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  • The post-acute sequelae of COVID-19 present major problems for many patients, their physicians and the health-care system. They are unrelated to the severity of the initial infection, are often highly symptomatic and can occur after vaccination. Many sequelae involve cardiovascular autonomic dysfunction, with postural orthostatic tachycardia syndrome in 30% of individuals. Prognosis is unknown, and treatment is still unsatisfactory.

    • Artur Fedorowski
    • Richard Sutton
    Clinical Outlook
  • Health-care delivery is evolving, with an increased availability of consumer and medical technology-enabled diagnostic devices powered by artificial intelligence. Physicians need to evolve by deprioritizing old skills in favour of new skills in statistics and medical decision-making psychology. Technology moves fast; physicians will need to pivot and adapt quickly.

    • Rashmee U. Shah
    News & Views
  • A subpopulation of cardiac-resident macrophages protect the heart against sepsis-induced cardiomyopathy by scavenging dysfunctional mitochondria ejected from cardiomyocytes; modulation or administration of these macrophages might be a potential therapeutic strategy.

    • Gregory B. Lim
    Research Highlight
  • A new study shows that age-dependent nuclear remodelling in cardiomyocytes (via age-related loss of nuclear lamins) contributes to cardiac dysfunction through a process that is conserved in flies, mice and nonhuman primates.

    • Irene Fernández-Ruiz
    Research Highlight
  • Alternative splicing determines which exons are included in mature RNA and accounts for the majority of transcriptomic diversity. In this Review, Gotthardt and colleagues discuss how alternative splicing is regulated in the heart and how it differs in cardiac development, physiological adaptation and pathological remodelling. They also summarize technological advances in the field and potential applications of splicing data in cardiovascular medicine.

    • Michael Gotthardt
    • Victor Badillo-Lisakowski
    • Leslie Leinwand
    Review Article
  • An intravascularly infused extracellular matrix preparation binds to leaky microvasculature, thereby localizing to inflamed tissues and promoting repair and regeneration, and potentially healing damaged tissues ‘from the inside out’.

    • Gregory B. Lim
    Research Highlight
  • The prevalence of hypertension in China has risen steadily in the past two to three decades. In this Review, Wang and colleagues summarize the latest epidemiological data on hypertension in China, describe the risk factors for hypertension that are relevant to this population, and provide an overview of initiatives aimed at improving awareness, treatment and control of hypertension, especially in the low-resource rural setting.

    • Ji-Guang Wang
    • Wei Zhang
    • Lisheng Liu
    Review Article
  • Macrophages are one of the most active cell types during all stages after myocardial infarction. In this Review, Boisvert and co-workers describe the populations of cardiac macrophage involved in myocardial infarction, their cardioprotective functions and their interactions with other cardiac cell types. The authors also explore potential therapeutic approaches to target macrophage-mediated inflammation in myocardial infarction.

    • Jonathan Yap
    • Jason Irei
    • William A. Boisvert
    Review Article
  • In this Review, Ntusi and colleagues examine the mechanistic links between dysbiosis of the oral microbiome and the pathogenesis of cardiovascular diseases, and explore potential strategies for prevention and treatment.

    • Andrea Tonelli
    • Evelyn N. Lumngwena
    • Ntobeko A. B. Ntusi
    Review Article
  • Cardiopulmonary resuscitation (CPR) provided by a bystander has saved the lives of many patients with out-of-hospital cardiac arrest. Several factors have been hypothesized to contribute to the low rates of bystander CPR, including the race and/or ethnicity of the recipient and the location of the out-of-hospital cardiac arrest.

    • Marcus Eng Hock Ong
    • Fahad Javaid Siddiqui
    News & Views
  • In this Review, Packer summarizes the latest advances in our understanding of the mechanisms that underlie the benefits of sodium–glucose cotransporter 2 (SGLT2) inhibitors in heart failure, identifies specific pathways that are likely to mediate a direct effect of SGLT2 inhibitors on cardiomyocytes and proposes a novel conceptual framework that explains the findings from experimental studies and clinical trials.

    • Milton Packer
    Review Article
  • In this Review, the authors summarize the evidence for physiological and pathological cardiac hypertrophy regression from clinical and basic science studies, discussing therapies and mechanisms involved in regression of cardiac hypertrophy and highlighting knowledge gaps and questions for future investigation to design specific therapies to promote regression of pathological hypertrophy.

    • Thomas G. Martin
    • Miranda A. Juarros
    • Leslie A. Leinwand
    Review Article
  • The global prevalence of atrial fibrillation (AF) is increasing, largely as a result of a rise in modifiable risk factors. In this Review, Sanders and colleagues summarize the epidemiology of AF and discuss lifestyle changes and risk factor interventions for the primary and secondary prevention of AF.

    • Adrian D. Elliott
    • Melissa E. Middeldorp
    • Prashanthan Sanders
    Review Article
  • After 40 years of spectacular technological innovation, catheter ablation has become central to the treatment of cardiac arrhythmias, revolutionizing patient care but with no consideration for environmental sustainability. With climate change being the biggest threat to humanity, all stakeholders urgently need to promote more virtuous and circular practices in the catheterization laboratory.

    • Julie Boussuge-Roze
    • Josselin Duchateau
    • Pierre Jaïs