The editor-in-chief plays a vital role in ensuring a journal’s scientific integrity and quality. Their primary responsibilities include managing the peer-review process, selecting qualified reviewers, and making final decisions on manuscript acceptance, revision, or rejection. In cases of scientific misconduct, conflicts of interest, authorship disputes, or ethical concerns, the editor has the ultimate authority. An editor’s vision for the journal shapes which manuscripts are reviewed and accepted, influencing the journal’s academic direction. While the role offers benefits such as scientific prestige, greater research visibility, and financial compensation, it also entails significant ethical responsibilities. Academic editor malpractice refers to any actions that violate ethical standards or compromises the integrity of the peer-review process. Editors typically serve five-year terms, often with the possibility of renewal, and are frequently evaluated based on the journal’s impact factor trend. However, their role extends beyond editorial duties—they act as gatekeepers, literary agents, accountants, mediators, and judges, navigating the complex relationships among authors, reviewers, and publishers. Editors of major journals hold an extraordinary amount of power within the publication process. They act as an umpire to judge the scientific research that is being published. Like an umpire, they must know about the sport and rules of play, but they themselves should never be in the competition. The problem is that this ideal is not always met. Whether the subject is the efficacy of an antihypertensive drug, the value of a new costly biomarker, or the origin of a pandemic, editors often make decisions for multi-parametric—and also extra-scientific—reasons. On this basis, some papers are published while others are declined, and the stream of scientific evidence can be polluted. In summary, the editor-in-chief is a cornerstone of academic publishing, ensuring that scientific quality and integrity are upheld while balancing multiple responsibilities.

Background: Patients with pre-existing heart failure (HF) are particularly vulnerable to adverse outcomes following coronavirus disease 2019 (COVID-19). Understanding of the long-term cardiovascular sequelae of COVID-19 in this high-risk group is essential to improve post-infection management and outcomes. Methods: A systematic review of PubMed, Scopus, Web of Science, and Embase was conducted to identify peer-reviewed studies published between 2020 and 2025. Eligible studies included adults with a confirmed diagnosis of HF prior to COVID-19 infection and reported cardiovascular outcomes assessed at least 12 weeks after the acute phase. Data were extracted on patient demographics, HF subtype, cardiovascular outcomes, quality of life (QoL), and management approaches. Results: Forty-five studies met the inclusion criteria, encompassing heterogeneous but predominantly high-income country populations across multiple regions and HF phenotypes. COVID-19 was associated with increased HF symptoms, hospital readmissions 28% [95% confidence interval (CI) 24–32%] at 12 months, and mortality 18% (95% CI 15–22%) at ≥ 12 months. Patients with HF with reduced ejection fraction (HFrEF) had a 1.4-fold greater readmission risk than HF with preserved ejection fraction (HFpEF). Mechanistic data implicated persistent myocardial inflammation, endothelial dysfunction, and autonomic dysregulation. Functional capacity declined, with a mean 68-meter reduction in six-minute walk distance (6MWD). Vaccination was associated with a ~40% reduction in mortality and major adverse cardiovascular events (MACE). Discussion: COVID-19 is associated with a sustained cardiovascular burden in individuals with HF, underscoring the importance of long-term surveillance, optimization of guideline-directed medical therapy, and structured rehabilitation. Standardized, prospective studies are needed to elucidate causal mechanisms and refine post-COVID management strategies.

Pulmonary embolism (PE) is the third most common cause of cardiovascular mortality and presents a significant challenge in acute care settings. EkoSonic Endovascular System (EKOS) (ultrasound assisted catheter directed thrombolysis) and suction thrombectomy have emerged as key treatment options for high and intermediate risk PE. EKOS delivers localized fibrinolytic therapy, whereas thrombectomy provides definitive clot removal using devices such as the FlowTriever System (Inari Medical). However, the optimal treatment strategy, particularly in recurrent PE, remains uncertain. We report a case requiring escalation of therapy from EKOS to suction thrombectomy due to recurrent PE and worsening hemodynamic status despite initial thrombolysis. The patient was initially treated with EKOS for a saddle PE but was rehospitalized with syncope and persistent right ventricular (RV) strain. Given the inadequate response to thrombolysis, suction thrombectomy was performed, leading to marked improvement in RV function and overall clinical status. This case underscores the importance of individualized management and timely escalation when initial therapy is insufficient. Assessment of therapeutic success should include not only symptomatic relief but also resolution of clot burden and RV recovery. A focused literature review comparing EKOS and suction thrombectomy suggests that while both modalities are viable, suction thrombectomy may offer faster hemodynamic improvement in select patients. However, available data remains limited, highlighting the need for further comparative studies. Overall, this case and review support a tailored, multidisciplinary approach to PE management, emphasizing shared decision making and early escalation in patients with clinical deterioration despite initial intervention.