JACC This Week

Reflective wrap-up from a live conference with highlights on why in-person meetings still matter. Discussion about audience feedback calling for both quick journal hits and deeper behind-the-scenes conversations. Plans to evolve formats to meet different listening preferences. Gratitude for listener input and a promise to iterate and return refreshed.

This week's edition of JACC This Week brings Dr. Carolyn Lam and Dr. Harlan Krumholz into a deep exploration of a special issue devoted to innovative cardiovascular research emerging from China. As they highlight newly published studies and their global significance, they reflect on how scientific progress accelerates when discoveries are shared across regions and cultures. Their conversation reinforces a central message: advancing cardiovascular health requires collective effort, open exchange, and a commitment to evaluating science based on quality—not geography.

Discussion of how COVID changed cardiovascular care, hospitalization patterns, and mortality. Examination of widening health disparities during the pandemic. Evaluation of PREVENT risk equations in young adults and limits of 10-year risk estimates. Exploration of low lipid testing and striking gaps in statin initiation among younger people. Conversation about prevention priorities and shared decision making.

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.

Rishi Wadhera, a noninvasive cardiologist and outcomes researcher who led the JACC Cardiovascular Statistics issue, discusses U.S. cardiovascular trends. He outlines reversals in hypertension control, rising diabetes in younger adults, and epidemic‑level obesity. The conversation highlights gaps in implementation, disparities in care, and how clear data visualizations can spur clinical and policy action.

In this episode of JACC This Week, Dr. Carolyn Lam and Dr. Harlan Krumholz spotlight a mini-focus issue on hypertrophic cardiomyopathy (HCM), a field undergoing rapid transformation. The discussion centers on the MAPLE-HCM trial comparing aficamten and metoprolol in symptomatic obstructive HCM, highlighting multidomain response analysis and what it means to measure meaningful improvement. Beyond gradients and biomarkers, the conversation explores a critical question: when physiologic surrogates improve, how should we interpret patient-centered outcomes? Framed by the Editor's Page, "What Does Improvement Mean?", this episode examines the evolving role of myosin inhibitors, disease modification, and the tension between surrogate markers and real-world clinical benefit. Additional highlights include disaggregation of Asian ethnicities in heart failure quality-of-care research and emerging evidence on AI-driven ECG models to predict incident heart failure—underscoring JACC's commitment to precision, equity, and innovation. This issue reflects a broader shift across cardiology: transforming once-static diseases into treatable chronic conditions guided by rigorous evidence.

In this episode of JACC This Week, Dr. Carolyn Lam and Dr. Harlan Krumholz spotlight the 2025 Adult Congenital Heart Disease (ACHD) Guidelines and explore what they signal for the future of cardiovascular care. Framed by Dr. Krumholz's Editor's Page, "From Survival to Stewardship," this discussion highlights a broader transformation in cardiology: advances that once turned fatal conditions into survivable ones now demand lifelong, structured, and hyper-specialized care. The conversation examines how ACHD exemplifies the shift from episodic survival to coordinated stewardship—where surveillance, systems design, and scalable expertise are essential. The episode also reviews key updates from the guidelines, including risk-based classification, lifelong monitoring, ACHD center collaboration, and global and early-career perspectives. Additional highlights from the issue include cardiac screening in the young, cardio-renal trial insights from CONFIDENCE, wildfire-related cardiovascular risk, and emerging cardiometabolic intersections. This mini-spotlight issue challenges clinicians to rethink how specialized cardiovascular care can be delivered effectively at scale.

In this episode of JACC This Week, Dr. Carolyn Lam and Dr. Harlan Krumholz explore the JACC Women's Cardiovascular Health Issue—an edition dedicated to advancing science, care, and professional culture for women in cardiology. The discussion spans original research and viewpoints addressing menopause and cardio-oncology risk, sex differences in dilated cardiomyopathy, device trials, rehabilitation after heart failure, global disparities, and the intersection of sex, race, and socioeconomic status in cardiovascular outcomes. Beyond inclusion, this episode highlights a deeper challenge: whether our systems of evidence generation, clinical care, and professional training are designed to serve women fully and routinely. The conversation also features a powerful viewpoint by Sarah Krumholz, Dueling Pursuits: Balancing Motherhood and Medicine, catalyzing a broader dialogue about leadership gaps, culture, and the future of cardiology. This episode sets the stage for a special bonus continuation focused on redesigning the profession for the next generation.

This bonus episode continues the conversation from the JACC Women's Cardiovascular Health Issue, moving from science to systems. In this extended discussion, Drs. Carolyn Lam and Harlan Krumholz are joined by Sarah Krumholz to reflect on how the culture and structure of cardiology shape the experiences of women in training and practice.

In this episode of JACC This Week, Dr. Harlan M. Krumholz and Dr. Carolyn S.P. Lam discuss a dedicated issue of JACC focused on cardiac amyloidosis—one of the fastest-evolving areas in cardiovascular medicine. They explore new evidence highlighting significant delays in diagnosing ATTR cardiomyopathy, the early divergence of mortality benefit with timely treatment, and why time to diagnosis is no longer a neutral factor. The conversation also examines secondary analyses from major clinical trials, practical guidance for amyloidosis evaluation and management, and Dr. Krumholz's Editor's Page on "computable diagnosis" as a moral imperative. This episode places emerging science in clinical context, emphasizing urgency, equity, and how clinicians should be thinking differently about diagnosis, staging, and access to therapy in amyloid heart disease. Read Full issue here: https://www.jacc.org/toc/jacc/87/5 Keywords: cardiac amyloidosis, amyloid heart disease, ATTR cardiomyopathy, computable diagnosis