Omega-3 for Cardiovascular Diseases

Angela Pirillo, Alberico L. Catapano

doi : 10.1161/CIRCULATIONAHA.121.053144

Circulation. 2021;144:183–185

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Composite Metric for Benchmarking Site Performance in Transcatheter Aortic Valve Replacement

Nimesh D. Desai, Sean M. O’Brien, David J. Cohen, John Carroll, Sreekanth Vemulapalli, Suzanne V. Arnold, John K. Forrest, Vinod H. Thourani, Ajay J. Kirtane, Brian O’Neil, Pratik Manandhar, David M. Shahian, Vinay Badhwar, Joseph E. Bavaria

doi : 10.1161/CIRCULATIONAHA.120.051456

Circulation. 2021;144:186–194

Transcatheter aortic valve replacement (TAVR) is a transformative therapy for aortic stenosis. Despite rapid improvements in technology and techniques, serious complications remain relatively common and are not well described by single outcome measures. The purpose of this study was to determine whether there is site-level variation in TAVR outcomes in the United States using a novel 30-day composite measure.

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Sequential Evolution of Quality Assessment for Aortic Valvular Heart Interventions

Dharam J. Kumbhani, Eric D. Peterson

doi : 10.1161/CIRCULATIONAHA.121.054897

Circulation. 2021;144:195–198

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Effect of Neprilysin Inhibition on Left Ventricular Remodeling in Patients With Asymptomatic Left Ventricular Systolic Dysfunction Late After Myocardial Infarction

Kieran F. Docherty, Ross T. Campbell, Katriona J.M. Brooksbank, John G. Dreisbach, Paul Forsyth, Rosemary L. Godeseth, Tracey Hopkins, Alice M. Jackson, Matthew M.Y. Lee, Alex McConnachie, Giles Roditi, Iain B. Squire, Bethany Stanley, Paul Welsh, Pardeep S. Jhund, Mark C. Petrie, John J.V. McMurray

doi : 10.1161/CIRCULATIONAHA.121.054892

Circulation. 2021;144:199–209

Patients with left ventricular (LV) systolic dysfunction after myocardial infarction are at a high risk of developing heart failure. The addition of neprilysin inhibition to renin angiotensin system inhibition may result in greater attenuation of adverse LV remodeling as a result of increased levels of substrates for neprilysin with vasodilatory, antihypertrophic, antifibrotic, and sympatholytic effects.

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Cyclin D2 Overexpression Enhances the Efficacy of Human Induced Pluripotent Stem Cell–Derived Cardiomyocytes for Myocardial Repair in a Swine Model of Myocardial Infarction

Meng Zhao, Yuji Nakada, Yuhua Wei, Weihua Bian, Yuxin Chu, Anton V. Borovjagin, Min Xie, Wuqiang Zhu, Thanh Nguyen, Yang Zhou, Vahid Serpooshan, Gregory P. Walcott, Jianyi Zhang

doi : 10.1161/CIRCULATIONAHA.120.049497

Circulation. 2021;144:210–228

Human induced pluripotent stem cells with normal (wild-type) or upregulated (overexpressed) levels of CCND2 (cyclin D2) expression were differentiated into cardiomyocytes (CCND2WTCMs or CCND2OECMs, respectively) and injected into infarcted pig hearts.

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Variant Intronic Enhancer Controls SCN10A-short Expression and Heart Conduction

Joyce C.K. Man, Fernanda M. Bosada, Koen T. Scholman, Joost A. Offerhaus, Roddy Walsh, Karel van Duijvenboden, Vincent W.W. van Eif, Connie R. Bezzina, Arie O. Verkerk, Bastiaan J. Boukens, Phil Barnett, Vincent M. Christoffels

doi : 10.1161/CIRCULATIONAHA.121.054083

Circulation. 2021;144:229–242

Genetic variants in SCN10A, encoding the neuronal voltage-gated sodium channel NaV1.8, are strongly associated with atrial fibrillation, Brugada syndrome, cardiac conduction velocities, and heart rate. The cardiac function of SCN10A has not been resolved, however, and diverging mechanisms have been proposed. Here, we investigated the cardiac expression of SCN10A and the function of a variant-sensitive intronic enhancer previously linked to the regulation of SCN5A, encoding the major essential cardiac sodium channel NaV1.5.

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Transgender People May Face Elevated, Often Untreated Heart Risks

Bridget M. Kuehn

doi : 10.1161/CIRCULATIONAHA.121.055711

Circulation. 2021;144:243–245

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An Ominous ECG

Aadhavi Sridharan, Janet K. Han, Zenaida Feliciano

doi : 10.1161/CIRCULATIONAHA.121.055225

Circulation. 2021;144:246–248

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Combining High-Sensitivity Troponin With the American Heart Association/American College of Cardiology Cholesterol Guidelines to Guide Evolocumab Therapy

Nicholas A. Marston, Kazuma Oyama, Petr Jarolim, Minao Tang, Peter S. Sever, Anthony C. Keech, Armando Lira Pineda, Huei Wang, Robert P. Giugliano, Marc S. Sabatine, David A. Morrow

doi : 10.1161/CIRCULATIONAHA.121.054663

Circulation. 2021;144:249–251

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Letter by Singh et al Regarding Article, “Effect of Empagliflozin on Left Ventricular Volumes in Patients With Type 2 Diabetes, or Prediabetes, and Heart Failure With Reduced Ejection Fraction (SUGAR-DM-HF)”

Jagdeep S. Singh, Allan D. Struthers, Chim C. Lang

doi : 10.1161/CIRCULATIONAHA.120.053057

Circulation. 2021;144:e38–e39

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Response by Lee et al to Letter Regarding Article, “Effect of Empagliflozin on Left Ventricular Volumes in Patients With Type 2 Diabetes, or Prediabetes, and Heart Failure With Reduced Ejection Fraction (SUGAR-DM-HF)”

Matthew M.Y. Lee, John J.V. McMurray, Pardeep S. Jhund, Mark C. Petrie, Naveed Sattar

doi : 10.1161/CIRCULATIONAHA.121.055067

Circulation. 2021;144:e40

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Recognition, Prevention, and Management of Arrhythmias and Autonomic Disorders in Cardio-Oncology: A Scientific Statement From the American Heart Association

Michael G. Fradley, Theresa M. Beckie, Sherry Ann Brown, Richard K. Cheng, Susan F. Dent, Anju Nohria, Kristen K. Patton, Jagmeet P. Singh, Brian Olshansky, on behalf of the American Heart Association Council on Clinical Cardiology; Council on Arteriosclerosis, Thrombosis and Vascular Biology; and Council on Cardiovascular and Stroke Nursing

doi : 10.1161/CIR.0000000000000986

Circulation. 2021;144:e41–e55

With the advent of novel cancer therapeutics and improved screening, more patients are surviving a cancer diagnosis or living longer with advanced disease. Many of these treatments have associated cardiovascular toxicities that can manifest in both an acute and a delayed fashion. Arrhythmias are an increasingly identified complication with unique management challenges in the cancer population. The purpose of this scientific statement is to summarize the current state of knowledge regarding arrhythmia identification and treatment in patients with cancer. Atrial tachyarrhythmias, particularly atrial fibrillation, are most common, but ventricular arrhythmias, including those related to treatment-induced QT prolongation, and bradyarrhythmias can also occur. Despite increased recognition, dedicated prospective studies evaluating true incidence are lacking. Moreover, few studies have addressed appropriate prevention and treatment strategies. As such, this scientific statement serves to mobilize the cardio-oncology, electrophysiology, and oncology communities to develop clinical and scientific collaborations that will improve the care of patients with cancer who have arrhythmias.

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Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association

Yerem Yeghiazarians, Hani Jneid, Jeremy R. Tietjens, Susan Redline, Devin L. Brown, Nabil El-Sherif, Reena Mehra, Biykem Bozkurt, Chiadi Ericson Ndumele, Virend K. Somers, on behalf of the American Heart Association Council on Clinical Cardiology; Council on Peripheral Vascular Disease; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Stroke Council; and Council on Cardiovascular Surgery and Anesthesia

doi : 10.1161/CIR.0000000000000988

Circulation. 2021;144:e56–e67

Obstructive sleep apnea (OSA) is characterized by recurrent complete and partial upper airway obstructive events, resulting in intermittent hypoxemia, autonomic fluctuation, and sleep fragmentation. Approximately 34% and 17% of middle-aged men and women, respectively, meet the diagnostic criteria for OSA. Sleep disturbances are common and underdiagnosed among middle-aged and older adults, and the prevalence varies by race/ethnicity, sex, and obesity status. OSA prevalence is as high as 40% to 80% in patients with hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation, and stroke. Despite its high prevalence in patients with heart disease and the vulnerability of cardiac patients to OSA-related stressors and adverse cardiovascular outcomes, OSA is often underrecognized and undertreated in cardiovascular practice. We recommend screening for OSA in patients with resistant/poorly controlled hypertension, pulmonary hypertension, and recurrent atrial fibrillation after either cardioversion or ablation. In patients with New York Heart Association class II to IV heart failure and suspicion of sleep-disordered breathing or excessive daytime sleepiness, a formal sleep assessment is reasonable. In patients with tachy-brady syndrome or ventricular tachycardia or survivors of sudden cardiac death in whom sleep apnea is suspected after a comprehensive sleep assessment, evaluation for sleep apnea should be considered. After stroke, clinical equipoise exists with respect to screening and treatment. Patients with nocturnally occurring angina, myocardial infarction, arrhythmias, or appropriate shocks from implanted cardioverter-defibrillators may be especially likely to have comorbid sleep apnea. All patients with OSA should be considered for treatment, including behavioral modifications and weight loss as indicated. Continuous positive airway pressure should be offered to patients with severe OSA, whereas oral appliances can be considered for those with mild to moderate OSA or for continuous positive airway pressure–intolerant patients. Follow-up sleep testing should be performed to assess the effectiveness of treatment.

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