Robert M. Califf
doi : 10.1161/CIRCULATIONAHA.121.053461
Circulation. 2021 | Volume 143, Issue 19: 1831–1834
During the past year, clinicians and the public have been focused on the coronavirus disease 2019 (COVID-19) pandemic and its associated societal and economic effects. However, once the acute phase of this crisis has passed, we will face an enormous wave of death and disability as a result of common chronic diseases (CCDs), with cardiometabolic diseases at the crest (Figure). A tsunami results when an earthquake on the ocean floor creates huge waves that can wreak devastation far distant from the original upheaval, especially when warnings are ignored. Similarly, underlying global and national demographic and risk factor profiles have for some time presaged an overwhelming burden of CCDs. However, although the pandemic has created additional impetus that unless heeded will amplify the consequences of this burden, the rapid adaptations and innovations in care and research prompted by the urgent response to it may also offer us the means to stem this flood.
Nanette Kass Wenger, Sandra Jean Lewis
doi : 10.1161/CIRCULATIONAHA.121.053860
Circulation. 2021 | Volume 143, Issue 19: 1835–1837
Mohita Singh, Jose Joglar
doi : 10.1161/CIRCULATIONAHA.120.051527
Circulation. 2021 | Volume 143, Issue 19: 1838–1840
Martin Abild Stengaard Meyer, Sebastian Wiberg, Johannes Grand, Anna Sina Pettersson Meyer, Laust Emil Roelsgaard Obling, Martin Frydland, Jakob Hartvig Thomsen, Jakob Josiassen, Jacob Eifer M?ller, Jesper Kjaergaard, Christian Hassager
doi : 10.1161/CIRCULATIONAHA.120.053318
Circulation. 2021 | Volume 143, Issue 19: 1841–1851
Patients experiencing out-of-hospital cardiac arrest who remain comatose after initial resuscitation are at high risk of morbidity and mortality attributable to the ensuing post–cardiac arrest syndrome. Systemic inflammation constitutes a major component of post–cardiac arrest syndrome, and IL-6 (interleukin-6) levels are associated with post–cardiac arrest syndrome severity. The IL-6 receptor antagonist tocilizumab could potentially dampen inflammation in post–cardiac arrest syndrome. The objective of the present trial was to determine the efficacy of tocilizumab to reduce systemic inflammation after out-of-hospital cardiac arrest of a presumed cardiac cause and thereby potentially mitigate organ injury.
Rahul Goli, Jian Li, Jeff Brandimarto, Lisa D. Levine, Valerie Riis, Quentin McAfee, Steven DePalma, Alireza Haghighi, J. G. Seidman, Christine E. Seidman, Daniel Jacoby, George Macones, Daniel P. Judge, Sarosh Rana, Kenneth B. Margulies, Thomas P. Cappola, Rami Alharethi, Julie Damp, Eileen Hsich, Uri Elkayam, Richard Sheppard, Jeffrey D. Alexis, John Boehmer, Chizuko Kamiya, Finn Gustafsson, Peter Damm, Anne S. Ersb?ll, Sorel Goland, Denise Hilfiker-Kleiner, Dennis M. McNamara and The IMAC-2 and IPAC Investigators, Zolt Arany
doi : 10.1161/CIRCULATIONAHA.120.052395
Circulation. 2021 | Volume 143, Issue 19: 1852–1862
Peripartum cardiomyopathy (PPCM) occurs in ?1:2000 deliveries in the United States and worldwide. The genetic underpinnings of PPCM remain poorly defined. Approximately 10% of women with PPCM harbor truncating variants in TTN (TTNtvs). Whether mutations in other genes can predispose to PPCM is not known. It is also not known if the presence of TTNtvs predicts clinical presentation or outcomes. Nor is it known if the prevalence of TTNtvs differs in women with PPCM and preeclampsia, the strongest risk factor for PPCM.
Alexander P. Benz, Ziad Hijazi, Johan Lindb?ck, Stuart J. Connolly, John W. Eikelboom, Jonas Oldgren, Agneta Siegbahn, Lars Wallentin
doi : 10.1161/CIRCULATIONAHA.120.053100
Circulation. 2021 | Volume 143, Issue 19: 1863–1873
The novel ABC (Age, Biomarkers, Clinical History) scores outperform traditional risk scores for stroke, major bleeding, and death in patients with atrial fibrillation (AF) receiving oral anticoagulation. To refine their utility, the ABC-AF scores needed to be validated in patients not receiving oral anticoagulation.
Joshua G. Travers, Sara A. Wennersten, Brisa Pe?a, Rushita A. Bagchi, Harrison E. Smith, Rachel A. Hirsch, Lauren A. Vanderlinden, Ying-Hsi Lin, Evgenia Dobrinskikh, Kimberly M. Demos-Davies, Maria A. Cavasin, Luisa Mestroni, Christian Steinkühler, Charles Y. Lin, Steven R. Houser, Kathleen C. Woulfe, Maggie P.Y. Lam, Timothy A. McKinsey
doi : 10.1161/CIRCULATIONAHA.120.046462
Circulation. 2021 | Volume 143, Issue 19: 1874–1890
Diastolic dysfunction (DD) is associated with the development of heart failure and contributes to the pathogenesis of other cardiac maladies, including atrial fibrillation. Inhibition of histone deacetylases (HDACs) has been shown to prevent DD by enhancing myofibril relaxation. We addressed the therapeutic potential of HDAC inhibition in a model of established DD with preserved ejection fraction.
Thomas G. Gillette
doi : 10.1161/CIRCULATIONAHA.121.054262
Circulation. 2021 | Volume 143, Issue 19: 1891–1893
Xujie Liu, Suya Wang, Xiaoling Guo, Yifei Li, Roza Ogurlu, Fujian Lu, Maksymilian Prondzynski, Sofia de la Serna Buzon, Qing Ma, Donghui Zhang, Gang Wang, Justin Cotton, Yuxuan Guo, Ling Xiao, David J. Milan, Yang Xu, Michael Schlame, Vassilios J. Bezzerides, William T. Pu
doi : 10.1161/CIRCULATIONAHA.120.048698
Circulation. 2021 | Volume 143, Issue 19: 1894–1911
Mutations in tafazzin (TAZ), a gene required for biogenesis of cardiolipin, the signature phospholipid of the inner mitochondrial membrane, causes Barth syndrome (BTHS). Cardiomyopathy and risk of sudden cardiac death are prominent features of BTHS, but the mechanisms by which impaired cardiolipin biogenesis causes cardiac muscle weakness and arrhythmia are poorly understood.
Somy Yoon, Mira Kim, Hangyeol Lee, Gaeun Kang, Kenneth Bedi, Kenneth B. Margulies, Rajan Jain, Kwang-Il Nam, Hyun Kook, Gwang Hyeon Eom
doi : 10.1161/CIRCULATIONAHA.119.043578
Circulation. 2021 | Volume 143, Issue 19: 1912–1925
Although the clinical importance of heart failure with preserved ejection fraction has been extensively explored, most therapeutic regimens, including nitric oxide (NO) donors, lack therapeutic benefit. Although the clinical characteristics of heart failure with preserved ejection fraction are somewhat heterogeneous, diastolic dysfunction (DD) is one of the most important features. Here we report that neuronal NO synthase (nNOS) induces DD by S-nitrosylation of HDAC2 (histone deacetylase 2).
Benjamin S. Hendrickson, Ryan E. Stephens, James V. Chang, Jacob M. Amburn, Lindsey L. Pierotti, Jessica L. Johnson, John C. Hyden, Jason N. Johnson, Ranjit R. Philip
doi : 10.1161/CIRCULATIONAHA.121.053982
Circulation. 2021 | Volume 143, Issue 19: 1926–1928
Lei Ji, Yuehong Zheng
doi : 10.1161/CIRCULATIONAHA.120.051731
Circulation. 2021 | Volume 143, Issue 19: e917–e918
Zhenguo Wu, Wencheng Zhang, Jianmin Yang
doi : 10.1161/CIRCULATIONAHA.120.053212
Circulation. 2021 | Volume 143, Issue 19: e919–e920
Sejin Jeon, Goo Taeg Oh
doi : 10.1161/CIRCULATIONAHA.121.053671
Circulation. 2021 | Volume 143, Issue 19: e921–e922
Curtis Benesch, Laurent G. Glance, Colin P. Derdeyn, Lee A. Fleisher, Robert G. Holloway, Steven R. Messé, Christina Mijalski, M. Timothy Nelson, Martha Power, Babu G. Welch and On behalf of the American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Epidemiology and Prevention
doi : 10.1161/CIR.0000000000000968
Circulation. 2021 | Volume 143, Issue 19: e923–e946
Perioperative stroke is a potentially devastating complication in patients undergoing noncardiac, nonneurological surgery. This scientific statement summarizes established risk factors for perioperative stroke, preoperative and intraoperative strategies to mitigate the risk of stroke, suggestions for postoperative assessments, and treatment approaches for minimizing permanent neurological dysfunction in patients who experience a perioperative stroke. The first section focuses on preoperative optimization, including the role of preoperative carotid revascularization in patients with high-grade carotid stenosis and delaying surgery in patients with recent strokes. The second section reviews intraoperative strategies to reduce the risk of stroke, focusing on blood pressure control, perioperative goal-directed therapy, blood transfusion, and anesthetic technique. Finally, this statement presents strategies for the evaluation and treatment of patients with suspected postoperative strokes and, in particular, highlights the value of rapid recognition of strokes and the early use of intravenous thrombolysis and mechanical embolectomy in appropriate patients.
Keith Churchwell, Elliott Antman, Jill Birnbaum, Nihar R. Desai, Robert A. Harrington, Emily J. Holubowich, Kendra N. Ivy, Mark Schoeberl, John J. Warner, Courtney J. White, Laurie P. Whitsel, Clyde Yancy and On behalf of the American Heart Association Advocacy Coordinating Committee
doi : 10.1161/CIR.0000000000000972
Circulation. 2021 | Volume 143, Issue 19: e947–e958
In 2021, the American Heart Association celebrates its 40th anniversary in advocacy. This policy statement details the arc of the organization’s nonpartisan, evidence-based, equity-focused approach to advocating for public policy change, highlighting key milestones and describing the core components of the association’s capacity and activity at all levels of government. This policy statement presents a vision and strategic imperative for future American Heart Association advocacy efforts to inform and influence policy changes that advance equitable, impactful societal solutions that transform and improve cardiovascular health for everyone. The American Heart Association maintains accountability by measuring and evaluating the totality of this work and its impact on equitable health outcomes. The American Heart Association will apply these lessons to constantly refine its own strategic policy focus and advocacy efforts. The association will also serve as a resource and catalyst to other organizations working to engage and educate policy makers, partners, the media, and funders about the important role and contribution of public policy change to achieve shared goals.
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