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Moderate exercise improves cardiovascular health and is associated with physiological cardiac adaptations; by contrast, the hearts of endurance athletes can undergo maladaptations, including myocardial fibrosis and arrhythmias. In this Review, Parry-Williams and Sharma discuss whether excessive endurance exercise might damage both diseased and otherwise normal hearts.
Cardiac imaging has a pivotal role in the prevention, diagnosis and treatment of ischaemic heart disease. In this Consensus Statement, the authors summarize the use of SPECT, PET, MRI, echocardiography, CT and invasive coronary flow and pressure measurement, and describe the relative strengths and weaknesses of each modality.
Diabetic cardiomyopathy occurs as a result of the dysregulated glucose and lipid metabolism, increased oxidative stress and activation of pro-inflammatory pathways associated with diabetes mellitus, which can induce cardiac remodelling and dysfunction. In this Review, Tan and colleagues discuss the pathogenesis of diabetic cardiomyopathy and describe signalling pathways that might be potential therapeutic targets.
Cardiac amyloidosis is a life-threatening cause of restrictive cardiomyopathy that is often underdiagnosed or misdiagnosed. This Review summarizes the latest non-invasive imaging techniques used to diagnose cardiac amyloidosis, including echocardiography, bone scintigraphy and cardiac MRI.
In this Review, Murry and colleagues describe the hallmarks of cardiomyocyte maturation and the current approaches to mature stem cell-derived cardiomyocytes, highlighting challenges and future directions to generate cardiomyocytes with an optimal maturation state for use in research and regenerative medicine.
In this Review, Soehnlein and colleagues discuss the role of neutrophils in cardiovascular inflammation and repair, describing the effect of cardiovascular risk factors on neutrophil production and function, appraising the contribution of neutrophils to the different stages of atherosclerosis and its clinical manifestations, and highlighting the evolving therapeutic strategies for targeting neutrophil numbers, functional status and effector mechanisms.
Familial hypercholesterolaemia is a genetic disorder that impairs the hepatic clearance of LDL, leading to premature atherosclerotic cardiovascular disease. In this Review, Watts and colleagues summarize the latest advances that can inform the development and implementation of new models of care for familial hypercholesterolaemia.
Inflammation has an important role in the pathogenesis of acute and chronic heart failure. This Review summarizes the latest findings on the role of the innate and adaptive immune systems in the pathogenesis of heart failure, and highlights the results of phase III clinical trials of therapies targeting inflammatory processes in this condition, such as anti-inflammatory and immunomodulatory strategies.
Many patients with cardiovascular disease have a residual risk of ischaemic events despite receiving antiplatelet therapy. In this Review, Angiolillo and colleagues discuss the pharmacological rationale and clinical development of dual-pathway inhibition strategies for the prevention of atherothrombotic events in patients with cardiovascular disease.
In the decade after the introduction of Impella heart pumps, their use has rapidly increased. However, to date, clinical trial data have not conclusively supported their superiority over other contemporary support devices, and observational experiences have identified signals of increased harm with Impella. Large, adequately powered clinical trials of Impella are eagerly awaited.
