News & Comment

Over recent decades, shifts toward translational or applied research in many countries have come at the expense of fundamental discovery research. Here we discuss the historical importance of basic science in the cardiovascular field, the risks in its decline and the ongoing need for a strong foundation in fundamental discovery research.

The rapid development of single-cell transcriptomics, epigenomics, proteomics and metabolomics has resulted in a wave of new biological discoveries. Here we explore what this has meant for the cardiovascular field and what the future might hold for developing treatments for patients.

Nature Cardiovascular Research is one year old. We look back at our first year and look forward to the years to come, grateful to our authors and audience for their contribution and support.

Pregnancy is associated with a substantial risk of short-term and long-term cardiovascular diseases. Here we discuss physiological and social factors that affect the risk of pregnancy-related cardiovascular diseases and opportunities to improve outcomes.

Iron is essential to the production of myocardial energy and proteins critical for cardiovascular function. Nearly 50% of patients with heart failure with reduced ejection fraction (HFrEF) meet current criteria for iron deficiency, and there has been considerable interest in intravenous repletion of iron stores as a therapeutic strategy to improve HFrEF outcomes. However, the data on intravenous iron therapy in HFrEF have been mixed.

Nature has evolved creative ways to maintain oxygen homeostasis, but what happens when these adaptations are insufficient? Here we discuss biochemical failure points across the oxygen spectrum from ‘too little’ to ‘too much’ oxygen and their potential contributions to cardiovascular disease.

Sleep modulates cardiovascular health, and recent studies have begun to uncover underlying mechanistic links. An integrated translational approach that combines animal models and human trials will enrich scientific discovery, improve therapy, and help to alleviate the global burden of insufficient sleep and cardiovascular disease.

Although cardiac arrhythmias have been observed and described during and after SARS-CoV-2 infection, rigorous studies designed to untangle the complex relationship between this proinflammatory illness and arrhythmogenesis are limited. Despite a pervasive opinion to the contrary, there is presently no definitive data to establish a causal, viral-specific association between COVID-19 and incident arrhythmia.

In the COVID-19 aftermath, academia experiences an unprecedented drought of postdoctoral researchers. The new generation of scientists refuses to face the low odds of starting their own labs in a competitive arena that does not align with their work–life balance needs. We discuss the possible reasons and potential measures needed to sustain talented and passionate early career researchers in academia.

Studies of the genetic architecture of cardiovascular disease once focused on heritable germline factors. Newer work has shed light on the role of somatic mutations in blood cells. These mechanistic and multi-omics studies, along with phenotypic analyses, offer the prospect of new precision cardiovascular medicine paradigms.

The REVIVED trial provides critical evidence on the management of patients with ischemic left ventricular dysfunction, highlighting the importance of optimal medical therapy. At the same time, it is another reminder of the fact that we are far from reaching adequate representation of women in cardiovascular disease trials.

The COVID-19 pandemic has unleashed a tidal wave of psychological distress. Here we discuss the biobehavioral mechanisms through which psychological distress amplifies the adverse effects of SARS-CoV-2 infection on cardiovascular outcomes. We also examine how the stress of caring for patients with COVID-19 increases cardiovascular risk in healthcare workers.

Genomic sequencing in hemophilia is a high-yield test and clinically useful for diagnosis, assessing the risk of developing neutralizing antibodies (‘inhibitors’) against the affected coagulation factor, pregnancy and neonatal management, and family counseling. New genomic technologies can detect several types of DNA change with high sensitivity. Systematic collection of genotype–phenotype data is important to better understand the genetics of hemophilia.