Review Articles in 2017

The most common genetic predisposition to dilated cardiomyopathy (DCM) is truncating variation in the giant sarcomeric protein, titin. Ware and Cook review the molecular mechanisms ofTTNgene variation in the pathogenesis of DCM, strategies for clinical interpretation of genetic variants for diagnosis, and the role of genetic stratification as a predictor of outcome and treatment response.

In this Review, Kivimäki and Steptoe assess the current evidence on the association between stress and cardiovascular disease, covering the multiple roles of stress in the development and triggering of disease and as a determinant of prognosis and outcome. In addition, they discuss the clinical and public health importance of major stressors and the implications for prevention and treatment of cardiovascular disease.

Ischaemic injury during an acute myocardial infarction (AMI) event is followed by an intense inflammatory response that occurs after reperfusion. The inflammasome is a protein complex involved in the regulation of this inflammatory response. In this Review, Toldo and Abbate summarize evidence supporting the therapeutic value of inflammasome-targeted strategies in the context of AMI.

Conduction system disorders lead to slow heart rates that are insufficient to support the circulation, necessitating implantation of electronic pacemakers. Current pacemakers, although effective, have limitations including lead malfunction, lack of autonomic responsiveness, and device-related infections. In this Review, Marbán and colleagues discuss next-generation electronic devices designed to address current limitations, as well as biological pacemakers as alternatives to implantable hardware.

The effects of microgravity and cosmic rays on the cardiovascular system are major health concerns for astronauts in space. In this Review, Hughson and colleagues summarize the current evidence on risk estimation and dysfunction of the cardiovascular system in space, and discuss potential countermeasures, including physical exercise, antioxidants, nutraceuticals, and radiation shielding.

Increased arterial stiffness influences pulse pressure, wave reflections, kidney function, and cardiovascular risk. In this Review, Safar describes the importance of arterial stiffness in the diagnosis and management of hypertension, using historical perspectives to emphasize the need for new treatment approaches in patients with essential hypertension.

In the past 2 decades, an increasing prevalence of risk factors for cardiovascular disease, such as obesity, physical inactivity, and diabetes mellitus, has been observed among young adults (aged 18–45 years) living in developed countries. In their Review, Andersson and Vasan discuss the evolving risk factor burden and available epidemiological data on cardiovascular disease in young adults.

Cardiovascular mortality among the almost 600 million people living in the Eastern Mediterranean region (EMR) has been proposed to increase more dramatically in the next decade than in any other region except Africa. Turk-Adawi and colleagues summarize the available data on cardiovascular disease burden, risk factors, and treatment modalities for the EMR population.

This Review summarizes the latest findings on heart reverse remodelling, which demonstrate that despite apparent normalization of function, the molecular changes associated with heart failure persist in the reverse-remodelled heart. This myocardial remission is distinct from true recovery, in which both function and molecular makeup are normalized. These findings have implications for developing therapies to repair the failing heart.

Over the past decade, marijuana has been legalized for medicinal purposes or recreational use in many countries, and the potency of marijuana and synthetic cannabinoids has substantially increased. In this Review, Pacher and colleagues summarize the role of the endocannabinoid system in cardiovascular health and disease, and critically discuss the beneficial and detrimental cardiovascular effects of marijuana and synthetic cannabinoid use.

Sudden infant death syndrome (SIDS) is the leading cause of infant mortality in developed countries. In this Review, Behr and colleagues provide an update on the spectrum and prevalence of the subset of SIDS mediated by cardiogenetic factors, and the clinical implications of SIDS in the surviving family and general population.

A growing body of evidence supports the role of the gut microbiota in regulating blood pressure. In their Review, Marques and co-workers describe how the gut microbiota and its metabolites act on downstream cellular targets to influence the pathogenesis of hypertension. Novel strategies to modify the gut microbiota might present a new therapeutic avenue to improve health and prevent disease.

Patients with autoimmune rheumatic disease have an increased risk of cardiovascular morbidity and mortality, but the mechanisms that mediate this phenomenon are not fully elucidated. In this Review, Bartoloni and colleagues highlight the relationship between hypertension and autoimmune rheumatic diseases, focusing on the immune-mediated mechanisms that influence blood-pressure control.

The left atrial appendage is known to be a source of thromboemboli in patients with nonvalvular atrial fibrillation, and the interventional or surgical occlusion or exclusion of this anatomical structure is an alternative approach to anticoagulation therapy for the prevention of stroke. In this Review, Caliskan et al. discuss the various methods for occlusion of the left atrial appendage, and provide an overview of the clinical studies investigating these techniques.

HDL-cholesterol levels in plasma predict the risk of cardiovascular disease, but a direct causal role for HDL in cardiovascular disease remains controversial. In this Review, Rosenson et al. discuss the opportunities afforded by an integrated approach that combines human genetic studies with systems biology to understand the complex metabolism of HDL and its potential atheroprotective properties.

Obesity is a risk factor for the development of cardiovascular diseases. In their Review, Lavie and colleagues summarize the deleterious consequences of obesity in patients with cardiovascular disease, review the available data on the benefits of weight loss, and explain the 'obesity paradox' phenomenon in this setting.

Strategies to reduce myocardial infarct size beyond early reperfusion have thus far yielded disappointing results in clinical trials. In this Review, Kloner and co-workers discuss several new approaches to preserve the reperfused myocardium, including those that target mitochondrial bioenergetics and autophagy.

Since the introduction of transcatheter aortic valve implantation (TAVI) as a treatment for inoperable patients with aortic stenosis >1 decade ago, the range of patients who can benefit from this technology has continued to grow. In this Review, Jones and colleagues discuss the current evidence for TAVI in different patient populations, and describe the differences in design features in currently available valve systems.

Cardiac implanted electronic devices (CIEDs) frequently detect subclinical atrial high-rate episodes (AHREs), but the relevance and appropriate clinical response to these episodes is uncertain. In this Review, Freedman and colleagues discuss the relationship between AHREs, atrial fibrillation, and risk of stroke, and propose a management algorithm for patients with CIED-detected AHREs.

Derailment of cellular protein homeostasis (proteostasis) and loss of protein quality control (PQC) are central factors in ageing and contribute to cardiovascular disease. In this Review, Henning and Brundel describe the mechanisms by which PQC can fail. Targeting PQC to maintain cardiac proteostasis offers a novel therapeutic strategy to promote cardiac health and combat cardiac disease.