The emerging role of extracellular vesicle RNAs as mediators of cardiometabolic diseases: from pathophysiology to clinical applications

Cardiometabolic diseases (CMDs) are a leading contributor to worldwide morbidity and mortality. Recent insights into the pathogenesis of CMDs reveal crucial roles of intercellular crosstalk between metabolically active organs and cardiac cells. In this context, extracellular vesicles (EVs), lipid membrane-delimited particles containing diverse cargo (including small and long RNAs, proteins, lipids, and metabolites), and nonvesicular extracellular particles (NVEPs) have emerged as key mediators of cell-to-cell communications. EV cargo can reflect the metabolic state of their cells of origin and affect the function of their target cells. Understanding EV cargo content and function is essential for unraveling the pathophysiology of CMDs. This mini-review describes recent studies on EV-mediated local and interorgan crosstalk in CMDs, focusing on those that lead to atrial and ventricular myopathy, which are hallmarks of atrial fibrillation and heart failure, respectively. Lastly, this review discusses the potential applications of EVs in the diagnostics and therapeutics of these CMDs.