Abstract
Enhancer RNAs (eRNAs), a class of non-coding RNAs transcribed from enhancer regions, have emerged as critical regulators of gene expression in cardiovascular diseases (CVDs), which are among the leading causes of morbidity and mortality in China. The pathogenesis of CVD is complex, involving precise regulation of diverse biological processes. Recent advances in epigenetics have highlighted the pivotal role of eRNAs in gene regulation. This review summarizes the fundamental characteristics of eRNAs and their mechanisms of action in CVD, focusing on how they regulate gene expression through enhancer-promoter looping, chromatin remodeling, and transcriptional control. Key eRNAs, including IRENES, CARMEN, LINC00607, HERNA1, PSMB8-AS1, and WISPER, are discussed in detail, emphasizing their roles in pathological processes, such as cardiac development, vascular remodeling, atherosclerosis, and fibrosis. These eRNAs interact with transcription factors and others to influence cardiovascular gene regulatory networks. Advances in high-throughput sequencing have identified eRNAs as potential biomarkers and therapeutic targets in CVDs, offering implications for diagnosis, treatment, and precision medicine. For instance, targeting CARMEN may attenuate atherosclerosis, while LEENE could address endothelial dysfunction. Despite their therapeutic potential, further studies are needed to elucidate the mechanisms underlying eRNAs function and their roles in CVD pathogenesis. A deeper understanding of eRNAs may pave the way for novel therapeutic strategies in cardiovascular medicine.