A recent international study has identified fifteen gut bacterial species significantly associated with coronary heart disease, highlighting metabolic and inflammatory pathways through which the microbiota could modulate the progression of atherosclerosis¹. This work reinforces a now central concept: the gut-heart axis is currently emerging as a pathophysiological reality, where microbial metabolites, inflammation and immune regulation contribute to cardiovascular risk. The report in this issue shows that the gut microbiota and its metabolites (protective SCFAs, pro-inflammatory TMAO or LPS) are players in cardiometabolic disorders, with specific microbial signatures associated with hypertension, diabetes, dyslipidaemia and obesity. Initial interventional trials (dietary, biotic, and faecal microbiota transplantation) suggest that these interactions can be modulated. The interview with Soraya Taleb sheds light on these mechanisms and explores the links between immunity, tryptophan metabolism and atherosclerosis. In addition to opening up innovative therapeutic avenues, these works embody a more systemic and personalized cardiology, towards which our discipline aims to move.
It is up to us, healthcare professionals, to integrate these advances into our practices, and promote a fibre-rich diet, encourage physical activity, and consider the microbiota as an additional lever to improve cardiovascular health.
Happy reading,
Jacques Amar
Editor in chief for this issue
Reference: 1. Lee S, et al. Metagenome-assembled genomes reveal microbial signatures and metabolic pathways linked to coronary artery disease. mSystems. 2025;10:e0095425.
