Nature Reviews Cardiology最新文献_第2页

Atherosclerotic plaque-derived microparticles as exporters of thrombotic risk. 动脉粥样硬化斑块衍生微粒作为血栓形成风险的输出者。

IF 50.2 1区医学

Nature Reviews Cardiology Pub Date : 2026-08-18 DOI: 10.1038/s41569-026-01340-5

Tipack Ayothyapattanam Shanmugam

引用次数: 0

Cardiac fibroblast diversity in HFpEF: states, niches, interorgan drivers and targets. HFpEF中心脏成纤维细胞的多样性：状态、利基、器官间驱动和靶标。

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Nature Reviews Cardiology Pub Date : 2026-08-18 DOI: 10.1038/s41569-026-01335-2

Muhammed Kiyar, Alexander R Pinto, John F O'Sullivan, Bing H Wang, David M Kaye

{"title":"Cardiac fibroblast diversity in HFpEF: states, niches, interorgan drivers and targets.","authors":"Muhammed Kiyar, Alexander R Pinto, John F O'Sullivan, Bing H Wang, David M Kaye","doi":"10.1038/s41569-026-01335-2","DOIUrl":"https://doi.org/10.1038/s41569-026-01335-2","url":null,"abstract":"Myocardial fibrosis is a key structural and prognostically adverse feature of heart failure with preserved ejection fraction (HFpEF), but its cellular and molecular drivers remain incompletely understood and are not specifically addressed by current therapies. Cardiac fibroblasts, previously considered to be largely structural, collagen-producing cells, are now recognized as being a heterogeneous family of trophic cells that integrate vascular, immune and metabolic cues to coordinate extracellular matrix remodelling. Single-cell and spatial transcriptomic analyses have resolved fibroblast states in the healthy and diseased myocardium, revealing that cardiac fibrosis in HFpEF (unlike in post-infarction scarring) results from the activation of profibrotic gene programmes across various fibroblast states, rather than the expansion of classic myofibroblasts. Hallmark programmes include increased nitrosative stress, dysregulated lipid handling and altered inflammatory signalling. These cardiac fibroblast-intrinsic alterations are further shaped by cardiac intercellular cues and by interorgan communication to the heart from the adipose tissue, bone marrow, gut, liver, lymphatic system and nervous system, positioning fibroblasts as myocardial integrators of systemic cardiometabolic stress. Emerging proof-of-concept studies in animal models of HFpEF demonstrate that selectively modulating fibroblast-specific targets can attenuate cardiac fibrosis, improve diastolic function and reduce susceptibility to arrhythmia. In this Review, we delineate HFpEF-specific fibroblast alterations, integrate cross-organ signalling networks that condition the cardiac stroma, and evaluate opportunities for fibroblast-directed therapies as next-generation antifibrotic strategies.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":" ","pages":""},"PeriodicalIF":50.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The biomechanical environment of coronary atherosclerotic plaque rupture. 冠状动脉粥样硬化斑块破裂的生物力学环境。

IF 50.2 1区医学

Nature Reviews Cardiology Pub Date : 2026-08-11 DOI: 10.1038/s41569-026-01337-0

Eirinaios Tsiartas, Martin Bennett

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Uncovering the role of chromatin organization and dynamics in heart disease. 揭示染色质组织和动态在心脏病中的作用。

IF 50.2 1区医学

Nature Reviews Cardiology Pub Date : 2026-08-11 DOI: 10.1038/s41569-026-01338-z

Karina Huynh

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Haemolytic injury and cardiovascular disease. 溶血性损伤和心血管疾病。

IF 50.2 1区医学

Nature Reviews Cardiology Pub Date : 2026-08-06 DOI: 10.1038/s41569-026-01329-0

Mark C Hieromnimon, Abdul Basit, Hanna M Hieromnimon, L Kristin Newby, Mark T Gladwin, Willard N Applefeld

{"title":"Haemolytic injury and cardiovascular disease.","authors":"Mark C Hieromnimon, Abdul Basit, Hanna M Hieromnimon, L Kristin Newby, Mark T Gladwin, Willard N Applefeld","doi":"10.1038/s41569-026-01329-0","DOIUrl":"https://doi.org/10.1038/s41569-026-01329-0","url":null,"abstract":"Haemoglobin is a ferrous iron (Fe2+)-containing intracellular protein that is crucial for multiple homeostatic functions, including transport of oxygen and carbon dioxide, acid-base buffering and cellular signalling through nitric oxide oxidation and nitrite reduction. When erythrocyte membranes are disrupted, a process known as haemolysis that is caused by either disease or an exogenous stressor, haemoglobin is liberated into the plasma. This plasma free haemoglobin is highly pathogenic, disrupting a range of physiological processes and causing downstream organ damage through multiple mechanisms, including nitric oxide scavenging, vasoconstriction, generation of reactive oxygen species, activation of innate immune inflammation, disruption of cellular signalling, activation of the coagulation cascade and direct end-organ injury. Haemolysis and an elevated level of plasma free haemoglobin are associated with increased cardiovascular mortality, haemodynamic derangements, renal dysfunction and immune system dysregulation. These injurious pathways are exacerbated as the plasma free haemoglobin concentration and duration of exposure increase and are mitigated by endogenous scavenging pathways. In cardiovascular disease, proliferation of the use of mechanical circulatory support technologies, as well as an ageing population with chronic low levels of haemolysis, has increased exposure to plasma free haemoglobin and its detrimental effects. In this Review, we summarize the relationship between chronic haemolysis and cardiovascular disease and discuss current and future approaches towards the prevention and treatment of haemolytic injury.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":" ","pages":""},"PeriodicalIF":50.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Social determinants of cardiovascular health: lessons from Whitehall. 心血管健康的社会决定因素：来自白厅的教训。

IF 50.2 1区医学

Nature Reviews Cardiology Pub Date : 2026-08-03 DOI: 10.1038/s41569-026-01333-4

Benjamin Dowsing

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Post-mitotic cardiomyocyte senescence redefines cardiac ageing. 有丝分裂后心肌细胞衰老重新定义了心脏老化。

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Nature Reviews Cardiology Pub Date : 2026-08-03 DOI: 10.1038/s41569-026-01332-5

Ilias Simon, Yohan Santin

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Mitochondrial uncoupling therapy reduces established atherosclerosis in mice. 线粒体解偶联治疗可减少小鼠已建立的动脉粥样硬化。

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Nature Reviews Cardiology Pub Date : 2026-07-28 DOI: 10.1038/s41569-026-01330-7

Irene Fernández-Ruiz

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Cardioprotective properties of empagliflozin and other SGLT2 inhibitors. 恩格列净和其他SGLT2抑制剂的心脏保护特性。

IF 50.2 1区医学

Nature Reviews Cardiology Pub Date : 2026-07-27 DOI: 10.1038/s41569-026-01325-4

Thomas A Zelniker, Eugene Braunwald

{"title":"Cardioprotective properties of empagliflozin and other SGLT2 inhibitors.","authors":"Thomas A Zelniker, Eugene Braunwald","doi":"10.1038/s41569-026-01325-4","DOIUrl":"https://doi.org/10.1038/s41569-026-01325-4","url":null,"abstract":"Since the publication of the landmark EMPA-REG OUTCOME trial, sodium-glucose cotransporter 2 (SGLT2) inhibitors have redefined the therapeutic landscape of cardiovascular-kidney-metabolic disease. Initially developed as glucose-lowering drugs, empagliflozin and subsequent SGLT2 inhibitors have demonstrated robust benefits in reducing hospitalization for heart failure, slowing the progression of chronic kidney disease and lowering cardiovascular mortality across diverse populations. Although the precise mechanisms underlying these effects are not completely understood, the cardioprotective effects of empagliflozin seem to be mediated by an interconnected network of pleiotropic mechanisms. Empagliflozin modulates haemodynamics, restores endothelial and vascular function, improves mitochondrial bioenergetics through increased mitochondrial activity and substrate flexibility, and attenuates maladaptive cardiac remodelling. In this Review, we synthesize the current mechanistic understanding of SGLT2 inhibitors and highlight key directions for the future of cardiovascular-kidney-metabolic disease management. The next decade of research on SGLT2 inhibitors will be shaped by efforts to close evidence gaps, including in kidney failure and cardio-oncology, as well as the integration of SGLT2 inhibitors with other guideline-directed therapies, optimization of therapeutic sequencing and broad implementation in clinical care.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":" ","pages":""},"PeriodicalIF":50.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148605059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The cardiac 4D nucleome: nuclear and chromatin dynamics across development, disease and ageing. 心脏4D核组：发育、疾病和衰老过程中的核和染色质动力学。

IF 50.2 1区医学

Nature Reviews Cardiology Pub Date : 2026-07-23 DOI: 10.1038/s41569-026-01322-7

Yinuo Wang, Gergana Dobreva

{"title":"The cardiac 4D nucleome: nuclear and chromatin dynamics across development, disease and ageing.","authors":"Yinuo Wang, Gergana Dobreva","doi":"10.1038/s41569-026-01322-7","DOIUrl":"10.1038/s41569-026-01322-7","url":null,"abstract":"The nucleus is a highly organized and dynamic organelle, with hierarchical layers ranging from nucleosome positioning to chromatin domains and higher-order 3D genome topology. Viewed over time as the 4D nucleome, this organization enables precise and context-dependent transcriptional control. In the heart, dynamic nuclear architecture orchestrates precise transcriptional programmes that control lineage commitment and the establishment of cardiac cell types crucial not only for heart development, but also for postnatal function and adaptive responses. Correspondingly, transitions between developmental and disease states are accompanied by coordinated changes in genome organization, chromatin accessibility and transcription factor occupancy. These architectural programmes are modulated by mechanical and metabolic inputs, which further shape chromatin organization, nuclear positioning and epigenetic state. Deciphering the 4D nucleome of the heart can potentially provide new insights into disease mechanisms, regenerative strategies and precision cardiovascular medicine. In this Review, we highlight studies that define the fundamental principles of nuclear organization; explore nuclear and chromatin reorganization during cardiac development, disease and ageing; and discuss emerging methods to interrogate nuclear architecture. We also consider how mechanical and metabolic signals shape the 4D epigenome and examine their therapeutic and translational implications for cardiovascular health and disease.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":" ","pages":""},"PeriodicalIF":50.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0