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Importance of Shared Decision Making for Return to Play After COVID-19
Benjamin H. Hammond, Peter F. Aziz, Dermot Phelan
doi : 10.1161/CIRCULATIONAHA.120.052372
Circulation. 2021 | Volume 143, Issue 18: 1733–1734
Blood Pressure Effects of Canagliflozin and Clinical Outcomes in Type 2 Diabetes and Chronic Kidney Disease
Nan Ye, Meg J. Jardine, Megumi Oshima, Carinna Hockham, Hiddo J.L. Heerspink, Rajiv Agarwal, George Bakris, Aletta E. Schutte, Clare Arnott, Tara I. Chang, Jose L. G?rriz, Christopher P. Cannon, David M. Charytan, Dick de Zeeuw, Adeera Levin, Kenneth W. Mahaffey, Bruce Neal, Carol Pollock, David C. Wheeler, Gian Luca Di Tanna, Hong Cheng, Vlado Perkovic, Brendon L. Neuen
doi : 10.1161/CIRCULATIONAHA.120.048740
Circulation. 2021 | Volume 143, Issue 18: 1735–1749
People with type 2 diabetes and chronic kidney disease experience a high burden of hypertension, but the magnitude and consistency of blood pressure (BP) lowering with canagliflozin in this population are uncertain. Whether the effects of canagliflozin on kidney and cardiovascular outcomes vary by baseline BP or BP-lowering therapy is also unknown.
Are SGLT2 Inhibitors New Hypertension Drugs?
Kazuomi Kario, Keith C. Ferdinand, Wanpen Vongpatanasin
doi : 10.1161/CIRCULATIONAHA.121.053709
Circulation. 2021 | Volume 143, Issue 18: 1750–1753
Primary Outcome Evaluation of a Next-Generation Left Atrial Appendage Closure Device
Saibal Kar, Shephal K. Doshi, Ashish Sadhu, Rodney Horton, Jose Osorio, Christopher Ellis, James Stone Jr, Manish Shah, Srinivas R. Dukkipati, Stuart Adler, Devi G. Nair, Jamie Kim, Oussama Wazni, Mathew J. Price, Federico M. Asch, David R. Holmes Jr, Robert D. Shipley, Nicole T. Gordon, Dominic J. Allocco, Vivek Y. Reddy and On behalf of the PINNACLE FLX Investigators
doi : 10.1161/CIRCULATIONAHA.120.050117
Circulation. 2021 | Volume 143, Issue 18: 1754–1762
Left atrial appendage (LAA) occlusion provides an alternative to oral anticoagulation for thromboembolic risk reduction in patients with nonvalvular atrial fibrillation. Since regulatory approval in 2015, the WATCHMAN device has been the only LAA closure device available for clinical use in the United States. The PINNACLE FLX study (Protection Against Embolism for Nonvalvular AF Patients: Investigational Device Evaluation of the Watchman FLX LAA Closure Technology) evaluated the safety and effectiveness of the next-generation WATCHMAN FLX LAA closure device in patients with nonvalvular atrial fibrillation in whom oral anticoagulation is indicated, but who have an appropriate rationale to seek a nonpharmaceutical alternative.
Replacement Myocardial Fibrosis in Patients With Mitral Valve Prolapse
Anne-Laure Constant Dit Beaufils, Olivier Huttin, Antoine Jobbe-Duval, Thomas Senage, Laura Filippetti, Nicolas Piriou, Caroline Cueff, Clément Venner, Damien Mandry, Jean-Marc Sellal, Solena Le Scouarnec, Romain Capoulade, Marie Marrec, Aurélie Thollet, Marine Beaumont, Gabriella Hossu, Claire Toquet, Jean-Baptiste Gourraud, Jean-Noël Trochu, Karine Warin-Fresse, Pierre-Yves Marie, Jean-Jacques Schott, Jean-Christian Roussel, Jean-Michel Serfaty, Christine Selton-Suty, Thierry Le Tourneau
doi : 10.1161/CIRCULATIONAHA.120.050214
Circulation. 2021 | Volume 143, Issue 18: 1763–1774
Mitral valve prolapse (MVP) is a frequent disease that can be complicated by mitral regurgitation (MR), heart failure, arterial embolism, rhythm disorders, and death. Left ventricular (LV) replacement myocardial fibrosis, a marker of maladaptive remodeling, has been described in patients with MVP, but the implications of this finding remain scarcely explored. We aimed at assessing the prevalence, pathophysiological and prognostic significance of LV replacement myocardial fibrosis through late gadolinium enhancement (LGE) by cardiac magnetic resonance in patients with MVP.
Dietary Geranylgeranyl Pyrophosphate Counteracts the Benefits of Statin Therapy in Experimental Pulmonary Hypertension
Liping Zhu, Fangbo Liu, Qiang Hao, Tian Feng, Zeshuai Chen, Shengquan Luo, Rui Xiao, Mengxiang Sun, Ting Zhang, Xiaohang Fan, Xianqin Zeng, Jianguo He, Ping Yuan, Jinming Liu, Matthieu Ruiz, Jocelyn Dupuis, Qinghua Hu
doi : 10.1161/CIRCULATIONAHA.120.046542
Circulation. 2021 | Volume 143, Issue 18: 1775–1792
The mevalonate pathway generates endogenous cholesterol and intermediates including geranylgeranyl pyrophosphate (GGPP). By reducing GGPP production, statins exert pleiotropic or cholesterol-independent effects. The potential regulation of GGPP homeostasis through dietary intake and the interaction with concomitant statin therapy is unknown.
Statins Do More Than Lower Cholesterol—Depending on What You Eat?
Thomas Eschenhagen, Ulrich Laufs
doi : 10.1161/CIRCULATIONAHA.121.054183
Circulation. 2021 | Volume 143, Issue 18: 1793–1796
Short-Chain Fatty Acids Outpace Ketone Oxidation in the Failing Heart
Andrew N. Carley, Santosh K. Maurya, Matthew Fasano, Yang Wang, Craig H. Selzman, Stavros G. Drakos, E. Douglas Lewandowski
doi : 10.1161/CIRCULATIONAHA.120.052671
Circulation. 2021 | Volume 143, Issue 18: 1797–1808
The failing heart is energy starved with impaired oxidation of long-chain fatty acids (LCFAs) at the level of reduced CPT1 (carnitine palmitoyltransferase 1) activity at the outer mitochondrial membrane. Recent work shows elevated ketone oxidation in failing hearts as an alternate carbon source for oxidative ATP generation. We hypothesized that another short-chain carbon source, short-chain fatty acids (SCFAs) that bypass carnitine palmitoyltransferase 1, could similarly support energy production in failing hearts.
Transcription Factor MAFF (MAF Basic Leucine Zipper Transcription Factor F) Regulates an Atherosclerosis Relevant Network Connecting Inflammation and Cholesterol Metabolism
Moritz von Scheidt, Yuqi Zhao, Thomas Q. de Aguiar Vallim, Nam Che, Michael Wierer, Marcus M. Seldin, Oscar Franzén, Zeyneb Kurt, Shichao Pang, Dario Bongiovanni, Masayuki Yamamoto, Peter A. Edwards, Arno Ruusalepp, Jason C. Kovacic, Matthias Mann, Johan L.M. Bj?rkegren, Aldons J. Lusis, Xia Yang, Heribert Schunkert
doi : 10.1161/CIRCULATIONAHA.120.050186
Circulation. 2021 | Volume 143, Issue 18: 1809–1823
Coronary artery disease (CAD) is a multifactorial condition with both genetic and exogenous causes. The contribution of tissue-specific functional networks to the development of atherosclerosis remains largely unclear. The aim of this study was to identify and characterize central regulators and networks leading to atherosclerosis.
A “Carousel” ECG Confusion
Ruben K.A. Tapia-Orihuela, Oswaldo J. Gutiérrez, Freddy Del-Carpio Munoz
doi : 10.1161/CIRCULATIONAHA.121.054672
Circulation. 2021 | Volume 143, Issue 18: 1824–1827
Impact of the Age-Adjusted D-Dimer Cutoff to Exclude Pulmonary Embolism
Helia Robert-Ebadi, Philippe Robin, Olivier Hugli, Franck Verschuren, Albert Trinh-Duc, Pierre-Marie Roy, Jeannot Schmidt, Thierry Fumeaux, Guy Meyer, Daniel Hayoz, Pierre-Nicolas Carron, Pierre-Yves Salaun, François Sarasin, Olivier Rutschmann, Grégoire Le Gal, Marc Righini
doi : 10.1161/CIRCULATIONAHA.120.052780
Circulation. 2021 | Volume 143, Issue 18: 1828–1830
A Return to Normal Is Not Good Enough
Mitchell S.V. Elkind, Robert A. Harrington, Donald M. Lloyd-Jones
doi : 10.1161/CIRCULATIONAHA.121.054920
Circulation. 2021 | Volume 143, Issue 18: e893–e897
Letter by Ferrero and Chessa Regarding Article, “Long-Term Follow-Up of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator: The DAI-T4F Nationwide Registry”
Paolo Ferrero, Massimo Chessa
doi : 10.1161/CIRCULATIONAHA.120.052619
Circulation. 2021 | Volume 143, Issue 18: e898–e899
Response by Waldmann et al to Letter Regarding Article, “Long-Term Follow-Up of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator: The DAI-T4F Nationwide Registry”
Victor Waldmann, Nicolas Combes, Kumar Narayanan, Eloi Marijon
doi : 10.1161/CIRCULATIONAHA.121.053670
Circulation. 2021 | Volume 143, Issue 18: e900–e901
Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women: A Scientific Statement From the American Heart Association
Nisha I. Parikh, Juan M. Gonzalez, Cheryl A.M. Anderson, Suzanne E. Judd, Kathryn M. Rexrode, Mark A. Hlatky, Erica P. Gunderson, Jennifer J. Stuart, Dhananjay Vaidya and On behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and the Stroke Council
doi : 10.1161/CIR.0000000000000961
Circulation. 2021 | Volume 143, Issue 18: e902–e916
This statement summarizes evidence that adverse pregnancy outcomes (APOs) such as hypertensive disorders of pregnancy, preterm delivery, gestational diabetes, small-for-gestational-age delivery, placental abruption, and pregnancy loss increase a woman’s risk of developing cardiovascular disease (CVD) risk factors and of developing subsequent CVD (including fatal and nonfatal coronary heart disease, stroke, peripheral vascular disease, and heart failure). This statement highlights the importance of recognizing APOs when CVD risk is evaluated in women, although their value in reclassifying risk may not be established. A history of APOs is a prompt for more vigorous primordial prevention of CVD risk factors and primary prevention of CVD. Adopting a heart-healthy diet and increasing physical activity among women with APOs, starting in the postpartum setting and continuing across the life span, are important lifestyle interventions to decrease CVD risk. Lactation and breastfeeding may lower a woman’s later cardiometabolic risk. Black and Asian women experience a higher proportion APOs, with more severe clinical presentation and worse outcomes, than White women. More studies on APOs and CVD in non-White women are needed to better understand and address these health disparities. Future studies of aspirin, statins, and metformin may better inform our recommendations for pharmacotherapy in primary CVD prevention among women who have had an APO. Several opportunities exist for health care systems to improve transitions of care for women with APOs and to implement strategies to reduce their long-term CVD risk. One proposed strategy includes incorporation of the concept of a fourth trimester into clinical recommendations and health care policy.
