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A weekly co-hosted podcast featuring JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC and JACC Senior Consulting Editor Carolyn S.P. Lam, MBBS, PhD, giving readers context on our weekly issues. Listen in as they break down the latest trends and share practical tips that are changing the way heart care works globally.
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Dr. Carolyn Lam and Dr. Harlan Krumholz sit down with Dr. Rishi Wadhera to unpack the first-ever JACC Cardiovascular Statistics issue. They explore why this annual report matters, the key trends in U.S. cardiovascular health, and what clinicians should take away about hypertension, diabetes, obesity, and heart‑failure patterns. The discussion highlights implementation gaps, disparities, and how data can guide action in heart health.
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.
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. 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.
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
Welcome to the new season of JACC This Week! In this episode, Editor-in-Chief Dr. Harlan Krumholz is joined by co-host Dr. Carolyn Lam to kick off a refreshed, more conversational era of the podcast. Together, they reflect on the evolution of the show, approach to thematic curation, and introduce the February 3 issue of JACC, curated around valve heart disease. The discussion explores JACC's approach to thematic issues, the importance of timely publication, and how emerging evidence is shifting valvular heart disease management toward lifetime decision-making and patient-centered outcomes. Highlights include insights into aortic stenosis and regurgitation, tricuspid regurgitation, global perspectives on valve care, and what clinicians should be watching as transcatheter therapies continue to evolve. Dr. Krumholz also shares the thinking behind his Editor's Page on scientific writing—specifically, how a strong introduction earns the reader's trust—offering practical guidance for researchers at all stages. The episode sets the tone for a new season focused on rigor, relevance, global inclusion, and meaningful dialogue with the cardiovascular community.
In the December 2, 2025 episode of JACC This Week, Editor-in-Chief Harlan M. Krumholz, MD, SM, introduces the Spotlight Issue, anchored by the manuscript "Global, Regional, and National Burden of Cardiovascular Disease and Risk Factors in 204 Countries and Territories, 1990–2023." Listen here as he reviews the issue and gives listeners perspective on the issue as a whole, which contains 19 viewpoints providing perspectives from experts around the world, plus his editor's page, aligned with a talk given at the UN with JACC Editor Emeritus Valentin Fuster, MD, and author Gregory A. Roth, MD. Other perspectives include: CVD in Sub-Saharan Africa; access to essential medicines and technologies; confronting inequities in pediatric cardiac care; and perspectives from Japan, Canada, the Middle East & North Africa, South America, Pakistan, and many others. Listen to the podcast and then check out the full issue online here: https://www.jacc.org/toc/jacc/86/22.
JACC's November 25, 2025 issue kicks off Thanksgiving week with JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, reflecting on his editor's page and the day he became a doctor (0:12). For original research articles, he discusses a study on colchicine & clonal hematopoiesis, an exploratory study of the LoDoCo2 trial (1:10), and a paired editorial comment with more perspectives and a reminder of the upcoming COLCOT trial (4:33). Next, a study on Lp(a) and IL-6 (4:54) and an editorial (6:12), 30-year CVD risk percentiles based on the PREVENT equations (6:30), and an accompanying editorial from JACC Deputy Editor Erica Spatz, MD, on next-generation strategies to encourage healthier behaviors (7:35). Other studies and editorials include a fascinating look at alcohol and blood pressure (8:04) and reinforcing the WHO public health guidance (10:05); remnant cholesterol in young adults (10:38) and implications for cholesterol guidelines (12:36). We also include four brief reports on RSV vaccine (13:11), long Covid (13:43), Lp(a) levels (14:06), the predictive power of polygenic risk scores (14:58), a viewpoint on US veterans (15:36), and our regular Amara Yad image (15:53), which we're delighted to be able to continue to promote with JACC: Clinical Electrophysiology Editor-in-Chief Kalyanam Shivkumar, MD.
In the November 18, 2025 issue of JACC, Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC, uses his editor's page to reflect on the evolving role of editors as partners with authors in strengthening cardiovascular science. The issue itself centers on adiposity, featuring multiple pooled analyses showing that waist-to-height ratio and waist circumference outperform BMI in predicting heart failure and mortality risk. Other highlights include a meta-analysis confirming GLP-1 receptor agonists' broad cardiovascular benefits, new insights into obesity's impact on biomarkers and disease interpretation, and several pieces, including state of the art reviews and viewpoints, on obesity-related conditions. Our issue focus on adiposity as a central driver of cardiometabolic disease shows the need for tailored, collaborative approaches to patient care and research. #stride #adipokinehypothesis
In this week's JACC podcast, Editor-in-Chief Dr. Harlan Krumholz explores how context, precision, and physiology converge to shape modern cardiovascular care. He opens with an editorial on "The Geography Gap," challenging the one-size-fits-all approach to cardiovascular risk models that ignore geographic variation in disease outcomes. Other featured studies in this issue include trials (OCEAN Mitral, PULSE), optimizing outcomes after transcatheter mitral repair, plus uncovering genetic links between placental malperfusion and congenital heart disease, evaluating CT angiography follow-up after left main PCI, and refining emergency triage with high-sensitivity troponin testing. Dr. Krumholz also speaks to editorials in this issue providing insight on the accompanying JACC articles, and a HeartBeat submission, with a reflection on balance and compassion in pediatric cardiology. Finally, he touches on our other JACC journal content, including new findings on blood groups and COVID-19 cardiovascular outcomes, and the first JACC: Basic to Translational Science Editor's page from the new editor-in-chief, Matthias Nahrendorf, MD, PhD, on the evolving landscape of translational science. This week in JACC highlights cardiology's movement toward more localized, integrated, and human-centered precision medicine.
In this special episode of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz introduces the November 4, 2025 issue, entirely devoted to hypertension and the landmark 2025 HAC Multi-Society High Blood Pressure Guideline. He discusses key updates—from reaffirming lower blood pressure targets and expanding out-of-office monitoring to integrating hypertension within the cardio-kidney-metabolic framework. Dr. Krumholz highlights expert commentaries covering policy, technology, therapeutics, and prevention, emphasizing how this forward-looking issue aims to move beyond publication toward true implementation. The episode calls for a cultural shift—making uncontrolled hypertension a "never event" through better systems, teamwork, and innovation.
Dr. Harlan Krumholz introduces a JACC issue unified around the question of how low to target blood pressure, highlighting growing evidence that aiming near 120 mm Hg improves cardiovascular outcomes without harming quality of life. Several studies from the STEP and ESPRIT trials show that intensive blood pressure control widens retinal arterioles, lowers stroke risk, enhances well-being, and remains safe even in older adults. Long-term follow-up data demonstrate that early initiation of intensive therapy provides lasting cardiovascular protection, while new analyses using the PREVENT equations confirm that higher-risk patients gain the most absolute benefit. The issue underscores that intensive control is both safe and effective, and that the next challenge is implementing these proven strategies consistently in clinical practice.
JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, introduces the October 21, 2025 issue of JACC, which is devoted entirely to Dr. Milton Packer's adipokine hypothesis. Dr. Krumholz explains the rationale behind dedicating the issue to this bold conceptual framework, which proposes that dysfunctional visceral fat and its secreted adipokines drive HFpEF. We're also thrilled to present readers with 10 accompanying expert commentaries that explore, challenge, and contextualize the hypothesis.
This episode of JACC This Week, hosted by Harlan M. Krumholz, MD, SM, highlights key research and perspectives from the October 14, 2025 issue of JACC. It opens with a call to modernize physician certification by distinguishing core knowledge from clinical reasoning, emphasizing continuous, engaging learning over rote memorization. Featured studies in this week's issue include the cardiovascular risks linked to clonal hematopoiesis in older women, improved clotting outcomes with third-generation LVADs despite ongoing bleeding risks, and how dapagliflozin reduces heart failure events post-TAVI without improving perceived quality of life. The episode also explores inflammation as a target after myocardial infarction, the evolving role of drug-coated balloons in PCI, and cardiac CT's expanding use in prosthetic valve assessment—signaling a shift toward more precise, less invasive cardiovascular care. We also feature an article from JACC: Asia this week on cardiovascular Implications of lipoprotein(a) and its genetic variants in patients from the Middle East.
In the October 7, 2025 issue of JACC, Editor-in-Chief Harlan Krumholz discusses how artificial intelligence can enhance clarity in scientific writing—serving as a tool, not a ghostwriter—while maintaining author accountability. A major study shows that nearly all cardiovascular events occur in people with at least one risk factor, reinforcing the need for early detection and management. Emerging research highlights a percutaneous "debulking" technique that may safely manage infected cardiac device leads, and a revived cholesterol ester transfer protein (CETP) inhibitor showing promising lipid and event outcomes. Additional trials explore the benefits of starting combination therapy earlier in diabetes and kidney disease, and a state-of-the-art review revisits the evolving role of fibrinolysis across thromboembolic conditions.
In the September 30 issue of JACC, Editor-in-Chief Dr. Harlan Krumholz explores the concept of "computable quality" in healthcare, advocating for real-time, data-driven improvement in clinical care. He reviews original research on pop-up cardiovascular screenings in pharmacies and sporting events, AI-driven echocardiographic automation, and anticoagulation in pulmonary arterial hypertension. The episode also features a three-part debate on transcatheter aortic valve replacement (TAVR) in low-risk patients, highlighting evolving evidence, clinical implications, and calls for guideline reassessment. Tune in for insights on innovation, equity, and the future of cardiovascular care.
In this episode, Editor-in-Chief Harlan Krumholz explores the evolving landscape of cardiovascular medicine, beginning with a call for responsible stewardship of artificial intelligence. Highlights include a major registry study on percutaneous aspiration for right-sided endocarditis, the predictive power of polygenic risk scores in heart failure, and the diverse causes of myocardial infarction in younger adults—especially women. The episode also covers a randomized trial on Intensive versus conventional intraoperative blood pressure management on cardiovascular events after major abdominal surgery, a state-of-the-art review on stressor-associated atrial fibrillation, and insights into long-term antithrombotic therapy after PCI. Each segment underscores the need for precision, equity, and innovation in clinical practice.
In this episode, Dr. Harlan Krumholz introduces the September 16, 2025 issue of JACC, which features studies that challenge conventional clinical thinking, including a detailed ECMO physiology study showing that higher ECMO flow does not uniformly raise pulmonary capillary wedge pressure, suggesting the need for individualized management. A novel analysis of the ISCHEMIA trial revealed distinct angina symptom trajectories, emphasizing that recovery is not binary and supporting a more personalized approach to treatment and monitoring. A landmark target trial emulation found that statins significantly reduce cardiovascular risk in patients with type 1 diabetes—filling a key evidence gap. Additional highlights include a call to redefine early cardiogenic shock, a nuanced review of moderate secondary mitral regurgitation, and an editorial reaffirming JACC's commitment to independent, transparent science in alignment with new "Gold Standard Science" principles.
In this episode, Dr. Harlan Krumholz reviews the September 9, 2025 issue of JACC, covering key studies on artificial intelligence in cardiovascular research, the effects of tirzepatide in heart failure with preserved ejection fraction (HFpEF), and how social, racial, and genetic factors influence heart failure risk. He discusses the growing burden of heart failure in the elderly, the need to disaggregate data in Asian American and Pacific Islander populations, and the role of rare genetic variants in atrial fibrillation outcomes. The episode also features perspectives on clinical trial design, complex case reports, and emphasizes the need for AI submissions to meet high standards of clinical relevance, feasibility, and long-term impact.
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sir your ENGLISH is so....especially for our english as second lang users... thats too difficult to understand.