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In the infarcted heart, pericytes have crucial roles in inflammatory signalling, angiogenesis, and scar formation and stabilization. In this Review, Avolio and colleagues discuss the numerous roles of cardiac pericytes in homeostasis and disease and describe the potential of pericyte-based therapy for restoring the perivascular niche after myocardial infarction.
A study shows that macrophages undergo substantial expansion in the diseased atria of patients with atrial fibrillation (AF), and identifies two potential immunotherapy targets for the treatment of AF.
In failing cardiomyocytes, depletion of carnitine acetyltransferase promotes cholesterol catabolism via the bile acid synthesis pathway. The intracellular accumulation of bile acid intermediates induces the release of mitochondrial DNA into the cytosol, triggering type I interferon responses and AIM2 inflammasome activation, thereby contributing to chronic myocardial inflammation and heart failure progression.
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.
Cardiovascular health is essential to achieving the United Nations Sustainable Development Goals (SDGs), particularly SDG3.4. Barriers include inequalities and a lack of political will and prioritization. A comprehensive approach is needed to reduce the global burden of cardiovascular disease and to achieve SDG3.4. The World Heart Federation addresses the determinants of cardiovascular disease and mobilizes the global community through roadmaps, roundtables and advocacy.
According to two papers from the OPTICO-ACS study, patients with acute coronary syndrome and an intact fibrous cap (plaque erosion), tend to have lower levels of inflammation and better prognosis than patients with rupture of the fibrous cap. In addition, Toll-like receptor 2-mediated neutrophil activation has a key role in plaque erosion.
Dual antiplatelet therapy (DAPT) reduces the risk of ischaemic events but can increase the risk of bleeding in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Gorog and colleagues provide consensus statements on strategies to reduce the risk of bleeding by de-escalating the intensity or abbreviating the duration of DAPT.
In this Roadmap, Föllmer et al. summarize the evidence for the application of artificial intelligence (AI) technology to the imaging of vulnerable plaques in coronary arteries and discuss the current and future approaches to addressing the limitations of AI-guided coronary plaque imaging, such as bias, uncertainty and generalizability.
Heart transplantation for patients with advanced heart failure is limited by a shortage of donor organs. In this Review, Jou and colleagues explore the options to increase the supply of donor hearts, including transplantation from donors with HCV, HIV or SARS-CoV-2 infection, national opt-out organ donation policies, donation after circulatory death, and xenotransplantation.
In this Review, the authors present an overview of the role of fibroblast growth factor 23 (FGF23) and klotho in normal mineral homeostasis, discuss disordered mineral homeostasis in chronic kidney disease (CKD), and explore CKD-associated FGF23 excess and klotho deficiency as novel risk factors and potential therapeutic targets for cardiovascular disease.
The FDA-approved drug ruxolitinib has been identified as an inhibitor of Ca2+/calmodulin-dependent protein kinase II (CaMKII) that has the potential to be repurposed to treat arrhythmias induced by CaMKII hyperactivity.
In the multicentre, randomized, placebo-controlled RAPID trial, use of symptom-prompted, self-administered, intranasally delivered etripamil was safe and superior to placebo for the conversion of paroxysmal superventricular tachycardia to sinus rhythm.
Testosterone-replacement therapy in men with hypogonadism and a high risk of cardiovascular disease does not increase the risk of adverse cardiac events, according to data from the TRAVERSE trial.
New research shows that the reduced risk of major adverse cardiovascular events associated with light or moderate alcohol consumption is partly mediated by attenuation of the activity of a stress-related neural network.
In this Review, Riksen and colleagues discuss the molecular and cellular mechanisms of trained immunity, the activation of these mechanisms by cardiovascular risk factors, and how trained immunity might contribute to atherosclerosis and atherosclerotic cardiovascular disease. The authors also propose potential strategies for the therapeutic modulation of trained immunity in atherosclerotic cardiovascular disease.
Familial hypercholesterolaemia (FH) is a preventable cause of premature coronary artery disease and death. This guidance article from the International Atherosclerosis Society provides a comprehensive overview of FH care that includes recommendations on the detection and management of patients with FH, as well as strategies to maximize implementation.
The benefits of oxygen therapy for the treatment of cardiovascular disease are unclear, and findings from preclinical studies have suggested potential adverse effects associated with its excessive use. In this Review, Eltzschig and colleagues provide an overview of studies on oxygen therapy for various cardiovascular conditions and describe alternative therapeutic strategies that target oxygen-sensing pathways.
