Nature Reviews Cardiology最新文献

{"title":"Reply to: ‘The effects of skeletal muscle and adipose tissue on outcomes in patients with heart failure’","authors":"Navin Suthahar","doi":"10.1038/s41569-026-01270-2","DOIUrl":"10.1038/s41569-026-01270-2","url":null,"abstract":"","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 5","pages":"376-377"},"PeriodicalIF":44.2,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147278709","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":"Cardiotoxicity of T cell immunotherapies","authors":"Michael A. Raddatz, Ashley F. Stein-Merlob, Syed S. Mahmood, Sarju Ganatra, Daniel Addison, Tasha L. Lin, Sarah M. Larson, Eric H. Yang","doi":"10.1038/s41569-026-01265-z","DOIUrl":"10.1038/s41569-026-01265-z","url":null,"abstract":"T cell immunotherapies offer a new approach to cancer therapy. Chimeric antigen receptor (CAR) T cell therapy is the most prolific of these treatments, leveraging genetically engineered T cells to augment the antitumour response. Bispecific antibodies, T cell receptor-engineered T cells and tumour-infiltrating lymphocytes have also emerged as novel T cell therapies with therapeutic benefit. As the variety of T cell therapies and indications for their use expand, a nuanced understanding of potential haemodynamic sequelae and cardiovascular toxicities is required. T cell activation can lead to massive cytokine release and excessive inflammation, termed cytokine release syndrome (CRS). Like other inflammatory syndromes, CRS can lead to cardiovascular complications, including arrhythmias, myocardial infarction and heart failure, with an incidence of cardiovascular events as high as 20% among patients who develop high-grade CRS. In this Review, we summarize the mechanisms, epidemiology and management of T cell therapy-associated CRS and subsequent cardiotoxicity. We also explore how an improved understanding of CAR T cell therapy, and other emerging T cell-based treatments, will inform the prevention and management of adverse cardiovascular events. As the indications for T cell immunotherapies, particularly chimeric antigen receptor T cell therapy, continue to expand, a nuanced understanding of their potential adverse effects is required. In this Review, Raddatz and colleagues summarize the mechanisms, epidemiology and management of T cell therapy-associated cytokine release syndrome and subsequent cardiotoxicity.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 9","pages":"619-630"},"PeriodicalIF":50.2,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276930","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":"HFpEF and MASLD: converging mechanisms and clinical implications","authors":"Federico Capone, Steffen P. Häseli, Luo Liu, Stefano Strocchi, Claudia Langenberg, Aldons J. Lusis, Maik Pietzner, Deborah M. Muoio, Oliver J. Rider, Betty Raman, Marat Fudim, Stefano Romeo, Yibin Wang, Mirko Völkers, Svati H. Shah, Gabriele G. Schiattarella","doi":"10.1038/s41569-026-01257-z","DOIUrl":"10.1038/s41569-026-01257-z","url":null,"abstract":"Heart failure with preserved ejection fraction (HFpEF) and metabolic dysfunction-associated steatotic liver disease (MASLD) are increasingly prevalent, interrelated conditions driven by the global rise in obesity and metabolic syndrome. Once viewed in isolation, HFpEF and MASLD are now recognized as organ-specific manifestations of shared systemic metabolic dysfunction. Evidence from the past decade highlights not only overlapping risk factors but also a dynamic, bidirectional inter-organ crosstalk between the liver and the heart that shapes their natural history. In this Review, we explore the epidemiological and mechanistic basis of the MASLD–HFpEF connection, focusing on shared metabolic drivers such as lipotoxicity, meta-inflammation and oxidative stress. We also discuss emerging liver-derived mediators, including hepatokines, metabolites and extracellular vesicles, that influence cardiac structure and function. Finally, we highlight diagnostic and therapeutic strategies relevant to both conditions and propose a multiorgan framework to improve their clinical recognition and management. Understanding the liver–heart axis is key to rethinking cardiometabolic disease beyond organ silos and towards more integrated, mechanism-based approaches. Schiattarella and colleagues propose a framework linking heart failure with preserved ejection fraction and metabolic dysfunction-associated steatotic liver disease as interconnected syndromes rather than coincidental comorbidities. The authors delineate shared metabolic, inflammatory and endocrine drivers and propose a shift towards coordinated strategies and integrated clinical algorithms to improve prevention, risk stratification, early detection and co-management of these disorders.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 8","pages":"584-608"},"PeriodicalIF":50.2,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147278711","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":"Invasive and medical management approaches to non-acute myocardial ischaemic syndromes","authors":"Nicholas Chiu, Deepak L. Bhatt, Raffaele De Caterina, Torsten Doenst, Hristo Kirov, Victor Dayan, David P. Faxon, Sanjay Kaul, Divaka Perera, John D. Puskas, Philippe Gabriel Steg, William E. Boden","doi":"10.1038/s41569-026-01259-x","DOIUrl":"10.1038/s41569-026-01259-x","url":null,"abstract":"Over the past two decades, approaches to managing patients with coronary artery disease have improved substantially with advances in percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) surgery, pharmacological secondary prevention, anti-anginal agents and lifestyle interventions. Accordingly, clinical management choices in non-acute myocardial ischaemic syndromes (NAMIS) remain a timely and important topic. The risks and benefits of an invasive strategy combined with optimal medical therapy (OMT) versus a conservative strategy of OMT alone should be discussed with patients to facilitate shared clinical decision making. The findings from high-quality, randomized, controlled trials in the era of modern OMT form an essential platform for these informed conversations. In totality, the evidence from randomized, controlled trials supports OMT as the first-line therapeutic approach in patients with NAMIS, whereas selected patients at high anatomical risk or those with persistent anginal symptoms despite initial OMT often derive further symptom relief from invasive therapy with PCI. In patients with high-risk NAMIS, including those with multivessel disease and diabetes mellitus, CABG surgery improves survival, whereas the benefit is less clear for PCI. In this Review, we discuss the findings from contemporary trials evaluating outcomes in patients with NAMIS treated invasively or conservatively with OMT alone, and we conclude with proposed management pathways. The clinical management of patients with non-acute myocardial ischaemic syndrome (NAMIS) continues to evolve as increasingly effective treatment approaches become available. In this Review, Chiu et al. summarize the evidence from randomized trials on optimal medical therapy with or without percutaneous coronary intervention or coronary artery bypass graft surgery to guide shared decision making in patients with NAMIS.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 9","pages":"661-677"},"PeriodicalIF":50.2,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146223159","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":"Neurovascular interactions in the ageing heart","authors":"Julian U. G. Wagner, Stefanie Dimmeler","doi":"10.1038/s41569-026-01260-4","DOIUrl":"10.1038/s41569-026-01260-4","url":null,"abstract":"The global rise in life expectancy underscores the urgent need to extend healthspan and prevent age-related diseases. Cardiovascular disease is the leading cause of death worldwide, with ageing as a major non-modifiable risk factor. Ageing drives progressive vascular dysfunction and cardiac decline, including heart failure with preserved or reduced ejection fraction. Vascular cells are particularly vulnerable to ageing, resulting in structural and functional deterioration of the microvasculature and macrovasculature. Emerging evidence highlights that ageing also disrupts the neurovascular interface — an intricate axis between the nervous and vascular systems that governs cardiac function. Alterations to the neurovascular unit in the heart contribute to impaired autonomic regulation, increasing the risk of arrhythmias and heart failure. In this Review, we examine how neurovascular ageing shapes cardiac dysfunction and explore the therapeutic potential of targeting the cardiac neurovascular unit to mitigate cardiovascular ageing and promote resilience in ageing populations. The ageing process leads to cellular changes that disrupt the intricate axis between the nervous and vascular systems that governs cardiac function. In this Review, Wagner and Dimmeler describe the crucial role of neurovascular ageing in cardiac dysfunction and explore the therapeutic potential of targeting the cardiac neurovascular unit to develop interventions for ageing populations.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 8","pages":"572-583"},"PeriodicalIF":50.2,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220543","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":"Mineralocorticoid antagonism in the treatment of heart failure","authors":"Seamus J. Heanue, Morag J. Young","doi":"10.1038/s41569-026-01261-3","DOIUrl":"10.1038/s41569-026-01261-3","url":null,"abstract":"Seamus Heanue and Morag Young describe the work from Hans Selye that paved the way for the concept of mineralocorticoid receptor antagonists as therapy for heart failure.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 4","pages":"218-218"},"PeriodicalIF":44.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166195","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-on-a-chip and vasculature-on-a-chip platforms as models of cardiovascular disease","authors":"Ramak Khosravi, Milica Radisic","doi":"10.1038/s41569-026-01255-1","DOIUrl":"10.1038/s41569-026-01255-1","url":null,"abstract":"Organ-on-a-chip platforms have revolutionized the modelling of cardiovascular pathophysiology, enabling researchers to elucidate underlying mechanisms and drug responses for a variety of inherited and acquired diseases. This emerging technology can overcome the limitations of traditional in vitro culture systems and animal models such as poor biological relevance and species-specific differences. Heart-on-a-chip and vasculature-on-a-chip models consist of 3D structures incorporating relevant cell populations (often derived from pluripotent stem cell sources) with precisely controlled electromechanical conditions and biochemical stimuli to form functional biomimetic microenvironments. These tunable platforms hold great promise in establishing patient-specific disease models and accelerating drug discovery and development, an important step in the direction of personalized cardiovascular medicine. In this Review, we highlight organ-on-a-chip models that have successfully mimicked cardiovascular disease phenotypes and contributed to the development of novel therapeutics, and summarize the technical and biological barriers to the widespread utilization of this technology. In this Review, Khosravi and Radisic highlight the use of heart-on-a-chip and vasculature-on-a-chip platforms consisting of 3D structures that incorporate relevant cell populations to model cardiovascular disease phenotypes and contribute to the development of novel therapeutics.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 8","pages":"537-554"},"PeriodicalIF":50.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166121","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":"Inherited risk of coronary artery disease: redefining care with imaging and genetics","authors":"Nick S. R. Lan, Girish Dwivedi, Graham S. Hillis, Derek P. Chew, Bu B. Yeap, Gemma A. Figtree, Amit V. Khera, Gerald F. Watts, Abdul Rahman Ihdayhid","doi":"10.1038/s41569-026-01254-2","DOIUrl":"10.1038/s41569-026-01254-2","url":null,"abstract":"Atherosclerotic cardiovascular disease remains a leading cause of morbidity and mortality globally, despite advances in preventative medicine. An individual’s family history of premature coronary artery disease (CAD) captures the complex interplay among shared genetic, environmental and lifestyle factors within families and is a well-established, independent risk factor for CAD. Although family history has high predictive value, it is inconsistently defined, variably applied and under-recorded in routine cardiovascular risk assessment. Advances in cardiac imaging and genomic medicine offer an opportunity to redefine cardiovascular risk assessment, laying the foundation for a precise approach to prevention in families at high risk of CAD. In this Review, we synthesize the pathogenic mechanisms underlying the inherited risk of CAD, highlight limitations of using family history in current risk stratification models and explore the evolving role of cardiac imaging and polygenic risk scores in risk assessment. We discuss the implications of these methods for lifestyle modifications and therapeutic interventions, and how integrating traditional and emerging tools can enable a precision approach to prevention throughout life. Finally, we examine the limitations of current cardiovascular disease prevention guidelines and highlight the need for studies that will improve equity, evaluate cost-effectiveness and address barriers to integrating novel tools into preventative care. Family history of premature coronary artery disease is a well-recognized, but under-recorded, risk factor that captures the complex interplay among shared genetic, environmental and lifestyle factors within families. Here, Lan et al. review the mechanisms of inherited risk, discuss the current limitations of family history in risk stratification models and outline future directions for precision care in families with a history of premature coronary artery disease.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 8","pages":"555-571"},"PeriodicalIF":50.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166178","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":"Vagal mechanoreceptors in the heart sense changes in blood volume","authors":"Karina Huynh","doi":"10.1038/s41569-026-01263-1","DOIUrl":"10.1038/s41569-026-01263-1","url":null,"abstract":"In a study published in Nature, Liberles and colleagues demonstrate that vagal PIEZO2 neurons in the heart respond to shifts in circulating blood volume to stabilize blood pressure during changes in posture.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 4","pages":"216-216"},"PeriodicalIF":44.2,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157777","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":"Calculation methods for LDL cholesterol are evolving tools for accuracy in lipidology","authors":"Rafael Zubiran, Alan T. Remaley","doi":"10.1038/s41569-026-01264-0","DOIUrl":"10.1038/s41569-026-01264-0","url":null,"abstract":"In this Tools of the Trade article, Zubiran and Remaley describe the importance of the modified Sampson–National Institutes of Health equation as a tool to calculate LDL-cholesterol concentrations.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 4","pages":"214-214"},"PeriodicalIF":44.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150135","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}