Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, Satoshi Shoji, MD, and Nobuhiro Ikemura, MD, welcome Dr. Yuki Sahashi of Cedars-Sinai Medical Center and the Ouyang Lab to discuss artificial intelligence automation of echocardiographic measurements and its cardiovascular implications. Dr. Sahashi provides expert commentary on the recent JACC publication (J Am Coll Cardiol. 2025; doi:10.1016/j.jacc.2025.07.053), which developed and validated 18 open-source deep learning models using 877,983 echocardiographic measurements from 155,215 studies across diverse datasets. This work demonstrates how AI can (1) reduce measurement variability, (2) improve efficiency, and (3) enable high-throughput cardiovascular research, while also raising critical questions around (1) clinical integration, (2) bias reduction, (3) regulatory standards, and (4) building trust in AI systems.

Hosts Dr. Mitsuaki Sawano, Dr. Kentaro Ejiri, and Dr. Satoshi Shoji welcome Dr. Takeshi Kitai and Dr. Koshiro Kanaoka of the National Cerebral and Cardiovascular Center to discuss their JACC study, Heart Failure in the Oldest-Old: A Growing Clinical and Economic Burden in Aging Japan. Drawing on over 730,000 HF hospitalizations from the JROAD-DPC registry (2016–2022), they reveal how the proportion of patients ≥85 years rose to nearly half of all admissions, with associated costs surging from $870M to $1.03B. Despite lower per-admission costs, the sheer growth in cases has intensified the national burden, underscoring the urgent need for rethinking care models, from palliative care and goal setting to balancing home- and facility-based management in Japan’s rapidly aging society.

Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, and Satoshi Shoji, MD, welcome Dr. Shunsuke Inoue of The University of Tokyo to discuss clonal hematopoiesis of indeterminate potential (CHIP) and its cardiovascular implications. Dr. Inoue provides expert commentary on two recent JACC publications: a Women’s Health Initiative analysis linking CHIP mutations such as TET2, ASXL1, and JAK2 with distinct cardiovascular outcomes in older women, and an exploratory substudy of the LoDoCo2 trial examining whether low-dose colchicine modifies CHIP clone dynamics. Together, these studies highlight the complexity of CHIP as both a biomarker and a potential therapeutic target, raising new questions about how age, mutation subtype, and anti-inflammatory strategies intersect in cardiovascular risk.