IMPROVING DIAGNOSTIC AND THERAPEUTIC APPROACHES TO ASSESS METABOLIC ACTIVITY OF THE GUT MICROBIOTA IN PATIENTS WITH ISCHEMIC HEART DISEASE

Abstract

Ischemic heart disease (IHD) remains one of the leading causes of morbidity and mortality worldwide, despite significant advances in diagnostic and therapeutic strategies. In recent years, growing scientific attention has been directed toward the role of gut microbiota as an active metabolic and regulatory system influencing cardiovascular health. The metabolic activity of intestinal microbiota, particularly the production of biologically active metabolites such as trimethylamine N-oxide, short-chain fatty acids, bile acid derivatives, and inflammatory mediators, has been increasingly associated with the initiation and progression of atherosclerosis and myocardial ischemia. This article aims to improve diagnostic and therapeutic approaches for assessing metabolic activity of gut microbiota in patients with ischemic heart disease by synthesizing theoretical, experimental, and clinical evidence. Emphasis is placed on modern diagnostic methodologies, including metabolomic profiling, microbiome sequencing, and biomarker-based risk stratification, which allow for more precise evaluation of microbiota-driven metabolic disturbances. Furthermore, the paper explores therapeutic optimization strategies targeting microbial metabolism through dietary interventions, prebiotics, probiotics, synbiotics, and microbiota-modulating pharmacological agents. Statistical data derived from large-scale epidemiological studies and meta-analyses demonstrate a consistent association between altered gut microbial metabolism and increased cardiovascular risk. The findings suggest that integrating gut microbiota metabolic assessment into the standard diagnostic algorithm of ischemic heart disease may enhance early detection of high-risk patients and improve individualized treatment outcomes. The article concludes that targeting intestinal microbiota metabolism represents a promising and scientifically grounded direction for advancing cardiovascular medicine and personalized therapeutic strategies.