 109240, Russia.
Therapy Faculty, Pirogov Russian National Research Medical University, Moscow, 115446, Russia.
Curr Nutr Rep. 2025 Jun 28;14(1):88. doi: 10.1007/s13668-025-00679-4.
Myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide, and rehabilitation is essential to improve patient outcomes and reduce the risk of recurrent cardiovascular events. This review aims to summarize research on the gut-heart axis and the therapeutic potential of probiotics and prebiotics in MI rehabilitation, highlighting their ability to modulate gut microbiota composition and activity to benefit cardiovascular health.
Recent studies have identified the gut microbiome as a critical modulator of myocardial health, with dysbiosis-an imbalance in microbial populations-associated with increased production of proinflammatory metabolites such as trimethylamine-N-oxide (TMAO), which exacerbate endothelial dysfunction and thrombosis in MI patients. Studies show that probiotic strains and prebiotics can improve blood lipid profiles, regulate blood pressure, inhibit the progression of endothelial dysfunction, promote the growth of beneficial bacteria, and increase cardioprotective short-chain fatty acids. The use of probiotics and prebiotics in MI patients may be of advantage in cardiac rehabilitation. Probiotics and prebiotics have been shown to offer potential benefits in mitigating inflammation, improving endothelial function, and optimizing metabolic health. These microbiome-targeted strategies may complement existing rehabilitation approaches, potentially reducing the risk of recurrent cardiovascular events and improving long-term outcomes for patients with MI. However, further research is necessary to elucidate the underlying mechanisms and substantiate the clinical efficacy of these therapeutic interventions.
心肌梗死（MI）仍是全球发病和死亡的主要原因，康复治疗对于改善患者预后和降低心血管事件复发风险至关重要。本综述旨在总结关于肠道-心脏轴以及益生菌和益生元在心肌梗死康复中的治疗潜力的研究，强调它们调节肠道微生物群组成和活性以促进心血管健康的能力。
最近的研究已确定肠道微生物群是心肌健康的关键调节因子，微生物群失调（微生物种群失衡）与促炎代谢物如氧化三甲胺（TMAO）的产生增加有关，这会加剧心肌梗死患者的内皮功能障碍和血栓形成。研究表明，益生菌菌株和益生元可改善血脂水平、调节血压、抑制内皮功能障碍的进展、促进有益细菌生长并增加具有心脏保护作用的短链脂肪酸。在心肌梗死患者中使用益生菌和益生元可能对心脏康复有益。益生菌和益生元已被证明在减轻炎症、改善内皮功能和优化代谢健康方面具有潜在益处。这些针对微生物群的策略可能补充现有的康复方法，并有可能降低心血管事件复发风险，改善心肌梗死患者的长期预后。然而，需要进一步研究以阐明这些治疗干预措施的潜在机制并证实其临床疗效。
