CirculationPub Date : 2025-10-21Epub Date: 2025-10-22DOI: 10.1161/CIR.0000000000001358
Therese Djärv, Matthew J Douma, Jestin N Carlson, Eunice M Singletary, David C Berry, Richard N Bradley, Pascal Cassan, Wei-Tien Chang, Nathan P Charlton, Diana Cimpoesu, Craig A Goolsby, Swee Han Lim, Jen Heng Pek, Barry Klaassen, Amy Kule, Jorien Laermans, Finlay Macneil, Abel Martinez-Mejias, Daniel Meyran, Masashi Okubo, Aaron M Orkin, James Raitt, Heba Shahaed, Anna Maria Subic, Kaushila Thilakasiri, Frances Williamson
{"title":"First Aid: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations.","authors":"Therese Djärv, Matthew J Douma, Jestin N Carlson, Eunice M Singletary, David C Berry, Richard N Bradley, Pascal Cassan, Wei-Tien Chang, Nathan P Charlton, Diana Cimpoesu, Craig A Goolsby, Swee Han Lim, Jen Heng Pek, Barry Klaassen, Amy Kule, Jorien Laermans, Finlay Macneil, Abel Martinez-Mejias, Daniel Meyran, Masashi Okubo, Aaron M Orkin, James Raitt, Heba Shahaed, Anna Maria Subic, Kaushila Thilakasiri, Frances Williamson","doi":"10.1161/CIR.0000000000001358","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001358","url":null,"abstract":"<p><p>The International Liaison Committee on Resuscitation conducts continuous reviews of new, peer-reviewed, published first aid and cardiopulmonary resuscitation science and publishes more comprehensive reviews every 5 years. The First Aid chapter of the <i>2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations</i> addresses all published evidence reviewed by the First Aid Task Force science experts since 2020. This summary includes new systematic reviews on manual uterine massage for postpartum hemorrhage, unintentional injury from chest compressions in noncardiac arrests, and treatment of jellyfish stings. There are also new scoping reviews on the topics of first aid interventions to prevent adverse consequences of postpartum hemorrhage, spinal motion restriction, and preservation of an amputated body part. Summaries of systematic and scoping reviews included in the 2021 to 2024 annual summaries are also included to provide a more comprehensive reference for the reader. Members of the First Aid Task Force have assessed, discussed, and debated the certainty of the evidence, on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task force are provided in the Justification and Evidence-to-Decision Framework Highlights sections. The task force also lists priority knowledge gaps for further research.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"152 16_suppl_1","pages":"S250-S282"},"PeriodicalIF":38.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CirculationPub Date : 2025-10-21Epub Date: 2025-10-22DOI: 10.1161/CIR.0000000000001373
Ashish R Panchal, Jason A Bartos, Myra H Wyckoff, Ian R Drennan, Melissa Mahgoub, Stephen M Schexnayder, Amber J Rodriguez, Comilla Sasson, Jaylen I Wright, Steven C Brooks, Dianne L Atkins, Marina Del Rios
{"title":"Part 2: Evidence Evaluation and Guidelines Development: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.","authors":"Ashish R Panchal, Jason A Bartos, Myra H Wyckoff, Ian R Drennan, Melissa Mahgoub, Stephen M Schexnayder, Amber J Rodriguez, Comilla Sasson, Jaylen I Wright, Steven C Brooks, Dianne L Atkins, Marina Del Rios","doi":"10.1161/CIR.0000000000001373","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001373","url":null,"abstract":"<p><p>The <i>2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care</i> is based on the extensive evidence evaluation performed in conjunction with the International Liaison Committee on Resuscitation. The Adult Basic and Advanced Life Support, Pediatric Basic and Advanced Life Support, Neonatal Resuscitation, Resuscitation Education Science, Special Circumstances, Post-Cardiac Arrest Care, Ethics, and Systems of Care Writing Groups drafted, reviewed, and approved recommendations, assigning to each recommendation a Class of Recommendation (ie, strength) and Level of Evidence (ie, quality). The 2025 Guidelines are organized in knowledge chunks that are grouped into discrete modules of information on specific topics or management issues. Each chapter of the 2025 Guidelines underwent blinded peer review by subject matter experts and was also reviewed and approved for publication by the American Heart Association Science Advisory and Coordinating Committee and the American Heart Association Executive Committee. Chapters with pediatric content (Neonatal Resuscitation, Pediatric Basic and Advanced Life Support) were also co-led by the American Academy of Pediatrics, and thereby the content was reviewed and approved by the American Academy of Pediatrics Board of Directors. The American Heart Association has rigorous conflict of interest policies and procedures to minimize the risk of bias or improper influence during development of the guidelines. Anyone involved in any part of the guideline development process disclosed all commercial relationships and other potential conflicts of interest.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"152 16_suppl_2","pages":"S313-S322"},"PeriodicalIF":38.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CirculationPub Date : 2025-10-21Epub Date: 2025-10-22DOI: 10.1161/CIR.0000000000001371
Jonathan Elmer, Dianne L Atkins, Mohamud R Daya, Marina Del Rios, Jessica T Fry, Carrie M Henderson, Mithya Lewis-Newby, Vanessa N Madrigal, Catherine A Marco, Joseph P Ornato, Erin T Paquette, Sam Parnia, Amber J Rodriguez, Joseph P Shapiro, Stephen M Schexnayder, Elliott M Weiss, David M Zientek, Ahamed H Idris
{"title":"Part 3: Ethics: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.","authors":"Jonathan Elmer, Dianne L Atkins, Mohamud R Daya, Marina Del Rios, Jessica T Fry, Carrie M Henderson, Mithya Lewis-Newby, Vanessa N Madrigal, Catherine A Marco, Joseph P Ornato, Erin T Paquette, Sam Parnia, Amber J Rodriguez, Joseph P Shapiro, Stephen M Schexnayder, Elliott M Weiss, David M Zientek, Ahamed H Idris","doi":"10.1161/CIR.0000000000001371","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001371","url":null,"abstract":"<p><p>In this chapter, the American Heart Association provides guidance on ethical considerations relevant to cardiopulmonary resuscitation and emergency cardiovascular care. An overview is provided of ethical frameworks that provide a structure through which difficult decisions can be analyzed. These include principlism, currently the predominant medical ethical framework, which considers moral principles of beneficence, nonmaleficence, respect for autonomy, and justice. Additional consideration is given to the value of dignity, and other ethical frameworks such as narrative ethics, crisis standards of care, utilitarianism, virtue ethics, and deontology. The importance of equity and the imperative for health care professionals and their organizations to actively address structural inequities, social determinants of health and resulting disparities related to Emergency Cardiovascular Care is highlighted. Processes for decision-making are discussed, including guidance on advance directives and shared decision-making. Decisions to initiate or withhold and subsequently to continue or terminate resuscitation are reviewed at length. In addition to considering this decision in adults and geriatric patients, specific attention is given to decision-making in children, newborn infants, and pregnant patients. The impact of prognostic uncertainty on these decisions is discussed, as well as the evaluation of potentially ineffective therapies and cultural and religious considerations. Other ethical topics are addressed briefly, including processes for research and knowledge generation; the impact of resuscitation on health care professionals, survivors, laypersons, families, and caregivers; family presence during resuscitation; crisis standards of care; advanced therapies, including extracorporeal support; and organ and tissue donation.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"152 16_suppl_2","pages":"S323-S352"},"PeriodicalIF":38.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CirculationPub Date : 2025-10-21Epub Date: 2025-08-29DOI: 10.1161/CIRCULATIONAHA.125.076616
Torbjørn Omland, Siri Lagethon Heck, Espen Holte, Albulena Mecinaj Lilleaasen, Mari Nordbø Gynnild, Morten Wang Fagerland, Victoria Vinje-Jakobsen, Anne-Katrine Lislegaard Næs, Egil Støre Blix, Alf Inge Larsen, Jürgen Geisler, Geeta Gulati, Torgeir Wethal
{"title":"Sacubitril/Valsartan and Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy: The PRADA II Randomized Clinical Trial.","authors":"Torbjørn Omland, Siri Lagethon Heck, Espen Holte, Albulena Mecinaj Lilleaasen, Mari Nordbø Gynnild, Morten Wang Fagerland, Victoria Vinje-Jakobsen, Anne-Katrine Lislegaard Næs, Egil Støre Blix, Alf Inge Larsen, Jürgen Geisler, Geeta Gulati, Torgeir Wethal","doi":"10.1161/CIRCULATIONAHA.125.076616","DOIUrl":"10.1161/CIRCULATIONAHA.125.076616","url":null,"abstract":"<p><strong>Background: </strong>Anthracycline- and trastuzumab-associated cardiotoxicity may lead to cardiac dysfunction and dose reduction or halt of potentially life-saving adjuvant cancer therapy. Whether angiotensin receptor/neprilysin inhibitors can prevent cancer therapy-related cardiac dysfunction and injury remains to be established.</p><p><strong>Methods: </strong>PRADA II (Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy) was a randomized, parallel-group, placebo-controlled, double-blind, multicenter trial conducted at 4 academic medical centers in Norway that evaluated the cardioprotective effect of sacubitril/valsartan versus placebo administered concomitantly with anthracycline-containing breast cancer therapy and continued for 18 months. The target dose was 97/103 mg BID. The primary outcome was change in left ventricular ejection fraction by cardiovascular magnetic resonance from prior to initiation of chemotherapy to 18 months thereafter. Secondary outcomes included change in echocardiographic global longitudinal strain, circulating cardiac troponins, and NT-proBNP (N-terminal pro-B-type natriuretic peptide).</p><p><strong>Results: </strong>In total, 138 women (mean±SD age: 54.0±9.4 years) were randomized. The overall decline in left ventricular ejection fraction from baseline to 18 months was 2.2 percentage points (95% CI, 1.1 to 3.3) in the placebo group and 1.1 percentage points (95% CI, -0.01 to 2.2) in the sacubitril/valsartan group. The between-group difference was 1.1 percentage points (95% CI, -0.4 to 2.7; <i>P</i>=0.16). Left ventricular global longitudinal strain was normal and remained stable in the sacubitril/valsartan group throughout the study (change from baseline to 18 months, -0.3 [95% CI, -0.80 to 0.2]). In contrast, there was a progressive decline in the placebo group (change from baseline to 18 months, 0.5 [95% CI, 0.05 to 1.0]). The between-group difference was -0.9 (95% CI, -1.5 to -0.2). The mean increases in NT-proBNP and cardiac troponin I concentrations from baseline to 18 months were greater in the placebo group than in the sacubitril/valsartan group (log difference, 0.3 [95% CI, 0.05 to 0.6] for NT-proBNP and 0.5 [95% CI, 0.1to 1.0] for cardiac troponin I).</p><p><strong>Conclusions: </strong>Anthracycline-based treatment for early breast cancer was associated with a reduction in left ventricular ejection fraction that was not significantly attenuated by sacubitril/valsartan.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03760588.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":"1136-1145"},"PeriodicalIF":38.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CirculationPub Date : 2025-10-21Epub Date: 2025-10-22DOI: 10.1161/CIR.0000000000001375
Karen G Hirsch, Edilberto Amorim, Patrick J Coppler, Ian R Drennan, Andrea Elliott, Alexandra June Gordon, Jacob C Jentzer, Nicholas J Johnson, Ari Moskowitz, Bryn E Mumma, Alexander M Presciutti, Amber J Rodriguez, Albert F Yen, Jon C Rittenberger
{"title":"Part 11: Post-Cardiac Arrest Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.","authors":"Karen G Hirsch, Edilberto Amorim, Patrick J Coppler, Ian R Drennan, Andrea Elliott, Alexandra June Gordon, Jacob C Jentzer, Nicholas J Johnson, Ari Moskowitz, Bryn E Mumma, Alexander M Presciutti, Amber J Rodriguez, Albert F Yen, Jon C Rittenberger","doi":"10.1161/CIR.0000000000001375","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001375","url":null,"abstract":"<p><p>Cardiac arrest is common and deadly, affecting up to 700 000 people in the United States annually. Advanced cardiac life support measures are commonly employed to improve outcomes. This 2025 guideline on adult post-cardiac arrest care from the American Heart Association summarizes the most recent published evidence for and recommendations on several important areas of post-cardiac arrest management. Based on structured evidence reviews, guidelines are provided for initial blood pressure, oxygen, ventilation, and glucose goals. Evidence evaluating the routine use of antibiotics after return of spontaneous circulation is reviewed. The update also reviews diagnostic testing modalities, temperature control goals and duration, and the use of percutaneous coronary intervention and mechanical circulatory support in the patient resuscitated from cardiac arrest. New data regarding the detection and management of seizures have been incorporated, along with updates regarding the timing and modalities used in neuroprognostication. These guidelines now differentiate prognostication for favorable versus unfavorable outcome. New sections on the utility of advanced neuromonitoring, along with definitions and treatment options for myoclonus, are included to guide the clinician. Expanded recommendations regarding how to optimize survivorship for patients, caregivers, and rescuers are reviewed. Finally, the potential role of organ donation in the patient resuscitated from cardiac arrest is reviewed.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"152 16_suppl_2","pages":"S673-S718"},"PeriodicalIF":38.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CirculationPub Date : 2025-10-21Epub Date: 2025-10-22DOI: 10.1161/CIR.0000000000001374
Aaron J Donoghue, Marc Auerbach, Arna Banerjee, Audrey L Blewer, Adam Cheng, Kelly D Kadlec, Yiqun Lin, Emily Diederich, Taylor Sawyer, Devita T Stallings, Lorrel E B Toft, Deborah Torman, Jaylen I Wright, Stephen M Schexnayder, Katie N Dainty
{"title":"Part 12: Resuscitation Education Science: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.","authors":"Aaron J Donoghue, Marc Auerbach, Arna Banerjee, Audrey L Blewer, Adam Cheng, Kelly D Kadlec, Yiqun Lin, Emily Diederich, Taylor Sawyer, Devita T Stallings, Lorrel E B Toft, Deborah Torman, Jaylen I Wright, Stephen M Schexnayder, Katie N Dainty","doi":"10.1161/CIR.0000000000001374","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001374","url":null,"abstract":"<p><p>Developed by the American Heart Association, these Guidelines represent the first comprehensive update of education recommendations since 2020. Incorporating the results of structured evidence reviews from the International Liaison Committee on Resuscitation, these are guidelines for the design and delivery of resuscitation training for health care professionals and lay rescuers. This update emphasizes the continuous evolution of evidence evaluation and the necessity of adapting educational strategies to local needs and diverse community demographics. Existing guidelines remain relevant unless specifically updated in this publication. Key topics that are new, are substantially revised, or have significant new literature include the use of cardiopulmonary resuscitation feedback devices in training, rapid-cycle deliberate practice, teamwork and leadership training, manikin fidelity, gamified learning, virtual and augmented reality, use of cognitive aids, stepwise training, blended learning, scripted debriefing, instructor training, alternative objects for lay rescuer chest compression training, and special considerations for training in the management of opioid overdose. How certain personal considerations may influence the overall impact of education are also reviewed, including disparities accordingly related to gender, race, socioeconomic status, and language; the impact of training for school children; and factors that act as barriers or facilitators to lay rescuer willingness to perform cardiopulmonary resuscitation. We conclude with a summary of current knowledge gaps in resuscitation education science and a discussion of future directions for optimizing the impact of resuscitation training programs.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"152 16_suppl_2","pages":"S719-S750"},"PeriodicalIF":38.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"ALDH2/eIF3E Interaction Modulates Protein Translation Critical for Cardiomyocyte Ferroptosis in Acute Myocardial Ischemia Injury.","authors":"Xin Chen, Xiujian Yu, Shanshan Zhong, Ping Sha, Rui Li, Xiaodong Xu, Ningning Liang, Lili Zhang, Luxiao Li, Jingyu Zhang, Mingyao Zhou, Tongwei Lv, Haoran Ma, Yongqiang Wang, Yanwen Ye, Chunzhao Yin, Shiting Chen, Jinwei Tian, Aijun Sun, Weiyuan Wang, Dewen Yan, Huangtian Yang, Hui Huang, Pan Li, Huiyong Yin","doi":"10.1161/CIRCULATIONAHA.125.075220","DOIUrl":"https://doi.org/10.1161/CIRCULATIONAHA.125.075220","url":null,"abstract":"<p><strong>Background: </strong>As an iron-dependent form of regulated cell death caused by lipid peroxidation, ferroptosis has been implicated in ischemic injury, but the underlying mechanisms in acute myocardial infarction (AMI) remain poorly defined. ALDH2 (acetaldehyde dehydrogenase 2) catalyzes detoxification of lipid aldehydes derived from lipid peroxidation and acetaldehydes from alcohol consumption. The Glu504Lys polymorphism of ALDH2 (rs671, ALDH2*2), affecting ≈40% of East Asians, is associated with increased risk of myocardial infarction (MI). This study aims to investigate the role of ALDH2*2 and ferroptosis in AMI.</p><p><strong>Methods: </strong>A Chinese cohort of 177 patients with acute heart failure with ALDH2 wild type and ALDH2*2 was enrolled. The MI mouse model of left anterior descending coronary artery ligation was conducted on wild-type and ALDH2*2 mice and mice with cardiomyocyte-specific knockdown of eIF3E (eukaryotic translation initiation factor 3 subunit E) by adeno-associated virus. The lipid peroxidation products were measured by mass spectrometry-based lipidomics and metabolomics in human plasma, mouse serum samples, mouse heart tissues, and primary cardiac myocytes.</p><p><strong>Results: </strong>Human ALDH2*2 carriers exhibit more severe heart failure after AMI with features of ferroptosis in plasma, as seen through lipidomic analysis, characterized by increased bioactive lipids and decreased antioxidants, such as coenzyme Q10 and BH4 (tetrahydrobiopterin). Similar features were observed in MI mouse models of ALDH2*2, whereas ferroptosis inhibition by Fer-1 significantly improved heart function and reversed ferroptosis markers. Importantly, ALDH2*2 significantly decreased ALDH2 protein levels, whereas ferroptosis-related markers, including TFRC (transferrin receptor) and ACSL4 (acyl-coenzyme A synthetase long-chain family member 4) were notably upregulated in the infarct heart tissues. Mechanistically, ALDH2 physically interacts with the eIF3 complex via the eIF3E factor, which prevents eIF3E-eIF4G1 (eukaryotic initiation factor 4G)-mRNA assembly. The ALDH2*2 variant causes ALDH2 deficiency, disrupting its interaction with the eIF3 complex by releasing the bound eIF3E to assemble an eIF3E-eIF4G1-mRNA ternary complex, thereby driving selective translation of mRNAs (eg, TFRC, ACSL4, and UAP1) containing the GAGGACR (R represents A/G) motif to promote ferroptosis. Consistently, cardiomyocyte-specific eIF3E knockdown restored ALDH2*2 cardiac function by attenuating ferroptosis in MI.</p><p><strong>Conclusions: </strong>ALDH2*2 aggravates acute heart failure after MI by promoting the selective translation of mRNAs containing the GAGGACR motif, thereby driving cardiomyocyte ferroptosis. Targeting ferroptosis represents a potential therapeutic option for mitigating MI injury, especially for ALDH2*2 carriers.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":""},"PeriodicalIF":38.6,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CirculationPub Date : 2025-10-20DOI: 10.1161/circulationaha.125.075592
Jessica A Regan,Melissa H Laitner,Victor J Dzau
{"title":"A Crossroads in Cardiovascular Medicine: Progress and Barriers to Impact.","authors":"Jessica A Regan,Melissa H Laitner,Victor J Dzau","doi":"10.1161/circulationaha.125.075592","DOIUrl":"https://doi.org/10.1161/circulationaha.125.075592","url":null,"abstract":"During the past 75 years, advances in cardiovascular science and technology have significantly reduced morbidity and mortality. In 2012, Drs Nabel and Braunwald reviewed this progress in A Tale of Coronary Artery Disease and Myocardial Infarction, highlighting the landmark innovations that contributed to the decline in cardiovascular death rates from 1950 to 2010. Since then, groundbreaking developments in pharmacologic therapies, interventional procedures, surgical techniques, and molecular medicine-including gene editing and RNA-based treatments-have emerged. However, despite these innovations, improvements in cardiovascular mortality have stalled, driven not only by epidemiologic shifts but also by persistent inequities in implementation. This article examines the past 15 years of progress in cardiovascular medicine and proposes a forward-looking roadmap focused on prevention, responsible innovation, and thoughtful health care delivery to ensure technological advancements translate into improved health outcomes for all.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"53 1","pages":"1166-1173"},"PeriodicalIF":37.8,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CirculationPub Date : 2025-10-20DOI: 10.1161/circulationaha.125.074546
Danyang Liu,Kun Huang
{"title":"Letter by Liu and Huang Regarding Article, \"Left Ventricular Entry to Reduce Brain Lesions During Catheter Ablation: A Randomized Trial\".","authors":"Danyang Liu,Kun Huang","doi":"10.1161/circulationaha.125.074546","DOIUrl":"https://doi.org/10.1161/circulationaha.125.074546","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"41 1","pages":"e293"},"PeriodicalIF":37.8,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}