News & Comment

  • Research Highlight |

    A new study reveals a developmental basis for mitral valve prolapse, caused by altered primary cilia-mediated regulation of extracellular matrix deposition during development, and suggests that mutations in primary cilia genes can be the cause of mitral valve prolapse in some patients.

    • Irene Fernández-Ruiz
  • Comment |

    The advent of ‘big data’ and modern analytics mandates a change of scale in every aspect of the biomedical enterprise. These forces are realigning academic medicine and traditional industrial partners, and also creating the context for an emerging new ecosystem for discovery, translation, care and implementation that promises to transform and integrate all these areas of endeavour.

    • Calum A. MacRae
  • Research Highlight |

    Cardiomyocyte-selective gene therapy to inhibit calcium/calmodulin-dependent protein kinase II effectively suppresses ventricular arrhythmias in mice with mutations known to cause catecholaminergic polymorphic ventricular tachycardia.

    • Gregory B. Lim
  • Research Highlight |

    Placental stem cells expressing caudal-type homeobox 2 can differentiate into cardiomyocytes and vascular cells, improving cardiac function in the infarcted hearts of mice.

    • Karina Huynh
  • Research Highlight |

    Viral vector delivery of microRNA-199a after myocardial infarction in pigs can stimulate endogenous myocardial repair mechanisms and improve cardiac function; however, persistent expression of the miRNA leads to sudden arrhythmic death.

    • Gregory B. Lim
  • News & Views |

    The global burden of cardiovascular disease morbidity and mortality demands increased awareness of effective prevention strategies by patients, communities and health-care providers. The new 2019 ACC/AHA guidelines provide evidence-based, preventive recommendations for patients without known cardiovascular disease, focusing on risk estimation, a healthy lifestyle and selective indications for pharmacotherapy.

    • Rhanderson Cardoso
    •  & Khurram Nasir
  • Research Highlight |

    Cardiac myofibroblasts in patients with end-stage heart failure retain the capacity to be dedifferentiated into a less activated state.

    • Karina Huynh
  • Research Highlight |

    Neutrophils exacerbate tissue damage and inflammation in advanced atherosclerosis by triggering smooth muscle cell (SMC) lysis and death. Lesional neutrophils release neutrophil extracellular traps that contain histone H4, which interacts with SMCs to induce cell lysis, leading to the destabilization of atherosclerotic plaques.

    • Irene Fernández-Ruiz
  • Research Highlight |

    High-sensitivity troponin I levels are positively and strongly linked with incident coronary heart disease, heart failure hospitalization and all-cause mortality in individuals without known cardiovascular disease.

    • Karina Huynh
  • Comment |

    Retinal microvascular changes are strongly linked to prevalent and incident cardiovascular disease. These changes can now be mapped with unparalleled accuracy using retinal optical coherence tomography. Novel retinal imaging, combined with the power of deep learning, might soon equip clinicians with unique and precise risk-assessment tools that enable truly individualized patient management.

    • Tariq E. Farrah
    • , David J. Webb
    •  & Neeraj Dhaun
  • Research Highlight |

    New research on the direct effects of stress on the heart highlights the importance of the balance of stress hormone signalling through glucocorticoid receptors and mineralocorticoid receptors in cardiomyocytes to maintain cardiac health.

    • Irene Fernández-Ruiz
  • Research Highlight |

    The scavenger receptor class B member 1 (SRB1) in endothelial cells mediates active transcellular transport of circulating LDL into the artery wall and thereby drives the accumulation of LDL in macrophages, which become foam cells and promote the development of atherosclerosis

    • Irene Fernández-Ruiz
  • Research Highlight |

    Researchers have developed a triboelectric nanogenerator that can harvest biomechanical energy from the motion of the heart and thereby power an implanted pacemaker.

    • Gregory B. Lim
  • Research Highlight |

    Patients with chemotherapy-induced cardiomyopathy have a high prevalence of rare variants of cardiomyopathy-related genes, in particular titin-truncating variants.

    • Karina Huynh
  • Research Highlight |

    A new mouse model involving mechanical and metabolic stress on the heart successfully recapitulates many of the human features of HFpEF, and researchers have used this model to identify nitrosative stress as an important driver of this prevalent syndrome.

    • Gregory B. Lim
  • Research Highlight |

    Two prespecified analyses of the DECLARE–TIMI 58 trial show that in patients with type 2 diabetes mellitus, dapagliflozin has greater cardiovascular benefit in those with heart failure with reduced ejection fraction at baseline and in those with prior myocardial infarction

    • Irene Fernández-Ruiz
  • Research Highlight |

    The Evolut Low Risk trial and the PARTNER 3 trial both show that transcatheter aortic valve replacement is at least equivalent to surgery in terms of efficacy and safety for patients with severe aortic stenosis at low operative risk.

    • Karina Huynh
  • Research Highlight |

    Dual therapies combining a calcium-channel blocker with an angiotensin-converting enzyme (ACE) inhibitor or thiazide diuretic are more effective at lowering blood pressure in black African patients than the combination of an ACE inhibitor and a thiazide diuretic.

    • Isobel Leake
  • Research Highlight |

    A regimen that includes a P2Y12 inhibitor plus apixaban without aspirin results in less bleeding and hospitalizations, without significant differences in ischaemic events, than use of regimens that include a vitamin K antagonist, aspirin or both

    • Irene Fernández-Ruiz
  • Research Highlight |

    In the COACT trial, a strategy of immediate coronary angiography and percutaneous coronary intervention did not improve outcomes following successful resuscitation after out-of-hospital cardiac arrest in the absence of ST-segment elevation myocardial infarction.

    • Gregory B. Lim
  • Research Highlight |

    AIBP-mediated cholesterol efflux promotes the specification of haematopoietic stem and progenitor cells (HSPCs) in embryogenesis and induces adult HSPC expansion in hypercholesterolaemic conditions, mediated by SREBP2-regulated activation of Notch signalling.

    • Irene Fernández-Ruiz
  • Research Highlight |

    Use of an absorbable antibacterial envelope is a safe and effective strategy for reducing major infections related to cardiac implantable electronic devices.

    • Isobel Leake
  • Research Highlight |

    In patients with symptomatic atrial fibrillation presenting to the emergency department, immediate cardioversion was noninferior to delayed cardioversion in re-establishing a normal rhythm after 4 weeks.

    • Karina Huynh
  • News & Views |

    Nonresolving inflammation underpins several prevalent diseases, including atherosclerosis and Alzheimer disease. The resolution of inflammation is an active process that tempers pro-inflammatory pathways and promotes tissue repair. Understanding the mechanisms that boost endogenous resolution is important for the design of new treatment strategies for nonresolving diseases.

    • Gabrielle Fredman
  • Research Highlight |

    Functional connectivity in the limbic system of the brain, which controls emotion and the autonomic system, is reduced in patients with Takotsubo syndrome compared with healthy individuals.

    • Gregory B. Lim
  • Research Highlight |

    The activin receptor type 2 (ACTRII) pathway is activated in ageing and heart failure (HF), and inhibition of this catabolic pathway is a potential therapeutic target for HF.

    • Gregory B. Lim
  • Research Highlight |

    A novel bioelectronic system that combines automated arrhythmia detection with optogenetic engineering for arrhythmia termination is able to stop atrial fibrillation without the need of electrical shock in a closed-chest experimental model.

    • Irene Fernández-Ruiz
  • Research Highlight |

    Singlet molecular oxygen generated by endothelial indoleamine 2,3-dioxygenase 1 has an important pathophysiological role in mammals in the redox regulation of arterial relaxation and blood pressure during inflammatory conditions through the formation of a tryptophan-derived metabolite

    • Irene Fernández-Ruiz
  • Research Highlight |

    New research shows that IL-1α and IL-1β have differential effects on atherosclerosis, which is important to consider when selecting anti-inflammatory therapies for patients with cardiovascular disease.

    • Gregory B. Lim
  • Research Highlight |

    A subset of T cells present in the small intestine modulate systemic metabolism and contribute to cardiovascular disease by limiting the bioavailability of the incretin hormone GLP1.

    • Irene Fernández-Ruiz
  • Research Highlight |

    Statin therapy significantly reduces major vascular events irrespective of age, but less direct evidence is available on the benefit of statins for the primary prevention of cardiovascular disease in people aged >75 years, according to a meta-analysis by the Cholesterol Treatment Trialists' Collaboration.

    • Irene Fernández-Ruiz
  • Research Highlight |

    Mutations in MYBPC3 cause increased cardiac contractility, reduced relaxation and excessive energy consumption characteristic of hypertrophic cardiomyopathy by disrupting normal myosin conformations. These abnormalities can be corrected by pharmacological targeting of myosin function.

    • Irene Fernández-Ruiz
  • Research Highlight |

    Mobilization of regulatory T cells to the site of myocardial infarction can be promoted with the use of a CXCR4 blocker, and the regulatory T cells attenuate inflammatory gene expression in monocytes and macrophages and augment infarct repair.

    • Gregory B. Lim
  • Comment |

    LDL cholesterol is an important contributor to the risk of coronary heart disease, and its measurement is central to evaluating the effects of lipid-modifying therapies. Several ‘LDL-cholesterol’ assays exist but their methodologies differ, leading to between-assay heterogeneity in values of ‘LDL cholesterol’. We advocate the need for awareness of the potential implications.

    • Michael V. Holmes
    •  & Mika Ala-Korpela