Volume 17 Issue 2, February 2020

Stem cell therapy does not promote the regeneration or production of new cardiomyocytes in the injured heart but induces a wound healing response that contributes to improved cardiac function.

In patients with a recent myocardial infarction, anti-inflammatory therapy with low-dose colchicine reduces the risk of ischaemic cardiovascular events compared with placebo.

In two post-hoc analyses of the DAPA-HF trial, the benefits of dapagliflozin were found to be consistent across all age groups and independent of baseline symptom status.

New analyses of the PARAGON-HF and PARADIGM-HF trials indicate that sacubitril–valsartan treatment might be beneficial in patients with heart failure with mildly reduced left ventricular ejection fraction and that the benefit might be greater in women than in men.

Results of the GALILEO trial presented at the AHA Scientific Sessions 2019 indicate that a strategy with rivaroxaban 10 mg daily is associated with a higher risk of death or thromboembolic events and a higher risk of bleeding than an antiplatelet-based strategy.

In the RECOVERY trial, asymptomatic patients with very severe aortic stenosis who underwent early surgery had lower risk of cardiovascular death than those treated using a conservative-care strategy.

Udenafil, a phosphodiesterase type 5 inhibitor, improves measures of exercise performance at the ventilatory anaerobic threshold in individuals with Fontan physiology.

Findings from a large, international study comprising 4.9 million people with mild hypertension suggest that thiazide and thiazide-like diuretics might be more effective and safer than other first-line antihypertensive drugs. However, the study was not randomized, and the findings might be explained by a phenomenon known as ‘confounding by indication’.

This Review discusses the evolving indications of transcatheter aortic valve implantation (TAVI), including the latest clinical trials in young and low-risk patients with symptomatic severe aortic stenosis and ongoing studies exploring TAVI for other indications, including severe bicuspid aortic valve stenosis and pure native aortic regurgitation, highlighting procedural implications and caveats of new and future indications.

Pulmonary arterial hypertension (PAH) is characterized by right ventricular hypertrophy and the absence of underlying cardiac or pulmonary disease. In this Review, Southgate and colleagues discuss the latest advances in the identification of genetic variants underlying PAH development and progression.

Lysine acetyltransferases (KATs) and lysine deacetylases (KDACs) are involved in the regulation of lysine acetylation, a conserved post-translational protein modification that is an important modulator of cardiac metabolism. Li and colleagues describe the complex roles of KATs and KDACs in both the normal and diseased heart and provide an overview of the evidence indicating a therapeutic role of KDAC inhibitors in cardiovascular disease.

The non-canonical axis of the renin–angiotensin system (RAS) has an important role in cardiovascular physiology and disease. In this Review, Ocaranza and colleagues discuss the interplay between components of the counter-regulatory RAS and the therapeutic potential of targeting this system to treat cardiovascular disease.