Liver Cirrhosis and Hepatocellular Carcinoma After the Fontan Operation: Reaching Clarity in the Face of Uncertainty

Christopher Z. Lam, Aliya Gulamhusein, and Rachel M. Wald

doi : 10.1161/CIRCULATIONAHA.121.057431

Circulation. 2021;144:1977–1980

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Effect of Long-Term Marine ?-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Baris Gencer, Luc Djousse, Omar T. Al-Ramady, Nancy R. Cook, JoAnn E. Manson, and Christine M. Albert

doi : 10.1161/CIRCULATIONAHA.121.055654

Circulation. 2021;144:1981–1990

Some, but not all, large-scale randomized controlled trials (RCTs) investigating the effects of marine ?-3 fatty acids supplementation on cardiovascular outcomes have reported increased risks of atrial fibrillation (AF). The potential reasons for disparate findings may be dose-related.

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Fish Oil Supplements May Increase the Risk for Atrial Fibrillation: What Does This Mean?

Michelle Samuel and Stanley Nattel

doi : 10.1161/CIRCULATIONAHA.121.057464

Circulation. 2021;144:1991–1994

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Anterior–Lateral Versus Anterior–Posterior Electrode Position for Cardioverting Atrial Fibrillation

Anders Sjørslev Schmidt, Kasper Glerup Lauridsen, Dorthe Svenstrup Møller, Per Dahl Christensen, Karen Kaae Dodt, Hans Rickers, Bo Løfgren, and Andi Eie Albertsen

doi : 10.1161/CIRCULATIONAHA.121.056301

Circulation. 2021;144:1995–2003

Smaller randomized studies have reported conflicting results regarding the optimal electrode position for cardioverting atrial fibrillation. However, anterior–posterior electrode positioning is widely used as a standard and believed to be superior to anterior–lateral electrode positioning. Therefore, we aimed to compare anterior–lateral and anterior–posterior electrode positioning for cardioverting atrial fibrillation in a multicenter randomized trial.

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Seamless Genetic Recording of Transiently Activated Mesenchymal Gene Expression in Endothelial Cells During Cardiac Fibrosis

Shaohua Zhang, Yan Li, Xiuzhen Huang, Kuo Liu, Qing-Dong Wang, Alex F. Chen, Kun Sun, Kathy O. Lui, and Bin Zhou

doi : 10.1161/CIRCULATIONAHA.121.055417

Circulation. 2021;144:2004–2020

Cardiac fibrosis is a lethal outcome of excessive formation of myofibroblasts that are scar-forming cells accumulated after heart injury. It has been reported that cardiac endothelial cells (ECs) contribute to a substantial portion of myofibroblasts through endothelial to mesenchymal transition (EndoMT). Recent lineage tracing studies demonstrate that myofibroblasts are derived from the expansion of resident fibroblasts rather than from the transdifferentiation of ECs. However, it remains unknown whether ECs can transdifferentiate into myofibroblasts reversibly or EndoMT genes were just transiently activated in ECs during cardiac fibrosis.

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Extracellular Matrix in Heart Failure: Role of ADAMTS5 in Proteoglycan Remodeling

Javier Barallobre-Barreiro, Tamás Radovits, Marika Fava, Ursula Mayr, Wen-Yu Lin, Elizaveta Ermolaeva, Diego Martínez-López, Eric L. Lindberg, Elisa Duregotti, László Daróczi, Maria Hasman, Lukas E. Schmidt, Bhawana Singh, Ruifang Lu, Ferheen Baig, Aleksandra Malgorzata Siedlar, Friederike Cuello, Norman Catibog, Konstantinos Theofilatos, Ajay M. Shah, Maria G. Crespo-Leiro, Nieves Doménech, Norbert Hübner, Béla Merkely, and Manuel Mayr

doi : 10.1161/CIRCULATIONAHA.121.055732

Circulation. 2021;144:2021–2034

Remodeling of the extracellular matrix (ECM) is a hallmark of heart failure (HF). Our previous analysis of the secretome of murine cardiac fibroblasts returned ADAMTS5 (a disintegrin and metalloproteinase with thrombospondin motifs 5) as one of the most abundant proteases. ADAMTS5 cleaves chondroitin sulfate proteoglycans such as versican. The contribution of ADAMTS5 and its substrate versican to HF is unknown.

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Centering Equity in Cardiovascular Care

Bridget M. Kuehn

doi : 10.1161/CIRCULATIONAHA.121.058471

Circulation. 2021;144:2035–2037

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From the Literature

Tracy Hampton

doi : 10.1161/CIRCULATIONAHA.121.058474

Circulation. 2021;144:2038–2039

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Wide Complex Tachycardia and Syncope in the Emergency Department

Andrés F. Miranda-Arboleda, Shireen Mohammad, and Adrian Baranchuk

doi : 10.1161/CIRCULATIONAHA.121.058181

Circulation. 2021;144:2040–2042

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Incidence and Expected Probability of Liver Cirrhosis and Hepatocellular Carcinoma After Fontan Operation

Masaki Nii, Ryo Inuzuka, Kei Inai, Eriko Shimada, Tokuko Shinohara, Tomomi Kogiso, Hiroshi Ono, Shinichi Ootsuki, Yoshihiko Kurita, Atsuhito Takeda, Keiichi Hirono, Kota Takei, Satoshi Yasukochi, Tadahiro Yoshikawa, Yoshiyuki Furutani, Tomohiro Shinozaki, Yutaka Matsuyama, Hideaki Senzaki, Katsutoshi Tokushige, and Toshio Nakanishi

doi : 10.1161/CIRCULATIONAHA.121.056870

Circulation. 2021;144:2043–2045

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Future Perspectives of Cardiovascular Biomarker Utilization in Cancer Survivors: A Scientific Statement From the American Heart Association

Vlad G. Zaha, Salim S. Hayek, Kevin M. Alexander, Theresa M. Beckie, W. Gregory Hundley, Lavanya Kondapalli, Bonnie Ky, Kasey J. Leger, Wouter C. Meijers, Javid J. Moslehi, Svati H. Shah, on behalf of the American Heart Association Cardio-Oncology Subcommittee of the Council on Clinical Cardiology; and Council on Genomic and Precision Medicine

doi : 10.1161/CIR.0000000000001032

Circulation. 2021;144:e551–e563

Improving cancer survival represents the most significant effect of precision medicine and personalized molecular and immunologic therapeutics. Cardiovascular health becomes henceforth a key determinant for the direction of overall outcomes after cancer. Comprehensive tissue diagnostic studies undoubtedly have been and continue to be at the core of the fight against cancer. Will a systemic approach integrating circulating blood-derived biomarkers, multimodality imaging technologies, strategic panomics, and real-time streams of digitized physiological data overcome the elusive cardiovascular tissue diagnosis in cardio-oncology? How can such a systemic approach be personalized for application in day-to-day clinical work, with diverse patient populations, cancer diagnoses, and therapies? To address such questions, this scientific statement approaches a broad definition of the biomarker concept. It summarizes the current literature on the utilization of a multitude of established cardiovascular biomarkers at the intersection with cancer. It identifies limitations and gaps of knowledge in the application of biomarkers to stratify the cardiovascular risk before cancer treatment, monitor cardiovascular health during cancer therapy, and detect latent cardiovascular damage in cancer survivors. Last, it highlights areas in biomarker discovery, validation, and clinical application for concerted efforts from funding agencies, scientists, and clinicians at the cardio-oncology nexus.

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Late-Breaking Science Abstracts and Featured Science Abstracts From the American Heart Association's Scientific Sessions 2021 and Late-Breaking Abstracts in Resuscitation Science From the Resuscitation Science Symposium 2021

doi : 10.1161/CIR.0000000000001041

Circulation. 2021;144:e564–e593

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