European Heart Journal Formatting Requirements: Complete Author Guide

This page was created by checking the current European Heart Journal general instructions, Oxford Academic submission guidance, ESC journal materials, SciRev community timing data, and our pre-submission review work on cardiovascular submissions. This page focuses on word limits, abstract structure, graphical abstract files, figure rules, references, and upload-ready compliance. The submission guide and submission-process pages own journal choice and portal workflow.

The original layer here is the formatting-to-triage connection. A failure pattern we see is an otherwise strong cardiovascular manuscript whose Structured Graphical Abstract cannot state the Key Finding as a concrete clinical consequence. That is not just a formatting issue; it tells the editor that the clinical claim may still be unclear.

Before working through the formatting details, a European Heart Journal formatting and readiness check flags the structural issues that cause desk rejection before editors even reach the formatting questions.

EHJ is the flagship journal of the European Society of Cardiology (ESC), published by Oxford University Press. Word counts exclude the title, abstracts, figure legends, and references.

Rapid Communications, Hypotheses, Discussion Forum letters, and Cardiovascular Flashlights allow only 1 figure or 1 table or 1 video, and Viewpoints allow none. Clinical Research, Translational Science, and Meta-analysis articles have no maximum number of figures or tables, though the guidelines say that submissions should typically have no more than eight figures and tables in total.

How EHJ compares to other top cardiology journals:

EHJ's 5,000-word limit ties Circulation and exceeds JACC by 500 words. The extra room helps for clinical trial reports with subgroup analyses and safety data. The Lancet is substantially tighter at 3,500 words.

If you are also weighing the general medical flagships, the formatting conventions diverge in ways that change how much reformatting each option costs:

The most EHJ-specific line is the graphical abstract: the two-part Structured Graphical Abstract (text element plus graphic) is mandatory for research articles, which neither Lancet nor JAMA nor NEJM requires, so it is the element most often missing from a manuscript reformatted from one of those journals.

EHJ uses a structured abstract with four headings, not three, and not the same headings as most cardiology journals. This catches many authors.

Required headings (Clinical Research, Translational Science, Meta-analysis):

1. Background and Aims

1. Methods

1. Results

1. Conclusions

Specs:

• 250-word maximum, no references

• Submit as a separate file in Editorial Manager

• For clinical trials, the paper should include the registration number and the name of the register (the guidelines do not say where)

Common mistakes: Using "Objectives" instead of "Background and Aims." Combining Methods and Results into one heading (that's EHJ Open's format, not the main journal). Using "Conclusion" singular instead of "Conclusions" plural.

State of the Art Reviews, Hypotheses, and Special Articles use an unstructured abstract of 250 words with no headings.

This is mandatory for Clinical Research, Translational Science, and Meta-analysis articles. It is not optional and it is not the same as a traditional graphical abstract.

Two separate components, submitted as separate files:

1. Text element, three headings, each up to 40 words:

• Key Question

• Key Finding

• Take-home Message

1. Graphic element, a visual summary of the study's design and main finding:

• Dimensions: 11.0 cm high x 18.0 cm wide (landscape)

• Resolution: 300 ppi minimum

• Font: sans serif (Myriad Pro, Arial, or Helvetica), 10-12 pt and no smaller than 8 pt

• File type: vector preferred (.pdf, .ai, .svg); photographs in.tiff at 300 ppi

• Figure legend: 80 words maximum

• Include an alphabetized abbreviation list if abbreviations appear in the graphic

If the paper is accepted, the text and graphic are professionally redrawn into a single Structured Graphical Abstract, and the illustrators work with the authors. You don't need to create the final combined version yourself.

Required for Translational Science Articles only, not Clinical Research articles.

• Maximum 100 words

• No references or abbreviations

• A summary of relevant translational aspects for clinical applications

Good example: "Our finding that elevated sST2 levels predict decompensation 48 hours before clinical deterioration could enable a biomarker-guided early intervention strategy. A prospective trial testing sST2-triggered diuretic adjustment in ambulatory heart failure patients is now warranted."

Bad example: "These results advance our understanding and may have implications for future clinical practice."

The Translational Perspective is peer-reviewed. Editors take it seriously.

Table rules:

• Submit each table as a separate editable file, not as an image

• Portrait layout preferred, maximum 9 columns

• No color or shading

• Every column must have a header

Alt text: Required for all figures. Include directly under the figure legend, preceded by "Alt text:".

Videos: .mp4 or .avi only. No YouTube or third-party hosting. Include a video still in vector format.

In-text: Arabic numerals in the order cited.

Reference list. Compare the EHJ Vancouver format against the APA/AMA habit authors carry over from other journals:

Correct (EHJ Vancouver; no comma after surname, MEDLINE journal abbreviation, semicolon before volume):
1. Smith AB, Jones CD, Williams EF. Title in sentence case. *Eur Heart J* 2025;**46**:1234-1242.
Wrong (APA habit: surname-comma-initials, parenthetical year, full journal name):
Smith, A. B., Jones, C. D., & Williams, E. F. (2025). Title in sentence case. European Heart Journal, 46, 1234-1242.

• List all authors for 6 or fewer; for 7+, list the first 6 then "et al"

• Journal names use MEDLINE abbreviations; write the full name if not indexed in MEDLINE

• Include DOIs where available

The maximum is 100 references for Clinical Research, Translational Science, and Meta-analysis articles, and 150 for State of the Art Reviews.

Reference manager note: Select "European Heart Journal" or "Vancouver" style. Do not use "AMA", the author cutoffs and punctuation differ.

EHJ calls this "Supplementary Material." It is submitted with the manuscript for peer review and published online with the article.

• Label as Supplementary Figure 1, Supplementary Table 1, Supplementary Video 1, etc.

• Cite in the main text

• Submit simultaneously with the manuscript

• Will not be copyedited or typeset, published in the format you provide

• Submit in non-editable format where possible

Data availability: A Data Availability Statement is required in every manuscript. Include it in the Declarations Form.

EHJ asks authors to follow the relevant reporting guideline for your study type.

Sex, gender, race, and ethnicity reporting: EHJ follows SAGER guidelines. You must indicate in the title or abstract what sex(es) and/or gender(s) the study applies to. Report in Methods how sex and gender were considered in the study design. Stratify results by sex and gender where appropriate. For race and ethnicity, prefer participant self-identification and describe populations specifically (e.g., "Chinese American" rather than "Asian American").

Ethics statements: For human experimentation, the research protocol must be approved by the locally appointed ethics committee and informed consent must be obtained from participants (or their legally authorized representative), and these facts must be stated in the manuscript.

Document setup:

• Prepare the manuscript in a word processing package (save in .doc format); journal-specific formatting is optional at initial submission

• Double-spaced, unjustified text, TAB-indented paragraphs

• Line numbers on all pages (restart per page)

• Oxford English spelling

• Define nonstandard abbreviations at first use; SI units throughout

Title page: Full title (as short as possible, avoiding abbreviations unless the title would be very long without them), all author names and affiliations, the institution where the work was performed, and the mailing address and email address of one corresponding author.

Cover letter: State the main finding. Explain fit with EHJ's scope. Note any conference presentations (ESC Congress, AHA, ACC). Suggest reviewers. Disclose related manuscripts under consideration.

Declarations Form: EHJ requires a completed Declarations Form at initial submission covering disclosure of interest, data availability, funding, ethical approval, and the pre-registered clinical trial number, as applicable to your article type. CRediT contributor roles are supplied separately in the submission system.

Fast Track Petition: EHJ offers an expedited pathway for time-sensitive findings. Submit a cover letter explaining the urgency, a text abstract, and the full manuscript as a "Fast Track Petition" article type. The editorial office targets a decision within 7 working days and publication within 10 working days of acceptance. Fast Track papers intended for simultaneous publication with a presentation at a major international congress are initially published as non-typeset accepted manuscripts.

EHJ offers both subscription and open-access publication. The open-access charge is set by Oxford University Press and shown in OUP's charge tool; the author guidelines say there is no charge to publish under a standard licence. Under the standard licence, authors may make their Accepted Manuscript publicly available in an institutional or other non-commercial repository after a 12-month embargo.

Many European funders (Wellcome Trust, ERC, UKRI) require immediate open access. If your funder mandates it, budget for the APC. Check whether your institution has a Read & Publish agreement with Oxford University Press, these can cover or discount the fee.

Preprints: You can post your Author's Original Version to any preprint server (medRxiv, bioRxiv) at any time before submission. You can also submit directly from medRxiv or bioRxiv to EHJ through the Author Area. After acceptance, add the DOI link to the preprint.

For manuscripts targeting European Heart Journal, four patterns generate the most consistent desk-rejection outcomes.

Graphical abstract Key Finding stated without a concrete clinical consequence. EHJ's mandatory Structured Graphical Abstract requires a "Key Finding" text block of up to 40 words. Editors use this as a triage tool before reading the manuscript. A vague finding ("our results suggest that X may be associated with Y in certain patient populations") signals a manuscript where the clinical consequence is not yet clearly formulated.

The guidelines require all three graphical abstract elements (Key Question, Key Finding, Take-home Message), each of up to 40 words. A Key Finding that cannot be written in one concrete sentence is a signal that the clinical framing needs more work before submission.

Single-center observational data without a cover-letter argument for why single-center design was necessary. EHJ's desk rejection rate for single-center observational studies is high. The narrow exceptions are novel surgical techniques requiring specific institutional expertise, rare disease series where multicenter data does not exist, and methodological innovations tied to one center's protocol. The cover letter must make a specific methodological argument for the design, not simply state that the study was large or well-executed.

Missing CODE-EHR compliance for observational studies using electronic health records. EHJ asks observational studies and clinical trials that use healthcare records or registries to follow STROBE and to demonstrate that they have met the minimum standards of the CODE-EHR framework. This is a distinct expectation, not boilerplate. A study using EHR or registry data that follows STROBE but has not shown the CODE-EHR minimum standards is missing something the guidelines ask for. Authors submitting observational database studies from outside Europe are often unaware this framework exists.

Surrogate endpoints in studies where hard outcomes were feasible. EHJ may send a manuscript to a Statistical Reviewer, and all provisionally accepted papers undergo a detailed statistical review. Studies using imaging parameters, biomarker levels, or other surrogate markers are likely to be flagged when the cohort size and follow-up period would have permitted reporting of mortality, hospitalization, or major adverse cardiovascular events. If surrogates were chosen, the cover letter must explain why hard outcomes were not feasible. This justification is expected in the submission package, not as a response to reviewer queries.

A European Heart Journal pre-submission readiness check evaluates whether your manuscript meets EHJ's scope, study design, and reporting requirements before submission.