Health sciences articles within Nature Reviews Cardiology

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  • 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

  • Research Highlight |

    In patients with heart failure (HF) with preserved ejection fraction and obesity, treatment with the glucagon-like peptide 1 receptor agonist semaglutide (2.4 mg) leads to large reductions in HF-related symptoms and physical limitations, improves exercise function and decreases body weight compared with placebo, according to the STEP-HFpEF trial.

    • Irene Fernández-Ruiz

  • Review Article |

    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.

    • George Markousis-Mavrogenis
    • , Lukas Baumhove
    •  & Peter van der Meer

  • Research Highlight |

    The FIRE trial showed that complete revascularization improves outcomes in older patients with myocardial infarction (MI) and multivessel disease compared with culprit-lesion-only revascularization, whereas the MULTISTARS AMI trial reported that immediate multivessel revascularization is non-inferior to staged revascularization in patients with ST-segment elevation MI.

    • Karina Huynh

  • Research Highlight |

    In the CASTLE HTx trial, patients with symptomatic atrial fibrillation and end-stage heart failure who underwent catheter ablation and received medical therapy had improved outcomes compared with patients who received medical therapy only.

    • Karina Huynh

  • Research Highlight |

    New data from the ECLS-SHOCK trial and a meta-analysis indicate that the routine use of venoarterial extracorporeal membrane oxygenation does not increase survival in patients with myocardial infarction-related cardiogenic shock.

    • Gregory B. Lim

  • Research Highlight |

    Two clinical trials presented at the ESC Congress 2023 provide conflicting evidence on the use of optical coherence tomography to guide percutaneous coronary intervention.

    • Irene Fernández-Ruiz

  • Clinical Outlook |

    In patients with an acute myocardial infarction, disrupted circadian rhythms during the initial days in the cardiac intensive care unit, caused by factors such as noise, excessive night-time light and frequent patient–staff interactions, can have devastating effects on cardiac repair and long-term prognosis. Providing care that aligns with the patient’s natural circadian rhythms is critical for optimum long-term recovery. Incorporating ‘circadian medicine’ into clinical practice will provide important health-care benefits.

    • Michael J. Sole
    •  & Tami A. Martino

  • Clinical Outlook |

    Novel non-steroidal mineralocorticoid receptor antagonists (MRAs) have improved pharmacological properties compared with steroidal MRAs. Among the non-steroidal MRAs, finerenone has been approved for patients with chronic kidney disease who have diabetes mellitus and has demonstrated favourable safety and promising early results in patients with heart failure.

    • Gerasimos Filippatos
    •  & Dimitrios Farmakis

  • Clinical Outlook |

    Unloading left atrial hypertension by catheter-based, transvenous creation of atrial shunts is being explored to treat heart failure. So far, trials including sham control have demonstrated safety and efficacy in lowering left-sided cardiac filling pressures. Ongoing trials will determine the effect on clinical outcomes.

    • Finn Gustafsson

  • Research Highlight |

    A new study reveals that the disrupted sleep patterns that are frequently observed in patients with cardiac disease are driven by immune-mediated sympathetic denervation and dysfunction of the pineal gland, which leads to a decrease in the circulating levels of melatonin and subsequent sleep disruption.

    • Irene Fernández-Ruiz

  • Review Article |

    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.

    • Michael Weinberger
    •  & Paul R. Riley

  • Review Article |

    In this Review, Marsan et al. discuss the different clinical scenarios in which valvular heart diseases and cardiomyopathies coexist, either as the cause of one another or because of a common aetiology, to highlight the need for an improved classification of these diseases with potential repercussions in clinical management and personalized treatment.

    • Nina Ajmone Marsan
    • , Francesca Graziani
    •  & Filippo Crea

  • Review Article |

    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.

    • Elisa Avolio
    • , Paola Campagnolo
    •  & Paolo Madeddu

  • Research Highlight |

    In failing cardiomyocytes, depletion of carnitine acetyltransferase promotes cholesterol catabolism via the bile acid synthesis pathway. The intracellular accumulation of bile acid intermediates induces the release of mitochondrial DNA into the cytosol, triggering type I interferon responses and AIM2 inflammasome activation, thereby contributing to chronic myocardial inflammation and heart failure progression.

    • Gregory B. Lim

  • Research Highlight |

    Patients with hypertension who receive a single subcutaneous dose of zilebesiran, a novel small-interfering RNA that inhibits hepatic angiotensinogen synthesis, have reductions in serum angiotensinogen levels and 24-h ambulatory blood pressure that last for up to 24 weeks, according to a phase I study.

    • Irene Fernández-Ruiz

  • Comment |

    Cardiovascular health is essential to achieving the United Nations Sustainable Development Goals (SDGs), particularly SDG3.4. Barriers include inequalities and a lack of political will and prioritization. A comprehensive approach is needed to reduce the global burden of cardiovascular disease and to achieve SDG3.4. The World Heart Federation addresses the determinants of cardiovascular disease and mobilizes the global community through roadmaps, roundtables and advocacy.

    • Daniel J. Piñeiro
    • , Elisa Codato
    •  & Jagat Narula

  • Research Highlight |

    According to two papers from the OPTICO-ACS study, patients with acute coronary syndrome and an intact fibrous cap (plaque erosion), tend to have lower levels of inflammation and better prognosis than patients with rupture of the fibrous cap. In addition, Toll-like receptor 2-mediated neutrophil activation has a key role in plaque erosion.

    • Jennifer Harman

  • Consensus Statement |

    Dual antiplatelet therapy (DAPT) reduces the risk of ischaemic events but can increase the risk of bleeding in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Gorog and colleagues provide consensus statements on strategies to reduce the risk of bleeding by de-escalating the intensity or abbreviating the duration of DAPT.

    • Diana A. Gorog
    • , Jose Luis Ferreiro
    •  & Gregory Y. H. Lip

  • Roadmap |

    In this Roadmap, Föllmer et al. summarize the evidence for the application of artificial intelligence (AI) technology to the imaging of vulnerable plaques in coronary arteries and discuss the current and future approaches to addressing the limitations of AI-guided coronary plaque imaging, such as bias, uncertainty and generalizability.

    • Bernhard Föllmer
    • , Michelle C. Williams
    •  & Marc Dewey

  • Review Article |

    Heart transplantation for patients with advanced heart failure is limited by a shortage of donor organs. In this Review, Jou and colleagues explore the options to increase the supply of donor hearts, including transplantation from donors with HCV, HIV or SARS-CoV-2 infection, national opt-out organ donation policies, donation after circulatory death, and xenotransplantation.

    • Stephanie Jou
    • , Sean R. Mendez
    •  & Claudia Gidea

  • Review Article |

    In this Review, the authors present an overview of the role of fibroblast growth factor 23 (FGF23) and klotho in normal mineral homeostasis, discuss disordered mineral homeostasis in chronic kidney disease (CKD), and explore CKD-associated FGF23 excess and klotho deficiency as novel risk factors and potential therapeutic targets for cardiovascular disease.

    • Daniel Edmonston
    • , Alexander Grabner
    •  & Myles Wolf

  • Research Highlight |

    In the multicentre, randomized, placebo-controlled RAPID trial, use of symptom-prompted, self-administered, intranasally delivered etripamil was safe and superior to placebo for the conversion of paroxysmal superventricular tachycardia to sinus rhythm.

    • Karina Huynh

  • Evidence-based Guidelines |

    Familial hypercholesterolaemia (FH) is a preventable cause of premature coronary artery disease and death. This guidance article from the International Atherosclerosis Society provides a comprehensive overview of FH care that includes recommendations on the detection and management of patients with FH, as well as strategies to maximize implementation.

    • Gerald F. Watts
    • , Samuel S. Gidding
    •  & Raul D. Santos

  • Review Article |

    In this Review, Riksen and colleagues discuss the molecular and cellular mechanisms of trained immunity, the activation of these mechanisms by cardiovascular risk factors, and how trained immunity might contribute to atherosclerosis and atherosclerotic cardiovascular disease. The authors also propose potential strategies for the therapeutic modulation of trained immunity in atherosclerotic cardiovascular disease.

    • Niels P. Riksen
    • , Siroon Bekkering
    •  & Mihai G. Netea

  • Review Article |

    The benefits of oxygen therapy for the treatment of cardiovascular disease are unclear, and findings from preclinical studies have suggested potential adverse effects associated with its excessive use. In this Review, Eltzschig and colleagues provide an overview of studies on oxygen therapy for various cardiovascular conditions and describe alternative therapeutic strategies that target oxygen-sensing pathways.

    • Yafen Liang
    • , Wei Ruan
    •  & Holger K. Eltzschig

  • Research Highlight |

    In a diverse population of patients with heart failure with mildly reduced or preserved ejection fraction stabilized after a recent worsening heart failure event, treatment with sacubitril–valsartan induces greater reductions in plasma NT-proBNP levels and is associated with clinical benefit compared with valsartan alone, despite a higher rate of symptomatic hypotension.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Results from the MONITOR-HF trial show that remote monitoring of pulmonary artery pressure using the implantable CardioMEMS sensor in patients with chronic heart failure improves quality of life and reduces hospitalizations.

    • Gregory B. Lim

  • Consensus Statement |

    In this Consensus Statement, Dewey and the other members of the Quantitative Cardiovascular Imaging Study Group provide clinical consensus recommendations on the optimal use of different imaging techniques in various patient populations to detect and assess coronary artery stenosis and atherosclerosis.

    • Aldo J. Vázquez Mézquita
    • , Federico Biavati
    •  & Marc Dewey

  • Review Article |

    In this Review, Ritterhoff and Tian describe the metabolic reprogramming that occurs in cardiac hypertrophy and heart failure; discuss the contribution of metabolism to energy-generating and non-energy-generating functions, including signalling, protein function and gene expression regulation; and highlight the role of metabolism in non-cardiomyocytes and the potential to develop metabolic therapies for heart failure.

    • Julia Ritterhoff
    •  & Rong Tian

  • Review Article |

    Acute coronary syndromes (ACS) are a major contributor to death from cardiovascular disease. In this Review, Timmis and colleagues present data on mortality from ACS for 122 countries and examine the regional and temporal changes in the epidemiology of ACS over the past 20 years.

    • Adam Timmis
    • , Denis Kazakiewicz
    •  & Panos Vardas

  • Clinical Outlook |

    Contemporary tools to predict cardiovascular risk lack accuracy on an individual-patient level. The use of single-cell RNA sequencing to identify specific leukocyte patterns might overcome some of these limitations, propelling us towards a precision medicine approach.

    • Johannes Gollmer
    •  & Andreas Zirlik

  • Research Highlight |

    Hyperphosphorylation of tau in the heart reduces the tyrosination of microtubules, leading to myocardial stiffness and heart failure. This novel mechanism of diastolic dysfunction parallels the aggregation of tau in the brain that leads to Alzheimer disease and might be amenable to treatment using monoclonal antibodies against tau.

    • Gregory B. Lim

  • Review Article |

    Individuals with type 2 diabetes mellitus are at high risk of developing cardiovascular disease (CVD). In the context of type 2 diabetes mellitus, Wong and Sattar discuss established and novel mechanisms of CVD, risk assessment and patient stratification, and strategies to reduce multiple risk factors to prevent CVD.

    • Nathan D. Wong
    •  & Naveed Sattar

  • Review Article |

    In this Review, Kroemer and colleagues describe eight molecular hallmarks of cardiovascular ageing: disabled macroautophagy, loss of proteostasis, genomic instability, epigenetic alterations, mitochondrial dysfunction, cell senescence, dysregulated neurohormonal signalling and inflammation. Therapeutically targeting these hallmarks might attenuate residual cardiovascular risk in older individuals.

    • Mahmoud Abdellatif
    • , Peter P. Rainer
    •  & Guido Kroemer

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