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Burnout is prevalent in medicine and has been further amplified by the COVID-19 pandemic. Strategies must be developed to reduce burnout by addressing a culture of wellness, efficiency of practice, and resiliency. The entire health-care community has a role in addressing burnout and promoting well-being.
The COVID-19 pandemic has accelerated the adoption and acceptance of remote monitoring and other digital approaches to cardiovascular disease management across the world. We argue that considerable additional effort is required to ensure appropriate multi-stakeholder involvement in the development, evaluation and best use of an ever-increasing number of digital technologies.
The histone reader PHF7 binds to cardiac super-enhancers and is a strong activator of the reprogramming of adult cardiac fibroblasts to induced cardiac-like myocytes.
A deep learning artificial intelligence algorithm applied to recordings from a digital stethoscope can be used to detect cardiac murmurs, aortic stenosis and mitral regurgitation with an accuracy that is similar to that of expert cardiologists.
A new randomized clinical trial shows that tocilizumab, a monoclonal antibody that inhibits IL-6 signalling by binding to the IL-6 receptor, increases myocardial salvage in patients with acute ST-segment elevation myocardial infarction who undergo myocardial revascularization with percutaneous coronary intervention.
In ischaemic tissues, macrophages accumulate in the perivascular region and regulate blood flow by releasing nitric oxide derived from inducible nitric oxide synthase, thereby increasing muscle perfusion and improving limb function.
The CD200 inhibitory immune checkpoint promotes arterial homeostasis and reduces atherosclerotic plaque progression and inflammation in mice by limiting the excessive supply, recruitment and activation of monocytes and macrophages during atherogenesis, according to a new study.
Sequencing studies demonstrate a strong clinical association between clonal haematopoiesis driven by acquired mutations and atherosclerotic disease. Previous research supports the idea that this association reflects a direct contribution of some clonal haematopoiesis-related mutations to atherosclerosis. Now, mathematical modelling suggests that atherosclerosis could instead accelerate clonal haematopoiesis.
In this Review, Friedman and colleagues summarize the use of artificial intelligence-enhanced electrocardiography in the detection of cardiovascular disease in at-risk populations, discuss its implications for clinical decision-making in patients with cardiovascular disease and critically appraise potential limitations and unknowns.
In this Review, Díez and colleagues summarize the mechanisms of diffuse myocardial fibrosis in heart failure, discuss imaging techniques and circulating biomarkers to characterize the variability of this lesion in patients, and highlight the available and potential future therapeutic strategies for personalizing the prevention and reversal of diffuse myocardial fibrosis.
In this Review, Ren and colleagues summarize the latest advances in understanding the unfolded protein response and endoplasmic reticulum stress in the pathogenesis of cardiovascular disease and discuss potential therapeutic strategies aimed at restoring endoplasmic reticulum proteostasis in cardiovascular diseases.
In this Review, Heusch summarizes the pathophysiology of myocardial stunning and hibernation and highlights potential treatments and clinical implications. A better understanding of these characteristic reperfusion phenomena is important for the potential indication for revascularization and its consequences in patients with chronic coronary syndromes.
