Comprehensive landscape and future perspectives of exosomal circular RNAs in cardiovascular disease

Cardiovascular diseases continue to be a predominant cause of global mortality, driven by pathological molecular transport networks. Exosomes, which encapsulate diverse molecular cargo reflective of their cellular origins and associated pathological states, serve as valuable resources for identifying diagnostic and prognostic biomarkers. An increasing number of studies conducted in recent years have shown that exosomal circular RNA (circRNA) is important for a variety of cardiovascular diseases (CVDs), such as coronary heart disease, atherosclerosis, senescence, myocardial infarction, and myocardial damage. Recent research has highlighted the critical functions of circRNAs, which operate through various mechanisms, including the regulation of gene expression by serving as microRNA (miRNA) sponges, operating a dual synergistic mechanism that simultaneously promotes cytokinesis and cell cycle restoration, which enhances myocardial repair, and directly combines RNA-binding proteins and ligases to promote the recognition and degradation of proteins. Exploring the mechanisms underlying CVDs from the perspective of exosomal circRNA is of great significance. It has far-reaching value for the prevention, early diagnosis, and effective treatment of cardiovascular disorders. This review summarizes the latest investigation on the hyperlink between CVDs and exosomal circRNA.