Health sciences articles within Nature Reviews Cardiology

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  • Review Article |

    In this Review, Bosworth and colleagues describe the causes of medication non-adherence, discuss interventions that have been clinically shown to improve adherence and identify areas for future research.

    • Adam J. Nelson
    • , Neha J. Pagidipati
    •  & Hayden B. Bosworth

  • Review Article |

    In this Review, Guzik and colleagues discuss immune and inflammatory mechanisms of hypertension, including upstream regulators and downstream effectors as well as the complex interplay between the immune system, blood pressure regulation and end-organ damage, which can help to identify new targets for therapeutic interventions.

    • Tomasz J. Guzik
    • , Ryszard Nosalski
    •  & Grant R. Drummond

  • Review Article |

    Cardiovascular autonomic dysfunction (CVAD) is a malfunction of the autonomic control of circulatory homeostasis and is an important component of post-COVID-19 syndrome. In this Review, Fedorowski and colleagues define the major forms of CVAD (including postural orthostatic tachycardia syndrome), and discuss the aetiology, diagnosis and management of post-COVID-19 syndrome-associated CVAD.

    • Artur Fedorowski
    • , Alessandra Fanciulli
    •  & Richard Sutton

  • Review Article |

    Macrophages in atherosclerotic plaques can undergo apoptosis and several forms of regulated necrosis, including necroptosis, pyroptosis and ferroptosis. In this Review, De Meyer and colleagues describe the various forms of programmed macrophage death in atherosclerosis and the potential therapeutic implications.

    • Guido R. Y. De Meyer
    • , Michelle Zurek
    •  & Wim Martinet

  • Review Article |

    In this Review, the authors discuss the latest insights on RNA-binding proteins and RNA biology and appraise them in the context of cardiovascular research, summarizing the progress in our understanding of the involvement of RNA-binding proteins in cardiac biology and disease.

    • Mirko Völkers
    • , Thomas Preiss
    •  & Matthias W. Hentze

  • Clinical Outlook |

    Left atrial appendage occlusion (LAAO) has been rapidly adopted for stroke prevention in patients with non-valvular atrial fibrillation and a contraindication to oral anticoagulation. Ongoing and planned clinical trials on LAAO and the development of new devices might expand clinical indications and address the remaining challenges of device-related thrombus and peridevice leak.

    • Jacqueline Saw

  • Research Highlight |

    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.

    • Irene Fernández-Ruiz

  • Clinical Outlook |

    The risk of stroke in patients with atrial high-rate episodes (AHREs) depends on age, comorbidities and AHRE burden. Two randomized clinical trials on the use of oral anticoagulant therapy for stroke prevention in older patients with short and rare AHREs have reported conflicting findings on the efficacy of oral anticoagulation in this patient population, although both trials report a significantly increased risk of major bleeding with oral anticoagulation.

    • Tatjana Potpara
    •  & Carina Blomstrom-Lundqvist

  • Comment |

    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.

    • LaPrincess C. Brewer
    •  & Joshua J. Joseph

  • Comment |

    Mosaic loss of chromosome Y (mLOY) refers to the condition in male individuals in which a detectable fraction of cells lose the Y chromosome. Prevalent in haematopoietic cells, this common somatic mutation is associated with decreased longevity and an increased risk of age-related diseases, including cardiovascular disease. Haematopoietic mLOY provides further insight into the sex-specific disparities that exist in disease susceptibility.

    • Soichi Sano
    •  & Kenneth Walsh

  • Research Highlight |

    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.

    • Irene Fernández-Ruiz

  • Comment |

    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.

    • Keith C. Ferdinand

  • Research Highlight |

    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.

    • Jennifer Harman

  • Research Highlight |

    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.

    • Gregory B. Lim

  • Research Highlight |

    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.

    • Irene Fernández-Ruiz

  • Research Highlight |

    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.

    • Gregory B. Lim

  • Research Highlight |

    Activation of a specific set of vagal sensory neurons connecting the ventricular wall of the heart to the area postrema in the brainstem causes mice to faint. This finding defines a cardiac reflex that recapitulates characteristics of human syncope.

    • Gregory B. Lim

  • Research Highlight |

    Two new studies using cryo-electron microscopy describe the structure and conformation of myosin in the cardiac thick filaments and how it interacts with other thick-filament proteins, such as titin and cardiac myosin-binding protein C, in mammalian hearts.

    • Gregory B. Lim

  • Review Article |

    In this Review, Tsimikas and co-workers re-examine the role of lipoprotein(a) in the regulation of platelet function and propose areas for future research to define its clinical relevance for cardiovascular disease.

    • Harpreet S. Bhatia
    • , Richard C. Becker
    •  & Sotirios Tsimikas

  • Research Highlight |

    Treatment with the small interfering RNA patisiran preserves functional capacity and improves health status and quality of life in patients with transthyretin cardiac amyloidosis, according to data from the 12-month double-blind period of the ongoing APOLLO-B trial.

    • Irene Fernández-Ruiz

  • Clinical Outlook |

    Transcatheter aortic valve implantation (TAVI) has become an important treatment option for aortic stenosis, even among younger patients, with similar rates of efficacy as compared with surgical valve replacement. However, complications including device failure persist; these can be addressed by surgical explantation and repeat TAVI. Ongoing research emphasizes the long-term potential of TAVI as an alternative to surgical intervention for aortic stenosis.

    • Marco Barbanti
    •  & John G. Webb

  • Review Article |

    The NLRP3 inflammasome can sense cardiac ischaemic and non-ischaemic injury, amplify the inflammatory response and induce inflammatory cell death. In this Review, Toldo and Abbate describe the role of the NLRP3 inflammasome in numerous cardiac pathologies and summarize evidence on the use of agents targeting the NLRP3 inflammasome and related cytokines.

    • Stefano Toldo
    •  & Antonio Abbate

  • Evidence-based Guidelines |

    A panel of experts from the World Heart Federation provide a revised set of guidelines for the echocardiographic detection of rheumatic heart disease (RHD) in patients living in RHD-endemic regions. The guidelines provide updated screening and confirmatory criteria, as well as a new stage-based classification of RHD based on risk of disease progression, which will improve the diagnosis and subsequent management of patients with RHD.

    • Joselyn Rwebembera
    • , James Marangou
    •  & Bo Reményi

  • Comment |

    For patients with heart failure and reduced left ventricular ejection fraction, intravenous iron is likely to deliver clinical and prognostic benefits for those with anaemia and transferrin saturation <20%, especially if serum ferritin exceeds 100 μg/l. A serum ferritin of <100 μg/l does not appear to be useful as a marker of iron deficiency.

    • John G. F. Cleland

  • Research Highlight |

    NAD-dependent protein deacetylase sirtuin 2 is a key protective mediator against cardiac ageing, according to a study in non-human primates.

    • Irene Fernández-Ruiz

  • Research Highlight |

    SARS-CoV-2 infects macrophages, especially lipid-laden foam cells, in coronary atherosclerotic plaques in patients with COVID-19; this infection initiates a strong proatherogenic inflammatory response, which might contribute to the ischaemic cardiovascular complications in these patients.

    • Gregory B. Lim

  • Review Article |

    In this Review, Tsimikas and Witztum discuss the role of oxidized phospholipids (OxPLs) in atherosclerosis, describe the methods for measuring OxPLs on apolipoprotein B-containing lipoproteins (OxPL–apoB) and their relationship with lipoprotein(a), and discuss the clinical applications of the OxPL–apoB measurement for improving diagnosis, prognosis, risk reclassification and therapeutic interventions in patients with atherosclerotic cardiovascular disease.

    • Sotirios Tsimikas
    •  & Joseph L. Witztum

  • Research Highlight |

    In a study published in Nature, Jia and colleagues use advanced optical electrophysiology tools coupled with 3D-printed moulds to capture the very first heartbeat of zebrafish.

    • Karina Huynh

  • Research Highlight |

    The metabolic maturation of mammalian cardiomyocytes that occurs during the early postnatal period shapes the epigenetic landscape of cardiomyocytes and creates a barrier for cell division, but reversing this remodelling process can restore the reparative capacity of the heart in mice, according to a study published in Nature.

    • Irene Fernández-Ruiz

  • Review Article |

    Low socioeconomic position (SEP) is associated with an increased risk of cardiovascular disease (CVD), but whether this association is causal is uncertain. In this Review, Bann and colleagues discuss how evidence from divergent study designs can help in understanding the causal relationship between SEP and CVD and how this relationship might have been affected by the COVID-19 pandemic.

    • David Bann
    • , Liam Wright
    •  & Nish Chaturvedi

  • Comment |

    Despite the high consumption of fermented foods and beverages worldwide, their role in a healthy diet is still up for debate. Some fermented beverages have been demonstrated to protect against cardiovascular disease, but many aspects of the effects of fermented foods on cardiovascular health are uncertain. Better-designed studies are warranted.

    • Ramon Estruch
    •  & Rosa M. Lamuela-Raventós

  • Review Article |

    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.

    • Jean-Paul Richalet
    • , Eric Hermand
    •  & François J. Lhuissier

  • Review Article |

    Myocardial infarction with non-obstructive coronary arteries (MINOCA) has been the focus of an increasing number of studies in the past decade. In this Review, Tavella and colleagues detail the prevalence and clinical presentation of MINOCA, describe the mechanisms underlying the syndrome, and summarize the sex-specific and ethnicity-specific differences in the clinical features, pathophysiological mechanisms, treatment and prognosis of MINOCA.

    • Sarena La
    • , John Beltrame
    •  & Rosanna Tavella

  • Review Article |

    In this Review, Swirski and co-workers discuss how lifestyle factors modulate haematopoiesis and leukocyte migration in the context of cardiovascular homeostasis and disease, with particular focus on the role of the nervous system as the key executor connecting environmental influences to leukocyte behaviour.

    • Henrike Janssen
    • , Laura L. Koekkoek
    •  & Filip K. Swirski

  • Review Article |

    The menopausal transition period, which begins with irregular menstrual cycles and ends with the final menstrual period, is associated with an increase in cardiovascular risk. In this Review, Mehta and Manson describe the metabolic and cardiovascular changes that occur during the menopausal transition period and summarize the evidence on the use of targeted interventions to slow the progression of atherosclerosis.

    • Jaya M. Mehta
    •  & JoAnn E. Manson

  • Clinical Outlook |

    The population of patients who undergo cardiac surgery is becoming older and more medically complex, and frailty is increasingly prevalent. Prehabilitation is a multicomponent programme intended to better prepare these vulnerable patients for the stresses of surgery. Nonetheless, the effectiveness, implementation and effects on long-term outcomes of prehabilitation have not been clearly established. In particular, frailty might not be easily mitigated by prehabilitation.

    • Atilio Barbeito
    •  & Daniel E. Forman

  • Research Highlight |

    Two studies now report that TET2-driven clonal haematopoiesis of indeterminate potential (CHIP) is associated with poor prognosis in patients with heart failure (HF) and preserved ejection fraction and that DNMT3A CHIP driver mutations promote dysregulated gene expression profiles that are associated with inflammation in monocytes in the setting of HF.

    • Karina Huynh

  • Clinical Outlook |

    The link between migraine and cardiovascular disease is complex and involves overlapping mechanisms, such as endovascular disturbances. Challenges in measuring migraine, in distinguishing between causation and prediction, and in the understanding of clinical implications highlight the need for further research to guide treatment and cardiovascular risk assessment for the millions of individuals living with migraine.

    • Tobias Kurth
    •  & Pamela M. Rist

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