Oct 23, 2026 · 23 min · 11 segments
Editor's Summary by Preeti Malani, MD, MSJ, and Christopher C. Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from…
Preeti MalaniHost
Christopher MuthHost
People of African ancestry are at increased risk for dilated cardiomyopathy, yet there are significant gaps in our genetic understanding of this condition in the population.
Chawla and colleagues analyzed four US data sets with more than 82,000 individuals of predominantly African ancestry to compare the risk associated with a recently identified fatty acid transporter variant called CD36Y325 with established cardiomyopathy genes, like variants in TTN, which encodes sarcomeric proteins.
CD36 accounted for approximately 9% of dilated cardiomyopathy disease burden, compared with 3.7% for TTN variants.
These findings not only change the current thinking about the genetics of dilated cardiomyopathy in individuals with African ancestry, but they also highlight the importance of representation in genomic research.
This one was presented this week at the American Society of Anesthesiologists Conference.
It looked at intraoperative hemodynamic management among patients undergoing high-risk abdominal surgery, specifically the use of cardiac index.
As a quick refresher, cardiac index is cardiac output divided by body surface area.
thereby providing a better measure of whether the heart's output is adequate for a patient's size.
Dr. Sagal and colleagues published the PELICAN trial, a multicenter, single-blind, randomized trial conducted at 12 university medical centers across Europe, with 1,095 patients in the primary analysis.
The investigators compared individualized cardiac index guided hemodynamic therapy targeting each patient's preoperative resting value with routine hemodynamic therapy.
The primary outcome was a composite of acute kidney injury, acute myocardial injury, severe infectious complications, non-fatal cardiac arrest, or death within seven operative days.
This occurred in 44.3% of the individualized group and 46.9% of the usual therapy group, resulting in no significant difference across groups.
There was also no between group differences in the individual components of the primary outcome, The individualized therapy group received more IV fluids and much more dobutamine.
Interestingly, 90-day mortality was higher in the individualized group as a secondary outcome, 5.7% compared with 2.8%.
Bottom line, the results do not support an individualized cardiac index-guided approach among patients undergoing high-risk abdominal surgery.
People of African ancestry are at increased risk for dilated cardiomyopathy, yet there are significant gaps in our genetic understanding of this condition in the population.
Chawla and colleagues analyzed four US data sets with more than 82,000 individuals of predominantly African ancestry to compare the risk associated with a recently identified fatty acid transporter variant called CD36Y325 with established cardiomyopathy genes, like variants in TTN, which encodes sarcomeric proteins.
CD36 accounted for approximately 9% of dilated cardiomyopathy disease burden, compared with 3.7% for TTN variants.
These findings not only change the current thinking about the genetics of dilated cardiomyopathy in individuals with African ancestry, but they also highlight the importance of representation in genomic research.
This one was presented this week at the American Society of Anesthesiologists Conference.
It looked at intraoperative hemodynamic management among patients undergoing high-risk abdominal surgery, specifically the use of cardiac index.
As a quick refresher, cardiac index is cardiac output divided by body surface area.
thereby providing a better measure of whether the heart's output is adequate for a patient's size.
Dr. Sagal and colleagues published the PELICAN trial, a multicenter, single-blind, randomized trial conducted at 12 university medical centers across Europe, with 1,095 patients in the primary analysis.
The investigators compared individualized cardiac index guided hemodynamic therapy targeting each patient's preoperative resting value with routine hemodynamic therapy.
The primary outcome was a composite of acute kidney injury, acute myocardial injury, severe infectious complications, non-fatal cardiac arrest, or death within seven operative days.
This occurred in 44.3% of the individualized group and 46.9% of the usual therapy group, resulting in no significant difference across groups.
There was also no between group differences in the individual components of the primary outcome, The individualized therapy group received more IV fluids and much more dobutamine.
Interestingly, 90-day mortality was higher in the individualized group as a secondary outcome, 5.7% compared with 2.8%.
Bottom line, the results do not support an individualized cardiac index-guided approach among patients undergoing high-risk abdominal surgery.
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