Nature Reviews Cardiology最新文献

{"title":"Multimodal, device-based therapeutic targeting of the cardiovascular autonomic nervous system","authors":"Julian F. R. Paton, Tymoteusz Żera, Rajanikanth Vadigepalli, Neil Herring, David J. Paterson","doi":"10.1038/s41569-025-01212-4","DOIUrl":"10.1038/s41569-025-01212-4","url":null,"abstract":"The miniaturization of implantable sensors and actuators, combined with advances in interactive modelling and high-resolution imaging, is propelling the use of medical devices for counteracting impaired neural control of the cardiovascular system. In this Review, we discuss the current effectiveness of this technology for modulating autonomic activity in numerous cardiovascular conditions, including high blood pressure, heart failure and cardiac arrhythmias. We advocate for smarter closed-loop bionic devices fitted with feedback from multiple sensors to allow adaptive, state-dependent control, and discuss how the adoption of artificial intelligence technology would facilitate auto-personalization to meet the needs of patients. We also describe how transcriptomics of autonomic circuits can guide device-based approaches. Finally, the use of stem cell therapies to target sympathetic circuits more precisely will help to optimize the therapeutic effects of autonomic modulation for the treatment of arrhythmia. For bioelectronic medicine to achieve clinical utility in neurocardiology, these innovations must demonstrate improved efficacy beyond that offered by contemporary interventions. In this Review, Paterson and colleagues describe how bioelectronic approaches involving site-specific targeting of the autonomic nervous circuit could be used to treat cardiovascular disease, and reflect on current bioelectronic modalities, their limitations and future ways to improve therapeutic efficiency.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 4","pages":"255-278"},"PeriodicalIF":44.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203620","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":"Resistin-like molecule-γ promotes arrhythmia and cell death after MI","authors":"Karina Huynh","doi":"10.1038/s41569-025-01221-3","DOIUrl":"10.1038/s41569-025-01221-3","url":null,"abstract":"In the mouse ischaemic myocardium, neutrophils promote ventricular tachycardia via the secretion of resistin-like molecule-γ, according to a new study published in Science.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 12","pages":"917-917"},"PeriodicalIF":44.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127173","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":"Influenza vaccination reduces hospitalization and improves heart failure outcomes","authors":"Gregory B. Lim","doi":"10.1038/s41569-025-01219-x","DOIUrl":"10.1038/s41569-025-01219-x","url":null,"abstract":"Large-scale clinical trials presented at the ESC Congress 2025 support the use of high-dose vaccination for influenza to reduce hospitalization for cardiorespiratory disease in older adults and to improve outcomes in patients who have been hospitalized for acute heart failure.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 11","pages":"838-838"},"PeriodicalIF":44.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083527","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":"Sleep and circadian rhythms in cardiovascular resilience: mechanisms, implications, and a Roadmap for research and interventions","authors":"Brooke Aggarwal, Yunling Gao, Alfonso Alfini, Ali Azarbarzin, Ron C. Anafi, Kelly Glazer Baron, Victoria L. Bautch, Nicole Bowles, Josiane L. Broussard, Marishka Brown, Philip Cheng, Stephanie H. Cook, Rene Cortese, Fabian-Xosé Fernandez, Zorina Galis, Dayna A. Johnson, Sanja Jelic, Jonathan O. Lipton, Pamela L. Lutsey, Qing Miao, Jose M. Ordovas, Aric A. Prather, Filip K. Swirski, Esra Tasali, Ivan Vargas, Michael A. Grandner, Donald Lloyd-Jones","doi":"10.1038/s41569-025-01188-1","DOIUrl":"10.1038/s41569-025-01188-1","url":null,"abstract":"The interaction between sleep, circadian rhythms and cardiovascular resilience is a crucial yet underexplored research area with important public health implications. Disruptions in sleep and circadian rhythms exacerbate hypertension, diabetes mellitus and obesity, conditions that are increasingly prevalent globally and increase the risk of cardiovascular disease. A National Heart, Lung, and Blood Institute workshop examined these connections, as well as the emerging concept of cardiovascular resilience as a dynamic and multifaceted concept spanning molecular, cellular and systemic levels across an individual’s lifespan. The workshop emphasized the need to expand the focus from solely understanding whether and how sleep and circadian rhythm disturbances contribute to disease, to also exploring how healthy sleep and aligned circadian rhythms can increase cardiovascular resilience. To develop a Roadmap towards this goal, workshop participants identified key knowledge gaps and research opportunities, including the need to integrate biological, behavioural, environmental and societal factors in sleep and circadian health with cardiovascular research to identify therapeutic targets. Proposed interventions encompass behavioural therapies, chronotherapy, lifestyle changes, organizational policies and public health initiatives aimed at improving sleep and circadian health for better cardiovascular outcomes. Future cross-disciplinary research and translation of discoveries into public health strategies and clinical practices could improve cardiovascular resilience across the lifespan in all populations. In this Roadmap, Aggarwal and colleagues summarize current research and knowledge gaps on the relationship between sleep, circadian rhythms and cardiovascular resilience; highlight potential therapeutic targets and interventions for optimizing sleep and circadian rhythms to improve cardiovascular function and prevent disease; and outline research directions and opportunities, emphasizing the need for multidisciplinary collaboration.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 2","pages":"116-130"},"PeriodicalIF":44.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083526","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":"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}

{"title":"Arrhythmia-induced cardiomyopathy: focus on atrial fibrillation","authors":"Larissa Fabritz, Stephane N. Hatem, Samuel Sossalla","doi":"10.1038/s41569-025-01195-2","DOIUrl":"10.1038/s41569-025-01195-2","url":null,"abstract":"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. Arrhythmia-induced cardiomyopathy (AIC) refers to heart failure caused or exacerbated by arrhythmias, which resolves completely after restoration of sinus rhythm. In this Review, Fabritz and colleagues focus on atrial fibrillation as the cause of AIC, describing its pathophysiology, epidemiology and clinical presentation, and the various approaches to the diagnostic–therapeutic strategy of rhythm restoration.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 3","pages":"197-207"},"PeriodicalIF":44.2,"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":"10.1038/s41569-025-01209-z","url":null,"abstract":"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. In this Review, Khoury and colleagues examine the growing body of evidence demonstrating the benefits of screening for cardiovascular risk factors, including dyslipidaemia and high blood pressure, starting in childhood to reduce the lifetime burden of cardiovascular disease.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 4","pages":"279-292"},"PeriodicalIF":44.2,"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}