Evidence map›Paper›PMID 42432348›Full record

ReviewCardiovascular drugs and therapy2026

DNA/RNA Methylation-Driven Coronary Microvascular Dysfunction: Emerging Pathogenic Mechanisms and Therapeutic Opportunities for Heart Failure in Diabetes.

Ariana Bacelar-Jimenez, Ammar S Alamareen, Vinuthna Vani Madishetti, Mohammad S Samarah, Chris J Watson, David J Grieve, Karla M O'Neill

Abstract readReview
PubMed Publisher
In one paragraph

Review in Cardiovascular drugs and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ariana Bacelar-JimenezWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.
Ammar S AlamareenWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.
Vinuthna Vani MadishettiWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.
Mohammad S SamarahWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.
Chris J WatsonWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.
David J GrieveWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.
Karla M O'NeillWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK. Karla.ONeill@qub.ac.uk.

Funding

British Heart Foundation FS/PhD/24/29562
6 · The paper itself

Abstract

Coronary microvascular dysfunction (CMD) is an established pathological driver of heart failure, with endothelial cell (EC) dysfunction representing a central determinant of its development and progression. EC impairment disrupts normal coronary microvascular tone and perfusion, and promotes myocardial inflammation, fibrosis, and cardiomyocyte stress, as characteristic features of the diabetic heart. CMD is often clinically silent and undiagnosed, whilst conventional therapies targeting cardiometabolic risk factors are largely ineffective towards restoring microvascular integrity. Emerging evidence implicates epigenetic dysregulation, including DNA and RNA methylation, as a critical mechanism underlying maladaptive EC signalling. These key modifications encode microvascular memory, sustaining endothelial dysfunction even after risk factors are optimally controlled; DNA methylation stabilises pathogenic transcription whilst RNA methylation regulates transcript stability and translation to support continued disruption of EC homeostasis. Indeed, preclinical studies demonstrate that pharmacological DNA methylation inhibitors and RNA methylation modulators can restore healthy EC function, reflected by reduced inflammation and preserved microvascular integrity, positioning such epigenetic pathways as central determinants of CMD with clear mechanistic relevance and therapeutic potential. Selective methylation targeting therefore offers exciting translational promise to reprogram dysfunctional ECs in diabetic patients, reversing CMD and preventing development and progression of associated heart failure. This timely review summarises current knowledge of EC epigenetic regulation, focusing on methylation modifications, and explores how emerging mechanistic insights may be leveraged to advance therapeutic targeting of CMD in the diabetic heart as foundation for development of innovative clinical management strategies.

Indexed as

Coronary microvascular dysfunctionDiabetesDNA methylationEpigenetic drugsHeart failureRNA methylation

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.