Nature cardiovascular research最新文献_第3页

Decentralized clinical trials in cardiovascular disease : A primer for clinical trialists 分散的心血管疾病临床试验：临床试验入门。

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-17 DOI: 10.1038/s44161-026-00788-5

Guillaume Baudry, Prashanth Kulkarni, Tor Biering-Sørensen, Adam D. DeVore, Charles Michael Gibson, Christopher B. Granger, Harriette G. C. Van Spall

{"title":"Decentralized clinical trials in cardiovascular disease : A primer for clinical trialists","authors":"Guillaume Baudry, Prashanth Kulkarni, Tor Biering-Sørensen, Adam D. DeVore, Charles Michael Gibson, Christopher B. Granger, Harriette G. C. Van Spall","doi":"10.1038/s44161-026-00788-5","DOIUrl":"10.1038/s44161-026-00788-5","url":null,"abstract":"Decentralized clinical trials (DCTs) move trial activities—such as recruitment, consent, delivery of the intervention, data collection and assessment of outcomes—away from traditional research sites to the homes or communities of patients. This participant-centered approach is accomplished through the use of digital health technology, remote monitoring, electronic data capture, and home- or community-based procedures. The advantage of DCTs may include broader trial recruitment pools with greater representativeness, reduced participant burden, greater operational efficiency and the ability to generate evidence in real-world settings. These features are particularly relevant in cardiovascular disease, which imposes a disproportionate population burden in regions where clinical trial centers are lacking. In this Perspective, we outline the essential components of the DCT ecosystem, discuss how DCTs can address key challenges in cardiovascular disease research, and using case examples, highlight operational and regulatory considerations in designing fully or partially (hybrid) decentralized trials. We also review the potential risks of DCTs and propose mitigation strategies to ensure high-quality, safe and reliable trial execution. Baudry et al. review the main components and operational considerations for running decentralized clinical trials, outline their specific advantages for the cardiovascular field, and propose strategies to mitigate their downsides and ensure their quality.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 3","pages":"193-203"},"PeriodicalIF":10.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multi-view deep learning for echocardiogram interpretation 超声心动图解释的多视点深度学习。

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-17 DOI: 10.1038/s44161-026-00780-z

Mostafa A. Al-Alusi

引用次数: 0

Multiview deep learning improves detection of major cardiac conditions from echocardiography 多视图深度学习改进了超声心动图对主要心脏疾病的检测。

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-17 DOI: 10.1038/s44161-026-00786-7

Joshua P. Barrios, Minhaj U. Ansari, Jeffrey E. Olgin, Sean Abreau, Jacques Delfrate, Elodie L. Langlais, Robert Avram, Geoffrey H. Tison

{"title":"Multiview deep learning improves detection of major cardiac conditions from echocardiography","authors":"Joshua P. Barrios, Minhaj U. Ansari, Jeffrey E. Olgin, Sean Abreau, Jacques Delfrate, Elodie L. Langlais, Robert Avram, Geoffrey H. Tison","doi":"10.1038/s44161-026-00786-7","DOIUrl":"10.1038/s44161-026-00786-7","url":null,"abstract":"Medical imaging often captures multiple two-dimensional views of three-dimensional anatomic structures, but most artificial intelligence (AI) models analyze two-dimensional data. Here we show that integrating multiple imaging views using a single AI model can improve diagnostic performance. We developed a deep neural network (DNN) architecture that combines information from multiple video views simultaneously. Using echocardiogram data from the University of California, San Francisco, and the Montreal Heart Institute, we applied our multiview DNN approach for three primary demonstration tasks: detecting any left or right ventricular abnormality, diastolic dysfunction, and substantial valvular regurgitation. Across various tasks, our multiview DNNs improved discrimination as measured by the area under the receiver operating characteristic curve by 0.06–0.09 compared to DNNs trained on any single view. This demonstrates that AI models that can combine information from multiple imaging views simultaneously can better capture complex anatomy and physiology for certain tasks, underscoring the value of a multiview paradigm for AI in medical imaging. Barrios et al. develop a multiview deep neural network to jointly analyze multiple echocardiographic video views, improving detection of cardiac anatomy and function.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 3","pages":"234-245"},"PeriodicalIF":10.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hematopoietic expression of cIAP2 drives inflammation and heart failure after myocardial infarction cIAP2的造血表达驱动心肌梗死后的炎症和心力衰竭。

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-12 DOI: 10.1038/s44161-026-00782-x

David Smyth, Liyong Zhang, Mohammad Al-Khalaf, Sabrina Robichaud, Richard Seymour, Michele Geoffrion, Richard Jung, Simon Parlow, Feng Du, Brian McNeill, Qiujiang Du, Caroline Beauregard, Xiaoling Zhao, Mireille Ouimet, Shawn T. Beug, Eric C. LaCasse, Katey J. Rayner, Tak W. Mak, Benjamin Hibbert, Robert G. Korneluk, Peter P. Liu

{"title":"Hematopoietic expression of cIAP2 drives inflammation and heart failure after myocardial infarction","authors":"David Smyth, Liyong Zhang, Mohammad Al-Khalaf, Sabrina Robichaud, Richard Seymour, Michele Geoffrion, Richard Jung, Simon Parlow, Feng Du, Brian McNeill, Qiujiang Du, Caroline Beauregard, Xiaoling Zhao, Mireille Ouimet, Shawn T. Beug, Eric C. LaCasse, Katey J. Rayner, Tak W. Mak, Benjamin Hibbert, Robert G. Korneluk, Peter P. Liu","doi":"10.1038/s44161-026-00782-x","DOIUrl":"10.1038/s44161-026-00782-x","url":null,"abstract":"Ischemic heart disease, driven largely by myocardial infarction (MI), remains the leading cause of mortality and morbidity. Although early suppression of post-MI inflammation improves outcomes, current therapies have limited efficacy. Here we show that the cellular inhibitor of apoptosis 2 (cIAP2), a regulator of cell death, is upregulated after MI and promotes acute inflammation and cardiac injury. Global deletion of cIAP2, or its loss through bone marrow transfer, reduced inflammatory injury and cardiac dysfunction after MI, indicating that the cardioprotective effect of cIAP2 deficiency is primarily mediated by the hematopoietic compartment. Reduced cardiac inflammation was associated with decreased splenic myeloid cell numbers due to increased cell death and elevated expression of the death-inducing factors TRAIL and TRAIL-R2/DR5. Pharmacologic degradation of cIAP proteins after MI using Smac mimetics similarly reduced cardiac inflammation and protected against injury. Together, these findings identify cIAP2 as a key hematopoietic cell-expressed regulator of survival and inflammation and support its inhibition as a potential immunotherapeutic strategy for MI. Smyth et al. demonstrate that a cellular inhibitor of apoptosis, cIAP2, exacerbates inflammation and cardiac injury after myocardial infarction and that its inhibition, either genetically or via Smac mimetics, offers a promising immunotherapeutic strategy to reduce post-MI damage and progression to heart failure.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 3","pages":"246-261"},"PeriodicalIF":10.8,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Valve biology and rheumatic heart disease pathogenesis 瓣膜生物学与风湿性心脏病的发病机制。

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-10 DOI: 10.1038/s44161-026-00792-9

Serene Yeow, Hannah Frost, Enzo R. Porrello, Andrew Steer, Holly K. Voges

{"title":"Valve biology and rheumatic heart disease pathogenesis","authors":"Serene Yeow, Hannah Frost, Enzo R. Porrello, Andrew Steer, Holly K. Voges","doi":"10.1038/s44161-026-00792-9","DOIUrl":"10.1038/s44161-026-00792-9","url":null,"abstract":"Rheumatic heart disease (RHD) is an acquired chronic inflammatory disease of the heart valves. Regarded as an autoimmune sequela of Streptococcus pyogenes infection, RHD is triggered by the development of carditis during acute rheumatic fever and persists as chronic rheumatic valvulitis in a proportion of patients with acute rheumatic fever. Permanent valve tissue damage ensues, often leading to heart failure. Effective interventions for established RHD are lacking and valve surgery is currently the only treatment option. The limited number of therapeutic targets for heart valve diseases reflects the complexities of studying the mechanisms underlying early valve pathobiology. However, technological advances now enable in-depth profiling of peripheral blood and valve tissue samples from people with RHD, opening new avenues to interrogate human-specific disease processes. In this Review, we revisit established immunological principles of RHD pathogenesis in light of emerging studies. We also explore both systemic and tissue-centric research gaps to advance our understanding of disease mechanisms and to identify human-relevant therapeutic strategies for RHD. Yeow et al. review the pathogenesis of rheumatic heart disease, discuss the role of valve biology in the progression of the disease, highlight ongoing research to address the critical healthcare burden and describe recent advances into the underlying pathogenic mechanisms.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 3","pages":"204-217"},"PeriodicalIF":10.8,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Planned early-term delivery based on risk lowers pre-eclampsia incidence 基于风险的计划早期分娩可降低先兆子痫的发生率。

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-09 DOI: 10.1038/s44161-026-00796-5

Elisa Martini

引用次数: 0

Leptin’s path to cardioprotection goes through fat from brain to heart 瘦素保护心脏的途径是从大脑到心脏的脂肪。

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-09 DOI: 10.1038/s44161-026-00795-6

Gerburg Schwaerzer

引用次数: 0

Oral PCSK9 inhibitor enlicitide lowers LDL cholesterol levels in phase 2 trial 口服PCSK9抑制剂enlicicitide在2期试验中降低LDL胆固醇水平

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-05 DOI: 10.1038/s44161-026-00794-7

Xiulin Koehler

引用次数: 0

Strategies to improve regional representation in heart failure randomized controlled clinical trials 提高心力衰竭随机对照临床试验区域代表性的策略。

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-05 DOI: 10.1038/s44161-026-00779-6

Guillaume Baudry, Luca Monzo, Rebecca A. V. Newton, Guowei Li, Mark C. Petrie, Nicolas Girerd, Alexandre Mebazaa, Diego Araiza Garaygordobil, Ana Mocumbi, Katja Rohwedder, Javed Butler, Lawrence Mbuagbaw, Faiez Zannad, Harriette G. C. Van Spall

{"title":"Strategies to improve regional representation in heart failure randomized controlled clinical trials","authors":"Guillaume Baudry, Luca Monzo, Rebecca A. V. Newton, Guowei Li, Mark C. Petrie, Nicolas Girerd, Alexandre Mebazaa, Diego Araiza Garaygordobil, Ana Mocumbi, Katja Rohwedder, Javed Butler, Lawrence Mbuagbaw, Faiez Zannad, Harriette G. C. Van Spall","doi":"10.1038/s44161-026-00779-6","DOIUrl":"10.1038/s44161-026-00779-6","url":null,"abstract":"The regional enrollment of participants in pivotal randomized controlled trials (RCTs) often does not represent the regional distribution of cardiovascular diseases. Over the past four decades, trials have enrolled participants primarily from North America and Europe, limiting the global generalizability of findings. In this Perspective, we review the evolution of regional participation in RCTs, using heart failure as a case study to assess temporal trends, current gaps in representativeness and opportunities for improvement. We assess the regulatory, logistical and financial barriers to clinical trial enrollment in underrepresented regions. We examine the manner in which global regions have been classified in trials, and propose a standardized regional classification system for reporting and subgroup analysis. To improve regional representativeness, we suggest targeted strategies that address barriers faced at the national, regulatory, sponsor or funder, institution and patient level. We also recommend the use of a representativeness index during trial planning and site selection to enhance regional representativeness. Expanding trial participation beyond historically dominant regions could be a key step in improving trial efficiency, external validity and global health equity. Baudry et al. review regional participation in heart failure clinical trials, summarize region-specific and regulatory elements that hinder the participation of underrepresented regions, and propose strategies to overcome these obstacles.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 3","pages":"183-192"},"PeriodicalIF":10.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microvascular senescence in single ventricle disease 单心室疾病的微血管衰老。

IF 10.8

Nature cardiovascular research Pub Date : 2026-03-04 DOI: 10.1038/s44161-026-00791-w

引用次数: 0