Meng Zhao, Qi Liu, Na-Jie Shi, Ying Li, Hong-Bao Li
{"title":"Gut microbiota and hypertension: role of exercise training.","authors":"Meng Zhao, Qi Liu, Na-Jie Shi, Ying Li, Hong-Bao Li","doi":"10.1080/10641963.2025.2608905","DOIUrl":"https://doi.org/10.1080/10641963.2025.2608905","url":null,"abstract":"<p><p>Regular exercise training can significantly improve the gut environment and influence the metabolic activity of the gut microbiota. These changes promote the production of beneficial metabolites, which may modulate blood pressure regulation through multiple mechanisms. The beneficial microbial species including <i>Faecalibacterium prausnitzii</i>, <i>Bifidobacterium</i> spp., <i>Lactobacillus</i> spp., <i>Roseburia</i> spp.,and <i>Bacteroides</i> spp. These beneficial microbes produce various metabolites during metabolism, including short-chain fatty acids, vitamins, lactic acid, bileacids, and gamma-aminobutyric acid. These metabolites are not only essential for maintaining gut health but also positively influence hypertension by modulating the nervous system, immune system, and improving metabolic function. This review aims to elucidate the complex interactions among exercise training, gut microbiota, and hypertension.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2608905"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bilateral hypertensive retinopathy (grade 4): Case report and review of the literature on intravitreal injection anti-VEGF therapy.","authors":"Yang Jianjun","doi":"10.1080/10641963.2025.2604831","DOIUrl":"10.1080/10641963.2025.2604831","url":null,"abstract":"<p><strong>Objective: </strong>To introduce bilateral hypertensive retinopathy (HR) (grade 4) complicated with macular edema (ME) patients with binocular intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) treatment.</p><p><strong>Methods: </strong>Three cases of hypertensive retinopathy were observed. The fundus examination was consistent with HR (grade 4). The patients received anti-VEGF intraocular injection.</p><p><strong>Results: </strong>The patient's ME and optic nerve edema were significantly reduced, visual acuity was significantly improved, and a case of secondary choroidal neovascularization (CNV) in the fundus of HR (grade 4) was also noted.</p><p><strong>Conclusions: </strong>The use of intravitreal anti-VEGF agents in stage IV hypertensive retinopathy appears satisfactory but not perfect. In severe cases with vitreous hemorrhage, early injection avoids vitrectomy.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2604831"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145818438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Longitudinal trajectory of circulating microRNA-210-3p and its association with low-dose aspirin use in gestational hypertension and preeclampsia: a pilot study.","authors":"Ming-Ju Wang, Chie-Pein Chen, Nan-Fu Chiu, Fang-Ju Sun, Hsin-Yi Hou, Chen-Yu Chen","doi":"10.1080/10641963.2026.2616534","DOIUrl":"https://doi.org/10.1080/10641963.2026.2616534","url":null,"abstract":"<p><strong>Background: </strong>Circulating microRNA-210-3p (miR-210-3p) is a hypoxia-related regulator implicated in placental maladaptation. Its longitudinal behavior across hypertensive disorders of pregnancy (HDP), and whether low-dose aspirin modifies its trajectory, remain insufficiently understood.</p><p><strong>Methods: </strong>This prospective case-control study was conducted between October 2021 and November 2024. Circulating miR-210-3p was measured in the first trimester and at delivery. Aspirin use followed routine clinical practice for preeclampsia prevention. Longitudinal trajectories were examined using generalized estimating equations (GEE) as the primary analytic approach and linear mixed effects models (LMM) as a secondary method.</p><p><strong>Results: </strong>Ninety-four women were enrolled, including 73 controls, 11 with gestational hypertension, and 10 with preeclampsia. miR-210-3p increased significantly from the first trimester to delivery in gestational hypertension (<i>p</i> = 0.003) and preeclampsia (<i>p</i> = 0.006), with no significant change in controls. In the first trimester, gestational hypertension exceeded controls (<i>p</i> = 0.006), and preeclampsia exceeded both groups (both <i>p</i> < 0.001). At delivery, gestational hypertension and preeclampsia remained higher than controls (both <i>p</i> < 0.001), and preeclampsia exceeded gestational hypertension (<i>p</i> = 0.036). GEE demonstrated a significantly slower rise in miR-210-3p among aspirin users with gestational hypertension (<i>p</i> = 0.042), and this association strengthened in sensitivity analysis (<i>p</i> = 0.001). LMM showed a similar, non-significant trend.</p><p><strong>Conclusion: </strong>miR-210-3p exhibited disorder-specific longitudinal patterns across HDP. Aspirin-associated changes were observed in gestational hypertension but not in preeclampsia, suggesting differences in molecular expression trajectories between the two conditions over the course of gestation, while the underlying biological mechanisms remain to be clarified.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2616534"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relationship between kidney length and renal risk in malignant hypertension patients with renal thrombotic microangiopathy.","authors":"Liyunfei Fan, Zhaocai Zhou, Sheng Zhao, Zhong Zhong, Jianwen Yu, Naya Huang, Yiqin Wang, Yunuo Wang, Qinghua Liu, Wei Chen, Jianbo Li, Feng He","doi":"10.1080/10641963.2026.2617514","DOIUrl":"https://doi.org/10.1080/10641963.2026.2617514","url":null,"abstract":"<p><strong>Background: </strong>Malignant hypertension (mHTN) is a severe hypertensive emergency, often associated with renal deterioration. Kidney length may be of useful to identify patients with renal dysfunction. Whether kidney length in mHTN patients is associated with renal prognosis is unclear.</p><p><strong>Methods: </strong>The study enrolled 280 mHTN patients with renal thrombotic microangiopathy (TMA) who underwent renal biopsy between 2008 and 2023. Linear regression was used to explore patient characteristics of kidney length. The association between kidney length and ≥15% increase in estimated glomerular filtration rate (eGFR), and end-stage renal disease (ESRD) was analyzed using Cox regression and logistic regression, respectively. Kidney length was analyzed in tertiles, using the first tertile as reference.</p><p><strong>Results: </strong>Patients with larger kidney length had higher levels of body mass index (BMI) and eGFR, but lower levels of urea nitrogen, serum creatinine, uric acid, global sclerosis ratio, and tubular atrophy/interstitial fibrosis ratio. Kidney length was strongly positively correlated with BMI, and negatively related to tubular atrophy/interstitial fibrosis ratio. During the follow-up, 72 patients experienced a ≥15% increase in eGFR and 172 patients progressed to ESRD. Patients in the third tertile of kidney length had a better renal recovery outcome of ≥15% increase in eGFR and lower odds of ESRD.</p><p><strong>Conclusions: </strong>In mHTN patients with renal TMA, large kidney length is associated with better renal function improvement of ≥15% increase in eGFR, and lower risk of ESRD. In clinical practice, the measurement of kidney length may serve as a non-invasive indicator to assess renal prognosis and inform timely treatment interventions in mHTN patients.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2617514"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dissecting burden of alcoholic cardiomyopathy: age-period-cohort analysis from the global burden of disease study 2019.","authors":"Huatao Zhou, Yu Mao, Zilong Zheng, Zhi Tu, Yichen Li, Jinfu Yang, Wangping Chen, Chengming Fan","doi":"10.1080/10641963.2026.2636171","DOIUrl":"https://doi.org/10.1080/10641963.2026.2636171","url":null,"abstract":"<p><strong>Background: </strong>Alcoholic cardiomyopathy (ACM) is a major cause of cardiovascular morbidity and mortality, characterized by ventricular dilation and impaired contractility resulting from chronic heavy alcohol use. Understanding its temporal and demographic trends is vital for guiding targeted public health interventions.</p><p><strong>Methods and findings: </strong>Using the Global Burden of Disease (GBD) 2019 dataset, we analyzed ACM trends from 1990 to 2019 across 204 countries and territories. Multi-level mixed-effects models were applied to assess age, period, and cohort effects on ACM mortality. Males consistently exhibited higher ACM rates across all age groups. Although global age-standardized prevalence and mortality rates have declined since 1990, regional disparities persist-mortality remains highest in Eastern Europe and lowest in Sub-Saharan Africa. Age, period, and cohort analyses revealed patterns reflecting cumulative alcohol-related cardiac damage, healthcare advancements, and generational shifts in alcohol consumption.</p><p><strong>Conclusions: </strong>Despite global improvement, ACM continues to impose a substantial health burden. Early interventions and policies addressing alcohol use throughout the life course are essential. Future longitudinal studies should identify critical prevention windows and explore genetic and environmental interactions. Advances in precision medicine, big data, and artificial intelligence may further enhance personalized treatment and optimize global resource allocation against ACM.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2636171"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From clinic to home monitoring: Diagnostic strategies and evidence landscape of white-coat uncontrolled hypertension.","authors":"Zhongming Zheng, Zhenqiu Yu","doi":"10.1080/10641963.2026.2663394","DOIUrl":"https://doi.org/10.1080/10641963.2026.2663394","url":null,"abstract":"<p><p>White-coat Uncontrolled Hypertension (WUH) is characterized by elevated office blood pressure but normal out-of-office levels, and it has shifted from a phenomenological concept to a precision diagnosis model centered on ambulatory and home monitoring. This study provides a comprehensive review of the evolution of definitions, epidemiology, pathophysiology, and risk evidence, and compares the diagnostic value of Office Blood Pressure Monitoring (OBPM), Ambulatory Blood Pressure Monitoring (ABPM), and Home Blood Pressure Monitoring (HBPM). Within this analytical framework, the investigation examines cardiovascular and metabolic risks, interventions in special populations, and ongoing controversies in treatment. These findings are significant for integrating both Chinese and international guidelines with emerging digital monitoring trends. The study further proposes an integrated \"home-clinic-cloud platform\" model to support individualized hypertension management. This framework offers a more nuanced understanding of evolving paradigms in hypertension diagnosis and treatment. Based on current guideline-supported evidence, we emphasize ABPM/HBPM-based confirmation, risk stratification, and long-term surveillance to avoid misclassification and overtreatment. Emerging directions-including psycho-physiological modeling, multi-scenario monitoring, and digital-twin-enabled simulation-should be regarded as conceptual or research-oriented frameworks that require prospective validation and outcome data before clinical implementation.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2663394"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inflammatory mechanisms and targeted drugs in heart failure.","authors":"Huize Han, Jianan Xu, Zhilin Zhou, Congbo Zhong, Hongyu Li, Aidong Liu, Junfeng Cui","doi":"10.1080/10641963.2025.2608225","DOIUrl":"https://doi.org/10.1080/10641963.2025.2608225","url":null,"abstract":"<p><p>Heart failure (HF) is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. Globally, the morbidity and mortality of HF are still on the rise, especially in elderly individuals, and the low 5-year survival rate of HF is a major social and health management problem. The pathogenesis of heart failure involves genetic factors and persistent cardiac inflammation. Genetic factors typically increase a patient's susceptibility to specific diseases. Notably, persistent cardiac inflammation is also a significant contributor to heart failure. Whether it is spontaneous aseptic inflammation of the heart or inflammation caused by infection, both can lead to excessive activation of the immune system, thereby triggering adverse cardiac remodeling. This review focuses on describing the inflammatory/immune activation mechanisms involved in heart failure and explores targeted drugs for inflammatory/immune activation. Additionally, we focused on the NLRP3 inflammasome (a cellular signaling protein complex), whose excessive activation produces large number of inflammatory factors, including IL-1β and IL-18, ultimately leading to persistent inflammation and excessive immune activation in the myocardium, which in turn triggers myocardial cell death and adverse remodeling. We have revealed the pathogenic role of NLRP3 in heart failure, providing a theoretical basis for further research into heart failure.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2608225"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Arachidonic acid intake promotes hypertension and target-organ fibrosis through CYP4A-mediated 20-HETE overproduction: Integrated evidence from human and animal studies.","authors":"Zhongzheng Zhou, Qinghua Fang, Xingyu Li, Chaohong Li, Jing Huang","doi":"10.1080/10641963.2025.2611130","DOIUrl":"10.1080/10641963.2025.2611130","url":null,"abstract":"<p><p>The unregulated use of highly purified arachidonic acid (AA) supplements among Chinese fitness enthusiasts raises concerns about cardiovascular safety. To evaluate these risks, we integrated population-based, genetic, and experimental evidence. Cross-sectional analysis of NHANES data demonstrated a higher risk of hypertension in individuals within the highest AA intake quartile (OR = 1.262, 95% CI: 1.109-1.438, <i>P</i> < 0.001). Two-sample Mendelian randomization confirmed causal effects of AA metabolites, including thromboxane (OR = 1.006, <i>P</i> < 0.001), eicosanoid C20H28O4 (OR = 1.305, <i>P</i> = 0.009), and 20-HETE-related C20H32O3 (OR = 1.290, <i>P</i> = 0.043). Single-cell transcriptomic profiling revealed increased renal expression of CYP4A11 in hypertensive patients, supporting a mechanistic link between AA metabolism and blood pressure regulation. In vivo, Wistar-Kyoto and spontaneously hypertensive rats fed a high-dose AA diet for six weeks exhibited significant elevations in systolic, diastolic, and mean arterial pressure, accompanied by increased renal vascular resistance. Mechanistic analyses showed that AA upregulated CYP4A1 expression and enhanced 20-HETE production without altering thromboxane synthase activity. Histological assessments revealed glomerular edema, tubular injury, and marked cardiac and renal fibrosis in AA-treated animals. Together, these convergent findings indicate that chronic high-dose AA intake promotes hypertension and multiorgan fibrosis via CYP4A/20-HETE activation. These results highlight the translational importance of AA metabolism in cardiovascular disease and underscore the need for regulatory oversight of AA supplements and therapeutic targeting of this pathway.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2611130"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Regayip Zehir, Cem Doğan, Anıl Avcı, Gökhan Alıcı, Cemalettin Yılmaz, Emrah Bayam, Elnur Alizade, Münevver Sarı, Ahmet Karaduman, Büşra Güvendi Şengör, Mustafa Ferhat Keten, Azmican Kaya, Doğan Şen, Muhammet Mücahit Tiryaki, Mehmet Kaan Kırali
{"title":"Assessment of the safety and effectiveness of catheter-based renal denervation with the symplicity spyral system in patients with resistant hypertension: A single-center experience.","authors":"Regayip Zehir, Cem Doğan, Anıl Avcı, Gökhan Alıcı, Cemalettin Yılmaz, Emrah Bayam, Elnur Alizade, Münevver Sarı, Ahmet Karaduman, Büşra Güvendi Şengör, Mustafa Ferhat Keten, Azmican Kaya, Doğan Şen, Muhammet Mücahit Tiryaki, Mehmet Kaan Kırali","doi":"10.1080/10641963.2026.2617997","DOIUrl":"https://doi.org/10.1080/10641963.2026.2617997","url":null,"abstract":"<p><strong>Background: </strong>Renal denervation (RDN) has emerged as a potential therapeutic option for resistant hypertension (HT), which remains a major clinical challenge due to poor blood pressure (BP) control despite optimized pharmacotherapy. This study aimed to assess the safety and effectiveness of catheter-based RDN in resistant hypertension patients, based on our center's experience.</p><p><strong>Methods: </strong>This retrospective, single-center study included 120 patients with resistant HT who were eligible for RDN and underwent the procedure using the Symplicity Spyral system between January 2023 and December 2024. Office systolic and diastolic BP were assessed at baseline and 6 months after RDN. The primary endpoint was the reduction in BP, while secondary endpoints included changes in the number of antihypertensive medications.</p><p><strong>Results: </strong>At 6 months, office systolic BP decreased significantly from 156 ± 7.7 mmHg to 143 ± 3.7 mmHg, while diastolic BP declined from 93.5 ± 5.5 mmHg to 90 ± 3.9 mmHg (both <i>p</i> < 0.001). Median per-patient reductions were 13 mmHg systolic and 3.5 mmHg diastolic. The mean number of antihypertensive medications decreased from 4.88 ± 0.9 to 4.47 ± 1.1 (<i>p</i> < 0.001). Minor adverse events included acute kidney injury in two patients (1.7%) and femoral artery injury in one patient (0.8%).</p><p><strong>Conclusion: </strong>Catheter-based RDN using the Symplicity Spyral system was safe and effective in reducing BP and medication burden in patients with resistant HT. These results support RDN as a potential therapeutic option in appropriately selected patients.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2617997"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kele Qin, Xiuneng Li, Xun Wu, Xiaohui Xie, Kun Xiang, Huatao Zhou, Jinfu Yang, Chengming Fan
{"title":"AMPK-dependent maturation of hiPSC-derived cardiomyocytes induced by human cardiac fibroblast exosomes.","authors":"Kele Qin, Xiuneng Li, Xun Wu, Xiaohui Xie, Kun Xiang, Huatao Zhou, Jinfu Yang, Chengming Fan","doi":"10.1080/10641963.2026.2631601","DOIUrl":"https://doi.org/10.1080/10641963.2026.2631601","url":null,"abstract":"<p><strong>Background: </strong>Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are a promising therapy for ischemic cardiomyopathy, which is often secondary to hypertension but remain functionally immature. We investigated whether exosomes from human cardiac fibroblasts (hc-FB-EXOs) promote hiPSC-CMs maturation and improve their reparative efficacy after myocardial infarction (MI).</p><p><strong>Methods: </strong>hc-FB-EXOs were isolated from cultured fibroblasts. hiPSC-CMs were treated with hc-FB-EXOs or vehicle and assessed for morphology, sarcomeric organization, metabolism, and electrophysiology. RNA sequencing and Western blotting were used to explore mechanisms. In a mouse MI model, left ventricular function, infarct size, wall thickness, and graft density were evaluated after intramyocardial injection of hiPSC-CMs with or without hc-FB-EXOs.</p><p><strong>Results: </strong>hc-FB-EXOs induced adult-like features in hiPSC-CMs, including increased cell size and sarcomere length, fetal-to-adult isoform switching of myosin and troponin, enhanced mitochondrial respiration, and a shift toward fatty acid-based oxidative metabolism. Electrophysiological maturation was evidenced by a higher peak sodium current density, faster upstroke velocity, and more mature action potential and field potential profiles. Transcriptomic and biochemical analyses identified activation of AMP-activated protein kinase (AMPK) signaling, with the modulation of downstream regulators of fatty acid oxidation. <i>In vivo</i>, co-delivery of hc-FB-EXOs with hiPSC-CMs improved the left ventricular ejection fraction, reduced the infarct size, and increased the graft density compared with those of hiPSC-CMs alone.</p><p><strong>Conclusion: </strong>hc-FB-EXOs promote the maturation of hiPSC-CMs via AMPK-mediated metabolic reprogramming and enhance their therapeutic benefit after MI. Cardiac fibroblast-derived exosomes may serve as a practical adjunct to optimize hiPSC-CMs-based therapy for ischemic cardiomyopathy.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2631601"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}