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Many patients who undergo doxorubicin chemotherapy develop cardiac complications later in life. Patient-derived cardiomyocytes can be used to predict individual susceptibility to drug-induced cardiotoxicity, as evidenced by enhanced doxorubicin responses in cardiomyocytes derived from induced pluripotent stem cells of patients who developed heart failure after chemotherapy.

Elevated heart rate can induce myocardial ischaemia in patients with coronary artery disease, and is a risk factor for cardiovascular events in those with heart failure. In this Review, Ferrari and Fox discuss the evidence for therapeutic heart rate reduction, drawing particularly on data from the BEAUTIFUL, SHIFT, and SIGNIFY trials.

A range of established and emerging invasive and noninvasive imaging modalities can be used to evaluate various parameters of coronary atherosclerosis, including functional severity, plaque burden, and high-risk characteristics. In this Review, Dweck et al. assess the relative strengths and weaknesses of these techniques, how they might be complementary when used in combination, and barriers that exist to their translation into clinical practice.

Veins are the most commonly used conduits for surgical revascularization; however, they are associated with a high failure rate. In this Review, de Vries and colleagues discuss the pathophysiological mechanisms underlying the development of vein graft failure, and summarize the current and developing therapies used to prevent graft failure.

Results from the HOPE-3 randomized trial reinforce and expand the evidence base supporting current clinical practice guidelines that recommend initiation of statin therapy in individuals at intermediate risk of atherosclerotic events. Furthermore, the results support the initiation of antihypertensive medication for patients with blood pressure above threshold values.

Sex has an important role in the diagnosis of coronary artery disease (CAD). Results from the PROMISE trial highlight the influence of sex on presentation characteristics, diagnostic testing, and subsequent cardiac events among patients with suspected CAD. Differences in plaque characteristics among patients with stable CAD have also been suggested.

Clinical trials are designed to test efficacy and safety of interventions in populations with carefully defined medical illnesses. Clinical practice is aimed at caring for individuals who might have similar characteristics. Clinical trial guidelines can obscure benefits of interventions in individuals, which might account for the failure to demonstrate benefit of a renin inhibitor in heart failure.

Newly published data recovered from a large, randomized, controlled trial conducted >4 decades ago show no difference in mortality between individuals with a diet rich in saturated fat and those with a diet rich in linoleic acid, despite the cholesterol-lowering effect of the latter. These findings challenge the widely accepted diet–heart hypothesis.

In this Review, Parati et al. outline the complex interactions between heart failure and sleep alterations, with a focus on sleep-disordered breathing, and describe the pathophysiology, diagnosis, and treatment of these sleep disorders. In the context of increasing evidence from clinical trials, the authors aim to raise awareness among clinicians of the importance of sleep-disordered breathing in heart failure management.

This Review summarizes the existing knowledge on the effects of vitamin D on cardiovascular diseases and the associated risk factors. Pilz and colleagues provide an update on clinical studies on vitamin D and cardiovascular risk, discuss ongoing vitamin D research, and consider the management of vitamin D deficiency from the perspective of cardiovascular health.

Multivalvular disease is common among patients with valvular disease, and has a complex pathophysiology. In this Review, Unger et al. discuss the mechanisms, diagnosis, and percutaneous and surgical treatment of multivalvular disease, focusing on the combinations of valve pathologies that are most often encountered in clinical practice.