{"title":"Rethinking the mentoring paradigm to include mentor, sponsor and advocate","authors":"Alessia Gimelli, Suvasini Lakshmanan","doi":"10.1038/s41569-025-01210-6","DOIUrl":"10.1038/s41569-025-01210-6","url":null,"abstract":"In the dynamic landscape of academic medicine, there is an increased interest in refining the traditional mentoring paradigm to address the many unmet challenges associated with gender disparities within academia. We highlight the need to expand the focus of mentorship to include sponsorship and advocacy, and hope that this shift will foster holistic development in mentees.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 11","pages":"835-836"},"PeriodicalIF":44.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068056","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}
Larissa Fabritz, Stephane N. Hatem, Samuel Sossalla
{"title":"Arrhythmia-induced cardiomyopathy: focus on atrial fibrillation","authors":"Larissa Fabritz, Stephane N. Hatem, Samuel Sossalla","doi":"10.1038/s41569-025-01195-2","DOIUrl":"https://doi.org/10.1038/s41569-025-01195-2","url":null,"abstract":"<p>Arrhythmias and heart failure (HF) are common causes of morbidity and premature death worldwide, and patients who present with both conditions have particularly poor outcomes. Arrhythmia-induced cardiomyopathy (AIC) is a condition in which arrhythmias, often atrial fibrillation (AF), but also frequent atrial or ventricular ectopic beats, cause or aggravate HF. The hallmark of this condition is partial or complete reversibility of left ventricular systolic dysfunction after restoration of normal sinus rhythm. Differentiation between HF that causes arrhythmias and arrhythmias that cause HF remains challenging, leads to the underuse of rhythm-control therapy and, consequently, to the under-diagnosis of AIC. In this Review, we describe the various pathophysiological mechanisms of AIC, with a focus on AF as the underlying arrhythmia. We then discuss the epidemiology, clinical presentation and assessment of patients with AIC, with consideration of the complex interactions between AF and left ventricular dysfunction. We also present the therapeutic approach taken in patients presenting with suspected AIC, including restoration of sinus rhythm to unmask a diagnosis of AIC and treatment of HF. We conclude with a discussion of priorities for future research and the observation that there is an urgent need for objective, easily quantifiable parameters to identify patients with AIC.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"24 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059286","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}
{"title":"Cardiac myosin inhibitors for the treatment of obstructive and non-obstructive HCM","authors":"Karina Huynh","doi":"10.1038/s41569-025-01218-y","DOIUrl":"10.1038/s41569-025-01218-y","url":null,"abstract":"Two late-breaking clinical trials presented at the ESC Congress 2025 have explored the efficacy of cardiac myosin inhibitors for the treatment of hypertrophic cardiomyopathy.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 11","pages":"840-840"},"PeriodicalIF":44.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035220","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}
{"title":"The prevention of adult cardiovascular disease must begin in childhood: evidence and imperative","authors":"Michael Khoury, Adam L. Ware, Brian W. McCrindle","doi":"10.1038/s41569-025-01209-z","DOIUrl":"https://doi.org/10.1038/s41569-025-01209-z","url":null,"abstract":"<p>Growing evidence from the past seven decades indicates that atherosclerosis begins in youth and progresses in response to exposure to cardiovascular risk factors, which contribute to the development of cardiovascular disease in later life. A long-term randomized clinical trial lasting at least 50 years and involving screening and follow-up of children across their lifespan would provide the highest level of evidence to determine the lifelong influence of cardiovascular risk factors on cardiovascular disease risk but such an approach is not feasible. However, much can be learned from observing patients with familial hypercholesterolaemia. Those patients who were treated at a young age remained event-free into adulthood, beyond the ages at which their affected parent, who initiated treatment at a much later age, experienced their first cardiovascular event. The evidence is less certain for other types of dyslipidaemia and other cardiovascular risk factors, including high blood pressure. Nonetheless, the strategy of waiting until later in adulthood to screen and intervene, often after a non-fatal cardiovascular disease event has already occurred, might no longer seem prudent. In this Review, we summarize the growing body of evidence supporting intensified efforts to identify cardiovascular risk factors in children and young adults, and to identify knowledge gaps among this cohort such as the optimal timing and strategy for blood lipid screening.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"74 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035221","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}
{"title":"Benefit of digitoxin therapy for HFrEF","authors":"Gregory B. Lim","doi":"10.1038/s41569-025-01217-z","DOIUrl":"10.1038/s41569-025-01217-z","url":null,"abstract":"In the DIGIT-HF trial, treatment with digitoxin in addition to guideline-directed medical therapy reduced the risk of hospitalization for worsening heart failure or all-cause death compared with placebo in patients with heart failure with reduced ejection fraction.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 11","pages":"842-842"},"PeriodicalIF":44.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031715","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}
{"title":"Baxdrostat beneficial in uncontrolled or resistant hypertension","authors":"Irene Fernández-Ruiz","doi":"10.1038/s41569-025-01216-0","DOIUrl":"10.1038/s41569-025-01216-0","url":null,"abstract":"In patients with uncontrolled or resistant hypertension, the addition of the aldosterone synthase inhibitor baxdrostat to background antihypertensive therapy reduces seated in-office systolic blood pressure after 12 weeks of treatment, according to findings from the BaxHTN trial presented at the ESC Congress 2025.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 11","pages":"840-840"},"PeriodicalIF":44.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025433","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}
{"title":"Home-based care improves blood pressure control","authors":"Irene Fernández-Ruiz","doi":"10.1038/s41569-025-01214-2","DOIUrl":"10.1038/s41569-025-01214-2","url":null,"abstract":"A home-based model of hypertension care can lower blood pressure in patients with hypertension compared with standard care in the clinic, according to the IMPACT-BP trial, which was performed in a rural setting in South Africa and presented at the ESC Congress 2025.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 11","pages":"841-841"},"PeriodicalIF":44.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025434","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}
{"title":"Role of Helicobacter pylori screening after myocardial infarction","authors":"Irene Fernández-Ruiz","doi":"10.1038/s41569-025-01215-1","DOIUrl":"10.1038/s41569-025-01215-1","url":null,"abstract":"Routine screening for Helicobacter pylori infection during hospitalization for myocardial infarction does not reduce the risk of upper gastrointestinal bleeding, according to findings from the HELP-MI SWEDEHEART trial, although secondary and subgroup analyses suggest potential clinically meaningful benefits.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 11","pages":"841-841"},"PeriodicalIF":44.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026022","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}
{"title":"Description of the cardiomyocyte sarcolemma by Ramón y Cajal","authors":"Jorge Peña Peña","doi":"10.1038/s41569-025-01213-3","DOIUrl":"https://doi.org/10.1038/s41569-025-01213-3","url":null,"abstract":"Jorge Peña Peña highlights the 1888 publication from Santiago Ramón y Cajal that provided the first description of the cardiomyocyte sarcolemma.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"103 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017618","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}
Enzo R. Porrello, Chang Jie Mick Lee, Roger S. Y. Foo, David A. Elliott
{"title":"Transcriptional regulation in heart development, disease and regeneration: reassessing the fetal gene hypothesis","authors":"Enzo R. Porrello, Chang Jie Mick Lee, Roger S. Y. Foo, David A. Elliott","doi":"10.1038/s41569-025-01205-3","DOIUrl":"https://doi.org/10.1038/s41569-025-01205-3","url":null,"abstract":"<p>A central paradigm in cardiac biology is the reactivation of the fetal gene programme in the adult heart in response to stress. This so-called ‘fetal gene hypothesis’ was first proposed almost 40 years ago following the observation that certain fetal contractile protein isoforms were re-expressed in hypertrophied ventricles in the rodent heart in response to haemodynamic overload. Consequently, this concept was broadly adopted, and activation of the fetal gene programme became synonymous in the literature with the cardiac stress response. Transcriptomic and epigenomic profiling studies from the past 20 years have revealed the extent to which the diseased heart redeploys fetal gene programmes in response to stress. In this Review, we describe the historical origins of the fetal gene hypothesis and re-evaluate the general principles of fetal gene regulation in heart development, disease and regeneration.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"30 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995331","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}