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  • In this Roadmap article, international experts summarize the evidence and provide consensus recommendations on the application of transcatheter aortic valve implantation in patients with bicuspid aortic valve anatomy in advance of the anticipated growth in the use of this procedure in this challenging cohort of patients.

    • Tian-Yuan Xiong
    • Walid Ben Ali
    • Darren Mylotte
  • The totality of evidence from large-scale, randomized, controlled clinical trials and mechanistic studies in the laboratory has provided six crucial lessons about the emerging role of SGLT2 inhibitors to prevent the onset of heart failure in patients at high risk and slow the progression of heart failure in patients with established disease.

    • Milton Packer
    Clinical Outlook
  • In this Review, the authors discuss the roles of non-canonical WNT signalling in cardiovascular disease. They provide an overview of non-canonical WNT signalling, describe its links to the pathogenesis of atherosclerosis, heart failure and arrhythmias, and explore the clinical potential of targeting individual components of non-canonical WNT signalling in cardiovascular disease.

    • Ioannis Akoumianakis
    • Murray Polkinghorne
    • Charalambos Antoniades
    Review Article
  • The evolution of stent design has reduced the incidence of stent thrombosis, meaning that the duration of dual antiplatelet therapy after percutaneous coronary intervention (PCI) might be shortened. In this Review, the authors describe the current evidence base and ongoing clinical trials into the use of P2Y12 inhibitor monotherapy after PCI.

    • Davide Capodanno
    • Usman Baber
    • Dominick J. Angiolillo
    Review Article
  • Wearable devices are widely used and have a high level of societal acceptance, opening unimagined and unexploited possibilities in cardiovascular medicine. In this Clinical Outlook, we highlight the disruptive potential of wearables for cardiovascular disease prevention, diagnosis and management, and suggest strategies for quickly and safely translating these lifestyle products into medical devices.

    • Sinje Gehr
    • Christoph Russmann
    Clinical Outlook
  • The relationship between climate change and health outcomes is complex. In this Review, Rajagopalan and colleagues describe the environmental exposures associated with climate change and provide an overview of the consequences of climate change, including air pollution and extreme temperatures, on cardiovascular health and disease.

    • Haitham Khraishah
    • Barrak Alahmad
    • Sanjay Rajagopalan
    Review Article
  • In this Review, Kluin and colleagues describe the historical milestones and lessons learned in the development of total artificial hearts (TAHs), discuss the current generation of TAHs and their working mechanisms, and highlight challenges and future perspectives for the field, including new technologies that will promote TAH development in the coming decade.

    • Annemijn Vis
    • Maziar Arfaee
    • Jolanda Kluin
    Review Article
  • Transcatheter aortic valve implantation (TAVI) is a breakthrough technology to replace the aortic valve in patients with severe aortic stenosis using simple cardiac catheterization instead of thoracic surgery. Initiated 20 years ago by my colleagues and me, TAVI has been performed in >1.5 million patients globally and has profoundly altered the landscape of cardiovascular medicine.

    • Alain Cribier
    World View
  • 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
    Research Highlight
  • Drugs can be repurposed for new therapeutic indications. In this Review, Mercola and colleagues summarize the latest techniques for systematic drug repurposing and re-engineering, which could increase the pace, efficiency and cost-effectiveness of drug discovery for the treatment of cardiovascular disease.

    • Mena Abdelsayed
    • Eric J. Kort
    • Mark Mercola
    Review Article
  • Moderate coffee consumption (2–5 cups per day) has been consistently associated with a lower risk of cardiovascular disease in epidemiological studies. For most individuals, a caffeine intake of up to 400 mg per day is safe and moderate coffee consumption can be included as part of a healthy lifestyle.

    • Rob M. van Dam
    • Frank B. Hu
  • In this Review, Khan and colleagues discuss the benefits and challenges of including pragmatism in the design, conduct and interpretation of randomized controlled trials (RCTs) for cardiovascular disease and highlight selected ongoing and completed cardiovascular RCTs that incorporate a pragmatic design.

    • Muhammad Shariq Usman
    • Harriette G. C. Van Spall
    • Muhammad Shahzeb Khan
    Review Article
  • The adventitia of atherosclerotic arteries is innervated by efferent and afferent neurons that form neuroimmune cardiovascular interfaces and modulate disease progression; ablating the sympathetic innervation to these regions is a potential therapeutic strategy.

    • Gregory B. Lim
    Research Highlight