Circulation 'Under Review': What Each Status Means and When to Expect a Decision
If your Circulation submission shows Under Review, here is what each status means, what the statistical review involves, and when to expect a decision.
Assistant Professor, Cardiovascular & Metabolic Disease
Author context
Works across cardiovascular biology and metabolic disease, with expertise in navigating high-impact journal submission requirements for Circulation, JACC, and European Heart Journal.
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Decision cue: Circulation is fast. The median first decision is about 17 days. If your paper shows "Under Review," it has already passed the editorial screen that rejects 60 to 70% of submissions. That means your Clinical Perspective box, study design, and clinical significance all cleared the desk. The statistical review is the next major checkpoint.
Quick answer
Circulation desk rejects 60 to 70% of submissions within 1 to 2 weeks. Papers that pass the desk go to 2 to 3 clinical expert reviewers plus an independent statistical reviewer. The acceptance rate is roughly 7%. The median time from submission to first decision is about 17 days, making Circulation one of the fastest top cardiovascular journals.
If your paper is Under Review, you have cleared the most aggressive filter. The editorial team considers the paper worthy of expert evaluation, which is a meaningful signal.
Circulation's review pipeline
Status | What is happening | Typical duration |
|---|---|---|
Submitted | Administrative processing | 1 to 2 days |
With Editor | Editor assessing for desk decision | 3 to 10 days |
Under Review | External reviewers + statistical reviewer evaluating | 1 to 3 weeks |
Required Reviews Complete | All reports received, editor deliberating | 2 to 5 days |
Decision Pending | Editor finalizing recommendation | 1 to 3 days |
Decision Made | Check email | Same day |
The desk screen (~60 to 70% rejected)
Before your paper reaches "Under Review," an editor-in-chief or associate editor reads the manuscript and Clinical Perspective box. This is the biggest filter.
Editors are evaluating:
- does the study change cardiovascular clinical practice in a concrete way?
- is the Clinical Perspective box compelling and specific?
- is the study design strong enough to support the clinical claims?
- will the finding interest Circulation's broad cardiovascular readership?
The most common desk rejection reasons:
- the clinical consequence is too narrow for one subspecialty (interventional, electrophysiology, heart failure) rather than broad cardiovascular medicine
- the Clinical Perspective box restates the abstract rather than articulating a practice change
- the study design is too weak for the claims (underpowered, retrospective when prospective is needed)
- the work is translational or mechanistic rather than directly clinical (consider Circulation Research)
Desk rejections arrive within 1 to 2 weeks. The editor may suggest a Circulation specialty journal (Circulation: Heart Failure, Circulation: Arrhythmia and Electrophysiology, etc.) or JACC as an alternative.
What happens during peer review
Papers that pass the desk go to 2 to 3 clinical expert reviewers. In parallel, the paper goes to an independent statistical reviewer.
Clinical reviewers evaluate:
- originality and scientific quality of the cardiovascular research
- clinical significance and practice implications
- study design, methodology, and execution
- whether the conclusions match the evidence
- topical balance and relevance to Circulation's readership
The statistical reviewer independently evaluates:
- appropriateness of statistical methods for the study design
- sample size adequacy and power calculations
- handling of missing data and sensitivity analyses
- multiple comparisons corrections
- reporting completeness (confidence intervals, effect sizes, exact p-values)
The statistical review is one of Circulation's distinctive features. Many authors receive feedback from the statistical reviewer that their clinical reviewers did not raise. Prepare for this by ensuring the statistical methods section is thorough and the analytical approach is well-justified.
What each decision means
Accept
Very rare on first round. Almost all Circulation acceptances follow revision.
Minor Revision
Specific, addressable changes. You have 6 weeks. Full AMA formatting is required at this stage (initial submissions are format-free). This is a strong signal of eventual acceptance.
Major Revision
Substantive concerns about the study. You have 3 months. The statistical review results are included. The revised paper returns to reviewers. Revision requests at Circulation sometimes require additional statistical analyses, subgroup analyses, or sensitivity analyses that the statistical reviewer identified.
Reject After Review
The reviewers or statistical reviewer found problems that cannot be adequately addressed. The decision letter includes full reviewer reports and statistical review feedback. Even in rejection, this feedback is often valuable for improving the manuscript before submitting elsewhere.
When to follow up
Situation | Action |
|---|---|
With Editor for 7 to 10 days | Normal desk review. Wait. |
With Editor for 14+ days | The paper may be in the desk rejection queue. Prepare for either outcome. |
Under Review for 14 days | Normal. |
Under Review for 21+ days | Slightly slower than Circulation's median. Wait a few more days. |
Under Review for 28+ days | Polite inquiry is reasonable. |
Required Reviews Complete for 7+ days | Editor may be consulting additional input. Wait. |
What to do while waiting
- Circulation's 17-day median means the wait is rarely long
- prepare for statistical review feedback that may require additional analyses
- if the editor desk rejected and suggested a Circulation specialty journal, evaluate the transfer option
- do not submit elsewhere while under review
- if you used format-free initial submission, prepare the full AMA formatting for a potential revision request
How Circulation compares
Feature | Circulation | European Heart Journal | JACC | |
|---|---|---|---|---|
Scope | Broad cardiovascular clinical | Basic and translational cardiovascular | Broad cardiovascular (European) | Clinical cardiology |
Desk rejection | ~60 to 70% | ~40% | ~50% | ~60% |
Median decision | ~17 days | ~30 days | ~21 days | ~14 days |
Statistical review | Yes, independent | Yes | Yes | Yes |
Best for | Practice-changing cardiovascular research | Mechanistic cardiovascular studies | European/global cardiovascular trials | Interventional and clinical cardiology |
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Sources
On this page
Reference library
Use the core publishing datasets alongside this guide
This article answers one part of the publishing decision. The reference library covers the recurring questions that usually come next: how selective journals are, how long review takes, and what the submission requirements look like across journals.
Dataset / reference guide
Peer Review Timelines by Journal
Reference-grade journal timeline data that authors, labs, and writing centers can cite when discussing realistic review timing.
Dataset / benchmark
Biomedical Journal Acceptance Rates
A field-organized acceptance-rate guide that works as a neutral benchmark when authors are deciding how selective to target.
Reference table
Journal Submission Specs
A high-utility submission table covering word limits, figure caps, reference limits, and formatting expectations.
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