Nature Reviews Cardiology最新文献

{"title":"Coronary CT angiography evaluation with artificial intelligence for individualized medical treatment of atherosclerosis: a Consensus Statement from the QCI Study Group","authors":"Kenrick Schulze, Anne-Marieke Stantien, Michelle C. Williams, Vassilios S. Vassiliou, Andreas A. Giannopoulos, Koen Nieman, Pál Maurovich-Horvat, Jason M. Tarkin, Rozemarijn Vliegenthart, Jonathan Weir-McCall, Mahmoud Mohamed, Bernhard Föllmer, Federico Biavati, Ann-Christine Stahl, Jakob Knape, Hanna Balogh, Nicola Galea, Ivana Išgum, Armin Arbab-Zadeh, Hatem Alkadhi, Robert Manka, David A. Wood, Edward D. Nicol, Nick S. Nurmohamed, Fabrice M. A. C. Martens, Damini Dey, David E. Newby, Marc Dewey","doi":"10.1038/s41569-025-01191-6","DOIUrl":"https://doi.org/10.1038/s41569-025-01191-6","url":null,"abstract":"<p>Coronary CT angiography is widely implemented, with an estimated 2.2 million procedures in patients with stable chest pain every year in Europe alone. In parallel, artificial intelligence and machine learning are poised to transform coronary atherosclerotic plaque evaluation by improving reliability and speed. However, little is known about how to use coronary atherosclerosis imaging biomarkers to individualize recommendations for medical treatment. This Consensus Statement from the Quantitative Cardiovascular Imaging (QCI) Study Group outlines key recommendations derived from a three-step Delphi process that took place after the third international QCI Study Group meeting in September 2024. Experts from various fields of cardiovascular imaging agreed on the use of age-adjusted and gender-adjusted percentile curves, based on coronary plaque data from the DISCHARGE and SCOT-HEART trials. Two key issues were addressed: the need to harness the reliability and precision of artificial intelligence and machine learning tools and to tailor treatment on the basis of individualized plaque analysis. The QCI Study Group recommends that the presence of any atherosclerotic plaque should lead to a recommendation of pharmacological treatment, whereas the 70th percentile of total plaque volume warrants high-intensity treatment. The aim of these recommendations is to lay the groundwork for future trials and to unlock the potential of coronary CT angiography to improve patient outcomes globally.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"27 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756462","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":"Cardiovascular–kidney–metabolic syndrome and MASLD: integrating medical perspectives","authors":"Xiao-Dong Zhou,&nbsp;Ming-Hua Zheng","doi":"10.1038/s41569-025-01199-y","DOIUrl":"10.1038/s41569-025-01199-y","url":null,"abstract":"Xiao-Dong Zhou and Ming-Hua Zheng discuss how Gerald Reaven’s 1988 Banting Lecture laid the groundwork for what we now call metabolic syndrome and reshaped our understanding of metabolic disease.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 11","pages":"843-843"},"PeriodicalIF":44.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747497","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":"CD40–CD40L: a milestone in the recognition of atherosclerosis as an immune disease","authors":"Leonardo Martin,&nbsp;Guido R. Y. De Meyer","doi":"10.1038/s41569-025-01198-z","DOIUrl":"10.1038/s41569-025-01198-z","url":null,"abstract":"Leonardo Martin and Guido De Meyer highlight the study that showed that blocking CD40–CD40L signalling could reduce atherosclerosis in mice in vivo.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 10","pages":"703-703"},"PeriodicalIF":44.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715299","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":"Heart failure and obesity: novel insights leading to new treatment paradigms","authors":"Laura M. G. Meems, Dirk J. van Veldhuisen, Naveed Sattar, Matthew M. Y. Lee","doi":"10.1038/s41569-025-01190-7","DOIUrl":"https://doi.org/10.1038/s41569-025-01190-7","url":null,"abstract":"<p>Heart failure (HF) and obesity place a substantial burden on health-care systems worldwide. Obesity is associated with an estimated 5–7% increase in the incidence of new-onset HF for each unit increase in body mass index. This obesity-associated risk is more pronounced for HF with preserved ejection fraction than for HF with reduced ejection fraction. The relationship between HF and obesity has historically been underrecognized. However, because of the development of weight-loss drugs with beneficial effects on outcomes in patients with HF with preserved ejection fraction, this link is now clear. In this Review, we provide a summary of the effects of obesity on the development of HF, exploring the epidemiology and potential pathophysiological mechanisms linking these two conditions. We also discuss management strategies, including lifestyle interventions and novel pharmaceutical approaches. This Review adds an impetus to all practitioners of cardiovascular medicine, especially specialists in HF, to become well-versed in obesity management and underscores the need for further research on the effects of intentional weight loss in various cardiovascular conditions.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"125 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715287","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":"European guidelines for hypertension in 2024: a comparison of key recommendations for clinical practice","authors":"Lucas Lauder,&nbsp;Thomas Weber,&nbsp;Michael Böhm,&nbsp;Sofie Brouwers,&nbsp;Rosa Maria Bruno,&nbsp;Eva Gerdts,&nbsp;Reinhold Kreutz,&nbsp;Thomas F. Lüscher,&nbsp;Giuseppe Mancia,&nbsp;John William McEvoy,&nbsp;Richard J. McManus,&nbsp;Mpiko Ntsekhe,&nbsp;Gianfranco Parati,&nbsp;Atul Pathak,&nbsp;Rosa de Pinho,&nbsp;Kazem Rahimi,&nbsp;Pantelis Sarafidis,&nbsp;Aletta E. Schutte,&nbsp;Bryan Williams,&nbsp;Rhian M. Touyz,&nbsp;Felix Mahfoud","doi":"10.1038/s41569-025-01187-2","DOIUrl":"10.1038/s41569-025-01187-2","url":null,"abstract":"Hypertension is the most prevalent modifiable risk factor for cardiovascular disease and for cardiovascular and all-cause mortality globally. Suboptimal control of elevated blood pressure places a substantial burden on health-care systems worldwide. Several factors contribute to this suboptimal control, such as limited awareness of hypertension, lack of appropriate diagnosis and poor control of blood pressure among those with a diagnosis. These factors can be due to patient non-adherence to treatment, inertia among health-care professionals and low uptake and implementation of clinical guideline recommendations. From 2003 to 2018, the European Society of Hypertension and the European Society of Cardiology jointly published four sets of guidelines on hypertension. However, the two societies released separate guidelines on hypertension in 2023 and 2024, respectively. These two sets of European guidelines agree on most recommendations, but some differences have been identified. In this Expert Recommendation, we highlight the key consensus recommendations from the two guidelines; compare differing approaches to the definition, classification, diagnosis and treatment of hypertension; and aim to help health-care professionals in their decision-making to improve the management of hypertension and to reduce the burden of hypertension-associated outcomes and premature deaths. In this Expert Recommendation, Lauder and colleagues compare the latest European Society of Cardiology and European Society of Hypertension guidelines on hypertension, highlight the key consensus recommendations and compare differing approaches to definitions, classification, diagnosis and treatment, with the aim to help health-care professionals in their decision-making to improve the management of hypertension.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 9","pages":"675-688"},"PeriodicalIF":44.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677456","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":"Regulatory T cells protect the heart in hypertrophic cardiomyopathy","authors":"Irene Fernández-Ruiz","doi":"10.1038/s41569-025-01196-1","DOIUrl":"10.1038/s41569-025-01196-1","url":null,"abstract":"Immune cells contribute to pathological remodelling in hypertrophic cardiomyopathy but regulatory T cells in particular can attenuate cardiac fibrosis and systolic dysfunction through their immunosuppressive properties, according to a new study.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 9","pages":"609-609"},"PeriodicalIF":44.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677447","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":"Metabolites matter for gut microbiota as a modifiable risk factor in cardiovascular diseases","authors":"Seyed Soheil Saeedi Saravi","doi":"10.1038/s41569-025-01193-4","DOIUrl":"10.1038/s41569-025-01193-4","url":null,"abstract":"Seyed Soheil Saeedi Saravi discusses the seminal study that linked a gut microbial metabolite to atherosclerotic cardiovascular disease and opened the way to mechanistic studies assessing how the gut microbiota influences host cardiovascular health.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 9","pages":"610-610"},"PeriodicalIF":44.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652278","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":"Myocardial infarction, stroke and arterial stenosis: time to reassess a major misunderstanding","authors":"Luca Saba, Peter Libby","doi":"10.1038/s41569-025-01186-3","DOIUrl":"https://doi.org/10.1038/s41569-025-01186-3","url":null,"abstract":"<p>A misconception persisting among the scientific and clinical communities relates to the correlation between arterial stenosis and acute ischaemic events, including myocardial infarction and cerebral stroke. This Perspective article challenges the approach that most of the current guidelines codify, which is based on the concept that occlusive arterial stenosis generally provokes ischaemic events. We highlight the mechanistic differences between chronic or inducible ischaemia caused by flow-limiting stenoses and acute thrombotic events and question the traditional reliance on stenosis grading as a biomarker for therapeutic decision-making that many guidelines enshrine. Furthermore, we review the latest evidence highlighting the lack of a correlation between stenosis severity and the occurrence of acute thrombotic complications of atherosclerosis, in the light of a major clinical trial that included a large contemporary population and showed that only one-third of major adverse cardiovascular events occur in individuals with obstructive coronary artery disease. These considerations aim to foster a shift, grounded in contemporary evidence, towards treatment approaches that address modifying plaque biology rather than stenoses per se, using pharmacological treatment as a fundamental factor in risk mitigation and moving away from sole reliance on stenosis grading as a primary determinant of therapeutic decisions.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"12 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652277","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":"Lipoprotein(a) in coronary artery disease","authors":"Jae Hyun Byun,&nbsp;Stella S. Daskalopoulou","doi":"10.1038/s41569-025-01194-3","DOIUrl":"10.1038/s41569-025-01194-3","url":null,"abstract":"Jae Hyun Byun and Stella S. Daskalopoulou describe the study that identified lipoprotein(a) as a genetically determined contributor to coronary artery disease.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 10","pages":"702-702"},"PeriodicalIF":44.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652279","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":"Access to digital health technologies: personalized framework and global perspectives","authors":"Sanjiv M. Narayan, Mina K. Chung, Demilade Adedinsewo, Luisa C. C. Brant, Leslie L. Davis, David Duncker, Jennifer L. Hall, Janet K. Han, Carolyn S. P. Lam, Eldrin Lewis, Joseph Loscalzo, Manlio F. Márquez, Vasiliki Rahimzadeh, Fatima Rodriguez, Prashanthan Sanders, Emma Svennberg, Kenneth Stein, Mintu Turakhia, Clyde Yancy, Antonis A. Armoundas","doi":"10.1038/s41569-025-01184-5","DOIUrl":"https://doi.org/10.1038/s41569-025-01184-5","url":null,"abstract":"<p>The emergence and rapid adoption of digital health technologies (DHT) present unprecedented opportunities to democratize and reduce disparities in health care by monitoring health and disease at the point of care in all patients. However, limited access to DHT is becoming a major obstacle to realizing these goals. Access to DHT is influenced not only by well-recognized social determinants of health, but also by digital determinants of health, such as digital literacy and the need for broad access to digital infrastructure, as well as commercial and economic factors. Addressing these challenges and designing unbiased systems of care are essential to enable broad access to DHT and to benefit diverse and under-represented communities. Doing so will fill gaps in the clinical evidence base and avoid perpetuating historical biases. In this Review, we propose a personalized framework to improve access to DHT, addressing determinants of access at the individual, interpersonal, community, society, government and industry levels. We frame these issues globally, highlighting how the challenges to DHT access and potential solutions might differ between continents while also emphasizing common themes. We provide perspectives from partners across the spectrum of health care, including clinicians, clinical trialists, and experts from digital health and industry.</p>","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"29 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640328","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}