JACC This Week March 17, 2026: Heart Failure, Chagas Research & AI in Cardiology | JACC This Week
Mar 17, 2026
They discuss a randomized trial in Chagas cardiomyopathy and its implications for treatment in neglected populations. Genetics papers linking cardiomyopathy variants and polygenic risk to atrial-first disease get attention. Surprising racial and ethnic patterns in England's heart‑failure care are explored. The conversation also covers the design and safety challenges of autonomous AI tools in cardiovascular care.
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First Randomized Heart Failure Trial In Chagas Disease
- ANSWER-HF is a randomized double-blind trial comparing sacubitril/valsartan to enalapril in 190 patients with chronic Chagas cardiomyopathy and LVEF <40% over six months.
- The trial found no definitive superiority by conventional analyses, though biomarker signals suggested possible differences and the study serves as an important evidence-building first step.
Non-White Patients Had Better Outcomes In England Audit
- Analysis of ~240,000 English heart failure admissions found non-white patients received more guideline-directed therapy and specialist care and had lower mortality versus white patients over median 68 weeks.
- In a universal NHS setting this unexpected reversal raises questions about mechanisms and how equitable care pathways may narrow historical disparities.
2025 Diastolic Guidelines Miss Many HFpEF Cases
- A well-phenotyped invasive cohort showed 2025 echocardiographic diastolic grading labeled two-thirds of HFpEF patients as normal or grade 1 despite elevated resting filling pressures.
- Barry Borlaug's group and Carolyn Lam's editorial emphasize echo is indispensable but insufficient alone; clinical judgement and broader evaluation remain essential.