Rethinking Tricuspid Regurgitation in Transthyretin Amyloid Cardiomyopathy
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853498
Transthyretin (TTR) amyloid cardiomyopathy (ATTR-CM) is increasingly recognized as a common, treatable cause of heart failure, with 5% to 15% of patients thought to have heart failure with preserved ejection fraction diagnosed with amyloid cardiomyopathy. The transformation in the field has been substantial. Improved diagnosis, better heart failure therapy, and disease-modifying therapies are changing the natural history of the disease. Contemporary cohorts demonstrate progressively better survival, with recent data suggesting that outcomes among appropriately treated patients approach those of age-matched individuals. As treatment improves prognosis, identifying the factors that continue to distinguish patients at highest risk becomes increasingly important. The study by Hauptmann and colleagues in JAMA Cardiology adds tricuspid regurgitation (TR) to the expanding list of informative prognostic markers.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853498
Transthyretin (TTR) amyloid cardiomyopathy (ATTR-CM) is increasingly recognized as a common, treatable cause of heart failure, with 5% to 15% of patients thought to have heart failure with preserved ejection fraction diagnosed with amyloid cardiomyopathy. The transformation in the field has been substantial. Improved diagnosis, better heart failure therapy, and disease-modifying therapies are changing the natural history of the disease. Contemporary cohorts demonstrate progressively better survival, with recent data suggesting that outcomes among appropriately treated patients approach those of age-matched individuals. As treatment improves prognosis, identifying the factors that continue to distinguish patients at highest risk becomes increasingly important. The study by Hauptmann and colleagues in JAMA Cardiology adds tricuspid regurgitation (TR) to the expanding list of informative prognostic markers.
Prognostic Thresholds of Tricuspid Regurgitation in Transthyretin Amyloid Cardiomyopathy
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853497
This cohort study derives and validates disease-specific, prognostic, quantitative tricuspid regurgitation risk thresholds in transthyretin amyloid cardiomyopathy and compares their prognostic performance with current guideline definitions and the Tricuspid Valve Academic Research Consortium criteria.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853497
This cohort study derives and validates disease-specific, prognostic, quantitative tricuspid regurgitation risk thresholds in transthyretin amyloid cardiomyopathy and compares their prognostic performance with current guideline definitions and the Tricuspid Valve Academic Research Consortium criteria.
Respiratory Season Virus Vaccines
https://jamanetwork.com/journals/jama/fullarticle/2853781
This Perspective describes the Vaccine Integrity Project, established in 2025 in response to concerns about the stability and integrity of US vaccine policy due to disruptions to the work of the Advisory Committee on Immunization Practices; outlines the process for the 2026-2027 evidence review; and summarizes key findings regarding vaccine effectiveness and safety.
https://jamanetwork.com/journals/jama/fullarticle/2853781
This Perspective describes the Vaccine Integrity Project, established in 2025 in response to concerns about the stability and integrity of US vaccine policy due to disruptions to the work of the Advisory Committee on Immunization Practices; outlines the process for the 2026-2027 evidence review; and summarizes key findings regarding vaccine effectiveness and safety.
RSV Immunization Effectiveness and Safety for the 2026-2027 Respiratory Season
https://jamanetwork.com/journals/jama/fullarticle/2853780
This systematic review summarizes evidence from recent randomized clinical trials and observational studies reporting on the effectiveness and safety of respiratory syncytial virus (RSV) vaccines and monoclonal antibodies, as well as the epidemiology of RSV in the US.
https://jamanetwork.com/journals/jama/fullarticle/2853780
This systematic review summarizes evidence from recent randomized clinical trials and observational studies reporting on the effectiveness and safety of respiratory syncytial virus (RSV) vaccines and monoclonal antibodies, as well as the epidemiology of RSV in the US.
Influenza Vaccine Effectiveness and Safety for the 2026-2027 Respiratory Season
https://jamanetwork.com/journals/jama/fullarticle/2853779
This systematic review summarizes research published 2025 to 2026 on the effectiveness and safety of seasonal influenza vaccines in the US.
https://jamanetwork.com/journals/jama/fullarticle/2853779
This systematic review summarizes research published 2025 to 2026 on the effectiveness and safety of seasonal influenza vaccines in the US.
COVID-19 Vaccine Effectiveness and Safety for the 2026-2027 Respiratory Season
https://jamanetwork.com/journals/jama/fullarticle/2853778
This Special Communication aims to identify and summarize the most recently published evidence evaluating the effectiveness and safety of US-licensed COVID-19 vaccines and report on the epidemiology of SARS-CoV-2 in the US.
https://jamanetwork.com/journals/jama/fullarticle/2853778
This Special Communication aims to identify and summarize the most recently published evidence evaluating the effectiveness and safety of US-licensed COVID-19 vaccines and report on the epidemiology of SARS-CoV-2 in the US.
Error in Results
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853793
The Original Investigation titled “Statin Eligibility According to Atherosclerotic Cardiovascular Disease Risk in the US,” published online August 20, 2025, and in the October 2025 issue was corrected to fix the analytic sample size reported in the results. The sample size was originally reported as 133.6 million; the correct value is 113.6 million. This article was corrected online.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853793
The Original Investigation titled “Statin Eligibility According to Atherosclerotic Cardiovascular Disease Risk in the US,” published online August 20, 2025, and in the October 2025 issue was corrected to fix the analytic sample size reported in the results. The sample size was originally reported as 133.6 million; the correct value is 113.6 million. This article was corrected online.
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Bilateral vs Single Internal Thoracic Artery Grafts
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853791
This secondary analysis of a randomized clinical trial evaluates 15-year outcomes among patients undergoing bilateral internal thoracic artery grafts vs single internal thoracic artery grafts.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853791
This secondary analysis of a randomized clinical trial evaluates 15-year outcomes among patients undergoing bilateral internal thoracic artery grafts vs single internal thoracic artery grafts.
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Multiple Giant Right Atrial Myxomas—the Carney Complex
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853792
This case report discusses a diagnosis of Carney complex type 1 after genetic testing of a male patient aged 36 years with multiple atrial myxomas, bilateral testicular calcification, and a history of recurrent skin masses since childhood.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2853792
This case report discusses a diagnosis of Carney complex type 1 after genetic testing of a male patient aged 36 years with multiple atrial myxomas, bilateral testicular calcification, and a history of recurrent skin masses since childhood.
Digoxin for Symptomatic Rheumatic Heart Disease
https://jamanetwork.com/journals/jama/fullarticle/2853691
To the Editor The recent Dig-RHD trial provided valuable data on the role of digoxin in rheumatic heart disease (RHD). However, several methodological and interpretative issues warrant careful consideration.
https://jamanetwork.com/journals/jama/fullarticle/2853691
To the Editor The recent Dig-RHD trial provided valuable data on the role of digoxin in rheumatic heart disease (RHD). However, several methodological and interpretative issues warrant careful consideration.
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Audio Highlights September 4, 2026
https://jamanetwork.com/journals/jama/fullarticle/2853925
Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.
https://jamanetwork.com/journals/jama/fullarticle/2853925
Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.
MC1R Variants and Parkinson Disease Progression Genetics
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853697
Understanding and predicting disease progression remains one of the central unsolved problems in Parkinson disease (PD). Although far from perfect, the advent of genetics and the delineation of environmental modifiers have at least partially enlightened who is at risk for PD and helped to explain why one patient declines slowly while another progresses more rapidly once motor symptoms begin. More generally, the relative contributions of genetic and environmental factors to PD continue to be debated, with strong arguments advanced for both predominantly genetic and predominantly environmental models. Focusing on genetics, the study by Schumacher and colleagues is intriguing because it addresses a question that has received far less attention than PD causal or risk genetics, ie, whether common inherited variation shapes the tempo and extent of disease progression, and it does so using longitudinal motor measures rather than cross-sectional case-control comparisons.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853697
Understanding and predicting disease progression remains one of the central unsolved problems in Parkinson disease (PD). Although far from perfect, the advent of genetics and the delineation of environmental modifiers have at least partially enlightened who is at risk for PD and helped to explain why one patient declines slowly while another progresses more rapidly once motor symptoms begin. More generally, the relative contributions of genetic and environmental factors to PD continue to be debated, with strong arguments advanced for both predominantly genetic and predominantly environmental models. Focusing on genetics, the study by Schumacher and colleagues is intriguing because it addresses a question that has received far less attention than PD causal or risk genetics, ie, whether common inherited variation shapes the tempo and extent of disease progression, and it does so using longitudinal motor measures rather than cross-sectional case-control comparisons.
Exhaled Carbon Monoxide and the Etiology of Parkinson Disease
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853696
Parkinson disease (PD) is the second most common neurodegenerative disorder worldwide with a growing prevalence—from 3 million affected individuals in 1990 to 12 million in 2021—and a profound negative impact on the quality of life of patients and their caregivers. There is broad interest in identifying modifiable risk factors of PD as targets for its prevention, which could profoundly reduce the global burden of PD. Tobacco smoking has emerged as a surprising yet compelling potential protective factor, as decades of observational studies consistently show that smoking is the most robust inversely associated risk factor for PD, with an estimated halving of risk and a clear dose response relationship. Although results are less consistent, even exposure to secondhand smoke has been associated with a lower risk of PD, arguing against reverse causation. As such, there is now broad interest in identifying candidate mechanisms underlying a potential neuroprotective effect of smoking, which—if isolated from the overall detrimental effects of smoking on health—could open avenues for the development of safe, neuroprotective therapies for PD.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853696
Parkinson disease (PD) is the second most common neurodegenerative disorder worldwide with a growing prevalence—from 3 million affected individuals in 1990 to 12 million in 2021—and a profound negative impact on the quality of life of patients and their caregivers. There is broad interest in identifying modifiable risk factors of PD as targets for its prevention, which could profoundly reduce the global burden of PD. Tobacco smoking has emerged as a surprising yet compelling potential protective factor, as decades of observational studies consistently show that smoking is the most robust inversely associated risk factor for PD, with an estimated halving of risk and a clear dose response relationship. Although results are less consistent, even exposure to secondhand smoke has been associated with a lower risk of PD, arguing against reverse causation. As such, there is now broad interest in identifying candidate mechanisms underlying a potential neuroprotective effect of smoking, which—if isolated from the overall detrimental effects of smoking on health—could open avenues for the development of safe, neuroprotective therapies for PD.
Common MC1R Variants and Parkinson Disease Progression
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853695
This cohort study assesses the association between common MC1R variants and Parkinson disease progression.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853695
This cohort study assesses the association between common MC1R variants and Parkinson disease progression.
Smoking, Exhaled Carbon Monoxide, and Risk of Parkinson Disease
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853694
This cohort study assesses prospective associations between carbon monoxide exhalation and lower risk of Parkinson disease.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853694
This cohort study assesses prospective associations between carbon monoxide exhalation and lower risk of Parkinson disease.
ECG Artifact Masking Complete Heart Block
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2853619
This case report describes a woman in her 70s whose initial electrocardiogram (ECG) suggested ventricular tachycardia but presented asymptomatically to the emergency department.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2853619
This case report describes a woman in her 70s whose initial electrocardiogram (ECG) suggested ventricular tachycardia but presented asymptomatically to the emergency department.
Errors in the Text
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2853618
In the Viewpoint, “Early Generic Semaglutide in Canada—Implications for US Patients and Policy,” published online June 8, 2026, and in the August 2026 issue of JAMA Internal Medicine, there were errors in the text. Corrections were made regarding expiration dates for the regularity exclusivity on the active ingredient for several semaglutide medications. This article was corrected online.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2853618
In the Viewpoint, “Early Generic Semaglutide in Canada—Implications for US Patients and Policy,” published online June 8, 2026, and in the August 2026 issue of JAMA Internal Medicine, there were errors in the text. Corrections were made regarding expiration dates for the regularity exclusivity on the active ingredient for several semaglutide medications. This article was corrected online.
Rebuilding Trust in Medicine Requires Structural Change
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2853617
Medicine is characterized by an inherent asymmetry of information and power between physicians and patients. Physicians, by virtue of their training and professional role, generally have acquired more medical knowledge than patients and exercise control over the diagnostic process and treatment selection. Thus, when patients seek medical care, they enter the physician-patient relationship from a position of vulnerability. Accepting medical care requires a leap of faith; patients must trust their physicians’ motivations and expertise, the institutions and systems in which they receive care, and the scientific foundation on which medicine rests. That leap of faith is increasingly difficult to make. Survey data now show that fewer than half of individuals in the US report high levels of trust in physicians and hospitals—a collapse too widespread to be explained by the quality of any individual clinical relationship.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2853617
Medicine is characterized by an inherent asymmetry of information and power between physicians and patients. Physicians, by virtue of their training and professional role, generally have acquired more medical knowledge than patients and exercise control over the diagnostic process and treatment selection. Thus, when patients seek medical care, they enter the physician-patient relationship from a position of vulnerability. Accepting medical care requires a leap of faith; patients must trust their physicians’ motivations and expertise, the institutions and systems in which they receive care, and the scientific foundation on which medicine rests. That leap of faith is increasingly difficult to make. Survey data now show that fewer than half of individuals in the US report high levels of trust in physicians and hospitals—a collapse too widespread to be explained by the quality of any individual clinical relationship.
Menopausal Hormone Therapy and Cardiovascular—Laying the Foundation for Future Trials
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2853616
In this issue of JAMA Internal Medicine, Wang et al leverage data from the Study of Women’s Health Across the Nation (SWAN; 1997-2017) of 2737 perimenopausal and recently postmenopausal women who reported vasomotor symptoms (VMS), including hot flashes and night sweats. The women had no history of cardiovascular disease (CVD) and no prior use of menopausal hormone therapy. Using a rigorous target trial emulation approach with sophisticated regression analyses to reduce common observational biases, the authors found that initiation of hormone therapy was associated with a 22% reduction in composite CVD events (adjusted hazard ratio [aHR] 0.78; 95% CI, 0.62-0.98). This apparent benefit was confined to women who began hormone therapy within 10 years of their final menstrual period (aHR, 0.73; 95% CI, 0.58-0.93), whereas initiation more than 10 years after menopause showed no benefit and possible risk (aHR, 1.53; 95% CI, 0.66-3.52). Heterogeneity by race and ethnicity was observed, with Black women experiencing the strongest reduction in CVD risk (aHR, 0.51; 95%, CI 0.33-0.81), while no clear effect was seen in White women or other racial and ethnic groups. Race-specific estimates were not further stratified by timing of hormone therapy initiation.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2853616
In this issue of JAMA Internal Medicine, Wang et al leverage data from the Study of Women’s Health Across the Nation (SWAN; 1997-2017) of 2737 perimenopausal and recently postmenopausal women who reported vasomotor symptoms (VMS), including hot flashes and night sweats. The women had no history of cardiovascular disease (CVD) and no prior use of menopausal hormone therapy. Using a rigorous target trial emulation approach with sophisticated regression analyses to reduce common observational biases, the authors found that initiation of hormone therapy was associated with a 22% reduction in composite CVD events (adjusted hazard ratio [aHR] 0.78; 95% CI, 0.62-0.98). This apparent benefit was confined to women who began hormone therapy within 10 years of their final menstrual period (aHR, 0.73; 95% CI, 0.58-0.93), whereas initiation more than 10 years after menopause showed no benefit and possible risk (aHR, 1.53; 95% CI, 0.66-3.52). Heterogeneity by race and ethnicity was observed, with Black women experiencing the strongest reduction in CVD risk (aHR, 0.51; 95%, CI 0.33-0.81), while no clear effect was seen in White women or other racial and ethnic groups. Race-specific estimates were not further stratified by timing of hormone therapy initiation.