Circulation Symposium at #AHA22

By Joseph A. Hill, M.D., Ph.D.

Professor of Internal Medicine and Molecular Biology
Chief of Cardiology
Editor-in-Chief, Circulation

This year, we once again sponsored a hugely successful Circulation Symposium at #AHA22. Over the course of two hours, we hosted five-minute presentations of some of the very best science we published this past year. And it was truly a tour de force of novel, important, and even practice-changing content!

Mirroring the format of the journal, we first enjoyed presentations of our short Frame of Reference pieces (On My Mind, Perspective). Josephine Harrington, M.D., a fellow from Duke, presented a compelling case for prioritizing “quad therapy” in heart failure. Paul Armstrong, M.D., from the University of Alberta, presented three Global Rounds papers, discussing Brazil, France, and Pakistan. One presentation reviewed secular trends in e-cigarette use. A clinical trial from Europe evaluated aortic valve replacement versus conservative medical therapy in asymptomatic severe aortic stenosis. Three talks discussed papers on the “hot topic” of SGLT2i therapy, examining: a) serum K+ levels (finding that SGLT2i decreased the likelihood of developing hyperkalemia without provoking hypokalemia, b) accelerated decongestion in patients presenting with acute decompensated heart failure when administered early on hospital presentation, and c) whether benefits of both SGLT2i and efpeglenatide are preserved when administered concurrently (they are).

Other talks presented papers discussing incident ASCVD among those with a CAC score of zero; a randomized trial testing ablation-based rhythm control versus rate control in heart failure and atrial fibrillation (RAFT-HF); the cardiovascular benefit of lowering LDL cholesterol below 40 mg/dL as recommended by the ESC (reporting no diminution of the beneficial effects); a meta-analysis of omega-3 fatty acids and atrial fibrillation (finding a signal of modest pro-arrhythmia); an analysis of quality of life in the ISCHEMIA trial; a comprehensive review of the role of colchicine across a variety of cardiovascular disease conditions; a review of COVID-associated acute myocarditis; a trial demonstrating decreased risk of acute limb ischemia after revascularization by rivaroxaban; and an analysis of an array of inflammatory markers in the mineral oil comparator in REDUCE-IT, which tested the utility of icosapent ethyl.

An especially poignant component of the symposium was the presentation by a cardiology fellow from Basel, Switzerland, of a prospective analysis of cTnI and cTnT in patients presenting with skeletal muscle disorders. She and her research team found that levels of cTnT, but not cTnI, were elevated, suggesting strongly that the elevated cTnT emerged from skeletal muscle, possibly from reactivation of the gene coding for TnT in the setting of an inflamed skeletal muscle. This paper won our prestigious Willerson Award for best clinical paper of the year.

We are honored at UT Southwestern to lead the No. 1 cardiovascular journal in the world, Circulation, and this year’s symposium presented highlights of important and impactful content published in another spectacular year.

Email: joseph.hill@utsouthwestern.edu

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