Hosts Mitsuaki Sawano, MD, Shun Kohsaka, MD, and Nobuhiro Ikemura, MD welcome Dr. Yuichi J. Shimada (Columbia University) to discuss his ACC presentation on plasma microRNA profiling in hypertrophic cardiomyopathy (HCM). In this episode, we explore how transcriptomic analysis of 1,600+ circulating microRNAs in 280 patients identified three distinct molecular subtypes of HCM, each associated with different risks of major adverse cardiovascular events. Moving beyond traditional phenotyping, this work highlights the biological heterogeneity of HCM and the potential of molecular stratification to refine risk prediction and guide future therapies. From early ACC experiences to building a research career across the U.S., Dr. Shimada also shares insights into the evolving landscape of HCM—from current therapies to the future promise of gene-based approaches.

Hosts Mitsuaki Sawano, MD, Shun Kohsaka, MD, and Nobuhiro Ikemura, MD welcome Dr. Ryohei Ono, MD, PhD (University of Glasgow / Chiba University) to discuss his simultaneously published JACC study analyzing over 23,000 patients from global HFrEF trials. Once considered regional, Chagas cardiomyopathy is now a global concern. This episode highlights its consistently higher risks of cardiovascular death, heart failure hospitalization, and stroke compared with other etiologies, and explores how etiology should shape prognosis, trial design, and future heart failure care.

Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, and Nobuhiro Ikemura, MD welcome Dr. Kanna Nakamura, MD and Dr. Yugo Yamashita, MD (Kyoto University) to discuss their Late Breaking Clinical Cohort presented at the 2026 JCS in Fukuoka, exploring venous thromboembolism (VTE) risk prediction in cancer patients using comprehensive genomic profiling. In a cohort of patients undergoing cancer genomic panel testing, 14.3% developed VTE over a median follow-up of ~2 years. Specific gene mutations—including KRAS, CDKN2A, and TP53—were associated with higher VTE risk, suggesting that genomic data may complement traditional clinical scores such as the Khorana score. This episode highlights a key shift in cardio-oncology: moving beyond conventional risk models toward precision risk stratification, where tumor genomics may help identify patients truly at risk for thrombotic complications and guide preventive strategies.