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    Basic research
    Preliminary study on a mechanics-parameter-based strategy for real-time vascular angle prediction and safety warning in vascular interventional robots
    Jia Yuanwang, Qu Ming, Xin Ran, Liu Zinuan, Yang Shiyi, Kang Wen, Wang Weiran, Liu Xiao, Yang Junjie, Chen Yundai
    2026, 46 (3):  265-274. 
    doi: 10.3969/j.issn.1674-8115.2026.03.001

    Abstract ( 9 )   HTML ( 1 )   PDF (5715KB) ( 17 )  

    Objective ·This study addresses the challenges of multimodal perception deficiencies and X-ray radiation dependency in vascular interventional robots. It investigated the mechanical characteristics of guidewire-vessel wall contact forces across varying vascular bending angles and established a contact force-angle mapping model to develop a novel robotic-assisted strategy integrating real-time vascular angle prediction and safety warning based on mechanical parameters. Methods ·An in vitro vascular model (bending angles: 0°‒80° at 5° intervals) was deployed on the R-One robotic platform. A force-sensing guidewire was advanced at 6 mm/s through curved segments. Using temporal registration, dynamic contact force variation trends (quantified as the rate of change) were extracted during the initial 2s traversal window. The correlation between vascular bending angles and variation rates was quantified. Based on this, a mapping model between contact force trends and vascular angles was constructed and evaluated using root mean squared error (RMSE) and mean absolute error (MAE). Results ·A very strong positive correlation was observed between vascular bending angle and the rate of change in guidewire contact force during the initial phase of traversal through the bend (rs =0.98, P<0.001). This relationship exhibited distinct phases relative to the 0° baseline: the rate remained stable within the 0°‒25°, with no statistically significant differences; a significant increase first appeared at 30° (P.adj<0.05); beyond 50°, the rate of increase accelerated markedly, accompanied by a sharp enhancement in statistical significance (P.adj decreasing from 10-5 to 10-8). By 80°, the rate of change in contact force increased by 24, 392.4%. Bayesian Information Criterion (BIC)-based changepoint analysis identified critical transition points at 35.60° and 50.65°, which closely align with the empirical thresholds of 30° and 50°, further confirming the structural nature of the relationship. The contact force-angle mapping model developed based on this relationship demonstrated excellent performance (R2=0.96, RMSE=4.93°, MAE=3.73°), significantly outperforming a conventional linear model (R2=0.89, RMSE=7.66°, MAE=5.03°). Conclusion ·In the in vitro model, the rate of change of contact force during the initial phase of guidewire entry into a curved segment exhibited a significant positive correlation with vascular bending angle, characterized by distinct phase transitions and critical inflection points. Based on this feature, a contact force-angle mapping model was established, which outperformed the traditional linear model. This study preliminarily validates the feasibility of inferring vascular anatomical structures from mechanical characteristics, providing a theoretical basis for mechanics-based safety warning and auxiliary navigation.

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    Analysis of cardiac features in Lmna N195K mutant mice using single-nucleus RNA sequencing
    Wang Junxiao, Wang Yuze, Zhang Shasha, Yuan Yu, Zhang Bing, Li Ruogu
    2026, 46 (3):  275-290. 
    doi: 10.3969/j.issn.1674-8115.2026.03.002

    Abstract ( 8 )   HTML ( 0 )   PDF (17356KB) ( 17 )  

    Objective ·To investigate the cardiac cellular composition and molecular alterations in a dilated cardiomyopathy (DCM) mouse model carrying the Lamin A/C p.Asn195Lys (Lmna N195K) mutation, single-nucleus RNA sequencing (snRNA-seq) was employed to elucidate the mutation′s impact on the cardiac multicellular ecosystem. The pathological phenotypes were systematically characterized in terms of cell type proportions, gene expression profiles, and intercellular communication networks. Methods ·A homozygous Lmna N195K mutant mouse model was generated using clustered regularly interspaced short palindromic repeats-associated protein 9 (CRISPR-Cas9) technology, with wild-type littermates serving as controls. Cardiac function was evaluated by echocardiography and electrocardiography, while histological analyses, including hematoxylin and eosin (HE) staining, Sirius Red staining, wheat germ agglutinin (WGA) staining, and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay, were performed to assess tissue pathology. Nuclei were isolated from cardiac tissue for snRNA-seq, and Seurat (v4.4.0) was applied for cell clustering, differential expression analysis, and subpopulation identification. Pseudotime analysis was used to trace cell state transitions, and CellChat (v1.6.1) was employed to infer intercellular communication networks. Quantitative reverse transcription polymerase chain reaction (RT-qPCR) and Western blotting (WB) were conducted to assess the expression of fibrosis markers and LMNA proteins, respectively. Results ·Homozygous Lmna N195K mutant mice exhibited chamber dilation, impaired systolic function, severe cardiac fibrosis, and high mortality. Histological analysis revealed disorganized cardiomyocyte alignment, significantly increased fibrotic area, elevated apoptosis, and reduced LMNA protein expression in the mutant group. SnRNA-seq identified nine major cardiac cell types, including cardiomyocytes, endothelial cells, and fibroblasts. In the mutant group, the proportion of metabolically active cardiomyocytes (CM2) was markedly decreased (P=0.005), while contractile cardiomyocytes (CM3) were increased (P=0.004). Nearly all fibroblasts were converted into a profibrotic subpopulation FB4 (P=0.001). Among endothelial cells, the extracellular matrix (ECM)-secreting subpopulation EC3 was significantly expanded (P=0.007), suggesting the occurrence of endothelial-to-mesenchymal transition (EndoMT). Differential expression analysis revealed dysregulation of genes related to fibrosis, energy metabolism, and cardiac injury. Intercellular communication analysis indicated significant activation of receptor-ligand signaling pathways, including periostin(POSTN)-integrin, vascular endothelial growth factor A(VEGFA)-vascular endothelial growth factor receptor 1(VEGFR1), and Laminin Subunit Alpha 2(LAMA2)-Integrin signaling pathways. Conclusion ·The Lmna N195K mutation disrupts the cardiac multicellular ecosystem, characterized by cardiomyocyte subpopulation imbalance (decreased metabolic cells and increased contractile cells), fibroblast conversion to profibrotic phenotypes, and endothelial EndoMT with enhanced ECM secretion. These alterations, reinforced by aberrant intercellular communication networks, collectively drive fibrosis and pathological remodeling, ultimately leading to dilated cardiomyopathy. This study reveals the impact of Lmna N195K mutation on cardiac cell composition and function at the single cell level, offering critical insights into the cellular basis of LMNA related DCM.

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    Role and mechanism of fibroblast mitochondrial dysfunction in pulmonary arterial hypertension
    Chen Jiayu, Zhang Huili
    2026, 46 (3):  291-300. 
    doi: 10.3969/j.issn.1674-8115.2026.03.003

    Abstract ( 9 )   HTML ( 0 )   PDF (1353KB) ( 14 )  

    Objective ·To preliminarily investigate the role and mechanism of fibroblast mitochondrial dysfunction and its phenotypic transition in pulmonary arterial hypertension (PAH). Methods ·A PAH model was established in rats by using monocrotaline (MCT). Rat pulmonary arterial adventitial fibroblasts (RPAAFs) were isolated and stimulated with transforming growth factor β1 (TGF-β1) to induce fibroblast-to-myofibroblast transition (FMT). Interventions were performed using the peroxisome proliferator-activated receptor γ coactivator 1-α (Pgc1α) agonist ZLN005 and the mitochondrial uncoupler Fccp. Hemodynamic parameters were measured via right heart catheterization. Vascular remodeling was assessed by using hematoxylin-eosin staining and immunofluorescence staining. Mitochondrial morphology and function were observed by using transmission electron microscopy and live-cell staining (Mitotracker, TMRM, and MitoSOX). The expression levels of Pgc1α, vimentin, and smooth muscle actin α (α-SMA) were detected by Western blotting. The mRNA expression levels of Col1a1 and Col3a1 were measured by qPCR. Results ·Four weeks after MCT injection, mitochondria in rat pulmonary arterial adventitial fibroblasts became fragmented with a reduced mean area (P<0.001), and the protein expression level of Pgc1α decreased (P=0.016), promoting the transition of fibroblasts into myofibroblasts. After stimulation with TGF-β1, RPAAFs showed reduced mitochondrial number (P<0.001), decreased membrane potential (P=0.006), increased reactive oxygen species (P<0.001), decreased Pgc1α expression (P=0.006), significantly increased α-SMA protein expression, and increased Col1a1 and Col3a1 mRNA expression (all P<0.001). Fccp treatment similarly reduced mitochondrial membrane potential (P=0.005) and increased α-SMA, Col1a1, and Col3a1 expression (all P<0.001). Pretreatment with ZLN005 upregulated Pgc1α expression (P<0.001), improved TGF-β1-induced mitochondrial dysfunction, and suppressed α-SMA expression (P<0.001) in fibroblasts. In vivo, ZLN005 attenuated pulmonary artery remodeling, reduced perivascular collagen deposition, lowered right ventricular systolic pressure and mean pulmonary arterial pressure (both P<0.001), upregulated tissue Pgc1α expression, and inhibited α-SMA expression (P=0.007). Conclusion ·Fibroblast mitochondrial dysfunction promotes FMT and plays an important role in the pathophysiology of PAH.

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    Study on the role of gastrodin-mediated autophagy in skeletal muscle atrophy after myocardial infarction
    Xu Zhoulin, Yin Gaosheng, Li Yuancong, Yang Yunheng, Zheng Qi, Yang Ping
    2026, 46 (3):  301-311. 
    doi: 10.3969/j.issn.1674-8115.2026.03.004

    Abstract ( 12 )   HTML ( 0 )   PDF (1730KB) ( 14 )  

    Objective ·To observe the occurrence of skeletal muscle atrophy at 4 weeks after myocardial infarction (MI), and to further investigate the therapeutic effects and underlying mechanisms of gastrodin (Gas) on post-MI cardiac injury and skeletal muscle atrophy. Methods ·In vivo, healthy adult male Sprague-Dawley (SD) rats were selected to establish animal models and were randomly divided into a sham operation group (Sham), MI model group (MI), and MI+Gas treatment group (MI+Gas), with 10 rats in each group. In vitro, L6 myotubes were cultured with conditioned medium from angiotensin II (AngII)-stimulated cardiac fibroblasts (CFs), and were divided into a control group (Control), model group (Model), gastrodin treatment group (Treatment), and chloroquine (CQ) treatment group (Treatment+CQ). Cardiac function, myocardial fibrosis, and the cross-sectional area and number of tibialis anterior muscle fibers in rats from the three groups were evaluated by M-mode echocardiography, Masson′s trichrome straining, and hematoxylin-eosin (HE) staining, respectively. Protein expression levels of myoblast determination protein (MyoD), myogenin (MyoG), muscle Ring finger-1 (MuRF-1), muscle atrophy F-box protein (MAFbx), Beclin-1, sequestosome-1 (p62/SQSTM1), and microtubule-associated protein 1 light chain 3-Ⅰ/Ⅱ (LC3-Ⅰ/Ⅱ) in tissues from the three groups and in L6 myotube groups were detected by Western blotting. L6 myoblasts were transfected with mRFP-eGFP-LC3 lentivirus to measure autophagic flux in the Control, Model, and Treatment groups. Results ·Compared with the MI group, the MI+Gas group showed significantly improved cardiac function, reduced myocardial fibrosis, increased cross-sectional area of tibialis anterior muscle fibers, and decreased number of tibialis anterior muscle fibers. At both the skeletal muscle tissue and L6 myotube levels, Gas treatment promoted the expression of myogenesis-related proteins MyoD and MyoG, and inhibited the expression of skeletal muscle atrophy-related proteins MuRF-1 and MAFbx (vs. MI/Model group, P<0.05). Gas also reduced the expression of autophagy-related proteins Beclin-1 and LC3-Ⅱ/GAPDH (vs. MI/Model group, P<0.001), increased p62 expression (P=0.036), and improved skeletal muscle autophagic flux. Compared with the Treatment group, CQ pretreatment reversed the regulatory effects of Gas on myogenic and atrophy markers. Conclusion ·This study confirms that MI induces skeletal muscle atrophy, while Gas ameliorates post-MI cardiac dysfunction and skeletal muscle atrophy by restoring autophagic flux to regulate metabolic balance.

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    Clinical research
    Impact of apolipoprotein B control on coronary atherosclerotic plaque progression: a cohort study using intravascular ultrasound
    Amuti Abulikemu, Li Youran, Yang Chendie, GuanPoh Tay, Feng Shuo, Zhang Ruiyan, Wang Xiaoqun
    2026, 46 (3):  312-321. 
    doi: 10.3969/j.issn.1674-8115.2026.03.005

    Abstract ( 8 )   HTML ( 1 )   PDF (1226KB) ( 13 )  

    Objective ·To investigate the correlation between apolipoprotein B (ApoB) control level and coronary plaque progression in patients with stable coronary atherosclerotic heart disease (CHD). Methods ·This study retrospectively enrolled 86 patients with stable CHD (146 lesions) who were treated in the Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from January 2020 to May 2023. At baseline, demographic characteristics, physical examination finding, medical history, and medication use were collected. At baseline and follow-up, cardiometabolic parameters (including blood lipids and blood glucose) were measured, and intravascular ultrasound (IVUS) was performed to evaluate the same untreated intermediate coronary lesions (stenosis rate 30%‒70%). Time-averaged values of cardiometabolic parameters during follow-up were calculated. Quantitative analysis was performed on IVUS images to measure total atheroma volume (TAV) and percent atheroma volume (PAV) at baseline and follow-up. Patients were divided into a plaque progression group and a non-progression group according to a cutoff value of PAV change ≥5%. Spearman correlation analysis and multivariate Logistic regression were used to evaluate the association between time-averaged ApoB control level and coronary plaque progression. Results ·During follow-up, the mean change in PAV was 3.6% (-2.7%, 9.7%), and plaque progression was detected in 65 lesions (44.5%). A positive correlation was observed between time-averaged ApoB control level and mean change in TAV (r=0.22, P=0.008). Multivariate logistic regression analysis further demonstrated that, after adjustment, each 0.1 mmol/L increase in time-averaged ApoB control level was associated with a 0.885-fold increase in the risk of plaque progression (P=0.048). Conclusion ·Higher ApoB levels remain an independent predictor of coronary plaque progression after adjustment for potential confounders. These findings suggest that comprehensive management of cardiometabolic parameters, including ApoB, should be strengthened in clinical practice to delay plaque progression and improve patient prognosis.

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    Diagnostic value of cardiac magnetic resonance for myocardial injury in patients with mild COVID-19 infection
    Quyang Danzeng, Xiao Huoyuan, Zhang Qingchen, Liu Yuting, Kang Sang, Feng Rui, Pan Jingwei
    2026, 46 (3):  322-331. 
    doi: 10.3969/j.issn.1674-8115.2026.03.006

    Abstract ( 8 )   HTML ( 5 )   PDF (2309KB) ( 12 )  

    Objective ·To establish a cardiac magnetic resonance (CMR)-based diagnostic model for detecting myocardial injury in patients with mild coronavirus disease 2019 (COVID-19). Methods ·A total of 64 patients with positive nucleic acid test results for COVID-19 and accompanying cardiovascular symptoms who visited Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, between January 2024 and June 2025 were enrolled. All patients underwent cardiac troponin I (cTnI) testing and CMR examination within 6 months after infection. According to cTnI levels, patients were divided into an elevated cTnI group [cTnI(+), n=26] and a non-elevated cTnI group [cTnI(-), n=38]. In addition, 37 age- and gender- matched individuals without prior COVID-19 infection were included as healthy controls. Baseline clinical characteristics and CMR parameters, including cardiac function and volumetric parameters, left ventricular global and segmental strain parameters, and myocardial tissue characterization parameters, were collected and compared among the three groups. Spearman rank correlation analysis was performed to evaluate the associations between cTnI and baseline clinical characteristics as well as CMR parameters. Univariate and multivariate Logistics regression analyses were used to establish a diagnostic model for early identification of COVID-19-related myocardial injury. Receiver operator characteristic (ROC) curve analysis and the DeLong test were used to assess the discriminative performance of the model. Results ·Comparative analysis of cardiac function and volumetric parameters showed no significant differences in indices such as left ventricular ejection fraction (LVEF) among the three groups. Compared with the healthy control group, the cTnI(+) group showed decreased left ventricular global circumferential strain (GCS), left ventricular basal-level circumferential strain (CSBasal), and left ventricular mid-level circumferential strian (CSMid) (P<0.001), as well as increased Native T1 mapping values (P<0.001); the cTnI(-) group also showed elevated Native T1 mapping values (P=0.007). Correlation analysis showed that cTnI was significantly negatively correlated with CSMid (r=‒0.600, P<0.001). Multivariate Logistic regression analysis revealed that CSMid and Native T1 mapping were independent predictors of COVID-19-related myocardial injury (P<0.001). ROC curve analysis showed that the combined diagnostic model based on CSMid and Native T1 mapping demonstrated good discriminative performance (AUC=0.950). Conclusion ·The CMR-based diagnostic model combining CSMid and Native T1 mapping can effectively identify potential myocardial injury in patients with mild COVID-19. It may provide objective imaging evidence for the early detection and clinical evaluation of COVID-19-related myocardial injury.

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    Clinical-inflammatory combined model for predicting poor prognosis in male patients with anterior circulation acute ischemic stroke with large vessel occlusion after mechanical thrombectomy
    Mei Zixian, Meng Xuchen, Su Wenjing, Zhong Weijie, Tang Dingzhong, Li Yi
    2026, 46 (3):  332-339. 
    doi: 10.3969/j.issn.1674-8115.2026.03.007

    Abstract ( 3 )   HTML ( 0 )   PDF (1091KB) ( 11 )  

    Objective ·To explore the factors influencing 90 d poor prognosis in male patients with anterior circulation acute ischemic stroke with large vessel occlusion (AIS-LVO) after mechanical thrombectomy (MT), and to develop a predictive model based on clinical characteristics and inflammatory markers. Methods ·This retrospective study enrolled 126 male patients who received MT for anterior circulation AIS-LVO at two hospitals in Shanghai from March 2022 to June 2024. The 90-day modified Rankin Scale (mRS) score after surgery was used as the outcome measure, based on which patients were divided into a good prognosis group and a poor prognosis group. Baseline data, perioperative clinical indicators, and admission laboratory indicators were collected and compared between the two groups. Univariate Logistic regression model was used to screen variables associated with 90-day poor prognosis, and multivariate Logistic regression model was subsequently performed to identify independent predictors and construct a predictive model. Receiver operator characteristic (ROC) curve was used to evaluate the performance of the predictive model. Results ·According to the 90-day mRS score, male patients with anterior circulation AIS-LVO after MT were divided into a good prognosis group (n=50) and a poor prognosis group (n=76). Analysis of baseline data, perioperative clinical indicators, and admission laboratory indicators between the two groups showed that there were statistically significant differences in admission National Institutes of Health Stroke Scale (NIHSS) score, history of previous stroke or transient ischemic attack (TIA), and neutrophil-lymphocyte ratio multiplied by fibrinogen-to-albumin ratio (NMF) index (P<0.05). Univariate Logistic regression analysis showed that an elevated NMF index was strongly correlated with an increased risk of poor prognosis (OR=6.944, 95% CI 2.636‒22.022, P<0.001). Multivariate Logistic regression analysis further confirmed that the NMF index was an independent predictor of poor prognosis (OR=6.153, 95% CI 1.939‒24.563, P=0.004). Other independent predictors included NIHSS score (P=0.003), history of previous stroke or TIA (P=0.034), large-artery atherosclerosis subtype (P=0.032) and undetermined etiology subtype (P=0.006) in the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, and white blood cell count (P=0.027). ROC curve analysis showed that the model exhibited excellent performance in predicting poor prognosis, with an area under the curve (AUC) of 0.889, a sensitivity of 70%, and a specificity of 96%. Conclusion ·NMF index may serve as a potential biomarker for predicting poor prognosis in male patients with anterior circulation AIS-LVO after MT. When combined with independent predictors such as admission NIHSS score, history of previous stroke or TIA, TOAST classification, and white blood cell count, it has high accuracy in predicting poor prognosis in the specific patient population.

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    Evidence-based medicine
    Causal relationship between liposome and essential hypertension based on two-sample Mendelian randomization analysis
    Huang Xi, Hou Qinwu, Zhang Zhaowei, Wang Yanan, Yang Qinghui, Cheng Ling
    2026, 46 (3):  340-347. 
    doi: 10.3969/j.issn.1674-8115.2026.03.008

    Abstract ( 6 )   HTML ( 0 )   PDF (1370KB) ( 11 )  

    Objective ·A two-sample Mendelian randomization (TSMR) approach was employed to investigate the causal relationship between liposomes and essential hypertension. Methods ·Genome-wide association study (GWAS) data for essential hypertension were obtained from the FinnGen database, while lipid profile data were sourced from the European Bioinformatics Institute (EBI). Data on 179 liposomes were downloaded from the EBI GWAS database, and relevant single-nucleotide polymorphisms (SNPs) were screened as instrumental variables. Inverse-variance weighted (IVW), MR-Egger, weighted median, weighted mode, and simple mode methods, combined with sensitivity analysis, were employed to evaluate the causal associations between the 179 liposomes and essential hypertension. Results ·Eight types of liposomes were identified as being associated with essential hypertension. According to the IVW results, six types of liposomes significantly increased the risk of essential hypertension, including triglyceride (52:3) (OR=1.061, 95%CI 1.022‒1.101, P=0.002), phosphatidylinositol (16:0‒18:1) (OR=1.066, 95%CI 1.025‒1.107, P=0.001), triglyceride (50:2) (OR=1.086, 95%CI 1.036‒1.139, P<0.001), triglyceride (54:3) (OR=1.062, 95%CI 1.027‒1.099, P<0.001), triglyceride (50:1) (OR=1.098, 95%CI 1.045‒1.154, P<0.001), and triglyceride (52:2) (OR=1.071, 95%CI 1.035‒1.110, P<0.001). Two types of liposome reduced the risk of essential hypertension, including sphingomyelin (d40:2) (OR=0.968, 95%CI 0.937‒0.999, P=0.042) and phosphatidylcholine (O-16:1‒18:1) (OR=0.960, 95%CI 0.924‒0.998, P=0.038). The causal directions revealed by the other four methods were consistent with those of the IVW method. Cochran′s Q test revealed slight heterogeneity, but its impact on the robustness of the overall results was limited. MR-Egger regression indicated no evidence of horizontal pleiotropy. Leave-one-out cross-validation demonstrated high robustness of the results. Reverse MR analysis indicated that the onset of essential hypertension did not alter the type of the aforementioned liposomes. Conclusion ·There is a causal relationship between specific liposomes and essential hypertension. Triglycerides (52:3, 50:2, 54:3, 50:1, 52:2) and phosphatidylinositol (16:0‒18:1) are risk factors for essential hypertension, which may promote hypertension development through metabolic disturbances. Moreover, sphingomyelin (D40:2) and phosphatidylcholine (O-16:1‒18:1) may have protective effects against the occurrence of essential hypertension.

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    Review
    Research progress on the molecular mechanisms and targeted interventions of macrophage-mediated myocardial fibrosis
    Qian Yile, Yao Sai, Chen Sifeng, Li Quanfu, Zhao Meng
    2026, 46 (3):  348-357. 
    doi: 10.3969/j.issn.1674-8115.2026.03.009

    Abstract ( 20 )   HTML ( 0 )   PDF (1000KB) ( 27 )  

    Myocardial fibrosis is a critical pathological basis underlying the progression of various cardiovascular diseases. It is characterized by the activation of fibroblasts into myofibroblasts and excessive synthesis of collagen, leading to abnormal accumulation of the extracellular matrix, which ultimately impairs cardiac structure and function. Cardiac macrophages, as key immune cells in the cardiovascular system, exhibit diverse functions that are regulated by their origin and local microenvironment. Distinct macrophage phenotypes play different roles during myocardial injury. Pro-inflammatory macrophages mediate the early inflammatory response, whereas pro-reparative macrophages promote fibroblast activation and collagen deposition via paracrine signaling. Recent advances in high-throughput techniques, such as single-cell and spatial transcriptomics, have provided unprecedented resolution for understanding the heterogeneity, dynamic changes, and intercellular communication networks of cardiac macrophages. Conventional therapies have limited capacity in reversing established fibrosis, but emerging approaches such as nanoparticle-based delivery systems and engineered cell therapies hold promise for the precise reprogramming of cardiac macrophages. This review summarizes the heterogeneity of cardiac macrophages, highlights the molecular mechanisms by which they regulate myocardial fibrosis under pathological conditions, and discusses the therapeutic potential of macrophage-targeted strategies, aiming to provide theoretical guidance for precise modulation of macrophage function and the development of novel anti-fibrotic interventions.

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    Advances in CRISPR/Cas gene editing and its applications in cardiovascular diseases
    Tian Qijia, Jia Kangni, Yan Xiaoxiang
    2026, 46 (3):  358-367. 
    doi: 10.3969/j.issn.1674-8115.2026.03.010

    Abstract ( 17 )   HTML ( 1 )   PDF (2271KB) ( 24 )  

    Gene editing technologies refer to a class of techniques capable of precisely modifying or manipulating the genome or transcriptome of living organisms. Over the past decade, next-generation gene editing tools, represented by CRISPR/Cas9, have rapidly advanced, demonstrating superior efficiency, safety, and broader applicability compared to traditional methods, such as zinc finger nuclease (ZFN) and transcription activator-like effector nuclease (TALEN). These advancements have facilitated the transition of gene editing from basic research to clinical applications. Cardiovascular diseases remain a leading cause of global mortality and health burden, yet current treatments face challenges such as undruggable targets, significant side effects, and limited efficacy. For certain conditions that are difficult to treat with conventional pharmacotherapy, gene editing offers a novel therapeutic approach. Currently, this technology has been successfully applied to drug development for diseases such as transthyretin amyloidosis and hyperlipidemia, with pioneering candidates such as NTLA-2001 and CTX310 having entered clinical trials. Mitigating immune responses and off-target effects, along with overcoming cardiac-targeted delivery barriers, are pivotal for clinical translation. With advancements in artificial intelligence-assisted design and non-viral vectors, CRISPR/Cas technology is expected to overcome current liver-predominant limitations, paving the way for in situ cardiac treatment and offering a curative strategy for cardiovascular diseases. This article systematically reviews the structure and mechanism of CRISPR/Cas systems and summarizes recent advances in their applications to cardiovascular diseases, including gene knockout, epigenetic editing, base editing, prime editing, and RNA editing, aiming to provide important references for subsequent research and clinical translation in this field.

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    Research progress on immune cells regulation of cardiac regeneration after ischemic myocardial injury
    Zhao Minjiong, Chen Lingfang, Hu Miaoqing, Feng Jie, Nie Yu
    2026, 46 (3):  368-376. 
    doi: 10.3969/j.issn.1674-8115.2026.03.011

    Abstract ( 6 )   HTML ( 1 )   PDF (5136KB) ( 14 )  

    Ischemic heart disease, particularly myocardial infarction, can lead to extensive and irreversible loss of cardiomyocytes. Due to the highly restricted proliferative capacity of cardiomyocytes in adult mammals, the damaged myocardial regions are typically replaced by fibrotic scar tissue, leading to ventricular remodelling and heart failure, which poses a serious threat to health. In recent years, promoting endogenous cardiac regeneration has emerged as an attractive strategy to improve outcomes following myocardial injury, and immune regulatory mechanisms play a central role in this process. Upon myocardial injury, the body initiates a complex inflammatory immune cascade. Studies have shown that the timing and magnitude of the inflammatory responses are critical determinants of tissue repair outcomes. In regenerative models, inflammatory responses initiate rapidly and resolve promptly, whereas in adults, inflammation often persists, and immune dysregulation leads to fibrotic scar formation. During this process, various immune cells (such as macrophages, neutrophils, and T cells) exert precise regulation on cardiomyocyte proliferation and tissue repair through direct intercellular contact or paracrine signalling pathways. This is achieved via their highly heterogeneous characteristics, sequential infiltration patterns, and microenvironment-specific distribution. These immune regulatory mechanisms coordinate to form a dynamic and interactive network that promotes cardiac regeneration. This review systematically summarises the response characteristics and regulatory mechanisms of various immune cells during the regenerative repair process following myocardial injury, aiming to provide novel insights and strategies for the clinical treatment of ischemic heart disease.

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    Research advances in nanomaterials in cardiac fibrosis repair: from precision therapy to tissue remodeling
    Xu Rui, Guo Jiacheng, Xie Shiyao, Han Deheng, Yue Xiuqin
    2026, 46 (3):  377-384. 
    doi: 10.3969/j.issn.1674-8115.2026.03.012

    Abstract ( 7 )   HTML ( 0 )   PDF (3105KB) ( 10 )  

    Cardiac fibrosis represents a common and pivotal pathological process in various cardiovascular diseases, significantly impeding cardiac functional recovery and adversely affecting long-term prognosis. Although conventional pharmacological agents, such as renin-angiotensin-aldosterone system inhibitors, exhibit certain anti-fibrotic effects, their insufficient targeting specificity and relatively confined mechanisms of action limit their capacity to achieve precise intervention in the core signaling pathways of cardiac fibrosis. In recent years, nanomaterials have demonstrated considerable potential in the precision treatment and tissue repair of cardiac fibrosis, owing to their unique size effects, tunable surface properties, and favorable biocompatibility. This review summarizes recent advances in nanomaterial-based approaches for cardiac fibrosis repair, with a focus on key strategies including precision delivery, intelligent controlled release, biomimetic functionality, and multifunctional integration. It further elucidates how nanomaterials modulate key signaling pathways at the molecular level and regulate the functions of critical cells, such as fibroblasts, immune cells, and endothelial cells, at the cellular level, thereby facilitating structural reconstruction and functional recovery at the tissue level, and ultimately achieving systematic repair from precision intervention to tissue remodeling. This article also discusses the current status and challenges associated with the clinical translation of nanomaterials in cardiovascular diseases, addressing issues such as biosafety, scalable production, and cross-species translation, and outlines future research directions. This review aims to provide a theoretical foundation and practical guidance for the development of effective and safe nano-therapeutic strategies against cardiac fibrosis.

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    Development and clinical application of natriuretic peptide system-targeted drugs
    Chen Tianyi, Jia Kangni, Yan Xiaoxiang, Zhang Ruiyan
    2026, 46 (3):  385-390. 
    doi: 10.3969/j.issn.1674-8115.2026.03.013

    Abstract ( 7 )   HTML ( 0 )   PDF (898KB) ( 14 )  

    The natriuretic peptide system plays a key endogenous protective role in the pathophysiological process of heart failure. Cardiomyocytes reactively express and secrete natriuretic peptides in response to stimuli such as myocardial stretch. These peptides activate downstream signaling pathways through natriuretic peptide receptors, exerting a series of physiological effects including natriuresis and vasodilation, and are ultimately cleared from the circulation via natriuretic peptide clearance receptors or hydrolases. This cascade pathway provides multiple intervention targets for heart failure treatment, covering the entire process of natriuretic peptide synthesis, receptor activation, signal transduction, and degradation. Among these, some therapeutic strategies have achieved significant clinical progress: recombinant human natriuretic peptide drugs have been recommended as treatment options for acute heart failure in the guidelines or consensus statements of some countries and regions; sacubitril/valsartan, a fixed-dose combination of a neprilysin inhibitor and an angiotensin Ⅱ receptor antagonist, has become the international standard treatment regimen for heart failure with reduced ejection fraction (HFrEF); natriuretic peptide receptor agonists have also entered clinical trials and exhibited promising therapeutic potential. Based on these advances, this review addresses the clinical application and development of drugs targeting the natriuretic peptide system, and systematically summarizes the clinical evidence and research progress of agents acting at different intervention nodes, so as to inform the optimization of therapeutic strategies for heart failure.

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    Overview of new advances in the treatment of myocardial injury with circular RNA
    Zhang Yeting, Zheng Yuxuan, Tao Pengjie, Zhou Wenqin, Lü Dongchao
    2026, 46 (3):  391-399. 
    doi: 10.3969/j.issn.1674-8115.2026.03.014

    Abstract ( 7 )   HTML ( 0 )   PDF (2139KB) ( 15 )  

    Cardiovascular disease is a major global public health issue, yet effective treatment methods are still lacking. Circular RNA, with its unique circular structure that confers remarkable stability, exhibits significant regulatory effects in myocardial infarction, myocardial ischemia reperfusion injury, heart failure, and cardiotoxicity induced by cancer treatment, all of which are associated with myocardial injury. Circular RNA influences the occurrence and development of myocardial injury by regulating key molecular signaling pathways, including cell survival, inflammatory responses, and oxidative stress. In addition, circular RNA, as a biomarker, shows certain application prospects in the early diagnosis and prognosis assessment of cardiovascular diseases. By using RNA technologies, including the circular RNA mimic system and the siRNA system, to regulate the gain and loss of circular RNA gene functions, the mechanisms by which circular RNA protects against myocardial injury can be further clarified. This paper systematically reviews the latest research progress of circular RNA in the field of myocardial injury treatment, focuses on summarizing the application strategies of circular RNA-based therapeutics developed through in vitro transcription and engineered circularization technologies in pre clinical research, explores the potential value of circular RNA as a novel therapeutic target, and provides new ideas and directions for the treatment of cardiovascular diseases.

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    Research progress on the role of internal chemical modifications of messenger RNA in vascular diseases
    Feng Qianqian, Ai Ding
    2026, 46 (3):  400-407. 
    doi: 10.3969/j.issn.1674-8115.2026.03.015

    Abstract ( 7 )   HTML ( 0 )   PDF (966KB) ( 11 )  

    The pathological alterations in vascular diseases encompass multiple facets, such as endothelial dysfunction, inflammatory response activation, phenotypic switching of smooth muscle cells, and extracellular matrix remodeling. In the multi-level regulation of gene expression, post-transcriptional modifications precisely modulate cellular physiological and pathological states by affecting processes such as RNA splicing, degradation, and translation. With advances in detection technologies, a more systematic understanding of the formation processes and biological functions of RNA modifications has been achieved. Among these, several abundant internal chemical modifications of eukaryotic mRNA, including N6-methyladenosine, 5-methylcytosine, and N4-acetylcytidine, are regarded as important epitranscriptomic regulatory mechanisms due to their reversible generation and removal, and recognition mediated by various RNA-binding proteins. Many studies have shown that alterations in the expression and activity of these RNA modifications and their regulatory proteins drive key pathological processes in common vascular diseases, such as atherosclerosis, aortic dissection/aneurysm, and pulmonary hypertension. Targeting specific RNA modification pathways holds promise for reprogramming gene expression networks and ameliorating vascular dysfunction, thereby providing novel strategies for the precise treatment of vascular diseases. This review systematically summarizes current understanding of how mRNA internal modifications regulate gene expression in common vascular diseases, providing a theoretical foundation for developing targeted therapies.

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    Review of impact of maternal perinatal mental health on offspring cardiovascular system
    Xu Yulin, Du Bowen, Wang Jian, Sun Kun
    2026, 46 (3):  408-414. 
    doi: 10.3969/j.issn.1674-8115.2026.03.016

    Abstract ( 9 )   HTML ( 2 )   PDF (3964KB) ( 12 )  

    Perinatal maternal mental health problems, such as depression, anxiety, and stress, are important risk factors affecting the long-term health of offspring. Although some epidemiological evidence and animal studies support an association between maternal mental health and offspring cardiovascular outcomes, the exact causal relationship remains controversial due to the presence of multiple confounding factors, such as genetic predisposition, social environment, and lifestyle, as well as the inherent limitations of causal inference in most observational studies. This article summarizes current advances in epidemiological, clinical, and basic research, and explores the short-long-term effects of maternal depression, anxiety, and other adverse mental health conditions during the perinatal period on the structure and function of the offspring cardiovascular system, as well as their potential biological mechanisms. The article further suggests that future research should further integrate prospective cohort designs with multi-omics approaches, including epigenomics and metabolomics, and combine these with interventional studies to systematically elucidate the underlying biological pathways and causal mechanisms, thereby providing a solid basis for the development of effective prevention and intervention strategies.

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