Rejected from European Heart Journal? The 7 Best Journals to Submit Next

ESC guideline relevance. The journal's editors ask whether a paper's findings could influence the next ESC guideline update. Research that addresses a current guideline gap, challenges an existing recommendation, or provides new evidence for a therapeutic approach under debate has a significant advantage.

European and international cohort data. While EHJ publishes excellent research from any country, the editors give preference to studies with European cohort data or international multi-center data that includes European sites. Single-center studies from outside Europe face a higher bar unless the findings are exceptionally strong.

Clinical over basic science. EHJ publishes some translational work, but the journal leans heavily clinical. Basic cardiovascular science papers, even excellent ones, are more likely to be redirected to Cardiovascular Research (the ESC's basic science journal) or another venue.

"The findings, while interesting, don't sufficiently advance current clinical practice." Your study is well-designed but confirmatory. EHJ wants papers that move the needle, and a study confirming what cardiologists already do isn't going to clear that bar.

"This topic has been well-addressed in recent literature." Bad timing. The journal recently published several papers on the same topic, and the editors are looking for diversity in their content mix. Your paper might be perfectly good but arrived when the editorial calendar was saturated.

"We suggest you consider one of our companion journals." The editors think your paper is publishable but not competitive for EHJ itself. This is an invitation to transfer, and you should take it seriously. EHJ's sister journals are well-indexed and respected in their respective subspecialties.

"The study design has limitations that reduce our confidence in the conclusions." Small sample sizes, single-center data, retrospective designs without adequate bias control, or subgroup analyses presented as primary findings. EHJ has a high statistical bar, and the journal's statistical editors are thorough.

"Primarily of regional interest." Your study describes cardiovascular outcomes in a specific country or healthcare system without discussing the broader implications. EHJ's readership spans dozens of countries, and the editors need papers to resonate beyond a single national context.

Before looking outside the ESC family, consider whether one of EHJ's companion journals is the right fit:

• EHJ - Cardiovascular Imaging (IF ~7) - Echocardiography, cardiac MRI, CT, nuclear
• EHJ - Cardiovascular Pharmacotherapy (IF ~5) - Drug therapy, pharmacology
• EHJ - Digital Health (IF ~4) - Digital tools, AI, wearables, telemedicine
• EHJ - Quality of Care and Clinical Outcomes (IF ~5) - Quality metrics, outcomes research
• EHJ - Acute Cardiovascular Care (IF ~4) - Emergency cardiology, acute coronary syndromes

Accepting a transfer to a sister journal preserves your peer review reports, which saves weeks or months. The sister journals are fully indexed and carry the EHJ brand, which matters for visibility.

Before choosing your next journal, a European Heart Journal manuscript fit check can tell you whether the issue was scope or something more fundamental to address first.

1. Circulation

Circulation is EHJ's American counterpart and the flagship of the American Heart Association. The two journals have comparable impact factors, similar acceptance rates, and overlapping scopes in clinical cardiology. The main difference is geographic editorial perspective: Circulation leans toward the American healthcare context, while EHJ leans European.

If EHJ rejected your paper but the clinical contribution is strong, Circulation is the most direct alternative. Be aware that Circulation's desk rejection rate is also high (around 60%), so the same paper that was desk-rejected at EHJ may face the same outcome. But the different editorial perspective means Circulation might value aspects of your paper that EHJ didn't prioritize.

Best for: Large clinical trials, AHA-guideline-relevant research, US cohort data, heart failure, atherosclerosis.

2. JACC (Journal of the American College of Cardiology)

JACC is the ACC flagship journal and has particular strength in interventional cardiology, structural heart disease, and cardiovascular imaging. If your EHJ submission was an interventional or imaging paper, JACC's editorial team has deep expertise in those areas.

JACC also publishes a family of subspecialty journals (JACC: Cardiovascular Imaging, JACC: Heart Failure, JACC: Clinical Electrophysiology, etc.) that can serve as cascade options. The JACC family uses a manuscript transfer system similar to EHJ's.

Best for: Interventional cardiology, structural heart disease, cardiovascular imaging, precision cardiology.

3. Heart

Heart is the BMJ's cardiology journal and occupies a solid mid-tier position in cardiovascular publishing. The journal publishes clinical cardiology research, educational reviews, and practice-oriented articles across all cardiovascular subspecialties.

For papers that EHJ rejected as "not competitive enough" but the science is sound, Heart is a well-regarded destination. The journal is particularly receptive to papers with a clinical practice angle, including those that describe outcomes from real-world registries or compare treatment strategies in routine clinical settings.

Best for: Clinical cardiology, registry-based studies, practice-oriented research, broad cardiovascular topics.

4. Cardiovascular Research

For basic and translational cardiovascular science, Cardiovascular Research is the ESC's dedicated venue. If EHJ rejected your paper because it was "too basic" or "primarily translational," CVR is where the ESC editors wanted you to go. The journal publishes molecular cardiology, vascular biology, cardiac electrophysiology mechanisms, and preclinical studies.

CVR has an IF around 10, making it one of the top basic cardiovascular science journals. If your paper has strong mechanistic data but limited direct clinical relevance, CVR's editorial team will evaluate it for its scientific contribution rather than its clinical impact.

Best for: Basic cardiovascular science, vascular biology, cardiac electrophysiology mechanisms, preclinical pharmacology.

5. Journal of the American Heart Association (JAHA)

JAHA is an open-access journal from the AHA that publishes clinical and translational cardiovascular research. The journal has a higher acceptance rate than EHJ, Circulation, or JACC (around 20%) and provides a well-indexed open-access platform for cardiovascular research.

For papers that are methodologically sound but didn't clear the "practice-changing" bar at EHJ, JAHA is a good option. The open-access format means your paper is freely accessible to clinicians worldwide, which can increase its practical impact even if the journal's IF is lower.

Best for: Clinical cardiovascular research, translational studies, open-access priority, broad CV topics.

6. International Journal of Cardiology

IJC publishes a high volume of cardiovascular research across all subspecialties and study types. The journal accepts retrospective studies, smaller trials, and preliminary clinical data that the top-tier journals might pass on. For papers that need a home without a prolonged cascade through multiple top journals, IJC offers reasonable review times and a broad readership.

Best for: All cardiovascular research, smaller clinical studies, international cohort data, preliminary findings.

7. Europace

For arrhythmia and cardiac pacing research specifically, Europace is the dedicated ESC journal. If your EHJ submission was about atrial fibrillation management, cardiac implantable device outcomes, ablation techniques, or cardiac electrophysiology, Europace's focused readership is the right audience.

The journal also publishes ESC guidelines and consensus statements related to cardiac rhythm management, which means publications in Europace can directly influence clinical practice in the arrhythmia space.

Best for: Atrial fibrillation, cardiac pacing, ablation, cardiac electrophysiology, arrhythmia management.

Large clinical trial rejected? Circulation first (different editorial perspective), then JACC. If all three top-tier journals pass, Heart and JAHA are strong mid-tier options where your trial will still reach cardiologists.

Imaging paper rejected? JACC: Cardiovascular Imaging (IF ~14) is the top imaging subspecialty journal. EHJ - Cardiovascular Imaging is the ESC alternative. Both are better fits than a general cardiology journal if imaging is your paper's primary contribution.

Basic science paper rejected? Cardiovascular Research is the intended destination for translational and basic work within the ESC ecosystem. Don't try to force basic science into clinical journals.

Heart failure paper rejected? JACC: Heart Failure and ESC Heart Failure are both dedicated venues. Heart failure is a large enough subfield to support specialized journals, and your paper will get more expert review in a dedicated venue.

Connect the findings to clinical guidelines. If EHJ rejected your paper for insufficient clinical relevance, explicitly state in the discussion how your findings relate to current ESC or AHA/ACC guidelines. Which guideline recommendation does your paper support, challenge, or extend?

Address the generalizability question. Single-center data needs a clear discussion of external validity. Why should cardiologists outside your institution care about these results? What makes your patient population representative of the broader cardiovascular population?

Improve the statistical presentation. EHJ's statistical reviewers are among the most thorough in cardiovascular publishing. If your paper was flagged for statistical issues, consult a cardiovascular biostatistician before resubmitting. Common issues include competing risks not addressed in survival analysis, time-varying confounders in observational studies, and multiplicity in subgroup analyses.

Consider the visual abstract. Many cardiovascular journals, including EHJ and Circulation, appreciate visual abstracts or graphical summaries. While not required, a well-designed visual abstract demonstrates that you understand how to communicate your findings efficiently.

Cardiovascular publishing moves quickly, and the journals you're competing against have increasingly sophisticated editorial processes. Run your revised manuscript through a manuscript scope and readiness check to check scope alignment, formatting compliance, and structural completeness before your next submission. The right journal match, combined with clean presentation, is what turns a rejection into an acceptance at the next stop.

Resubmit to the same tier if:

• Reviewers praised the science but identified fixable issues
• You can address concerns within 2-3 months

Move to a different journal if:

• The rejection cited scope mismatch, not quality
• Your timeline needs a decision within 2-3 months

Reframe before resubmitting if:

• Reviewers found fundamental methodology concerns
• New experiments are needed to support the claims

In our pre-submission review work with manuscripts targeting European Heart Journal, four patterns generate the most consistent desk rejections worth knowing before resubmission.

Clinical significance insufficient for EHJ's guideline-level readership. European Heart Journal publishes the ESC clinical guidelines and expects original research to meet the same standard: findings that would change how European cardiologists manage patients or that the ESC guideline committees would need to consider in future revisions. We see this failure as the most common pattern in EHJ desk rejections we review: well-powered cardiovascular trials and cohort analyses where the finding confirms existing practice or demonstrates an association the field has already recognized. In our review of EHJ submissions, we find that editors consistently require that the clinical implication be direct, immediate, and likely to influence guideline-level decisions.

European cohort studies with conclusions that do not generalize internationally. EHJ publishes for a global cardiovascular audience despite its European Society of Cardiology base. Papers presenting findings from European registries, healthcare systems, or patient populations where the applicability to non-European practice is not discussed face editorial concerns about generalizability. We see this pattern in EHJ submissions we review present European health system-specific findings without addressing international relevance.

Basic cardiovascular science without a clear translational bridge. EHJ is a clinical cardiovascular journal. Mechanistic studies in animal models or cell culture without connecting to a clinical question or human cardiovascular disease phenotype face consistent scope redirection to Cardiovascular Research or Circulation Research. We see this failure regularly in manuscripts we review for EHJ: mechanistically rigorous work where the clinical connection is speculative.

Methodological or reporting gaps for cardiovascular trials. EHJ checks CONSORT compliance and requires pre-registered endpoints for clinical trials. We see this pattern in clinical trial submissions we review: missing flow diagrams, post-hoc endpoints without disclosure, or subgroup analyses without pre-specification. Editors return these before peer review.

SciRev community data for European Heart Journal confirms desk decisions typically within 1-2 weeks and post-review first decisions within 4-6 weeks, consistent with the fast editorial cadence the ESC maintains for its flagship journal.