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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.
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.
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.
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.
A liberal strategy of blood transfusion might improve outcomes in patients with acute myocardial infarction and anaemia, according to results from the MINT trial.
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.
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.
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.
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.
In aged mice, but not young mice, with atherosclerosis, depletion of CD8+ T cells significantly reduces atherosclerotic lesion size and necrotic core area.
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.
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.
Hypoxic conditions encountered at high altitude affect all physiological functions. In this Review, Richalet et al. describe the cardiovascular responses to acute and chronic exposure to hypoxia and provide recommendations that clinicians can give to patients with cardiovascular disease who wish to travel to high-altitude destinations.
Some species have a greater capacity for cardiac regeneration than others. In this Review, Weinberger and Riley summarize the diverse array of vertebrates that have been studied for their cardiac regenerative potential and the core mechanisms that regulate cardiac regeneration across vertebrate species.
In the infarcted heart, pericytes have crucial roles in inflammatory signalling, angiogenesis, and scar formation and stabilization. In this Review, Avolio and colleagues discuss the numerous roles of cardiac pericytes in homeostasis and disease and describe the potential of pericyte-based therapy for restoring the perivascular niche after myocardial infarction.
In this Review, the authors discuss the clinical and experimental data on immunomodulatory effects of evidence-based treatments for heart failure and their primary mechanisms of action, and highlight potential therapeutic targets and opportunities for the development and application of novel immunomodulatory treatments for heart failure.
