Gold nanoparticles in cardiovascular medicine: current applications and future directions in nano-cardiology

Gold nanoparticles (GNPs) are poised to revolutionize the diagnosis and treatment of cardiovascular diseases (CVDs). This review uniquely synthesizes current research by focusing on three critical, interlinked advancements that address key translational challenges in nano-cardiology: (1) the precise engineering of size-optimized GNPs (20-50 nm) to enhance hemodynamic stability and targeted tissue penetration, overcoming limitations of broader size ranges; (2) the development of dual-modality imaging probes specifically designed to leverage macrophage-targeted photoacoustic signals for precise and early detection of vulnerable atherosclerotic plaques, a significant unmet diagnostic need; and (3) the innovation of stimuli-responsive drug delivery systems that exploit GNPs' tunable surface chemistry to achieve localized and efficient therapeutic effects, thereby minimizing systemic toxicity and improving drug concentrations at diseased sites. We critically examine how these advancements are transforming early CVD detection (e.g., highly sensitive heart attack diagnostics), targeted therapies (e.g., specific drug delivery for heart failure), and regenerative medicine (e.g., enhanced cardiac tissue repair). Finally, we identify current challenges, such as ensuring rigorous biocompatibility and optimizing blood flow interactions, and propose specific, actionable strategies to accelerate the translation of these promising laboratory discoveries into clinical practice, charting a clear path for the next generation of nano-cardiology solutions.