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Chest Pain Redux: Updated and Patient Centered
Karen P. Alexander and Pamela S. Douglas
doi : 10.1161/CIRCULATIONAHA.121.056714
Circulation. 2021;144:1735–1737
Predictors of Atrial Fibrillation Development in Patients With Embolic Stroke of Undetermined Source: An Analysis of the RE-SPECT ESUS Trial
Maria Cecilia Bahit, Ralph L. Sacco, J. Donald Easton, Juliane Meyerhoff, Lisa Cronin, Eva Kleine, Claudia Grauer, Martina Brueckmann, Hans-Christoph Diener, Renato D. Lopes, Michael Brainin, Phillippe Lyrer, Rolf Wachter, Tomas Segura, Christopher B. Granger, and on behalf of the RE-SPECT ESUS Steering Committee and Investigators
doi : 10.1161/CIRCULATIONAHA.121.055176
Circulation. 2021;144:1738–1746
A proportion of patients with embolic stroke of undetermined source have silent atrial fibrillation (AF) or develop AF after the initial evaluation. Better understanding of the risk for development of AF is critical to implement optimal monitoring strategies with the goal of preventing recurrent stroke attributable to underlying AF. The RE-SPECT ESUS trial (Randomized, Double-Blind Evaluation in Secondary Stroke Prevention Comparing the Efficacy and Safety of the Oral Thrombin Inhibitor Dabigatran Etexilate Versus Acetylsalicylic Acid in Patients With Embolic Stroke of Undetermined Source) provides an opportunity to assess predictors for developing AF and associated recurrent stroke.
Embolic Stroke of Undetermined Source: Can We Identify Subgroups With High Risk for Atrial Fibrillation Who May Benefit From Oral Anticoagulation?
Graeme J. Hankey
doi : 10.1161/CIRCULATIONAHA.121.057615
Circulation. 2021;144:1747–1749
Benefits of Icosapent Ethyl Across the Range of Kidney Function in Patients With Established Cardiovascular Disease or Diabetes: REDUCE-IT RENAL
Arjun Majithia, Deepak L. Bhatt, Allon N. Friedman, Michael Miller, Ph. Gabriel Steg, Eliot A. Brinton, Terry A. Jacobson, Steven B. Ketchum, Rebecca A. Juliano, Lixia Jiao, Ralph T. Doyle Jr, Craig Granowitz, Matthew Budoff, R. Preston Mason, Jean-Claude Tardif, William E. Boden, Christie M. Ballantyne, on behalf of the REDUCE-IT Investigators
doi : 10.1161/CIRCULATIONAHA.121.055560
Circulation. 2021;144:1750–1759
Chronic kidney disease is associated with adverse outcomes among patients with established cardiovascular disease (CVD) or diabetes. Commonly used medications to treat CVD are less effective among patients with reduced kidney function.
Therapeutic Exon Skipping Through a CRISPR-Guided Cytidine Deaminase Rescues Dystrophic Cardiomyopathy in Vivo
Jia Li, Kaiying Wang, Yuchen Zhang, Tuan Qi, Juanjuan Yuan, Lei Zhang, Han Qiu, Jinxi Wang, Huang-Tian Yang, Yi Dai, Yan Song, and Xing Chang
doi : 10.1161/CIRCULATIONAHA.121.054628
Circulation. 2021;144:1760–1776
Loss of dystrophin protein causes Duchenne muscular dystrophy (DMD), characterized by progressive degeneration of cardiac and skeletal muscles, and mortality in adolescence or young adulthood. Although cardiac failure has risen as the leading cause of mortality in patients with DMD, effective therapeutic interventions remain underdeveloped, in part, because of the lack of a suitable preclinical model.
Cardiovascular Progerin Suppression and Lamin A Restoration Rescue Hutchinson-Gilford Progeria Syndrome
Amanda Sánchez-López, Carla Espinós-Estévez, Cristina González-Gómez, Pilar Gonzalo, María J. Andrés-Manzano, Víctor Fanjul, Raquel Riquelme-Borja, Magda R. Hamczyk, Álvaro Macías, Lara del Campo, Emilio Camafeita, Jesús Vázquez, Anna Barkaway, Loïc Rolas, Sussan Nourshargh, Beatriz Dorado, Ignacio Benedicto, and Vicente Andrés
doi : 10.1161/CIRCULATIONAHA.121.055313
Circulation. 2021;144:1777–1794
Hutchinson-Gilford progeria syndrome (HGPS) is a rare disorder characterized by premature aging and death mainly because of myocardial infarction, stroke, or heart failure. The disease is provoked by progerin, a variant of lamin A expressed in most differentiated cells. Patients look healthy at birth, and symptoms typically emerge in the first or second year of life. Assessing the reversibility of progerin-induced damage and the relative contribution of specific cell types is critical to determining the potential benefits of late treatment and to developing new therapies.
NAD+ Metabolism in Cardiac Health, Aging, and Disease
Mahmoud Abdellatif, Simon Sedej, and Guido Kroemer
doi : 10.1161/CIRCULATIONAHA.121.056589
Circulation. 2021;144:1795–1817
Nicotinamide adenine dinucleotide (NAD+) is a central metabolite involved in energy and redox homeostasis as well as in DNA repair and protein deacetylation reactions. Pharmacological or genetic inhibition of NAD+-degrading enzymes, external supplementation of NAD+ precursors, and transgenic overexpression of NAD+-generating enzymes have wide positive effects on metabolic health and age-associated diseases. NAD+ pools tend to decline with normal aging, obesity, and hypertension, which are all major risk factors for cardiovascular disease, and NAD+ replenishment extends healthspan, avoids metabolic syndrome, and reduces blood pressure in preclinical models. In addition, experimental elevation of NAD+ improves atherosclerosis, ischemic, diabetic, arrhythmogenic, hypertrophic, or dilated cardiomyopathies, as well as different modalities of heart failure. Here, we critically discuss cardiomyocyte-specific circuitries of NAD+ metabolism, comparatively evaluate distinct NAD+ precursors for their preclinical efficacy, and raise outstanding questions on the optimal design of clinical trials in which NAD+ replenishment or supraphysiological NAD+ elevations are assessed for the prevention or treatment of major cardiac diseases. We surmise that patients with hitherto intractable cardiac diseases such as heart failure with preserved ejection fraction may profit from the administration of NAD+ precursors. The development of such NAD+-centered treatments will rely on technological and conceptual progress on the fine regulation of NAD+ metabolism.
Highlights From the Circulation Family of Journals
doi : 10.1161/CIRCULATIONAHA.121.058142
Circulation. 2021;144:1818–1823
Wide and Narrow QRS Complex Tachycardia With Cycle Length Alternans: What Is the Mechanism?
Bryan Richard Sasmita, Suxin Luo, and Bi Huang
doi : 10.1161/CIRCULATIONAHA.121.057578
Circulation. 2021;144:1824–1826
Sudden Death in Female Athletes: Insights From a Large Regional Registry in the United Kingdom
Gherardo Finocchiaro, Joe Westaby, Raghav Bhatia, Aneil Malhotra, Elijah R. Behr, Michael Papadakis, Sanjay Sharma, and Mary N. Sheppard
doi : 10.1161/CIRCULATIONAHA.121.055535
Circulation. 2021;144:1827–1829
Letter by Spiering et al Regarding Article, “Effect of Denosumab or Alendronic Acid on the Progression of Aortic Stenosis: A Double-Blind Randomized Controlled Trial”
Wilko Spiering, Willem P. Mali, and Pim A. de Jong
doi : 10.1161/CIRCULATIONAHA.121.055622
Circulation. 2021;144:e334
Response by Bing et al to Letter Regarding Article, “Effect of Denosumab or Alendronic Acid on the Progression of Aortic Stenosis: A Double-Blind Randomized Controlled Trial”
Rong Bing, David E. Newby, Stuart H. Ralston, and Marc R. Dweck
doi : 10.1161/CIRCULATIONAHA.121.057127
Circulation. 2021;144:e335
2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
Martha Gulati, Phillip D. Levy, Debabrata Mukherjee, Ezra Amsterdam, Deepak L. Bhatt, Kim K. Birtcher, Ron Blankstein, Jack Boyd, Renee P. Bullock-Palmer, Theresa Conejo, Deborah B. Diercks, Federico Gentile, John P. Greenwood, Erik P. Hess, Steven M. Hollenberg, Wael A. Jaber, Hani Jneid, José A. Joglar, David A. Morrow, Robert E. O’Connor, Michael A. Ross, and Leslee J. Shaw
doi : 10.1161/CIR.0000000000001030
Circulation. 2021;144:e368–e454
This executive summary of the clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients.
2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
Martha Gulati, Phillip D. Levy, Debabrata Mukherjee, Ezra Amsterdam, Deepak L. Bhatt, Kim K. Birtcher, Ron Blankstein, Jack Boyd, Renee P. Bullock-Palmer, Theresa Conejo, Deborah B. Diercks, Federico Gentile, John P. Greenwood, Erik P. Hess, Steven M. Hollenberg, Wael A. Jaber, Hani Jneid, José A. Joglar, David A. Morrow, Robert E. O’Connor, Michael A. Ross, and Leslee J. Shaw
doi : 10.1161/CIR.0000000000001029
Circulation. 2021;144:e368–e454
This clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients.
Correction to: 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
doi : 10.1161/CIR.0000000000001047
Circulation. 2021;144:e455
Correction to: Chest Pain Redux: Updated and Patient Centered
doi : 10.1161/CIR.0000000000001048
Circulation. 2021;144:e456
