Circulation Submission Process

This page uses AHA/Circulation author instructions, AHA article-type guidance, Circulation journal information, Clarivate JCR metrics, SciRev timing benchmarks, and Manusights internal analysis of cardiovascular pre-submission reviews.

The page owns the Circulation submission process intent: what to prepare before the AHA portal, what happens during triage, and how to interpret the process after upload. It should not compete with the Circulation submission guide, review-time page, under-review page, or cover-letter page.

The specific failure pattern we see is a Clinical Perspective box that reads like an abstract remix. Editors consistently screen for practice consequence, not just statistical strength. If the box does not tell a cardiologist what to think or do differently, the format-free submission process will not save the paper.

This is Circulation-specific and required for all original research submissions. It consists of two sections:

What Is New? (maximum 100 words, 2 to 3 bullet points)

State what the paper adds to existing knowledge. Each bullet should be one complete sentence.

What Are the Clinical Implications? (maximum 100 words, 2 to 3 bullet points)

State how the findings affect clinical practice or understanding. Each bullet should be one complete sentence.

Paragraph format is not accepted. It must be bulleted. Editors use this box to quickly assess whether the paper changes clinical thinking. A weak Clinical Perspective signals that the clinical consequence is unclear, which is exactly what gets papers desk rejected.

Go to the AHA submission portal, log in, and select Circulation as the target journal.

Common types for original research:

• Original Research Article: full-length study reporting new clinical or translational findings
• Research Letter: shorter format for time-sensitive or focused results
• Review: invited or open, comprehensive treatment of a cardiovascular topic

Select the type that matches your manuscript. Each type has different requirements at the revision stage, but the initial submission is format-free for original research.

Provide the title, structured abstract, author list, and ORCID identifiers. All authors must have ORCID registered.

Upload the manuscript file with continuous line numbering. The Clinical Perspective box must be included in the manuscript file itself, not as a separate document.

All supplemental material must be submitted with the initial manuscript. It is included in peer review. Do not plan to add supplemental material after the first submission.

All authors must disclose conflicts of interest. Provide a data sharing statement describing how other researchers can access the underlying data. Circulation takes data transparency seriously.

The initial submission does not require perfect AMA formatting. Reviewers and editors need to evaluate the science, not the citation style. Save the detailed formatting for revision.

Circulation's desk rejection rate is 60 to 70%. This is the biggest filter. The editor-in-chief or an associate editor reads the manuscript and Clinical Perspective to decide whether external review is warranted.

Editors are asking:

• does this paper change clinical practice or cardiovascular understanding?
• is the study design strong enough to support the claims?
• is the clinical consequence visible and concrete?
• does the Clinical Perspective box make the case quickly?
• is the topic relevant to Circulation's broad cardiovascular readership?

Desk rejections typically arrive within 1 to 2 weeks. The process is deliberately fast so authors can redirect without long delays.

Papers that pass triage are assigned to an associate editor who selects reviewers.

Papers sent for review go to 2 to 3 expert reviewers with typical turnaround of 2 to 4 weeks. If the paper is promising, it also goes to a statistical reviewer who evaluates the analytical methods independently.

Reviewers evaluate:

• originality and scientific quality
• clinical significance and practice implications
• study design, methodology, and statistical analysis
• whether the conclusions are proportional to the evidence
• topical relevance to the cardiovascular community

• Accept: rare on first round at Circulation.

• Minor revision: the paper is essentially accepted pending specific changes. You have 6 weeks. Full AMA formatting is required at this stage.

• Major revision: substantive concerns. You have 3 months. The statistical review results will be included with the decision letter. Full formatting required.

• Reject: the paper does not meet Circulation's threshold. The letter may suggest a more appropriate AHA journal (Circulation Research, Circulation: Heart Failure, etc.).

At revision, you must switch from format-free to Circulation's detailed style (AMA references, specific heading structure, figure formatting requirements). This is intentional: authors only invest in formatting after the paper has cleared the hardest filter.

• Submitted: your manuscript is in the system
• With Editor: an associate editor is reviewing or selecting reviewers
• Under Review: sent to external reviewers
• Required Reviews Complete: reviewers have returned reports
• Decision Pending: editor is making a final recommendation
• Decision Made: check your email

If "With Editor" persists beyond 3 weeks without moving to "Under Review," the paper is likely in the desk rejection queue.

This is the most common mistake. Authors spend months on the methods and results, then write the Clinical Perspective in five minutes before submission. Editors can tell. The box should articulate a genuine shift in clinical understanding, not restate the abstract in bullet form.

Circulation explicitly allows format-free first submissions. If you spend days perfecting AMA style before knowing whether the paper will be reviewed, you may have wasted that time. Get the science right. Format at revision.

Unlike some journals that allow supplemental material to be added later, Circulation requires it at initial submission. If your supplemental data, methods, or tables are not ready, the submission is not ready.

Circulation editors are cardiologists and cardiovascular scientists who recognize when clinical claims outpace the evidence. An observational study described as "practice-changing" without a mechanistic or interventional basis will trigger skepticism at triage.

In our pre-submission review work with manuscripts targeting Circulation, three patterns generate the most consistent desk rejections among the papers we analyze.

Clinical Perspective boxes that restate the abstract. Circulation editors explicitly describe the Clinical Perspective as a tool to "help clinicians immediately understand the significance and application of the findings." We see the majority of desk-rejected manuscripts where the Clinical Perspective reads as a third version of the abstract, using the same language as the structured abstract conclusions. The box is supposed to answer a different question than the abstract: not what the study found, but what a cardiologist should do or think differently as a result. Editors read both the abstract and the Clinical Perspective before deciding whether to desk-reject; when both say the same thing, the manuscript fails the clinical consequence test.

Translational papers submitted to Circulation rather than Circulation Research. We observe a consistent pattern where mechanistic cardiovascular studies with animal model validation and human biomarker associations are submitted to Circulation because the authors perceive it as higher prestige. Editors redirect these papers to Circulation Research (IF ~15) within 1-2 weeks. Circulation's primary audience is clinical cardiologists, not cardiovascular scientists. A mechanistic story that is important for understanding cardiovascular biology but does not directly change clinical practice is a stronger fit for Circulation Research, and editors know it.

Observational studies presented as practice-changing without mechanistic or interventional grounding. We find that large retrospective cohort studies, even with strong statistical support, that claim to change clinical practice without randomized evidence or a biological mechanism explaining the observed association consistently receive desk rejections at Circulation. The journal's implicit standard is that practice-change claims require either interventional trial design or mechanistic validation. Observational associations that argue only from statistical association are classified as hypothesis-generating, not practice-changing.

SciRev author-reported data confirms Circulation's 17-day median to first editorial decision. A Circulation desk-rejection risk and clinical-consequence framing check can assess whether your Clinical Perspective box and clinical-consequence argument meet Circulation's bar before you submit.