Biotechnology articles within Nature Reviews Cardiology

Featured

  • Research Highlight |

    Gene therapy involving adenine base editing can correct a pathogenic variant in the Scn5a gene and alleviate arrhythmia phenotypes in a mouse model of long QT syndrome type 3.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Treatment with the small interfering RNA patisiran preserves functional capacity and improves health status and quality of life in patients with transthyretin cardiac amyloidosis, according to data from the 12-month double-blind period of the ongoing APOLLO-B trial.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Patients with hypertension who receive a single subcutaneous dose of zilebesiran, a novel small-interfering RNA that inhibits hepatic angiotensinogen synthesis, have reductions in serum angiotensinogen levels and 24-h ambulatory blood pressure that last for up to 24 weeks, according to a phase I study.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Findings from the DREAM-HF trial, the largest clinical trial of cell therapy in heart failure with reduced ejection fraction (HFrEF) to date, suggest that cardiac therapy with mesenchymal precursor cells might benefit patients with HFrEF, particularly those with inflammation.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Olpasiran, a small interfering RNA (siRNA) that reduces lipoprotein(a) (Lp(a)) production in the liver, administered every 12 weeks induces a pronounced and sustained decrease in the plasma levels of Lp(a) in patients with established atherosclerotic cardiovascular disease, according to findings from the OCEAN(a)-DOSE trial.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Different Notch ligands have opposing roles in regulating the proliferation and differentiation of vascular smooth muscle cells in the pulmonary vasculature in pulmonary arterial hypertension. Selectively targeting Jagged 1–NOTCH3 signalling might be an effective and safe strategy for the treatment of this condition.

    • Irene Fernández-Ruiz

  • Review Article |

    Extracellular vesicles are a heterogeneous group of natural particles that can deliver their biologically active molecular cargo to recipient cells. In this Review, the authors outline the endogenous properties of extracellular vesicles that make them natural delivery agents and the features that can be improved by bioengineering for the treatment of cardiovascular diseases.

    • Ricardo Cerqueira de Abreu
    • , Hugo Fernandes
    •  & Lino Ferreira

  • Research Highlight |

    The safety and durability of the LDL-cholesterol-lowering effects of inclisiran, a small interfering RNA that inhibits the synthesis of PCSK9 in the liver, have now been confirmed in three phase III clinical trials published in the New England Journal of Medicine.

    • Irene Fernández-Ruiz

  • Review Article |

    In this Review, Murry and colleagues describe the hallmarks of cardiomyocyte maturation and the current approaches to mature stem cell-derived cardiomyocytes, highlighting challenges and future directions to generate cardiomyocytes with an optimal maturation state for use in research and regenerative medicine.

    • Elaheh Karbassi
    • , Aidan Fenix
    •  & Charles E. Murry

  • Comment |

    Despite substantial advances, bona fide regeneration of the damaged human heart is still an unmet ambition. By extracting our current knowledge from developmental biology, animal models of heart regeneration, and clinical observations, we propose five hallmarks of cardiac regeneration and suggest a holistic approach to reconstituting human heart function.

    • Alessandro Bertero
    •  & Charles E. Murry

  • Review Article |

    Research on cardiac repair and regeneration is shifting from a stem cell focus towards the dynamic interplay of stromal and immune cells of the cardiac interstitium. This Review provides new insights into the immunoregulatory functions of cardiac interstitial cells and their complex network of interactions, highlighting the therapeutic potential for cardiac disease.

    • Elvira Forte
    • , Milena Bastos Furtado
    •  & Nadia Rosenthal

  • Review Article |

    This Review summarizes the current understanding on the roles of the Hippo–YAP pathway in cardiac development, growth, homeostasis, disease, and regeneration, with a particular focus on the roles of the Hippo–YAP pathway in endogenous cardiac muscle renewal, including the pivotal role of this pathway in regulating cardiomyocyte proliferation, differentiation, stress response, and mechanical signalling.

    • Jun Wang
    • , Shijie Liu
    •  & James F. Martin

  • Review Article |

    The epicardium is a multipotent cardiac progenitor tissue that serves as a crucial signalling centre for heart development and repair. This Review describes recent advances in our understanding of the biology of the epicardium and discusses the potential to harness the properties of the epicardium to develop therapeutic strategies for heart repair and regeneration.

    • Jingli Cao
    •  & Kenneth D. Poss

  • Review Article |

    This Review discusses the advances in therapeutic approaches for cardiac repair and regeneration, including cell-based therapies as well as the use of secretory factors, such as microRNAs and exosomes, direct reprogramming strategies, and gene editing to control cardiac remodelling and redirect the adult heart to a regenerative state, and highlights the future prospects of preclinical and clinical trials of heart regeneration.

    • Hisayuki Hashimoto
    • , Eric N. Olson
    •  & Rhonda Bassel-Duby

  • Review Article |

    The conflicting results of cell therapy clinical trials for heart regeneration have led to some confusion over the efficacy of this approach. This Review summarizes the main outcomes of these studies and gives perspectives for future cell-based regenerative trials largely based on the primary therapeutic target: regeneration of lost myocardium by exogenous cells or promotion of intrinsic repair though paracrine signalling.

    • Philippe Menasché

  • Year in Review |

    Important milestones in cardiac regenerative medicine that will define future research were reached in 2017: demonstration of adult cardiomyocyte renewal capacity, recognition of the importance of the extracellular matrix and the higher regenerative efficacy of repetitive dose protocols, and the publication of human data supporting paracrine effects of stem cell therapies and guidelines from TACTICS, the first international alliance on cardiac regenerative medicine.

    • Francisco Fernández-Avilés

  • Review Article |

    Advanced vascular occlusion, a leading cause of death in Western countries, can be treated by CABG surgery. Autografts are the gold-standard treatment, but prosthetic grafts are under development as an alternative source of vessels. Vascular tissue engineering is a fast-moving area of research that promises soon to allow the synthesis of responsive, living conduits, with properties similar to those of native tissue.

    • Dawit G. Seifu
    • , Agung Purnama
    •  & Diego Mantovani

  • Review Article |

    Oral anticoagulation therapy is the most effective strategy for preventing thromboembolic complications in pregnant women with prosthetic heart valves. However, this therapy is associated with increased fetal morbidity and mortality. The authors discuss the controversies surrounding the choice of prosthetic heart valve in women of childbearing age and the advantages and disadvantages of various anticoagulation strategies during pregnancy.

    • Jose M. Castellano
    • , Rajeev L. Narayan
    •  & Valentin Fuster

  • Review Article |

    Transcatheter aortic valve implantation is increasingly being used to treat aortic valve disease in patients at high surgical risk, but data indicate an emerging association between the procedure and incident conduction abnormalities. The authors review the frequency, potential anatomical and procedural causes, and clinical consequences of these adverse effects.

    • Robert M. van der Boon
    • , Rutger-Jan Nuis
    •  & Peter P. T. de Jaegere

  • News & Views |

    Octogenarians are a growing population of patients undergoing percutaneous coronary intervention (PCI) and, yet, they are under-represented in clinical trials. Wang et al. demonstrate the increasing need for PCI, but declining use of drug-eluting stents in this age group, despite associated reductions in mortality, myocardial infarction, and rehospitalization.

    • Mario Gössl
    •  & David R. Holmes Jr

  • Review Article |

    This Review outlines the main ethical and legal issues surrounding informed consent for the insertion, removal, and deactivation of implantable cardioverter-defibrillators (ICDs). The authors also provide an overview of current guidelines for communication with and involvement of patients and next of kin throughout the decision-making process.

    • Alexander M. Clark
    • , Tiny Jaarsma
    •  & David R. Thompson

  • Review Article |

    Prosthetic aortic valves are often required for patients with aortic stenosis. The optimal choice of valve in middle-aged patients is not clear and the available options all have drawbacks. Patient choice is the most important factor in deciding which valve to use, with biological valves increasingly favored over mechanical valves. The authors of this Review present the various prosthetic aortic valves currently in use and discuss the implications of prosthesis selection in this group of patients.

    • Joanna Chikwe
    • , Farzan Filsoufi
    •  & Alain F. Carpentier

  • Review Article |

    Induced pluripotent stem (iPS) cells are somatic cells that have been reprogrammed to an embryonic stem-cell-like state. This technology enables us to study the molecular mechanisms of development and disease processes, and provides a strategy for individualized diagnostics and therapy. In this Review, Timothy Nelson and colleagues describe the steps involved in bioengineering somatic cells to achieve pluripotency, allowing their differentiation into cardiomyocytes or any other cell type. Clinical applications of iPS cells, including treatment of cardiovascular conditions, are also discussed.

    • Timothy J. Nelson
    • , Almudena Martinez-Fernandez
    •  & Andre Terzic

  • News & Views |

    Although the majority of implanted valves used in aortic valve surgery are tissue valves (bioprostheses), the mechanisms by which they interact with the host are not well understood. A new study by Flameng et al. gives insight into the structural and functional changes that result from patient–bioprosthesis mismatch.

    • Magdi H. Yacoub
    •  & Ismail El-Hamamsy

  • Review Article |

    The introduction of drug-eluting stents (DES) has greatly reduced in-stent restenosis. Improvements to this technology are required, however, as safety and efficacy are still a problem. This Review describes current DES and the methods that are being used to optimize the performance of these stents. The author also suggests the direction of DES in the future, including tailored therapy to improve patient outcomes.

    • Rainer Wessely

  • Review Article |

    Cell therapy could improve cardiac function in patients with coronary heart disease. In this article, the authors provide an overview of the clinical trials in this field and highlight the limitations of cardiac cell therapy. They also discuss how these issues are being addressed and what the future may hold for this therapy.

    • Kai C. Wollert
    •  & Helmut Drexler

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