心血管疾病（CVD）是全世界死亡的主要原因，尽管进行了治疗，但心血管功能并不总是能够恢复，并且疾病的进展也无法得到预防。关键见解通常基于组织样本。目前对组织病理学的了解通常依赖于侵入性活检或尸检样本。液体活检可评估循环介质以推断远处组织的组织学和病理学，在癌症研究中取得了迅速进展，并为理解和治疗 CVD 提供了一种有前景的方法。人们普遍认为，急性和慢性心血管疾病期间游离 DNA 的升高与疾病、严重程度相关，并具有预后价值。中性粒细胞胞外陷阱 (NET) 和循环核酸酶在血栓形成中的作用为 CVD 液体活检提供了坚实的理论依据。 cfDNA 源自各种组织类型和细胞来源，包括线粒体和细胞核，可用于追踪细胞和组织类型谱系，以及深入了解细胞的激活状态。本文讨论了 cfDNA 的起源、结构和潜在效用，为理解 CVD 的复杂性提供了一种更深入、侵入性较小的方法。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

Cardiovascular disease (CVD) is the leading cause of death worldwide, and despite treatment efforts, cardiovascular function cannot always be restored, and progression of disease be prevented. Critical insights are oftentimes based on tissue samples. Current knowledge of tissue pathology typically relies on invasive biopsies or postmortem samples. Liquid biopsies, which assess circulating mediators to deduce the histology and pathology of distant tissues, have been advancing rapidly in cancer research and offer a promising approach to be translated to the understanding and treatment of CVD. The widely understood elevations in cell-free DNA during acute and chronic cardiovascular conditions, associate with disease, severity, and offer prognostic value. The role of neutrophil extracellular traps (NETs) and circulating nucleases in thrombosis provide a solid rationale for liquid biopsies in CVD. cfDNA originates from various tissue types and cellular sources, including mitochondria and nuclei, and can be used to trace cell and tissue type lineage, as well as to gain insight into the activation status of cells. This article discusses the origin, structure, and potential utility of cfDNA, offering a deeper and less invasive approach for the understanding of the complexities of CVD.Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.