Gut Microbiome and Carotid Artery Intima-Media Thickness: A Narrative Review of the Current Scenario

Abstract

Up to the last update, the gut microbiome (GM) had been associated with a different physiologic host process, including those affecting cardiovascular health. The carotid intima-media thickness (IMT) is an indicator of atherosclerosis and cardiovascular risk. The GM influence on atherosclerosis progression has garnered growing attention in recent years but the consensus in subclinical atherosclerosis remains elusive. The aim of this narrative review is to investigate the connection between the GM and carotid IMT, encompassing mechanisms like the microbiome impact on metabolite production, and systemic inflammation, and its effects on endothelial function. The literature analysis revealed that the GM appears to exert an influence on carotid IMT development, likely through mechanisms involving metabolites' production, systemic inflammation, and endothelial function modulation. Additional research, however, is needed to finely elucidate the relationship between the GM and atherosclerosis. Specifically, more extensive studies are required to pinpoint individuals at the highest risk of developing atherosclerosis based on their GM composition. This will facilitate the enhancement and optimization of cardiovascular disease prevention strategies and enable the treatments' customization for each patient. Further investigations are required to refine patient outcomes in the context of probiotics and other interventions aimed at improving microbiome composition and function.

Keywords: carotid atherosclerosis; carotid plaques; gut microbiome; intima-media thickness; ultrasound.

Figure 1

The thickness of the carotid artery wall and its stability plays a crucial role as a major risk factor for strokes, directly, and acute myocardial infarction, indirectly. How does the GM alter the atherosclerotic plaques scenario, and what does it alter in it? Created with Biorender.com.

Figure 2

The gut microbiome plays a crucial role in the thickness and stability of the carotid artery wall, directly affecting the risk of stroke and indirectly influencing the risk of acute myocardial infarction. Maintaining correct microbiota eubiosis and a balance of its metabolites is essential for preventing acute cardiovascular syndromes. Created with Biorender.com.