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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.
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.
In treatment-naive patients with essential hypertension, supplementation with prebiotic acetylated and butyrylated high amylose maize starch significantly reduces systolic blood pressure levels compared with placebo.
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.
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.
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’.
A machine learning model trained using clinical data from electronic health records generated a novel in silico quantitative score for coronary artery disease
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.
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.
Calcific aortic valve disease and stenosis have a complex pathogenesis, and no therapies are available that can halt or slow their progression. In this Perspective, Narula and colleagues explore a possible relationship between amyloid deposition, calcification and the development of aortic valve stenosis.
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.
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.
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.
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.
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.
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.
Immune checkpoint inhibitors (ICIs) have become a pillar of cancer therapy. The cardiovascular complications of ICIs extend beyond myocarditis and can involve any component of the cardiovascular system, including the pericardium, coronary arteries and conduction system. Clinicians caring for patients treated with ICIs must be vigilant for the cardiovascular complications of these therapies, which might portend a poor prognosis.
