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      Reflections on Our Inaugural Year of JACC: CardioOncology, With Gratitude and Tireless Devotion

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      , MD, MSCE
      Jacc. Cardiooncology
      The Author. Published by Elsevier on behalf of the American College of Cardiology Foundation.

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          Abstract

          One year ago, we launched the first issue of JACC: CardioOncology, wherein I outlined my vision for this journal: to become the essential resource for the field of cardio-oncology; to play a vital and transformative role in advancing the field and care of our patients by innovating science and positively impacting clinical care; to be driven by the highest standards of excellence; and to educate, engage, and strengthen the international community (1). Excellence, rigor, and community. These are the principles to which we at JACC: CardioOncology strive for and use to guide us in our decision-making. Each journal issue has been built on a strong foundation of original basic, translational, and clinical science; seminal reviews and primers; educational case challenges; impactful patient perspectives; and global viewpoints from key leaders in cardiology and oncology. We have held international sessions at the China International Heart Failure Congress and the Global Cardio-Oncology Society Meeting in Brazil (2), and have hosted live, interactive Journal clubs (3); virtual case presentations (4); and podcast interviews highlighting the patient’s perspective (5). As I reflect on the past year and the wonderful advances we have made together as a community, I feel a tremendous sense of gratitude. I am thankful to the communities of cardiology and oncology, and to our enthusiastic and engaged readers who turn to JACC: CardioOncology to learn the most current knowledge in our field. We are committed to providing highly accessible content, and we launched original research podcast summaries in March 2020, recorded by our Associate Editors to provide their unique context to the papers. Our podcasts have had >1,500 downloads since April 2020. I am grateful to the authors who have entrusted us with their work. Manuscript submissions have continued to grow, and we have a strong, healthy submission volume. The depth and breadth of topics published in JACC: CardioOncology within our first year have been remarkable, with some of our most downloaded pieces covering topics including coronavirus disease-2019 (COVID-19) (6,7); amyloidosis (8); cardioprotective strategies in both primary and secondary prevention (9, 10, 11, 12); cancer therapies, including osimertinib, CAR T cell, androgen deprivation therapy, tyrosine kinase inhibitors, and their cardiotoxic risk (13, 14, 15, 16); and the intersection between cardiovascular disease and cancer in our patients (17, 18, 19). In the second quarter of 2020 alone, we had nearly 130,000 article usage sessions, and each quarter, this number has grown. The work of our authors is being read for utilization in clinical practice and research, which is always the most important metric for a JACC journal. As a physician scientist, I recognize that the choice of “which journal” is not an easy one and requires careful consideration. We remain committed to serving our authors and working tirelessly to ensure that the peer review process is respectful, fair, constructive, and as seamless as possible. Our average time to first decision in second quarter 2020 was 15 days, and we will strive to maintain this standard. We seek to partner and work collaboratively with our authors to ensure the highest quality contribution to our community. I am grateful to the reviewers, who provide timely, incisive insight and lend their valued expertise to help ensure the quality of our journal. We have had nearly 300 peer reviewers contribute their evaluations over the past year. We know this takes dedicated time and effort, amid busy professional and personal lives and amid the painful challenges of COVID-19 and racial injustice that continue to afflict our world today. Of course, I am grateful to my many mentors, including Dr. Fuster and the JACC family Editors-in-Chief: Drs. Doug Mann, Dave Moliterno, Julia Grapsa, Chris O’Connor, Chandra Shekhar, and Shiv Kumar; the leadership team at the American College of Cardiology; and the entire American College of Cardiology publishing team, led by Justine Varieur Turco, Divisional Senior Director. Eileen Cavanagh, Nandhini Kuntipuram, Colleen Whipple-Erno, Tamika Edaire at the ACC, and the entire team at Elsevier have been wonderful collaborative partners in ensuring our success. I have to especially acknowledge the remarkable efforts of Michelle McMullen, our Managing Editor. Launching JACC: CardioOncology has been a community effort, and I am thankful to our excellent multidisciplinary Editorial Board, including our International and Senior Advisors, Social Media Editors, Editorial Consultants, Assistant Editors, and Guest Editor, Dr. Anju Nohria; our highly committed Associate Editor team, comprised of our Deputy Editors Drs. Saro Armenian and Dan Lenihan; and our Associate Editors Drs. Greg Armstrong, Ana Barac, Anne Blaes, Paul Burridge, Katie Ruddy, and Ron Witteles. Each has worked tirelessly and selflessly as we together cohesively advance our mission. As I look forward to the year ahead, I am hopeful. I am proud to announce we are now indexed on Scopus, and much of our U.S. National Institutes of Health–funded science and COVID-19 papers are already indexed on PubMed. Our goal is that we continue to stimulate, innovate, and inspire rigorous peer-reviewed science and advance clinical care. Over the next year, we will improve access to JACC: CardioOncology through additional platform changes to improve searchability and integration across the JACC Journals. Clinical, translational, and basic science original research manuscripts will continue to serve as our foundation. As we evaluate each manuscript, we will continue to ask ourselves the following key questions: Are the findings valid? Is the methodology rigorous? Is the topic of clinical importance? Are the findings incremental to our current understanding of the topic and do they fulfill an evidence gap? What is the potential clinical impact and the potential for advancing the field? We will continue to publish State-of-the-Art Reviews and Primers, and similarly ask ourselves: is this an authoritative, critical appraisal of the literature? Is it comprehensive, yet focused? Is this data-driven and accurately reflective of the current evidence? We will look to Clinical Case Challenges to provide evidence-based descriptions of unique cases that thoughtfully illustrate the diagnostic and therapeutic dilemmas that we as clinicians face as we care for our patients (20). Our Viewpoints will continue to express opinion pieces on important and timely topics, and present thought-provoking, community-building, evidence-based perspectives. We will continue to grow our international engagement events, podcasts, live Journal clubs, and dynamic case presentations, each occurring at least once per quarter. We also will launch a new “How To” series that will offer practical, evidence-based education on common clinical questions that are relevant to the everyday cardiovascular care of our cancer patients. I am grateful. I serve a wonderful community, one made of patients, physicians, scientists, and care providers who inspire and motivate me daily. I look forward to continuing to work with a tireless devotion to “never feeling satisfied”—in our mission to educate our global community and positively impact the care of our patients.

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          Most cited references17

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          The Novel Coronavirus Disease (COVID-19) Threat for Patients with Cardiovascular Disease and Cancer

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            Is Open Access

            Efficacy of Neurohormonal Therapies in Preventing Cardiotoxicity in Patients With Cancer Undergoing Chemotherapy

            Objectives This study sought to assess the effects of neurohormonal therapies in preventing cardiotoxicity in patients receiving chemotherapy. Background Various cardioprotective approaches have been evaluated to prevent chemotherapy-related cardiotoxicity; however, their overall utility remains uncertain. Methods This meta-analysis included randomized clinical trials of adult patients that underwent chemotherapy and neurohormonal therapies (β-blockers, mineralocorticoid receptor antagonists, or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers) versus placebo with follow-up ≥4 weeks. The primary outcome was change in left ventricular ejection fraction (LVEF) from baseline to the end of the trial. Other outcomes of interest were measures of LV size, strain, and diastolic function. Pooled estimates for each outcome were reported as standardized mean difference and weighted mean difference between the neurohormonal therapy and placebo groups using random effects models. Results We included 17 trials, collectively enrolling 1,984 participants. In pooled analysis, neurohormonal therapy (vs. placebo) was associated with significantly higher LVEF on follow-up (standardized mean difference: +1.04 [95% confidence interval (CI): 0.57 to 1.50]) but with significant heterogeneity in the pooled estimate (I 2  = 96%). Compared with placebo-treated patients, those randomized to neurohormonal therapies experienced a 3.96% (95% CI: 2.90 to 5.02) less decline in LVEF estimated by weighted mean difference, but with significant heterogeneity (I 2  = 98%). There was a trend toward lower adverse clinical events with neurohormonal therapy (vs. placebo) that did not meet statistical significance (risk ratio: 0.80 [95% CI: 0.53 to 1.20]; I 2  = 71%). Conclusions Neurohormonal therapies are associated with higher LVEF in follow-up among cancer patients receiving chemotherapy, although absolute changes in LVEF are small and may be within inter-test variability. Furthermore, significant heterogeneity is observed in the treatment effects across studies highlighting the need for larger trials of cardioprotective strategies.
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              Is Open Access

              Hypertension in Cancer Patients and Survivors : Epidemiology, Diagnosis, and Management

              Cancer patients and survivors of cancer have a greater burden of cardiovascular disease compared with the general population. Much of the elevated cardiovascular risk in these individuals is likely attributable to hypertension, because individuals with cancer have a particularly high incidence of hypertension following cancer diagnosis. Treatment with chemotherapy is an independent risk factor for hypertension due to direct effects of many agents on endothelial function, sympathetic activity, and renin-angiotensin system activity, as well as nephrotoxicity. Diagnosis and management of hypertension in cancer patients requires accurate blood pressure measurement and consideration of potential confounding factors, such as adjuvant treatments and acute pain, that can temporarily elevate blood pressure readings. Home blood pressure monitoring can be a useful tool to facilitate longitudinal blood pressure monitoring for titration of antihypertensive medications. Selection of antihypertensive agents in cancer patients should account for treatment-specific morbidities and target organ damage. • Cancer patients and survivors are at a high risk for hypertension. • Hypertension likely contributes to the high burden of cardiovascular disease in cancer patients and survivors. • Accurate in- and out-of-office blood pressure measurement is important in cancer patients and survivors. • Target organ damage and treatment-specific morbidities should be considered when selecting antihypertensive agents in cancer patients.
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                Author and article information

                Contributors
                Role: Editor-in-Chief, JACC: CardioOncology
                Journal
                JACC CardioOncol
                JACC CardioOncol
                Jacc. Cardiooncology
                The Author. Published by Elsevier on behalf of the American College of Cardiology Foundation.
                2666-0873
                15 September 2020
                September 2020
                15 September 2020
                : 2
                : 3
                : 532-534
                Author notes
                [] Address for correspondence: Dr. Bonnie Ky, Department of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Smilow Center for Translational Research, 3400 Civic Center Boulevard, Philadelphia, Pennsylvania 19104.
                Article
                S2666-0873(20)30172-1
                10.1016/j.jaccao.2020.08.002
                7492054
                6f0c770b-5256-4cc5-9732-33522c886d13
                © 2020 The Author

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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