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The pathophysiology of heart failure with preserved ejection fraction (HFpEF) remains poorly understood. In this Review, Redfield and colleagues highlight the importance of studying human cardiac tissue in HFpEF, discuss sources, challenges and methods for studying human myocardial samples, summarize pathophysiological insights derived from studies of human myocardium in HFpEF and outline knowledge gaps to guide future research.
Acute ischaemic stroke induces persistent innate immune memory through epigenetic changes in myeloid progenitors in the bone marrow, and this innate immune training contributes to cardiac remodelling and dysfunction in the long term, according to a new study.
In this Review, Ghofrani and colleagues discuss the mechanisms underlying the development of pulmonary arterial hypertension, provide an overview of approved therapies and describe the predominantly non-vasodilatory drugs that are currently being tested in clinical trials.
Cardiovascular diseases are the leading cause of death in Latin America and the Caribbean (LAC), precipitated by the unique milieu of population growth, rapid urbanization, socioeconomic disparities and prevalent cardiometabolic risk factors. Brant and colleagues summarize trends in cardiometabolic health in LAC and discuss tailored, innovative solutions to address the growing burden of disease in the region.
In this Review, Touyz and colleagues discuss the role of reactive oxygen species in the pathophysiology of hypertension, focusing on the mechanisms of reactive oxygen species generation and oxidative stress in hypertension, as well as the alterations in redox signalling. They also discuss potential therapeutic strategies for targeting oxidative stress in hypertension.
A new study indicates that proteins in the sarcomere complex are stochastically removed and degraded and are replaced by newly translated proteins. Sarcomere turnover occurs at a similar rate within cardiomyocytes and across the heart and slows with ageing.
In this Roadmap arising from an NHLBI workshop, Chew and colleagues explore the use of retinal imaging biomarkers for the prediction, diagnosis and monitoring of systemic cardiovascular diseases. The authors identify knowledge gaps and research opportunities to translate retinal imaging biomarkers into clinical practice.
Contraction of the heart is driven by cyclical interactions between myosin and actin filaments driven by ATP hydrolysis. In this Review, Irving summarizes the basal cardiac cycle of the healthy human heart at the ventricular, cellular, sarcomeric, and molecular levels and the implications for the development of novel therapies for heart disease.
During commercial spaceflight, individuals who might have underlying cardiovascular disease will be exposed to increased gravitational and acceleration (G) forces. In this Review, Morris and colleagues explore the use of computational models to simulate the effects of G forces on human cardiovascular pathophysiology to risk-stratify individuals and help to improve safety in commercial suborbital spaceflight.
Various dietary patterns have been proposed to improve cardiometabolic health. In this Review, Pagidipati et al. emphasize the commonalities between recommendations on what to eat (Mediterranean, Dietary Approaches to Stop Hypertension and low-carbohydrate or ketogenic diets) and the possible benefits of time-restricted eating and intermittent fasting.
Infection with Trypanosoma spp. can cause Chagas disease or human African trypanosomiasis. In this Review, Sabino and colleagues discuss the effects of these infections on the heart, with particular emphasis on the pathogenesis, diagnosis and treatment of Chagas cardiomyopathy.
In this Review, Wu and co-workers describe the consequences of radiation exposure on the cardiovascular system, drawing insights from individuals exposed to whole-body radiation (including nuclear and medical workers) and from patients with cancer undergoing radiation therapy.
In this Review, Catapano and colleagues discuss the evidence supporting the LDL cumulative exposure hypothesis and how measuring cumulative LDL exposure can be used to estimate risk and contribute to the prevention of atherosclerotic cardiovascular disease.
Preliminary experience with the use of transcatheter aortic valve implantation (TAVI) to treat non-calcific aortic regurgitation has raised concerns about the short-term effectiveness of TAVI in this setting. A deeper understanding of the interaction between transcatheter heart valves and anatomy in patients with non-calcific aortic valve disease, coupled with the introduction of dedicated TAVI devices, is providing new opportunities in the management of this condition.
In this Review, Porsch and Binder discuss the evidence for and mechanisms of the increased and premature risk of atherosclerotic cardiovascular disease in patients with autoimmune disease, with particular focus on systemic lupus erythematosus and rheumatoid arthritis.
In this Review, Khan and colleagues explore the evolving global epidemiology of heart failure (HF), focusing on changes in incidence and prevalence across the spectrum of left ventricular ejection fraction. The authors highlight the disparities in our understanding of HF epidemiology in low-income and middle-income countries, affirming the need for improved surveillance and resource allocation in vulnerable areas and populations.
The advent of pulsed-field ablation — a series of ultra-rapid, high-energy pulses that result in non-thermal cell death via electroporation — is revolutionizing the field of atrial fibrillation ablation. Data on first iterations of the technology indicate that safety and efficacy are at least similar to that of thermal ablation but with meaningfully shorter procedure duration.
In this Tools of the Trade article, Berkeley and Thomson describe the use of a minimally invasive strategy to standardize the induction of myocardial infarction in mice.
In this Tools of the Trade article, Jablonska describes the use of proximity-based labelling for the proteomic profiling of novel protein–protein interactions.
