{"title":"Dual mechanotherapy for the treatment of cardiac fibrosis","authors":"Irene Fernández-Ruiz","doi":"10.1038/s41569-025-01172-9","DOIUrl":"https://doi.org/10.1038/s41569-025-01172-9","url":null,"abstract":"Inhibition of mechanotransduction selectively in cardiac fibrolasts, especially when combined with inhibition of transforming growth factor-β signalling, triggers a reversal of fibroblast activation and suppresses fibrosis in diseased hearts.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"38 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096869","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":"BMAL1 and HIF2α are key regulators of circadian-dependent variations in myocardial injury","authors":"Karina Huynh","doi":"10.1038/s41569-025-01169-4","DOIUrl":"https://doi.org/10.1038/s41569-025-01169-4","url":null,"abstract":"A new study published in Nature reveals the role of the interaction between the circadian transcription factor BMAL1 and hypoxia-inducible factor 2α in circadian-dependent cardioprotection after ischaemia–reperfusion injury, and highlights the potential of chronotherapeutic approaches for ischaemic heart disease.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"5 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143933468","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}
Alessandra Pasut, Eleonora Lama, Amaryllis H. Van Craenenbroeck, Jeffrey Kroon, Peter Carmeliet
{"title":"Endothelial cell metabolism in cardiovascular physiology and disease","authors":"Alessandra Pasut, Eleonora Lama, Amaryllis H. Van Craenenbroeck, Jeffrey Kroon, Peter Carmeliet","doi":"10.1038/s41569-025-01162-x","DOIUrl":"https://doi.org/10.1038/s41569-025-01162-x","url":null,"abstract":"<p>Endothelial cells are multifunctional cells that form the inner layer of blood vessels and have a crucial role in vasoreactivity, angiogenesis, immunomodulation, nutrient uptake and coagulation. Endothelial cells have unique metabolism and are metabolically heterogeneous. The microenvironment and metabolism of endothelial cells contribute to endothelial cell heterogeneity and metabolic specialization. Endothelial cell dysfunction is an early event in the development of several cardiovascular diseases and has been shown, at least to some extent, to be driven by metabolic changes preceding the manifestation of clinical symptoms. Diabetes mellitus, hypertension, obesity and chronic kidney disease are all risk factors for cardiovascular disease. Changes in endothelial cell metabolism induced by these cardiometabolic stressors accelerate the accumulation of dysfunctional endothelial cells in tissues and the development of cardiovascular disease. In this Review, we discuss the diversity of metabolic programmes that control endothelial cell function in the cardiovascular system and how these metabolic programmes are perturbed in different cardiovascular diseases in a disease-specific manner. Finally, we discuss the potential and challenges of targeting endothelial cell metabolism for the treatment of cardiovascular diseases.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"10 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930876","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":"Social media in modern cardiology: a tool for building community, visibility and impact","authors":"Ritu Thamman, Rafael Vidal-Perez","doi":"10.1038/s41569-025-01164-9","DOIUrl":"https://doi.org/10.1038/s41569-025-01164-9","url":null,"abstract":"Digital communication increasingly shapes early-career cardiology. Social media offers powerful tools for education, networking and career growth, but also poses challenges such as misinformation and lack of professionalism. In this Comment article, we outline practical strategies for effectively navigating social media in the early stages of a cardiology career.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"103 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920220","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}
Clément Menuet,Alona Ben-Tal,Ambre Linossier,Andrew M Allen,Benedito H Machado,Davi J A Moraes,David G S Farmer,David J Paterson,David Mendelowitz,Edward G Lakatta,Edwin W Taylor,Gareth L Ackland,Irving H Zucker,James P Fisher,James S Schwaber,Julia Shanks,Julian F R Paton,Julie Buron,K Michael Spyer,Kalyanam Shivkumar,Mathias Dutschmann,Michael J Joyner,Neil Herring,Paul Grossman,Robin M McAllen,Rohit Ramchandra,Song T Yao,Thomas Ritz,Alexander V Gourine
{"title":"Redefining respiratory sinus arrhythmia as respiratory heart rate variability: an international Expert Recommendation for terminological clarity.","authors":"Clément Menuet,Alona Ben-Tal,Ambre Linossier,Andrew M Allen,Benedito H Machado,Davi J A Moraes,David G S Farmer,David J Paterson,David Mendelowitz,Edward G Lakatta,Edwin W Taylor,Gareth L Ackland,Irving H Zucker,James P Fisher,James S Schwaber,Julia Shanks,Julian F R Paton,Julie Buron,K Michael Spyer,Kalyanam Shivkumar,Mathias Dutschmann,Michael J Joyner,Neil Herring,Paul Grossman,Robin M McAllen,Rohit Ramchandra,Song T Yao,Thomas Ritz,Alexander V Gourine","doi":"10.1038/s41569-025-01160-z","DOIUrl":"https://doi.org/10.1038/s41569-025-01160-z","url":null,"abstract":"The variation of heart rate in phase with breathing, known as 'respiratory sinus arrhythmia' (RSA), is a physiological phenomenon present in all air-breathing vertebrates. RSA arises from the interaction of several physiological mechanisms but is primarily mediated by rhythmic changes in cardiac parasympathetic (vagal) activity, increasing heart rate during inspiration and decreasing heart rate during expiration. RSA amplitude is an indicator of autonomic and cardiac health; RSA is diminished or absent in common pathological conditions such as chronic heart failure and hypertension. In this Expert Recommendation, we argue that the term 'RSA', although historically important, is semantically inaccurate and carries misleading pathological connotations, contributing to misunderstanding and misinterpretation of the origin and the physiological importance of the phenomenon. We propose replacing 'RSA' with the term 'respiratory heart rate variability' (RespHRV), which avoids pathological connotations and emphasizes the specific respiratory contribution to heart rate variability. We clarify that RespHRV encompasses respiratory-related heart rate variations in both the low-frequency and high-frequency bands traditionally defined in heart rate variability analysis, and that its amplitude should not be misconstrued as a measure of vagal tone. Adopting the proposed term 'RespHRV' is expected to unify understanding and stimulate further experimental and clinical research into the physiological mechanisms and functional importance of this phenomenon.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"51 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915152","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":"Cholesterol crystals in the pathogenesis of atherosclerosis.","authors":"Yvonne Baumer, Jason Irei, William A Boisvert","doi":"10.1038/s41569-024-01100-3","DOIUrl":"10.1038/s41569-024-01100-3","url":null,"abstract":"<p><p>The presence of cholesterol crystals (CCs) in tissues was first described more than 100 years ago. CCs have a pathogenic role in various cardiovascular diseases, including myocardial infarction, aortic aneurysm and, most prominently, atherosclerosis. Although the underlying mechanisms and signalling pathways involved in CC formation are incompletely understood, numerous studies have highlighted the existence of CCs at various stages of atheroma progression. In this Review, we summarize the mechanisms underlying CC formation and the role of CCs in cardiovascular disease. In particular, we explore the established links between lipid metabolism across various cell types and the formation of CCs, with a focus on CC occurrence in the vasculature. We also discuss CC-induced inflammation as one of the pathogenic features of CCs in the atheroma. Finally, we summarize the therapeutic strategies aimed at reducing CC-mediated atherosclerotic burden, including approaches to inhibit CC formation in the vasculature or to mitigate the inflammatory response triggered by CCs. Addressing CC formation might emerge as a crucial component in our broader efforts to combat cardiovascular disease.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":" ","pages":"315-332"},"PeriodicalIF":41.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668251","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}
Jianyi Jay Zhang, Steven M Pogwizd, Keiichi Fukuda, Wolfram-Hubertus Zimmermann, Chengming Fan, Joshua M Hare, Roberto Bolli, Philippe Menasché
{"title":"Trials and tribulations of cell therapy for heart failure: an update on ongoing trials.","authors":"Jianyi Jay Zhang, Steven M Pogwizd, Keiichi Fukuda, Wolfram-Hubertus Zimmermann, Chengming Fan, Joshua M Hare, Roberto Bolli, Philippe Menasché","doi":"10.1038/s41569-024-01098-8","DOIUrl":"10.1038/s41569-024-01098-8","url":null,"abstract":"<p><p>Heart failure (HF) remains a leading cause of mortality, responsible for 13% of all deaths worldwide. The prognosis for patients with HF is poor, with only a 50% survival rate within 5 years. A major challenge of ischaemia-driven HF is the loss of cardiomyocytes, compounded by the minimal regenerative capacity of the adult heart. To date, replacement of irreversibly damaged heart muscle can only be achieved by complete heart transplantation. In the past 20 years, cell therapy has emerged and evolved as a promising avenue for cardiac repair and regeneration. During this time, cell therapy for HF has encountered substantial barriers in both preclinical studies and clinical trials but the field continues to progress and evolve from lessons learned from such research. In this Review, we provide an overview of ongoing trials of cell-based and cell product-based therapies for the treatment of HF. Findings from these trials will facilitate the clinical translation of cardiac regenerative and reparative therapies not only by evaluating the safety and efficacy of specific cell-based therapeutics but also by establishing the feasibility of novel or underexplored treatment protocols such as repeated intravenous dosing, personalized patient selection based on pharmacogenomics, systemic versus intramural cell delivery, and epicardial engraftment of engineered tissue products.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":" ","pages":"372-385"},"PeriodicalIF":41.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639368","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":"Decongestion in heart failure: medical and device therapies","authors":"Zachary L. Cox, Kevin Damman, Jeffrey M. Testani","doi":"10.1038/s41569-025-01152-z","DOIUrl":"https://doi.org/10.1038/s41569-025-01152-z","url":null,"abstract":"<p>Heart failure is a leading cause of hospitalization worldwide, and congestion is the predominant cause of heart failure symptoms and hospitalization. The primary therapy used to treat and prevent congestion has historically been loop diuretics. However, many patients are discharged from hospital with residual congestion, which is associated with persistent heart failure symptoms, adverse outcomes and hospital readmission. Multiple medical strategies and devices have been and are being investigated with the aim of improving decongestion and subsequent heart failure outcomes. Numerous questions exist about the design of clinical trials to test emerging medical and device therapies, including the magnitude of benefit on congestive, kidney and post-discharge outcomes relative to conventional decongestion practices, and how best to implement novel therapies. In this Review, we discuss emerging medical and device strategies targeting congestion in patients with heart failure.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"32 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880706","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":"Sotatercept as add-on therapy for advanced PAH","authors":"Xiulin Köhler","doi":"10.1038/s41569-025-01161-y","DOIUrl":"https://doi.org/10.1038/s41569-025-01161-y","url":null,"abstract":"Sotatercept, an activin-signalling inhibitor, is a promising add-on treatment for patients with advanced pulmonary arterial hypertension and a high risk of death, according to data from the ZENITH trial.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"108 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857762","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":"Pulsed field ablation non-inferior to cryoablation for paroxysmal AF","authors":"Irene Fernández-Ruiz","doi":"10.1038/s41569-025-01159-6","DOIUrl":"https://doi.org/10.1038/s41569-025-01159-6","url":null,"abstract":"In patients with symptomatic paroxysmal atrial fibrillation, pulsed field ablation is non-inferior to cryoballoon ablation for preventing the recurrence of atrial tachyarrhythmia, according to findings from the SINGLE SHOT CHAMPION trial.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"7 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836689","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}