Committed to my family, friends, and colleagues - working to make the future better than the past.
Harlan M. Krumholz, MD, SM is an American cardiologist, a leading research scientist, and the Harold H. Hines, Jr. Professor of Medicine at Yale School of Medicine, where he has been on faculty since 1992. A pioneer in the development of the field of outcomes research, Krumholz is an international expert in the science to evaluate and improve the quality and efficiency of care, reduce disparities, improve integrity in medical research, promote better health policies and regulations, and promote patient-centeredness in research and clinical care. He is the founder and director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation. .. more
neverdelegateunderstanding.substack.com/p/fat-reframed
Maybe the answers lie not in the heart alone, but in the cross-talk between fat and myocardium.
Read the full JACC Adipokine Spotlight and join the conversation.
🔗 www.jacc.org/toc/jacc/cur...
#JACC #HFpEF #Cardiology #AdipokineHypothesis
Some cases of HFpEF may not fit the model.
But frameworks like this push the field forward—helping us ask sharper questions and design better studies.
• It’s about fat distribution, not just BMI.
• Adipokines act through endocrine-paracrine signaling.
• Sex, race, and metabolic context all shape expression and risk.
• New therapies (GLP-1RA, SGLT2i) may restore adipokine balance.
• Erica Spatz: A Turning Point
• Carolyn Lam & Dalane Kitzman: From Pariah to Paradigm
• Subodh Verma & Deepak Bhatt: Parsing the Adipokine Axis
• Faiez Zannad, Jennifer Ho, Robert Mentz, and others.
Because progress in medicine requires ideas that connect disciplines and challenge assumptions.
🧠 “Ideas Worth Testing: The Adipokine Hypothesis.”
www.jacc.org/doi/10.1016/...
It’s bold, ambitious—and worth debating.
In other words: HFpEF may begin in fat, not the heart.
Could heart failure with preserved EF actually be an adipose-driven disease?
JACC’s latest issue explores “The Adipokine Hypothesis.”
@jaccjournals.bsky.social
🔗 www.jacc.org/toc/jacc/cur...
My @jaccjournals.bsky.social Journals Editor’s Page explores how we can modernize physician certification to be relevant, humane, and effective.
🔗 www.jacc.org/doi/10.1016/...
At JACC, we won’t stigmatize responsible use of AI. But we will insist on accountability.
jacc.org/doi/10.1016/...
@jaccjournals.bsky.social
At JACC,we won’t stigmatize responsible use of AI. We will insist on accountability.
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @yalemed.bsky.social
The 2025 ACC Scientific Statement on Inflammation and Cardiovascular Disease. @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
Reposted by Harlan M. Krumholz
Her paper: pubmed.ncbi.nlm.nih.gov/40708351/
Living, real-time intelligence from routine clinical data that will:
-Support accountability
-Fuel improvement
-Accelerate discovery
Registries = richer than claims but costly, delayed, and not built for improvement
Claims = coarser, even more delayed
Neither delivers what clinicians need at the point of care.
When hospitals had real-time feedback, mortality for STEMI dropped—without new drugs or devices.
The lesson?
👉 Quality improves when data are timely, trusted, and actionable.
But today it’s too slow, too costly, and too disconnected from daily care.
It’s time to reinvent it.
🆕 My Editor’s Page in JACC: www.jacc.org/doi/epdf/10....
@jaccjournals.bsky.social @yalemed.bsky.social
I lay out 5 operational principles—from rigorous validation to bias reduction—to make AI safe, equitable & impactful in cardiology.
➡️ www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @yalemed.bsky.social @yaleschoolofmed.bsky.social
Reposted by Harlan M. Krumholz
insights.som.yale.edu/podcasts/hea...
Reposted by Harlan M. Krumholz, Eric J. Topol
pod.link/1588414491/e... @thehowie.bsky.social @hmkyale.bsky.social
That’s the message from #ESCCongress.
Fat is not just storage, it’s an organ.
Its signals may drive heart failure and more.
Read my take: Fat, Reframed: A Turning Point in Heart Disease.
substack.com/home/post/p-... @jaccjournals.bsky.social @yaleschoolofmed.bsky.social
Reposted by Harlan M. Krumholz
Rehabilitation can ⬆️ Functional Independence and ⬇️ Long-term Cognitive Impairment among #ICU survivors. But how often do hospitals deliver it?
Led by @yalemedicine.bsky.social resident Jose Victor, our paper bit.ly/41p9fPT in @accpchest.bsky.social provides insights
Reposted by Nicholas A. Christakis
🫀 Cardiovascular mortality progress has stalled
📉 In some areas, it’s reversing
💡 We must confront what’s happening on our watch—and what comes next
👉 authors.elsevier.com/a/1lfjn2d9GI...
#CardioTwitter #HealthEquity @jaccjournals.bsky.social
Did you know air pollution can raise blood pressure?
I break down a just-published JACC trial testing HEPA filters in homes near highways—and what it means for heart health.
@jaccjournals.bsky.social
👉 neverdelegateunderstanding.substack.com/p/00314b6f-e...
My latest JACC #DeepDive explores a new trial of in-home air filtration—what it found, why the effect size matters, and how it fits into decades of research on air pollution and CVD risk.
🎧 www.jacc.org/digital-cont...
@jaccjournals.bsky.social
This issue features:
🔹 CSPACE RCT — CSP vs RV pacing in AV block
🔹 HEPA filtration & blood pressure
🔹 FLAVOUR 6-year follow-up—FFR vs IVUS
🔹 Editor’s Page: excess CV mortality in Black Americans
🎧 Listen: www.jacc.org/digital-cont...
@jaccjournals.bsky.social