The adult heart is a complex, multicellular organ that is subjected to a series of regulatory stimuli and circuits and has poor reparative potential. Despite progress in our understanding of disease mechanisms and in the quality of health care, ischaemic heart disease remains the leading cause of death globally, owing to adverse cardiac remodelling, leading to ischaemic cardiomyopathy and heart failure. Therapeutic targets are urgently required for the protection and repair of the ischaemic heart. Moreover, personalized clinical biomarkers are necessary for clinical diagnosis, medical management and to inform the individual response to treatment. Non-coding RNAs (ncRNAs) deeply influence cardiovascular functions and contribute to communication between cells in the cardiac microenvironment and between the heart and other organs. As such, ncRNAs are candidates for translation into clinical practice. However, ncRNA biology has not yet been completely deciphered, given that classes and modes of action have emerged only in the past 5 years. In this Review, we discuss the latest discoveries from basic research on ncRNAs and highlight both the clinical value and the challenges underscoring the translation of these molecules as biomarkers and therapeutic regulators of the processes contributing to the initiation, progression and potentially the prevention or resolution of ischaemic heart disease and heart failure.

成人心脏是一个复杂的多细胞器官，受到一系列调节刺激和回路的影响，修复潜力较差。尽管我们对疾病机制和医疗保健质量的理解取得了进展，但由于不良的心脏重塑，缺血性心脏病仍然是全球死亡的主要原因，导致缺血性心肌病和心力衰竭。迫切需要保护和修复缺血心脏的治疗靶点。此外，个性化临床生物标志物对于临床诊断、医疗管理和告知个体对治疗的反应是必要的。非编码 RNA (ncRNA) 深刻影响心血管功能，有助于心脏微环境中的细胞之间以及心脏与其他器官之间的通讯。因此，ncRNA 是转化为临床实践的候选者。然而，鉴于 ncRNA 的类别和作用模式是在过去 5 年才出现的，因此 ncRNA 生物学尚未被完全破译。在这篇综述中，我们讨论了 ncRNA 基础研究的最新发现，并强调了这些分子作为生物标志物和治疗调节剂的临床价值和挑战，这些过程有助于癌症的发生、进展以及潜在的预防或解决。缺血性心脏病和心力衰竭。