Artificial intelligence is rapidly transforming cardiovascular medicine, offering breakthroughs in diagnosis, treatment personalization, and research acceleration. However, its responsible integration requires guiding principles: focusing on clinical problems over technology, rigorous evaluation, bias mitigation, thoughtful implementation, and building trust. If applied wisely, AI can become a powerful partner in advancing equitable and effective cardiovascular care.

In June 2025, the White House introduced "Gold Standard Science" principles to enhance the rigor, transparency, and trustworthiness of federally funded research—values long embraced by top journals like JACC. These include reproducibility, openness to null results, interdisciplinary collaboration, and unbiased peer review, all of which align with JACC's ongoing commitment to scientific integrity. The journal is advancing efforts to improve transparency, peer review, and reproducibility through clearer data policies, stronger editorial oversight, and new tools like AI to support integrity and efficiency. Ultimately, JACC views these principles not as a shift, but as a reaffirmation of its mission to uphold scientific excellence while remaining independent, accountable, and open to challenge and debate.

This week's Editor’s Page outlines JACC’s expectations for AI research manuscripts in cardiovascular care, emphasizing the need for clinical relevance, real-world feasibility, and responsible evaluation beyond retrospective model performance. We present a framework focusing on three core domains: addressing a genuine clinical need, using fit-for-purpose evaluation methods across different development stages, and ensuring transparency, interpretability, and reproducibility. JACC prioritizes submissions that demonstrate real-world impact, responsible innovation, and a clear path to improving patient care—especially those that go beyond early model development.

JACC’s September 2 issue features a new editor’s page from Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC. In it, he brings up a troubling stagnation and reversal in U.S. cardiovascular health progress since 2010, despite advances in medical treatments and increased healthcare spending. Click here to listen to this call for a shift from individual interventions to systemic accountability, equity, and prevention, urging a bold, coordinated effort to improve population-level outcomes and close persistent disparities.

This update to the JACC Report Card highlights ongoing disparities in cardiovascular mortality between Black and White Americans. While some metrics, such as ischemic heart disease, show modest improvement, excess age-adjusted mortality rates and years of potential life lost remain alarmingly high for Black Americans. These findings reinforce the urgent need for structural reform, sustained investment, and accountability to close persistent gaps in cardiovascular outcomes.

Cardiovascular devices are at the heart of modern clinical practice, yet gaps in surveillance, reporting, and clinician awareness continue to pose serious risks to patient safety. This week’s Editor’s Page highlights the urgent need for improved transparency, stronger reporting systems, and clinician-led engagement around device recalls. With expert perspectives on FDA oversight, the role of unique device identifiers (UDI), and opportunities for real-time communication and consensus-building, this commentary challenges the cardiovascular community to take an active role in shaping the future of device safety. By addressing long-standing misconceptions and systemic limitations, it calls for smarter systems, faster responses, and shared accountability in delivering safe and effective cardiovascular care.

Therapeutic breakthroughs in ATTR cardiomyopathy have ushered in a new era of treatment, with gene silencers, stabilizers, and next-generation therapies extending life and improving quality for patients once left with few options. Yet this progress has exposed a profound and growing divide—between innovation and access. This week’s Editor’s Page explores the striking disconnect between clinical value and global affordability, calling attention to pricing challenges, equity gaps, and the real-world implications of cost-based care limitations. By highlighting the urgency of equitable implementation alongside scientific success, the issue urges clinicians, manufacturers, policymakers, and journals to work together in shaping a future where life-changing therapies reach all who need them.

This issue of JACC showcases a diverse yet thematically cohesive collection of articles that explore the complexities of cardiovascular medicine, from ethical dilemmas and patient-reported outcomes to emerging therapies and methodological innovations. Highlights include a poignant HeartBeats essay on the emotional weight of clinical decisions, debates on responder analyses, promising data on Factor XI inhibitors, and groundbreaking registry findings on balloon pulmonary angioplasty. The issue also features insights into risk prediction, statistical modeling in heart failure trials, rare case reports, and a continued commitment to ethically grounded anatomical education.