Bullying is common in cardiology and can have substantial adverse effects. However, bullying can be addressed by substantive leadership, organizational and individual efforts to build an inclusive and respectful culture.

Haematopoietic mosaic loss of the Y chromosome, a phenomenon that frequently occurs with age, directly contributes to cardiac fibrosis and dysfunction.

Childbearing cardiologists face a number of challenges before, during and after pregnancy, including radiation concerns, infertility, pregnancy-related complications, and inadequate parental leave and return-to-work structures. Institutions can promote an equitable work environment by creating policies to mitigate these challenges.

In a new mouse model of spontaneous ventricular tachycardia after myocardial infarction, cardiac neutrophils increased the likelihood of arrhythmia, whereas cardiac macrophages protected against arrhythmia.

Overexpression of a circular RNA derived from the gene encoding the insulin receptor (Circ-INSR) prevents the development of cardiac dysfunction that occurs in response to anti-cancer therapy with doxorubicin.

Transient inhibition of the glucocorticoid receptor promotes cardiomyocyte proliferation and heart regeneration after myocardial infarction in the adult mouse heart.

The lowering of dietary recommendations for the consumption of free or added sugar from 25% to 10% of daily calories has been criticized as being based on low-quality scientific evidence, ill-informed opinions and over-extrapolation of results from studies on sugar-sweetened beverages. This Comment rebuts these criticisms.

Meteorin-like protein acts on endothelial cells through the receptor KIT to promote angiogenesis and reduce scar formation after myocardial infarction.

Two new papers describe the transcriptional programmes of congenital heart disease and dilated and hypertrophic cardiomyopathy assessed using single-nucleus RNA-sequencing technologies.

Activating the serine biosynthesis pathway might be a potential strategy for the treatment of dilated cardiomyopathy, according to a phenotypic screening study.

More than 50% of patients with chronic heart failure present with iron deficiency, which is associated with reduced quality of life and worse prognosis. Intravenous iron supplementation therapy has been shown to improve clinical outcomes in these patients.

High plasma levels of HDL cholesterol have been shown to be associated with a lower risk of cardiovascular disease. However, paradoxically, very high HDL-cholesterol levels are associated with increased mortality in patients with coronary artery disease, according to a new study.

The stretch-activated, calcium-permeable Piezo1 channel is the mechanosensor that transduces cardiomyocyte stretch into the biochemical signalling pathway that leads to cardiac hypertrophy in mice.

Adding remnant cholesterol levels to traditional risk scores for ischaemic heart disease and myocardial infarction improves the accuracy of individual risk stratification.

Gene therapy targeting the protein trafficking regulator MOG1 successfully reversed clinical features of Brugada syndrome in a knock-in mouse model.

The cardiac parasympathetic nervous system is composed of two parallel circuits with distinct functions: one selectively controls cardiac function and another coordinates cardiac and pulmonary function.

The totality of evidence from large-scale, randomized, controlled clinical trials and mechanistic studies in the laboratory has provided six crucial lessons about the emerging role of SGLT2 inhibitors to prevent the onset of heart failure in patients at high risk and slow the progression of heart failure in patients with established disease.

WNT signalling comprises a diverse spectrum of receptor-mediated pathways activated by a large family of WNT ligands and influencing fundamental biological processes. WNT signalling includes the β-catenin canonical pathway and the non-canonical pathways, namely the planar cell polarity and the calcium-dependent pathways. Advances over the past decade have linked non-canonical WNT signalling with key

For 20 years, dual antiplatelet therapy (DAPT), consisting of the combination of aspirin and a platelet P2Y12 receptor inhibitor, has been the gold standard of antithrombotic pharmacology after percutaneous coronary intervention (PCI). In the past 5 years, several investigations have challenged this paradigm by testing the efficacy and safety of P2Y12 inhibitor monotherapy (that is, without aspirin)

Wearable devices are widely used and have a high level of societal acceptance, opening unimagined and unexploited possibilities in cardiovascular medicine. In this Clinical Outlook, we highlight the disruptive potential of wearables for cardiovascular disease prevention, diagnosis and management, and suggest strategies for quickly and safely translating these lifestyle products into medical devices

Climate change is the greatest existential challenge to planetary and human health and is dictated by a shift in the Earth’s weather and air conditions owing to anthropogenic activity. Climate change has resulted not only in extreme temperatures, but also in an increase in the frequency of droughts, wildfires, dust storms, coastal flooding, storm surges and hurricanes, as well as multiple compound

Many patients with end-stage heart disease die because of the scarcity of donor hearts. A total artificial heart (TAH), an implantable machine that replaces the heart, has so far been successfully used in over 1,700 patients as a temporary life-saving technology for bridging to heart transplantation. However, after more than six decades of research on TAHs, a TAH that is suitable for destination therapy

Transcatheter aortic valve implantation (TAVI) is a breakthrough technology to replace the aortic valve in patients with severe aortic stenosis using simple cardiac catheterization instead of thoracic surgery. Initiated 20 years ago by my colleagues and me, TAVI has been performed in >1.5 million patients globally and has profoundly altered the landscape of cardiovascular medicine.

Different Notch ligands have opposing roles in regulating the proliferation and differentiation of vascular smooth muscle cells in the pulmonary vasculature in pulmonary arterial hypertension. Selectively targeting Jagged 1–NOTCH3 signalling might be an effective and safe strategy for the treatment of this condition.

Dietary interventions can reduce the risk of cardiovascular events. According to the CORDIOPREV study, a Mediterranean-style diet is superior to a low-fat diet in preventing major cardiovascular events in patients with cardiovascular disease.

A new study demonstrates that direct infection of cardiomyocytes is required to induce the cardiovascular effects of influenza virus infection.

Drug repurposing is the use of a given therapeutic agent for indications other than that for which it was originally designed or intended. The concept is appealing because of potentially lower development costs and shorter timelines than are needed to produce a new drug. To date, drug repurposing for cardiovascular indications has been opportunistic and driven by knowledge of disease mechanisms or

Moderate coffee consumption (2–5 cups per day) has been consistently associated with a lower risk of cardiovascular disease in epidemiological studies. For most individuals, a caffeine intake of up to 400 mg per day is safe and moderate coffee consumption can be included as part of a healthy lifestyle.

The soybean flavonoid genistein can attenuate cannabis-induced inflammation, oxidative stress and atherosclerosis by binding to and inhibiting cannabinoid receptor 1.

The majority of cardiovascular randomized controlled trials (RCTs) test interventions in selected patient populations under explicitly protocol-defined settings. Although these ‘explanatory’ trial designs optimize conditions to test the efficacy and safety of an intervention, they limit the generalizability of trial findings in broader clinical settings. The concept of ‘pragmatism’ in RCTs addresses

The adventitia of atherosclerotic arteries is innervated by efferent and afferent neurons that form neuroimmune cardiovascular interfaces and modulate disease progression; ablating the sympathetic innervation to these regions is a potential therapeutic strategy.

Cardiovascular disease remains the leading cause of death worldwide. Cardiovascular research has therefore never been more crucial. Cardiovascular researchers must be provided with a research environment that enables them to perform at their highest level, maximizing their opportunities to work effectively with key stakeholders to address this global issue. At present, cardiovascular researchers face

Mitochondria are organelles involved in the regulation of various important cellular processes, ranging from ATP generation to immune activation. A healthy mitochondrial network is essential for cardiovascular function and adaptation to pathological stressors. Mitochondria undergo fission or fusion in response to various environmental cues, and these dynamic changes are vital for mitochondrial function

Cardioimmunology is a field that encompasses the immune cells and pathways that modulate cardiac function in homeostasis and regulate the temporal balance between tissue injury and repair in disease. Over the past two decades, genetic fate mapping and high-dimensional sequencing techniques have defined increasing functional heterogeneity of innate and adaptive immune cell populations in the heart and

Heart failure is a systemic disease in which neuroendocrine activation, inflammation and metabolic changes can impair cardiac function. In addition, variants in genes encoding sarcomeric proteins can predispose individuals to develop heart failure. The 2022 Gordon Research Conference on Cardiac Regulatory Mechanisms aims to identify novel treatment targets by applying high-resolution approaches to

The results of two early-phase trials of novel lipid-lowering agents targeting ANGPTL3 and lipoprotein(a) might help to combat the residual risk of cardiovascular events in patients treated with statins and/or PCSK9 inhibitors to lower LDL-cholesterol levels.

Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit

In patients with atrial fibrillation, treatment with asundexian, a novel, oral, small-molecule inhibitor of coagulation factor XIa, reduces the incidence of bleeding compared with standard dosing with the factor Xa inhibitor apixaban.

A strategy of treating mild chronic hypertension in pregnant women using a blood pressure target of <140/90 mmHg reduces the risk of pre-eclampsia and does not increase the risk of poor fetal growth or fetal death.

In the PROMPT-HF trial, alerts embedded within electronic health records that contained guideline-directed recommendations for patients with heart failure improved the prescription of guideline-directed medical therapy.

Use of hormone-replacement therapy (HRT) for menopausal symptoms is associated with a modest reduction in plasma lipoprotein(a) (Lp(a)) levels but is not associated with a lower Lp(a)-associated risk of coronary heart disease compared with no HRT use, according to findings presented at ACC.22.

A model generated using proteomics and machine learning that included 27 proteins was able to predict the 4-year risk of myocardial infarction, heart failure, stroke or all-cause death better than a clinical model and was sensitive to the adverse and beneficial changes in outcome.

A prospective cohort study is the first to show a direct link between childhood cardiovascular risk factors and cardiovascular events in adults.

Cardiovascular disease and cancer are the two leading causes of morbidity and mortality in the world. The emerging field of cardio-oncology has revealed that these seemingly disparate disease processes are intertwined, owing to the cardiovascular sequelae of anticancer therapies, shared risk factors that predispose individuals to both cardiovascular disease and cancer, as well the possible potentiation

The microtubule network of cardiac muscle cells has unique architectural and biophysical features to accommodate the demands of the working heart. Advances in live-cell imaging and in deciphering the ‘tubulin code’ have shone new light on this cytoskeletal network and its role in heart failure. Microtubule-based transport orchestrates the growth and maintenance of the contractile apparatus through

Paradigm-shifting studies have revealed that the heart contains heterogeneous and dynamic immune and stromal cell populations that are crucial determinants of health and disease. Advances in molecular imaging now make it possible to non-invasively visualize the cardiac cellular landscape in humans, providing a means to guide precision therapies.

Current hypertension guidelines recommend using the average values of several blood pressure (BP) readings obtained both in and out of the office for the diagnosis and management of hypertension. In-office BP measurement using an upper-arm cuff constitutes the evidence-based reference method for current BP classification and treatment targets. However, out-of-office BP evaluation using 24 h ambulatory

In patients with acute myocardial infarction, the addition of the PCSK9 inhibitor alirocumab to high-intensity statin therapy leads to a greater regression of atherosclerotic plaques in non-infarct-related arteries after 52 weeks than statin therapy alone, according to findings from the PACMAN-AMI trial.