With this issue, we mark 4 complete years of publication of Circulation: Cardiovascular Quality and Outcomes (CQO). Thank you to our editors, readers, authors, reviewers, and supporters—and especially to Emily Picillo, Katie Sullivan, Karen Barry, and the rest of the outstanding Circulation staff—for helping CQO to mature as a publication with impact. Earlier this year, we submitted a report to the Scientific Publishing Committee of the American Heart Association. We would like to share the key aspects of the report. The mission of CQO is to improve clinical care and healthcare delivery for patients with, or at risk for, cardiovascular disease and stroke. We pursue this mission through a format that promotes scholarship, education, and constructive debate. The audience includes researchers, clinicians, policymakers, administrators, health plan executives, and government agency professionals. In addition to serving as a venue for high-quality scholarship, we seek to be a catalyst for good science, a vehicle for strengthening and expanding the community that is committed to improving clinical care and population health, and a means to inspire junior investigators to engage in scholarly activities of consequence. CQO has included original research, methods (describing studies that have been implemented) and methodological (describing specific research methods) articles, commentaries, data reports, quality improvement articles, and editorial perspectives. Our original articles span a broad set of disciplines. We consider the journal to be a home for high-quality epidemiology studies that have relevance for patient outcomes and public health. In a word cloud from the titles of 100 articles published in CQO earlier in the year (Figure 1), with word size proportionate to frequency of use, it is most heartening that the largest word is patients . Figure 1. Word cloud created from text contained in a sample of 100 articles published in CQO in 2012. Although the impact factor, defined …