Reviews & Analysis

In this Review, Touyz and colleagues discuss the role of reactive oxygen species in the pathophysiology of hypertension, focusing on the mechanisms of reactive oxygen species generation and oxidative stress in hypertension, as well as the alterations in redox signalling. They also discuss potential therapeutic strategies for targeting oxidative stress in hypertension.

In this Roadmap arising from an NHLBI workshop, Chew and colleagues explore the use of retinal imaging biomarkers for the prediction, diagnosis and monitoring of systemic cardiovascular diseases. The authors identify knowledge gaps and research opportunities to translate retinal imaging biomarkers into clinical practice.

Contraction of the heart is driven by cyclical interactions between myosin and actin filaments driven by ATP hydrolysis. In this Review, Irving summarizes the basal cardiac cycle of the healthy human heart at the ventricular, cellular, sarcomeric, and molecular levels and the implications for the development of novel therapies for heart disease.

During commercial spaceflight, individuals who might have underlying cardiovascular disease will be exposed to increased gravitational and acceleration (G) forces. In this Review, Morris and colleagues explore the use of computational models to simulate the effects of G forces on human cardiovascular pathophysiology to risk-stratify individuals and help to improve safety in commercial suborbital spaceflight.

Various dietary patterns have been proposed to improve cardiometabolic health. In this Review, Pagidipati et al. emphasize the commonalities between recommendations on what to eat (Mediterranean, Dietary Approaches to Stop Hypertension and low-carbohydrate or ketogenic diets) and the possible benefits of time-restricted eating and intermittent fasting.

Infection with Trypanosoma spp. can cause Chagas disease or human African trypanosomiasis. In this Review, Sabino and colleagues discuss the effects of these infections on the heart, with particular emphasis on the pathogenesis, diagnosis and treatment of Chagas cardiomyopathy.

In this Review, Wu and co-workers describe the consequences of radiation exposure on the cardiovascular system, drawing insights from individuals exposed to whole-body radiation (including nuclear and medical workers) and from patients with cancer undergoing radiation therapy.

In this Review, Catapano and colleagues discuss the evidence supporting the LDL cumulative exposure hypothesis and how measuring cumulative LDL exposure can be used to estimate risk and contribute to the prevention of atherosclerotic cardiovascular disease.

In this Review, Porsch and Binder discuss the evidence for and mechanisms of the increased and premature risk of atherosclerotic cardiovascular disease in patients with autoimmune disease, with particular focus on systemic lupus erythematosus and rheumatoid arthritis.

In this Review, Khan and colleagues explore the evolving global epidemiology of heart failure (HF), focusing on changes in incidence and prevalence across the spectrum of left ventricular ejection fraction. The authors highlight the disparities in our understanding of HF epidemiology in low-income and middle-income countries, affirming the need for improved surveillance and resource allocation in vulnerable areas and populations.

In this Review, the authors describe the changes in metabolism that predispose individuals to developing atrial fibrillation (AF) and highlight the potential of available and emerging therapeutic strategies that target metabolic remodelling to treat AF.

In this Review, Adkar and Leeper describe the mechanisms of programmed cell death and efferocytosis, discuss how efferocytosis becomes impaired in atherosclerosis and other cardiometabolic diseases, and suggest potential strategies to target these pathways for the treatment of atherosclerotic cardiovascular disease.

In 1993, Lincoff and Topol claimed that the thrombolytic treatment of ST-segment elevation myocardial infarction was suboptimal in many patients and gave an ‘illusion of reperfusion’. In this Perspective article, the authors propose that a similar illusion of revascularization exists for contemporary percutaneous revascularization in patients with coronary artery disease and ischaemia, and identify how outcomes might be improved.

Physiological responses to stress are thought to increase the risk of cardiovascular disease via haemodynamic, vascular and immune perturbations. In this Review, Vaccarino and Bremner focus on issues with the measurement of psychological stress and the underlying pathobiology connecting stress to the risk of cardiovascular disease.

In this Review, the authors discuss the receptors, ligands and interactors that regulate immune cell recruitment in atherosclerosis, describe mechanisms that promote the resolution of inflammation in atherosclerotic lesions, and highlight potential strategies to target these pathways for the treatment of atherosclerotic cardiovascular disease.

In this Review, Kemper and colleagues discuss the canonical and non-canonical roles of the complement system in the pathogenesis of atherosclerosis and discuss potential new therapeutic strategies targeting the complement system for the prevention and treatment of atherosclerotic cardiovascular disease.

Patients with cardiovascular disease (CVD) have an increased risk of cancer, and patients with cancer have an increased risk of CVD. In this Review, the authors discuss the shared modifiable risk factors and the shared pathophysiological mechanisms underlying the bidirectional relationship between these two prevalent diseases.

In this Review, van Leent and colleagues provide an overview of current PET imaging approaches for assessment of atherosclerotic cardiovascular disease, as well as of whole-body PET applications; discuss the link between imaging readouts and atherosclerotic plaque pathology; and highlight promising developments in PET systems and radiotracer synthesis.

In this Review, Bozkurt provides an overview of the management of patients with heart failure across the full range of left ventricular ejection fraction, derived from the recommendations in the latest US and European guidelines.

In this Review, the authors address considerations for enteral antithrombotic therapy in patients with cardiovascular disease and gastrointestinal comorbidities, who often have an increased risk of gastrointestinal bleeding. Approaches include tailoring of antithrombotic regimens and gastrointestinal-protection strategies.