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In this Review, Bäckhed and colleagues summarize the evidence for gut microbiome alterations in cardiometabolic and cardiovascular diseases and the rationale and potential benefit motivating translational approaches to target the gut microbiota and its metabolites for prevention and treatment.
Advances in single-cell RNA sequencing technologies in the past 5 years have led to a greater understanding of endothelial cell development and heterogeneity. In this Review, Red-Horse and Trimm discuss the most up-to-date research on vascular endothelial cell development and diversity, and highlight the latest findings on organ-specific endothelial cells in the heart, brain, lungs, kidneys and liver.
In this Review, the authors describe the features of coronary artery vulnerable plaques as well as non-invasive and invasive diagnostic modalities that can be used to characterize them. They also discuss the prognostic utility of identifying vulnerable plaques and the best current approaches to manage these lesions, and highlight evidence gaps and future directions.
Advances in machine learning technology in the past decade have accelerated the discovery of genetic loci associated with aortic disease. In this Review, Lindsay and colleagues discuss how emerging insights into the genetic architecture of aortic disease can improve the accuracy of disease prediction and facilitate the discovery of new therapeutic targets.
In this Review, Nattel and colleagues discuss the evidence suggesting a pathophysiological role of cardiomyocyte inflammatory signalling in atrial fibrillation, consider the therapeutic potential associated with these signalling pathways, including strategies promoting the resolution of inflammation, and highlight crucial questions to be addressed in future research.
In this Review, McGarrah and White outline the major factors regulating branched-chain amino acid (BCAA) abundance and metabolic fate, highlight molecular mechanisms connecting impaired BCAA homeostasis to cardiovascular disease and discuss the epidemiological evidence connecting BCAAs with various cardiovascular disease states.
In this Review, Fischmeister and colleagues describe cAMP and cGMP signalling in cardiomyocytes and summarize the various phosphodiesterase (PDE) families expressed in the heart and how they are modified in heart failure. They also assess the potential use of inhibitors or activators of specific PDEs to treat heart failure.
The mortality and birth prevalence of congenital heart disease (CHD) have shifted in the past 50 years owing to advances in diagnosis and treatment. In this Review, Marelli and colleagues discuss the effect of this shift in CHD epidemiology on outcomes and disease burden in adult patients and describe new initiatives and technology that can improve the delivery of health care.
Hydrogen sulfide (H2S) is a gaseous signalling molecule with important roles in cardiovascular health and disease. In this Review, Kevil and colleagues discuss the role of H2S, its synthesizing enzymes and metabolites, their roles in the cardiovascular system, and their involvement in cardiovascular disease and associated pathologies.
In this Review, Donato and colleagues discuss the cellular and molecular mechanisms that induce endothelial cell senescence. They also discuss how endothelial cell senescence causes arterial dysfunction and contributes to cardiometabolic diseases, and the potential therapeutic role of senolytic agents in eliminating senescent endothelial cells.
In this Review, the authors describe the mechanisms underlying lipopolysaccharide translocation from the gut to the systemic circulation and the ensuing low-grade endotoxaemia, discuss studies suggesting a role for low-grade endotoxaemia in atherothrombosis and cardiovascular complications, and highlight potential therapeutic strategies to improve gut permeability and eliminate low-grade endotoxaemia.
Since the discovery of ferroptosis a decade ago, this iron-dependent form of regulated cell death has been implicated in the pathogenesis of cardiovascular disease. In this Review, Fudi Wang and colleagues discuss the link between the metabolic pathways of iron signalling and ferroptosis in the context of the cardiovascular system and describe the potential of ferroptosis inhibitors in the treatment of cardiovascular disease.
In this Roadmap article, international experts summarize the evidence and provide consensus recommendations on the application of transcatheter aortic valve implantation in patients with bicuspid aortic valve anatomy in advance of the anticipated growth in the use of this procedure in this challenging cohort of patients.
In this Review, the authors discuss the roles of non-canonical WNT signalling in cardiovascular disease. They provide an overview of non-canonical WNT signalling, describe its links to the pathogenesis of atherosclerosis, heart failure and arrhythmias, and explore the clinical potential of targeting individual components of non-canonical WNT signalling in cardiovascular disease.
The evolution of stent design has reduced the incidence of stent thrombosis, meaning that the duration of dual antiplatelet therapy after percutaneous coronary intervention (PCI) might be shortened. In this Review, the authors describe the current evidence base and ongoing clinical trials into the use of P2Y12 inhibitor monotherapy after PCI.
The relationship between climate change and health outcomes is complex. In this Review, Rajagopalan and colleagues describe the environmental exposures associated with climate change and provide an overview of the consequences of climate change, including air pollution and extreme temperatures, on cardiovascular health and disease.
In this Review, Kluin and colleagues describe the historical milestones and lessons learned in the development of total artificial hearts (TAHs), discuss the current generation of TAHs and their working mechanisms, and highlight challenges and future perspectives for the field, including new technologies that will promote TAH development in the coming decade.
Drugs can be repurposed for new therapeutic indications. In this Review, Mercola and colleagues summarize the latest techniques for systematic drug repurposing and re-engineering, which could increase the pace, efficiency and cost-effectiveness of drug discovery for the treatment of cardiovascular disease.
In this Review, Khan and colleagues discuss the benefits and challenges of including pragmatism in the design, conduct and interpretation of randomized controlled trials (RCTs) for cardiovascular disease and highlight selected ongoing and completed cardiovascular RCTs that incorporate a pragmatic design.
Cardiovascular researchers face a range of challenges, including reduced grant funding, job insecurity and a lack of diversity in leadership roles. In this Roadmap article, Marques and colleagues propose strategies to overcome these challenges, focusing on three key areas: capacity building, research funding and fostering diversity and equity.
