Review Articles in 2019

In this Review, Rosenbaum and colleagues give a broad perspective on the genetic causes of dilated cardiomyopathy to provide a context for a discussion of the pragmatic use of genetic testing in heart failure clinics for patients presenting with new-onset dilated cardiomyopathy.

In this Review, Cai and colleagues discuss the complex crosstalk between different oxidase systems and the consequences of this crosstalk in mediating cardiovascular disease processes, focusing on the central role of particular NADPH oxidase isoforms activated in specific cardiovascular diseases.

Inherited arrhythmias are a major cause of sudden cardiac death, particularly among young individuals. In this Review, Offerhaus and colleagues provide an overview of the epidemiology of inherited ventricular arrhythmias, focusing on natural history, prevalence and patient demographics.

Non-atherosclerotic processes are important contributors to a substantial number of acute coronary syndrome events. In this Review, Gulati and colleagues discuss the diagnosis, management and prognosis of patients with spontaneous coronary artery dissection, coronary artery embolism, vasospasm, myocardial bridging or stress-induced cardiomyopathy (Takotsubo syndrome).

This Review summarizes the role of transcription factors and epigenetic remodelling in modulating macrophage plasticity, provides an overview of the cooperative action of transcription factors and epigenetic modifiers controlling macrophage activation in the context of atherosclerosis and inflammation, and highlights the therapeutic potential of modulating transcription factor activity.

This Review discusses the evolving indications of transcatheter aortic valve implantation (TAVI), including the latest clinical trials in young and low-risk patients with symptomatic severe aortic stenosis and ongoing studies exploring TAVI for other indications, including severe bicuspid aortic valve stenosis and pure native aortic regurgitation, highlighting procedural implications and caveats of new and future indications.

Rheumatic heart disease is a complication of group A streptococcal infection and rheumatic fever. In this Review, Muhamed and colleagues assess the emerging role of genome-wide association studies in detecting loci associated with genetic susceptibility to rheumatic heart disease.

Although saphenous vein grafts (SVGs) are the most commonly used conduit in coronary artery bypass graft surgery, vein graft failure (VGF) occurs in almost half of all patients with SVGs by 10 years after surgery. In this Review, Caliskan and colleagues discuss approaches to prevent saphenous VGF, including optimal harvesting techniques and intraoperative preservation strategies.

The non-canonical axis of the renin–angiotensin system (RAS) has an important role in cardiovascular physiology and disease. In this Review, Ocaranza and colleagues discuss the interplay between components of the counter-regulatory RAS and the therapeutic potential of targeting this system to treat cardiovascular disease.

Clonal haematopoiesis of indeterminate potential (CHIP) commonly occurs as a result of mutations in transcriptional regulators and is associated with a doubling of the risk of atherosclerotic cardiovascular disease. Jaiswal and Libby propose that CHIP contributes to the increased inflammation seen in ageing and thereby explains some of the age-related risk of cardiovascular disease.

Pulmonary arterial hypertension (PAH) is characterized by right ventricular hypertrophy and the absence of underlying cardiac or pulmonary disease. In this Review, Southgate and colleagues discuss the latest advances in the identification of genetic variants underlying PAH development and progression.

The shear stress generated by flowing blood has major effects on vascular function, with low shear stress promoting vascular dysfunction and atherosclerosis. This Review describes the latest findings on how endothelial cells decode complex shear stress environments to regulate physiological and pathophysiological responses, highlighting the role of pathways involved in embryonic development.

Patients with known cardiovascular disease but no recent acute event are often referred to as having ‘stable’ coronary artery disease. In this Review, Fox and colleagues describe why this concept of stable disease is misleading and should instead be characterized as chronic disease with an increased risk of atherothrombotic events.

Lysine acetyltransferases (KATs) and lysine deacetylases (KDACs) are involved in the regulation of lysine acetylation, a conserved post-translational protein modification that is an important modulator of cardiac metabolism. Li and colleagues describe the complex roles of KATs and KDACs in both the normal and diseased heart and provide an overview of the evidence indicating a therapeutic role of KDAC inhibitors in cardiovascular disease.

This Review outlines the drawbacks and lessons learned from first-generation drug-eluting stents, and then discusses design features and preclinical, pathology and clinical data from newer-generation devices. The authors focus on how evolution in stent design has improved biomaterial–blood interactions and vascular healing.

By stimulating the His–Purkinje network directly, His bundle pacing results in synchronized, physiological ventricular activation, which might improve clinical outcomes compared with the use of right ventricular apical pacing. Sharma and colleagues summarize early clinical observations, implantation techniques and outcome data with permanent His bundle pacing.

The role of aspirin for the primary prevention of cardiovascular disease is controversial. In this Review, Patrono and Baigent discuss the new randomized trials on aspirin for the primary prevention of cardiovascular disease in the context of previous evidence, and appraise whether the new evidence is likely to enable a more targeted use of aspirin

In this Review, Mallat and colleagues critically evaluate the studies on the origin, fate and functions of vascular smooth muscle cells (VSMCs) in atherosclerosis, highlighting the importance of developmental origin, clonal expansion and plasticity of VSMCs cells in atherosclerosis and summarizing the roles of VSMCs and VSMC-derived cells in plaque development and progression.

Neuromodulation therapy might be clinically useful in the management and prevention of lethal arrhythmias. In this Review, the authors discuss the neuroanatomical and neurophysiological basis for neuromodulation therapy, critically appraise the latest data on the clinical efficacy of this approach and highlight areas in the field of cardiac autonomic control that show the most promise for clinical translation.

With the increase in the availability of RNA screening tools, numerous non-coding RNAs with important functions in the heart have been identified. In this Review, Lu and Thum discuss the non-coding RNA candidates with diagnostic and therapeutic potential in cardiovascular disease.