Volume 23 Issue 2, February 2026

The use of robotics in cardiac surgery initially replicated components of operations, then evolved to assist with entire operations, and is now becoming the standard of care for an increasing number of cardiac procedures. Its expanded use and rapid innovation promise to combine high-precision, partially automated cardiac surgery with robotically deployed devices, thereby transforming the surgical experience for both patients and surgeons.

Andrea Zambrano highlights the study that catalysed the field of reverse cardio-oncology by showing that myocardial infarction promotes breast tumour growth in mice.

Annelise Poss discusses the importance of mouse substrain selection in models of cardiovascular research, highlighting a study that demonstrated the influence of mouse substrain genetic diversity on the phenotypic characteristics of the disease model.

Liu and Bursill highlight a landmark study that described the presence of in-stent neoatherosclerosis in bare-metal and drug-eluting stents, which has reshaped the clinical management of coronary artery disease.

Heart failure (HF) and obesity are growing global health problems, and excess body weight is associated with an increased risk of HF across the spectrum of left ventricular ejection fraction. In this Review, Meems et al. explore the pathophysiological mechanisms linking these two conditions and how management strategies targeting obesity could also improve HF-related outcomes.

This expert Consensus Statement from the Quantitative Cardiovascular Imaging Study Group provides evidence-based recommendations for integrating coronary CT angiography and artificial intelligence-supported evaluation of atherosclerotic plaque in patients with stable chest pain. The authors aim to harness the reliability and precision of artificial intelligence to individualize treatment based on atherosclerotic plaque analysis.

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.

In this Perspective article, Saba and Libby review the latest evidence highlighting the lack of a correlation between stenosis severity and the risk of atherosclerosis-induced thrombotic complications and question the overreliance on stenosis grading for therapeutic decision-making.