T Cell Receptor Repertoires Across the Continuum of Vascular, Myocardial, and Age-Related Diseases.

Cardiovascular diseases (CVD) are shaped by a complex interplay with immune mechanisms. In particular, the distinct roles of antigen-specific T cell mechanisms are emerging as critical determinants across a broad spectrum of conditions, ranging from atherosclerosis, myocardial infarction (MI), heart failure (HF), and myocarditis. Because these T cell responses are fundamentally driven by antigen recognition of cardiovascular antigens, understanding T cell clonal dynamics via accessing T cell receptor (TCR) repertoires might provide valuable mechanistic insights for developing targeted diagnostic and therapeutic immunomodulatory approaches in cardiology. In this review, we discuss T cell-dependent mechanisms and TCR clonal dynamics across various CVD. Moreover, by curating public bulk and single-cell TCR datasets across different etiologies, we present a first-in-class adaptive immune receptor database in cardiovascular diseases (CVD-TCR database). The discussions and resources herein presented seek to promote an integrated understanding of tissue-specific immune mechanisms across different CVD, facilitate the identification of shared clonotypes and motifs, and provide a framework for computational modeling of TCR repertoires across the CVD spectrum.