Review Articles in 2018

Fully bioresorbable scaffolds (BRS) were designed to overcome the limitations of metallic drug-eluting stents, but long-term results with these devices have been disappointing. In this Review, the authors discuss the available preclinical and clinical data for BRS and how this information can inform the development of next-generation BRS.

This Review summarizes the mechanisms of ectopic calcification processes in the cardiovascular system, with an emphasis on emerging knowledge obtained from advances in imaging methods, experimental models and multiomics-generated big data. This Review highlights the potential and challenges of artificial intelligence, machine learning and deep learning to integrate imaging and mechanistic data to identify biomarkers and effective treatments for cardiovascular calcification

Stent thrombosis is a rare but severe complication of coronary intervention and has a complex underlying pathophysiology. In this Review, Gori and colleagues describe the risk factors for stent thrombosis and discuss how a better understanding of the mechanisms underlying this complication can inform its prevention and treatment.

Cardiovascular disease (CVD) is the leading cause of death in China. In this Review, Zhao and colleagues summarize eight important features of the evolving epidemiology of CVD in China and discuss how this information can help to develop effective and timely strategies to prevent and treat CVD.

This Review discusses the latest findings and current theories on the pathogenesis of abdominal aortic aneurysm (AAA) and highlights potential medical therapies for AAA, summarizing previous, ongoing, and potential clinical trials of medical interventions for small AAAs. This expanding volume of research is expected to result in a range of novel medical therapies for AAA within the next decade.

This Review provides an update of the latest developments in our understanding of platelet functions and populations in normal physiology and in haemorrhagic, thrombotic, and inflammatory conditions. These advancements can aid in tailoring new strategies to target platelets in disease states while avoiding the increased risk of bleeding associated with current antiplatelet therapies.

Three cardiovascular outcome trials have now demonstrated the clinical benefit of achieving lower plasma LDL-cholesterol levels with the addition of PCSK9 inhibitors to statin therapy. In this Review, Marc Sabatine discusses the safety and efficacy data from these trials and their possible implications, such as the definition of new plasma LDL-cholesterol targets.

Metabolites produced by gut microorganisms from dietary metabolism have been linked to the pathogenesis of heart failure, suggesting that the gut microbiome functions like an endocrine organ. In this Review, Tang and colleagues discuss the gut microbial metabolic pathways involved in heart failure and propose the gut microbiome as a therapeutic target.

Antibody-producing B cells perform a unique role in responses to stress, injury, and infection. In this Review, Sage and colleagues discuss the spectrum of B cell involvement in dyslipidaemia and atherosclerotic plaque development.

This Review describes the effects of short sleep duration on cardiovascular health and diseases, and the authors discuss the main pathophysiological mechanisms involved, taking into account both experimental data and clinical evidence.

The current guidelines recommending the use of higher-intensity statin therapy to reduce the risk of cardiovascular disease have raised concerns about potential adverse effects associated with long-term statin therapy. In this Review, Adhyaru and Jacobson discuss the evidence for the efficacy and safety of statins to help clinicians and patients make informed decisions about statin therapy.

In this Review, Yacoub and McLeod summarize the rationale for monitoring patients with heart failure or pulmonary arterial hypertension to detect haemodynamic changes that predict the deterioration from subclinical to overt disease, the transition from noninvasive to implantable devices and the current and anticipated clinical use of these devices.

Computational models are increasingly used in cardiology to integrate multiple data sets from individual patients and create virtual-patient simulations. In this Review, Niederer and colleagues discuss how multi-scale models of cardiac electrophysiology and mechanics can support diagnostic assessment and clinical decision-making and pave the way to personalized cardiac care.

The cardiac lymphatic system has a physiological role in the maintenance of cardiac health, and its structure and function are altered in cardiovascular diseases such as atherosclerosis and myocardial infarction. Cardiac lymphatics might be a therapeutic target to reduce myocardial oedema and chronic inflammation.

This Review summarizes the current knowledge on the biology and regional variability of the adipose tissue, highlighting the molecular mechanisms controlling the crosstalk between the adipose tissue and the cardiovascular system. Current state-of-the-art techniques in adipose tissue imaging for cardiovascular risk stratification and the potential of the adipose tissue as a target for the treatment of cardiovascular disease are also described.

In this Review, de la Pompa and colleagues describe the role of the Notch pathway during the differentiation and patterning of cardiac tissues and in valve and ventricular chamber development, discussing the crosstalk with other signalling pathways, how defective Notch signalling is linked to congenital heart diseases, and the relevance of the Notch pathway in heart regeneration and repair.

The incidence of atrial fibrillation (AF) and the risk of cognitive impairment both increase with age, and the two pathologies share important risk factors. In this Review, Madhavan and colleagues explore the association and mechanisms of cognitive decline and AF, and discuss potential therapies to prevent cognitive impairment in these patients.

In this Review, Meilhac and Buckingham discuss the origin of cardiac cell populations, their lineage relationships and the genes that regulate their behaviour and differentiation. Characterizing the progenitor cells that form the heart and the gene regulatory networks controlling their deployment is of major importance for understanding the origin of congenital heart malformations and for developing cardiac regeneration therapies.

Over the past 20 years, new insights into cardiovascular immunopathology have shifted the therapeutic focus from lipids to inflammation. In this Review, Duivenvoorden and colleagues discuss recent discoveries in the immunopathology of atherosclerosis, advances in bioengineering techniques, and how these advances have guided the development of innovative nanoimmunotherapeutic strategies to modulate immune responses in cardiovascular disease.

Research on cardiac repair and regeneration is shifting from a stem cell focus towards the dynamic interplay of stromal and immune cells of the cardiac interstitium. This Review provides new insights into the immunoregulatory functions of cardiac interstitial cells and their complex network of interactions, highlighting the therapeutic potential for cardiac disease.