Review Articles

Sudden infant death syndrome (SIDS) is the leading cause of infant mortality in developed countries. In this Review, Behr and colleagues provide an update on the spectrum and prevalence of the subset of SIDS mediated by cardiogenetic factors, and the clinical implications of SIDS in the surviving family and general population.

A growing body of evidence supports the role of the gut microbiota in regulating blood pressure. In their Review, Marques and co-workers describe how the gut microbiota and its metabolites act on downstream cellular targets to influence the pathogenesis of hypertension. Novel strategies to modify the gut microbiota might present a new therapeutic avenue to improve health and prevent disease.

Patients with autoimmune rheumatic disease have an increased risk of cardiovascular morbidity and mortality, but the mechanisms that mediate this phenomenon are not fully elucidated. In this Review, Bartoloni and colleagues highlight the relationship between hypertension and autoimmune rheumatic diseases, focusing on the immune-mediated mechanisms that influence blood-pressure control.

The left atrial appendage is known to be a source of thromboemboli in patients with nonvalvular atrial fibrillation, and the interventional or surgical occlusion or exclusion of this anatomical structure is an alternative approach to anticoagulation therapy for the prevention of stroke. In this Review, Caliskan et al. discuss the various methods for occlusion of the left atrial appendage, and provide an overview of the clinical studies investigating these techniques.

HDL-cholesterol levels in plasma predict the risk of cardiovascular disease, but a direct causal role for HDL in cardiovascular disease remains controversial. In this Review, Rosenson et al. discuss the opportunities afforded by an integrated approach that combines human genetic studies with systems biology to understand the complex metabolism of HDL and its potential atheroprotective properties.

Obesity is a risk factor for the development of cardiovascular diseases. In their Review, Lavie and colleagues summarize the deleterious consequences of obesity in patients with cardiovascular disease, review the available data on the benefits of weight loss, and explain the 'obesity paradox' phenomenon in this setting.

Strategies to reduce myocardial infarct size beyond early reperfusion have thus far yielded disappointing results in clinical trials. In this Review, Kloner and co-workers discuss several new approaches to preserve the reperfused myocardium, including those that target mitochondrial bioenergetics and autophagy.

Since the introduction of transcatheter aortic valve implantation (TAVI) as a treatment for inoperable patients with aortic stenosis >1 decade ago, the range of patients who can benefit from this technology has continued to grow. In this Review, Jones and colleagues discuss the current evidence for TAVI in different patient populations, and describe the differences in design features in currently available valve systems.

Cardiac implanted electronic devices (CIEDs) frequently detect subclinical atrial high-rate episodes (AHREs), but the relevance and appropriate clinical response to these episodes is uncertain. In this Review, Freedman and colleagues discuss the relationship between AHREs, atrial fibrillation, and risk of stroke, and propose a management algorithm for patients with CIED-detected AHREs.

Derailment of cellular protein homeostasis (proteostasis) and loss of protein quality control (PQC) are central factors in ageing and contribute to cardiovascular disease. In this Review, Henning and Brundel describe the mechanisms by which PQC can fail. Targeting PQC to maintain cardiac proteostasis offers a novel therapeutic strategy to promote cardiac health and combat cardiac disease.

The optimal reperfusion strategy in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease is still uncertain. In this Review, Mehran and colleagues discuss the available evidence on the different treatment options for patients with STEMI and multivessel disease, highlighting current guideline recommendations and providing future directions on reperfusion strategies in these patients.

The epidemiology of pulmonary arterial hypertension (PAH) has evolved considerably in the past 2 decades. In this Review, Lau and colleagues describe how this evolving epidemiology has influenced the treatment and management of PAH.

Mendelian randomization (MR) is an increasingly common tool that involves the use of genetic variants to evaluate causal relationships between exposures and outcomes. In this Review, Holmes et al. describe some of the scenarios in which findings from MR analyses can be challenging to evaluate, using examples from studies on cardiometabolic diseases.

Physical activity and exercise training are important for improving outcomes in patients with heart failure (HF), especially elderly patients, but uptake remains poor. In this Review, Stewart Coats and colleagues discuss the importance of exercise training among the older patient population with HF, and provide potential strategies to improve uptake and adherence rates.

Cardiovascular disease (CVD) follows a seasonal pattern in many populations, often peaking after 'cold snaps'. In this Review, Stewart and colleagues identify the physiological and environmental factors that contribute to seasonality in nearly all forms of CVD, and describe the potential strategies that might attenuate peaks in cardiovascular events during cold and hot periods of the year.

Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome associated with poor quality of life, substantial health-care resource utilization, and premature mortality. Dunlay and colleagues summarize the epidemiological data on HFpEF, with a focus on the prevalence and incidence of HFpEF in the community as well as associated conditions and risk factors, morbidity and mortality after diagnosis, and quality of life.

The identification of mutations in ion channels has been crucial to understanding the pathogenesis of cardiac arrhythmias, but the aetiology of a considerable number of arrhythmogenic disorders remains unknown. In this Review, Lazzerini and colleagues discuss the role of autoimmunity in the pathogenesis of cardiac arrhythmias, describing how different autoantibodies against ion channels in the heart participate in the development of these conditions.

Cardiac tumours include a wide array of both neoplastic and non-neoplastic entities. Cardiac tumours are often found incidentally during imaging by ultrasonography, CT, or MRI. In this Review, Maleszewiski and colleagues discuss the clinical presentation, imaging characteristics, pathological characteristics, and treatment of these lesions.

Muscle wasting (sarcopenia) and loss of weight (cachexia) can occur in patients with heart failure. In this Review, von Haehling and colleagues provide an overview of the prevalence and pathophysiological mechanisms of these processes in heart failure, and discuss potential therapeutic strategies, including exercise training, nutritional supplements, and drug treatments.

Activated cardiac fibroblasts in adult hearts participate in the healing response after acute myocardial infarction and during chronic disease states. In this Review, Tallquist and Molkentin discuss insights gained from the use of genetically engineered mice that allow a systematic evaluation of fibroblast identity, origins, and response during cardiac disease and ventricular remodelling.