Volume 17 Issue 12, December 2020

Strategies that replicate the living aortic valve’s biological sophistication are likely to translate into optimal long-term outcomes.

A network of macrophages in the heart supports cardiac health and function by removing dysfunctional mitochondria and waste material released from cardiomyocytes in subcellular particles called exophers.

A new study shows that exosomes secreted by cardiac cells derived from human induced pluripotent stem cells improve myocardial recovery without arrhythmogenic complications and might provide an acellular therapeutic option for myocardial infarction.

A new single-cell data set defines the immune response to myocardial infarction, from origins in the bone marrow and its translational potential in the blood to diversification and regulation within the heart.

Higher levels of angiotensin-converting enzyme 2 in plasma are associated with a greater risk of major cardiovascular disease events, according to a global, population-based study.

The cellular composition of the heart is highly heterogeneous, plastic and sex-specific. These findings have important implications for understanding the functional specialization of the heart and also highlight the importance of considering biological sex in preclinical studies.

SGLT2 inhibitors improve cardiovascular and renal outcomes even in patients without diabetes mellitus. In this Review, Cowie and Fisher describe the additional mechanisms of benefit of SGLT2 inhibitors, unrelated to improved glycaemic control.

In this Review, Gerd Heusch revisits the pathophysiology of myocardial ischaemia–reperfusion injury, discusses the latest developments in cardioprotective interventions and the signalling pathways involved, identifies the challenges for their clinical translation and advocates the use of additive cardioprotective interventions and a focus on patients with severe haemodynamic alterations.

The development of the coronary vasculature involves numerous cellular sources and a multitude of distinct processes. In this Review, Smart and colleagues describe the latest insights into the mechanisms involved in coronary vessel formation during development and disease, which might contribute to the identification of therapeutic targets for the promotion of neovascularization after myocardial infarction.

In this Review, Alfieri and colleagues focus on new concepts on mitral valve pathophysiology and patient risk profile assessment to guide the indication and timing of the management of mitral valve regurgitation. The authors also describe new imaging modalities and contemporary surgical and transcatheter techniques, highlighting the need for a multidisciplinary approach.