Reviews & Analysis

Over the past year there have been major advances in the rapidly evolving field of atherothrombosis study, in both basic and experimental research, and in clinical studies. In this Review, Javier Sanz, Pedro Moreno and Valentin Fuster provide an update of such advances for physicians and scientists with an interest in the study of atherothrombotic disease.

Conceptually and in practice cardiac dyssynchrony is complex. In this Review, Cleland et al. discuss the results of atrio-biventricular pacing trials, and examine how this pacing can improve cardiac synchrony in many patients and whether cardiac resynchronization is indeed the mechanism by which atrio-biventricular pacing exerts its effects.

Five years on from the initial report in Nature that cell therapy showed potential therapeutic benefit for cardiac disease, Eric Adler and Thomas Maddox present their Viewpoint on the first three randomized, clinical trials of bone marrow cell therapy in patients with myocardial infarction.

Catheter ablation of atrial fibrillation is a relatively novel procedure that has rapidly become widely practiced. In this Viewpoint, Hugh Calkins highlights the potential dangers of this intervention, and cautions that it is premature to adopt catheter ablation as first-line therapy for patients with atrial fibrillation until data from large, prospective multicenter clinical trials are available.

In addition to morphological structures resembling bone, cartilage and bone marrow being found in calcified vascular structures, several studies have indicated that vascular calcification develops along with coronary artery disease. Hence, mechanisms resembling bone remodeling could be relevant to the development of vascular disease. Here, Raggi et al. review some of the mechanisms that could underlie the parallel development of vascular and bone disease.

Given the obesogenic environment in which we live, characterized by the abundance of energy-dense, processed and highly convenient foods, and sedentary lifestyle, overweight and obesity have become an epidemic. Concomitant with this increase has been the rise in the number of weight-loss diets. In this Review, Vasanti Malik and Frank Hu discuss the current evidence on the efficacy of low-fat, low-carbohydrate and Mediterranean-style dietary patterns for weight loss, their potential mechanisms of action and clinical utility.

Variability seems to exist in patients' responsiveness to aspirin, to the point of producing no measurable response at all. The characteristics of aspirin resistance differ, however, from those traditionally associated with drug resistance. Here, Patrono and Rocca discuss why aspirin resistance is thought to occur and how to manage it.