Welcome to the ESC journal family

Until the end of World War II, the main medical problems were infectious in nature. Of note, neither antibiotics nor vaccination except for small pox were available and hence tuberculosis, pneumonia, and viral infections such as polio among others were major causes of death. After the war, however, heart disease became a major issue.1 Although the electrocardiogram had been invented and the first cardiac catheterization had been performed by Werner Forsmann three decades ago, these diagnostic tools were hardly used in daily practice, because − with the exception of pioneering surgery in a few cases − no effective treatments were available for cardiac conditions. Indeed, when the then President of the USA, Dwight Eisenhower, had a heart attack on 26 September 1955, the treating physicians had to bring an electrocardiogram from another hospital to confirm the diagnosis.2 The only remedies available were morphine and nitrate of amyl, already described by Thomas Lauder Brunton in 1867,3 and papaverine. Fortunately, although it was an anterior infarction myocardial infarction, Eisenhower did not develop ventricular fibrillation. Indeed, Paul M Zoll invented defibrillation only in 1956.4 Since Eisenhower’s heart attack, progress has been really impressive in diagnosing and managing this deadly condition. Of note, while in-hospital mortality averaged about 50% in these days, thanks to defibrillation, the coronary care unit, aspirin, thrombolysis, and later acute percutaneous coronary intervention5 in conjunction with novel platelets inhibitors (i.e. clopidogrel, prasugrel, and ticagerlor) and statins, fatality was impressively reduced to around 5% today. Thus, the diagnosis and management of acute coronary syndromes, as defined by the European Society of Cardiology (ESC) and American College of Cardiology,6 is a paradigmatic example of the progress achieved by science-based medicine over the last five decades. With the impressive progress made in medicine and cardiovascular care in particular, the distribution of knowledge became an issue. The ESC started its first journal in 19807 under the leadership of Desmond Julian with a small number of submissions and no impact factor. Over the last 30 years, under the leadership of four succeeding editors (i.e. Henry Kulbertus, Kim Fox, Frans van de Werf, and Thomas F Lüscher), the European Heart Journal has made it to centre stage in cardiovascular medicine.8 Submissions have increased steadily over the years and have now reached more than 3500 annually. As a consequence, the acceptance rate has decreased to around 12% and its impact factor rose to more than 10. But it was not just the main journal that contributed to the success of the ESC, rather a growing number of subspecialty journals were a key part of it as well. General cardiologists and specialists in the rapidly evolving fields of cardiology started to have different interests. In general, technical aspects of imaging, procedures, and programming of devices among other topics are mainly of interest for those performing the examinations, interventions or those who implant devices, while clinical aspects remain interesting for the community as a whole. This development called for journals tailored specifically for individual readers. The first subspecialty journal, introduced in 1999 was Europace, followed by the European Journal of Heart Failure and later followed by others (Figure 1). Today, the ESC journal family encompasses nine journals covering important subspecialties of cardiovascular medicine.9 Importantly, EuroIntervention has recently reached an official agreement with the ESC, thereby adding this important subspecialty of cardiology to the ESC journal family. Of note, the European Journal of Echocardiography expanded its scope as of this year and now, under its new name European Heart Journal Cardiovascular Imaging, also accepts and promotes submissions on other imaging modalities such as computer tomography, MRI, and nuclear cardiology. Finally, the European Journal of Cardiovascular Prevention and Rehabilitation changed its name to European Journal of Preventive Cardiology. With the new editorship of the European Heart Journal starting in 2009, the ESC journal family came closer together. A new manuscript transfer system was introduced permitting transfer of papers reviewed by experts of the main journal to a suitable subspecialty journal. With the decreasing acceptance rate to an all-time low of 12%, in the European Heart Journal, many interesting papers had to be rejected due to an increasing strictness in priority. Obviously, more than 12% of the submitted papers are worthy of publication. Some just did not make it, but are interesting for cardiologists working in this field, while others might be too technical for the general cardiologist. The manuscript transfer system now allows to rescue papers that are excellent, but better suited for physicians interested in more specialized areas and to offer them based on the available reviews to the subspecialty journal editor for decision. If the editor of the approached subspecialty journal finds the paper interesting and the reviewer comments constructive, he might reach a decision ‘reconsider after revision’. The author then gets a decision letter with this offer and he may or may not resubmit along this recommendation. Since the introduction of the manuscript transfer system, we have transferred 948 papers to different subspecialty journals. The offered manuscripts were accepted pending revision as suggested by the initial reviewers provided by the European Heart Journal by the responsible subspecialty editors in 60% of the cases. Overall, 55% of the authors have accepted this opportunity and resubmitted their revised manuscript to the subspecialty journal. Eventually, some 40% of the manuscripts were accepted and published. Of note, the acceptance by the authors depended to a large extent on the impact factor of the subspecialty journal that was offered for re-submission (Figure 2). Indeed, over the years, the author acceptance averaged 52% with the European Journal of Heart Failure (impact factor (IF) 4.512), 47% with the European Journal of Preventive Cardiology (IF 2.633), 27% with Europace (IF 839), and 1% with the European Journal of Echocardiography (IF 2.117). results of manuscript transfers from the European Heart Journal to the subspecialty journals of the ESC journal family.EHJ, European Heart Journal; CVR, Cardiovascular Research; EP, Europace; EJHF, European Journal of Heart Failure; EHJCI, European Heart Journal Cardiovascular Imaging; EJPC, European Journal of Preventive Cardiology; EJCN, European Journal of Cardiovascular Nursing. It is the intention of the ESC that this strategy will permit increased manuscript flow to the ESC journal family, and, in turn, hopefully the quality of the manuscripts and the impact factor rise. Since the introduction of the manuscript transfer, the IF of the European Journal of Heart Failure has increased from 3.706 in 2009 to its current 4.512. It is hoped that we will be able to help all other ESC journals to grow further over time. Although the ESC journal family covers most parts of cardiovascular medicine with it’s products, there are still white spots on the map. One of them is acute coronary syndromes. While interventional cardiology plays a dominant role in the management of this group of diseases, the management of such patients involves much more than just an acute percutaneous coronary intervention. Thousands of papers are currently published on the pathophysiology, diagnosis, and management of acute coronary syndromes worldwide every year. Acute cardiovascular syndromes attract such extensive attention for good reasons. They still account for a large part of morbidity and mortality in the Western world. Further, the number of patients suffering from acute coronary syndromes is increasing also in other parts of the world such as the Middle East, India, Southeast Asia, and China. It therefore comes as no surprise, that, particularly with the extensive progress in the diagnosis and management of acute cardiovascular conditions during the last decades, acute cardiovascular care more and more became a subspecialty requiring specific additional training above and beyond the common trunk core curriculum of cardiology. To address these developments, the ESC Board recently approved the formation of a novel ESC Association on Acute Cardiovascular Care. With the new ESC association also comes a new journal − Acute Cardiovascular Care − under the editorship of Christiaan Vrints from Antwerp. It is therefore with great joy that we can welcome Acute Cardiovascular Care as a new member to the ESC journal family. Acute coronary syndromes are also an important subject for the European Heart Journal, the flagship of the ESC journal family. For instance, under the current editorship the journal has received 6290 manuscripts since 2009 in this category with some of them being highly cited. For instance: ‘Intracoronary infusion of bone marrow-derived selected CD34(+)CXCR4(+) cells and non-selected mononuclear cells in patients with acute STEMI and reduced left ventricular ejection fraction: results of randomized, multicentre Myocardial Regeneration by Intracoronary Infusion of Selected Population of Stem Cells in Acute Myocardial Infarction (REGENT) Trial.’10 ‘A systematic review and meta-analysis of intra- aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines?’11 ‘Associations of major bleeding and myocardial infarction with the incidence and timing of mortality in patients presenting with non-ST-elevation acute coronary syndromes: a risk model from the ACUITY trial.’12 Furthermore, the European Heart Journal published two guidelines on acute coronary syndromes, i.e. one on STEMI,13 which received 606 citations and 17,700 downloads, and one on non-STEMI,14 which has been cited eight times and downloaded 3219 times. A focus issue on antiplatelet therapy in cardiovascular disease was published in December of last year,15 further documenting the importance of the topic. Given the enormous research activity in the field of acute cardiovascular care, there are good reasons to start a journal specifically dedicated to this issue. We can be sure that Acute Cardiovascular Care addresses a need and therefore will grow to become an important member of the ESC journal family. The European Heart Journal will help to promote this new journal and include it into the manuscript transfer system. With more than 2000 manuscripts within this category submitted and the very low acceptance rate currently, a large number of remarkable scientific quality and interest will certainly be suitable for transfer. It is hoped that the readers and the authors of the ESC journals, and of Acute Cardiovascular Care in particular, will appreciate this new opportunity to publish and read work in the area of acute cardiovascular care. We wish this new journal all the best in the future and look forward to reading it.