Atrial cardiomyopathy: from knowledge gaps to clinical impact : The role of the EmbRACE Network.
16 affiliations
- 1Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. [email protected].
- 2Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
- 3Department of Cardiology, Maastricht UMC+, Maastricht, The Netherlands.
- 4Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
- 5Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands.
- 6Department of Biochemistry, Maastricht University, Maastricht, The Netherlands.
- 7Department of Genetic Epidemiology, Institute of Human Genetics, University of Münster, Münster, Germany.
- 8Laboratory of Experimental Cardiology, Department of Cardiology, Heart Lung Centre Leiden, Leiden University Medical Centre, Leiden, The Netherlands.
- 9Gottfried Schatz Research Center, Division of Medical Physics and Biophysics, Medical University of Graz, Graz, Austria.
- 10Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
- 11Department of Cardiology, Martini Hospital, Groningen, The Netherlands.
- 12Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands.
- 13Department of Cardiology, Radboud University Medical Centre, Radboud University, Nijmegen, The Netherlands.
- 14Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam UMC, Amsterdam, The Netherlands.
- 15Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
- 16Amsterdam Public Health, Personalized Medicine, Amsterdam, The Netherlands.
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.
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BibTeX
@article{vreeswijk2026atrial,
title = {{Atrial cardiomyopathy: from knowledge gaps to clinical impact : The role of the EmbRACE Network.}},
author = {Nick L van Vreeswijk and Zarina Habibi and Sander van Doorn and Joris R de Groot and Monika Stoll and Daniël A Pijnappels and Jordi Heijman and Robert G Tieleman and Ron Pisters and Martin E W Hemels and Fleur V Y Tjong and Ulrich Schotten and Michiel Rienstra and Geert-Jan Geersing and Jelle C L Himmelreich},
journal = {Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation},
year = {2026},
month = oct,
doi = {10.1007/s12471-026-02081-3},
url = {https://europepmc.org/article/MED/42881355},
note = {CC BY},
}
RIS
TY - JOUR
TI - Atrial cardiomyopathy: from knowledge gaps to clinical impact : The role of the EmbRACE Network.
AU - Nick L van Vreeswijk
AU - Zarina Habibi
AU - Sander van Doorn
AU - Joris R de Groot
AU - Monika Stoll
AU - Daniël A Pijnappels
AU - Jordi Heijman
AU - Robert G Tieleman
AU - Ron Pisters
AU - Martin E W Hemels
AU - Fleur V Y Tjong
AU - Ulrich Schotten
AU - Michiel Rienstra
AU - Geert-Jan Geersing
AU - Jelle C L Himmelreich
PY - 2026
DA - 2026/10/15
JO - Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
DO - 10.1007/s12471-026-02081-3
UR - https://europepmc.org/article/MED/42881355
AB - 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.
SN - 1568-5888
SN - 1876-6250
ER -