The mechanistic target of rapamycin (mTOR) is evolutionarily conserved from yeast to humans and is one of the most fundamental pathways of living organisms. Since its discovery three decades ago, mTOR has been recognized as the center of nutrient sensing and growth, homeostasis, metabolism, life span, and aging. The role of dysregulated mTOR in common diseases, especially cancer, has been extensively studied and reported. Emerging evidence supports that mTOR critically regulates innate immune responses that govern the pathogenesis of various cardiovascular diseases. This review discusses the regulatory role of mTOR in macrophage functions in acute inflammation triggered by ischemia and in atherosclerotic cardiovascular disease (ASCVD) and heart failure with preserved ejection fraction (HFpEF), in which chronic inflammation plays critical roles. Specifically, we discuss the role of mTOR in trained immunity, immune senescence, and clonal hematopoiesis. In addition, this review includes a discussion on the architecture of mTOR, the function of its regulatory complexes, and the dual-arm signals required for mTOR activation to reflect the current knowledge state. We emphasize future research directions necessary to understand better the powerful pathway to take advantage of the mTOR inhibitors for innovative applications in patients with cardiovascular diseases associated with aging and inflammation.

雷帕霉素（mTOR）的机制靶点从酵母到人类在进化上是保守的，是生物体最基本的途径之一。自三十年前被发现以来，mTOR 已被公认为营养感知和生长、体内平衡、新陈代谢、寿命和衰老的中心。mTOR 失调在常见疾病（尤其是癌症）中的作用已得到广泛研究和报道。新的证据表明，mTOR 严格调节先天免疫反应，从而控制各种心血管疾病的发病机制。本综述讨论了 mTOR 在缺血引发的急性炎症、动脉粥样硬化性心血管疾病 (ASCVD) 和射血分数保留的心力衰竭 (HFpEF) 中巨噬细胞功能的调节作用，其中慢性炎症起着关键作用。具体来说，我们讨论了 mTOR 在训练免疫、免疫衰老和克隆造血中的作用。此外，本综述还讨论了 mTOR 的架构、其调节复合物的功能以及 mTOR 激活所需的双臂信号，以反映当前的知识状态。我们强调未来的研究方向，以更好地了解利用 mTOR 抑制剂在与衰老和炎症相关的心血管疾病患者中进行创新应用的强大途径。