Articles in 2023

During myocardial infarction, haematopoietic stem and progenitor cells increase fatty acid oxidation, and bone marrow adipocytes can act as a local energy resource for these cells.

Left atrial appendage occlusion (LAAO) has been rapidly adopted for stroke prevention in patients with non-valvular atrial fibrillation and a contraindication to oral anticoagulation. Ongoing and planned clinical trials on LAAO and the development of new devices might expand clinical indications and address the remaining challenges of device-related thrombus and peridevice leak.

A method named photoacoustic vector tomography now enables the quantification of haemodynamics in veins at depths of more than 5 mm below the skin surface, outperforming current pure optical modalities for deep haemodynamic imaging.

In aged mice, but not young mice, with atherosclerosis, depletion of CD8⁺ T cells significantly reduces atherosclerotic lesion size and necrotic core area.

The use of intravenous levothyroxine does not increase the likelihood of hearts being transplanted from haemodynamically unstable, brain-dead potential donors, suggesting that current practice recommendations should be revised.

The risk of stroke in patients with atrial high-rate episodes (AHREs) depends on age, comorbidities and AHRE burden. Two randomized clinical trials on the use of oral anticoagulant therapy for stroke prevention in older patients with short and rare AHREs have reported conflicting findings on the efficacy of oral anticoagulation in this patient population, although both trials report a significantly increased risk of major bleeding with oral anticoagulation.

Representation of Black patients in cardiovascular clinical trials remains dismally low, reflective of systemic and structural barriers, which can lead to missed opportunities to meet community-identified needs, understand responses to medical therapies and improve cardiovascular care. Innovative, multilevel strategies focused on Black communities are warranted to increase enrolment of this population into clinical research.

Mosaic loss of chromosome Y (mLOY) refers to the condition in male individuals in which a detectable fraction of cells lose the Y chromosome. Prevalent in haematopoietic cells, this common somatic mutation is associated with decreased longevity and an increased risk of age-related diseases, including cardiovascular disease. Haematopoietic mLOY provides further insight into the sex-specific disparities that exist in disease susceptibility.

Gene therapy involving adenine base editing can correct a pathogenic variant in the Scn5a gene and alleviate arrhythmia phenotypes in a mouse model of long QT syndrome type 3.

Racial and ethnic disparities in cardiovascular health in the USA result in a persistent mortality gap between white and Black individuals, increase health-care costs and compromise an egalitarian society. Solutions to racial inequities require risk factor control and the implementation of evidence-based medicine and anti-racism policies. Overcoming these disparities is not only a practical necessity, but also a moral imperative.

Aster proteins are involved in the non-vesicular transport of cholesterol derived from dietary lipids in the small intestine from the plasma membrane to the endoplasmic reticulum in enterocytes.

In the ORBITA-2 trial, percutaneous coronary intervention was associated with a lower angina symptom score compared with a placebo procedure in patients with stable angina who were receiving minimal or no antianginal medication.

In patients with severe calcified aortic valve stenosis, treatment with transthoracically delivered non-invasive ultrasound is safe and improves valve function.

A liberal strategy of blood transfusion might improve outcomes in patients with acute myocardial infarction and anaemia, according to results from the MINT trial.

Treatment with the glucagon-like peptide 1 receptor agonist semaglutide, administered subcutaneously at a dose of 2.4 mg once per week, reduces the risk of major cardiovascular events by 20% compared with placebo in patients who are overweight or obese and with pre-existing cardiovascular disease but without diabetes mellitus, according to findings from the SELECT trial.

In women with elevated levels of blood pressure during pregnancy, the use of a physician-guided remote telemonitoring programme during the postpartum period improves BP control, according to findings from the POP-HT trial.

Data from the ARIES-HM3 trial show that excluding aspirin from the antithrombotic regimen in patients with advanced heart failure and a left ventricular assist device reduces the number of bleeding events and does not increase the risk of thromboembolism.

Coronary microvascular obstruction and dysfunction (CMVO) is common in patients with ST-segment elevation myocardial infarction (STEMI) despite prompt reperfusion. In this Review, the authors discuss the mechanisms of CMVO as well as strategies to reduce its incidence and improve prognosis.