Epigenetic mechanisms shaping cytoskeleton dynamics in cardiovascular diseases

Cytoskeleton is an important component of cell structure and function. In the cardiovascular system, it is involved in the remodeling process of a variety of cardiovascular diseases, including cardiac fibrosis, valvular disease, atrial fibrillation, thoracic aortic aneurysm and vascular stiffness related changes. Recent studies have shown that there is a significant synergy between cytoskeletal regulation and epigenetic processes. Notably, epigenetic alterations have been identified as one of the core features of ageing, a major risk factor for cardiovascular disease. Together, these factors regulate the fate determination, function maintenance and pathological transformation of cardiovascular cells. This review focuses on how age-related epigenetic changes, such as DNA methylation, histone modifications, and chromatin remodeling, directly affect cytoskeletal dynamics and nuclear mechanics, and ultimately lead to cardiovascular remodeling. This review systematically summarizes the key molecular pathways that drive pathological remodeling of cardiomyocytes during contraction, phenotypic switching of vascular smooth muscle cells, and activation of fibroblasts. In addition, we discuss potential therapeutic targets, biomarkers, and intervention strategies in this rapidly evolving field to address current challenges and identify future directions for research in order to lay the theoretical foundation for precision medicine in cardiovascular disease.