Netherlands Heart Journal· 2026Q2
Atrial cardiomyopathy: from knowledge gaps to clinical impact
- 1citations
- Q2SCImago
- 2026year
Short summary
The EmbRACE network is a national consortium established to address critical knowledge gaps in atrial cardiomyopathy (AtCM), integrating mechanistic research, computational modeling, and clinical trials to develop diagnostic criteria, disease thresholds, and targeted treatments.
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Key points
- The EmbRACE network integrates mechanistic research, computational modeling, clinical trials, and implementation science to address knowledge gaps in atrial cardiomyopathy (AtCM).
- Key activities include human atrial tissue biobanking, molecular profiling, experimental validation, and AI-driven integration of multimodal data to derive AtCM phenotypes.
- Clinical trials will evaluate substrate-targeting therapies such as AF ablation, GLP-1 agonists for weight reduction, and optimized rate control.
- The consortium aims to define clinically meaningful AtCM thresholds, validate indirect markers, and determine if targeted treatments modify disease progression and outcomes.
AI-generated from the title and abstract; the full text is not read.
Abstract
Abstract Background Atrial cardiomyopathy (AtCM) is increasingly recognised as an underlying atrial substrate contributing to atrial fibrillation (AF), heart failure (HF), and cardio-embolic stroke. However, diagnostic criteria, disease thresholds, and targeted treatment strategies remain poorly defined. Objective To describe the rationale, structure, and translational strategy of the EmbRACE (Electro-Molecular Basis and the theRapeutic management of Atrial Cardiomyopathy, fibrillation and associated outcomEs) network, a national consortium established to address key knowledge gaps in AtCM. Methods EmbRACE integrates mechanistic research, computational modelling, clinical trials, and implementation science within seven interconnected work packages. Human atrial tissue biobanking and deep phenotyping (WP1) enable molecular profiling of candidate pathways (WP2), which are validated in experimental models (WP3). Computational modelling and artificial intelligence (WP4) integrate multimodal clinical and biological data to derive composite AtCM phenotypes and severity frameworks. Substrate-targeting clinical trials evaluate AF ablation (RACE X; WP5), weight reduction using GLP‑1 agonists (DUTCH-WAIST; WP6), and optimised rate control using calcium channel antagonists (SMART-VERAPAF; WP6). Implementation science (WP7) focuses on guideline integration, decision-support tools, and governance of AI-based risk models. EmbRACE establishes a translational pipeline from mechanistic discovery to clinical application. By integrating tissue-level insights with multimodal risk modelling and interventional trials, the consortium aims to define clinically meaningful AtCM thresholds, to validate indirect markers, and to determine whether targeted treatment modifies disease progression and clinical outcomes. Conclusion EmbRACE provides a multidisciplinary framework to transform AtCM from a theoretical construct into a clinically actionable entity, enabling earlier detection, improved risk stratification, and AtCM-directed therapy in cardiovascular prevention.
The authors' abstract, as published at the source. Netherlands Heart Journal, 2026 · DOI ↗
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Field: Cardiology and Cardiovascular Medicine
Cardiology and Cardiovascular MedicineMedicine