Program

Arterial calcification develops under the influence of various factors, including aging, chronic kidney disease, diabetes mellitus, inflammation, and dyslipidemia, and plays an important role in a broad spectrum of cardiovascular diseases, such as coronary artery disease, peripheral artery disease, and aortic valve stenosis. In the field of coronary intervention, severely calcified lesions remain a major challenge because they are associated with device delivery failure, inadequate stent expansion, restenosis, and thrombotic events, all of which can adversely affect clinical outcomes.
Recent evidence has shown that vascular calcification is not merely a passive degenerative process, but rather an active biological phenomenon involving inflammation, cell death, osteogenic differentiation, extracellular vesicles, thrombosis, and vascular healing responses. In addition, calcified nodule has attracted increasing attention as one of the important underlying mechanisms of acute coronary syndrome. However, many issues remain unresolved regarding its pathological characteristics, intracoronary imaging findings, clinical significance, and optimal treatment strategy.
In this plenary session entitled “Arterial calcification and calcified nodule,” leading experts from Japan and abroad will present state-of-the-art lectures from the perspectives of pathology, intracoronary imaging, clinical research, and interventional treatment. Speakers will share not only their own research data but also an overview of the current status and future directions in this field. We hope that this session will provide a valuable opportunity to deepen our understanding of arterial calcification and to discuss future diagnostic and therapeutic strategies.

Coronary revascularization is undergoing a major transformation. Traditionally, decision-making for PCI and CABG has relied primarily on anatomical assessment by coronary angiography. Today, however, an integrated approach combining physiology, which evaluates ischemia and coronary flow impairment, and imaging, which provides detailed information on vessel morphology and plaque characteristics, is becoming increasingly important. Furthermore, advances in CT technology and artificial intelligence are expanding the role of coronary imaging from diagnosis to treatment planning and prognostic assessment.
This session will provide a comprehensive overview of the current state and future directions of coronary revascularization guidance from both physiological and imaging perspectives. Topics will include conventional pressure wire–based physiological assessment, rapidly evolving non-wire–based physiological technologies such as angiography-derived physiology, IVUS- and OCT-guided revascularization, CT-guided strategies for PCI and CABG, and next-generation guidance technologies utilizing artificial intelligence and virtual reality.
In addition, a portion of this session will be dedicated to presentations selected through an open abstract submission process. We welcome innovative research, novel technologies, and original clinical experiences that contribute to the advancement of physiology- and imaging-guided revascularization. By bringing together both invited experts and selected investigators, we hope to foster lively discussion and stimulate new ideas for the future of coronary intervention.
Physiology and imaging are no longer competing concepts but complementary tools that together enable more precise and personalized revascularization strategies. Through this session, we aim to explore emerging standards in coronary revascularization and discuss future directions in patient-centered cardiovascular care.
We look forward to sharing the latest advances in the rapidly evolving “Physiology and Imaging Era.”

Coronary imaging has the potential to play an important role in precision preventive medicine by visualizing disease activity in individual patients and enabling intervention before the onset of myocardial infarction.
The management of coronary artery disease is undergoing a major paradigm shift—from treating patients after the development of myocardial infarction or angina to preventing atherosclerosis from an early age and managing cardiovascular risk throughout life. To achieve this goal, coronary imaging plays a critical role by visualizing the presence and progression of disease, enhancing patients’ understanding of their condition, and thereby promoting lifestyle modification and adherence to medical therapy.
Current coronary imaging technologies range from noninvasive coronary computed tomography to next-generation hybrid intravascular imaging capable of assessing not only plaque characteristics and vessel wall morphology but also inflammation and biological activity. However, applying the most advanced technologies to all patients is neither practical nor necessary. Appropriate selection based on clinical value and cost-effectiveness remains essential.
In this session, we will review the latest advances in coronary imaging, including their integration with artificial intelligence, and discuss the strengths and limitations of each modality. We will also explore how these emerging technologies may transform the management of coronary artery disease across the continuum from prevention to treatment.

The management of acute type B aortic dissection (TBAD) is undergoing a paradigm shift, driven by rapid advancements in endovascular technology. For complicated cases involving rupture or malperfusion, acute-phase Thoracic Endovascular Aortic Repair (TEVAR) is the undisputed standard of care—a life-saving intervention that justifies the inherent procedural risks. However, for uncomplicated cases, the rationale and optimal timing for preemptive TEVAR remain fiercely debated.
The latest ESC guidelines recommend intervening during the subacute phase (14 to 90 days)—allowing time for the initial tissue fragility to resolve—in patients at high risk for future aortic expansion. These high-risk predictors include partial false lumen thrombosis, a maximum aortic diameter of >40mm, a false lumen diameter of >22mm, and a primary entry tear of >10mm. Yet, early intervention is a double-edged sword. While it drives positive aortic remodeling and true lumen expansion, it also exposes patients to potentially devastating complications, such as retrograde type A aortic dissection (RTAD), spinal cord ischaemia (SCI), and late stent-graft-induced new entry (SINE).
Today, we are joined by leading global experts to examine the real-world clinical outcomes of early TEVAR. Our goal is to deepen our understanding of optimal strategies and future directions for uncomplicated acute TBAD. By exploring rigorous anatomical patient selection to mitigate risks, the utility of next-generation devices, precise sizing, and advanced technical modifications, we aim to uncover how best to navigate this complex clinical landscape.

Acute limb ischemia (ALI) is an extremely serious condition that can lead to irreversible tissue damage within a short time of onset; the selection of a rapid and appropriate revascularization strategy significantly influences limb salvage rates and patient prognosis. Traditionally, treatment for ALI has centered on surgical thrombectomy and bypass surgery; however, due to recent advances in endovascular therapy (EVT) and a shortage of urokinase, treatment strategies are undergoing a major transformation. In particular, the advent of thrombus aspiration devices has made it possible to select minimally invasive and rapid treatment options tailored to lesion morphology and the severity of ischemia. Furthermore, advancements in imaging technology and hybrid treatment are supporting a multidisciplinary approach that flexibly combines surgical treatment with EVT. On the other hand, ALI arises from a variety of underlying conditions, including embolism, thrombosis, and vascular injury, and the optimal treatment varies significantly depending on patient background, ischemia duration, and comorbidities. Therefore, algorithm-based decision-making that does not rely on a single approach is essential. In this session, we’d like to discuss the latest EVT devices and clinical outcomes, the division of roles with surgical treatment, and multidisciplinary treatment strategies for critical limb, with the aim of establishing an “optimal treatment algorithm” for ALI.

Pulse Field Ablation (PFA), founded upon the principle of irreversible electroporation, introduces a fundamentally new energy modality to arrhythmia ablation. Through its remarkable tissue selectivity for the myocardium, it offers the promise of sparing surrounding structures from injury—an aspiration long held in our field.
In the few short years since its clinical introduction, PFA has brought about a transformation of remarkable rapidity, becoming the first-line energy source for atrial fibrillation ablation at many institutions. This swift and widespread adoption rests upon its high efficacy and reproducibility in pulmonary vein isolation, its procedural efficiency, and a favorable safety profile that markedly reduces the risk of esophageal and phrenic nerve injury. The path ahead now turns toward how its full promise may be realized—through the continued evolution of devices, the refinement of waveforms, and further validation of lesion durability, as well as the extension of its reach beyond pulmonary vein isolation: to substrate modification for persistent atrial fibrillation, and to the management of ventricular arrhythmias.
In this plenary session, a state-of-the-art lecture will be followed by presentations in which speakers share data reflecting the current status and their perspectives on future directions. We hope to portray the full picture of the paradigm shift that PFA has brought, from the dual perspectives of what has been achieved and where the field is heading.

The pathophysiology, diagnosis, and treatment of hypertrophic cardiomyopathy (HCM) have advanced remarkably in recent years. In this session, “All Things HCM,” we aim to explore the latest developments in HCM management from a broad perspective and promote discussions that are directly applicable to everyday clinical practice.
In the field of diagnosis, imaging modalities such as echocardiography and cardiac magnetic resonance imaging (CMR) have evolved substantially, enabling not only detailed morphological assessment but also evaluation of disease progression and underlying pathophysiology. In addition, the implementation of genetic testing has facilitated the identification of causative variants, family screening, and potentially improved risk stratification and prognostic assessment.
With regard to treatment, the advent of cardiac myosin inhibitors has ushered in a new era in HCM management. Therapeutic strategies that directly target the underlying disease mechanism are becoming a reality, and active discussions are ongoing regarding their indications, long-term efficacy, and safety. These developments are transforming the therapeutic landscape of HCM and creating new opportunities for personalized care.
At the same time, clinicians frequently encounter situations in daily practice for which clinical guidelines do not provide definitive answers. Many practical issues remain unresolved and require careful clinical judgment.
Through this session, we hope to share the latest evidence while fostering lively discussion on real-world clinical challenges that extend beyond current guideline recommendations. We anticipate that these exchanges will contribute to further advances in the diagnosis and management of patients with HCM.

Cardiovascular imaging, particularly coronary computed tomography angiography (CCTA), has rapidly evolved in recent years. Among emerging technologies, photon-counting CT (PCCT) has attracted considerable attention as a next-generation imaging modality that simultaneously provides high spatial resolution, excellent temporal resolution, and spectral imaging capability. In particular, reduction of blooming artifacts in heavily calcified lesions and improved visualization of fine anatomical structures may enable more accurate quantitative and qualitative assessment of coronary artery disease than ever before.
Beyond the evaluation of coronary stenosis, the clinical applications of PCCT are rapidly expanding to coronary plaque composition analysis, myocardial tissue characterization, and AI-integrated risk stratification. These advances are expected not only to improve diagnostic accuracy but also to reduce unnecessary invasive coronary angiography and facilitate personalized cardiovascular medicine.
This plenary session will highlight the latest technological advances, current clinical applications, and future perspectives of PCCT through presentations by internationally recognized experts and leading investigators. We hope this session will provide an opportunity to explore the future direction of cardiovascular imaging and next-generation cardiovascular care.

In secondary prevention of atherosclerotic cardiovascular disease (ASCVD), intensive and sustained LDL-C control remains a central therapeutic goal. Beyond statins and ezetimibe, anti-PCSK9 monoclonal antibodies have become established as potent LDL-C-lowering therapies for patients with familial hypercholesterolemia and high-risk ASCVD. Inclisiran, an siRNA therapeutic targeting PCSK9 mRNA, further expands treatment options and highlights the importance of long-term strategies, including dosing intervals, adherence, and treatment persistence.
Lipoprotein(a) [Lp(a)] is increasingly recognized as a genetically determined residual risk factor for ASCVD and calcific aortic valve stenosis, persisting despite adequate LDL-C control. Clinical implementation requires further refinement of assay standardization, risk thresholds, interpretation, and patient communication. Selective Lp(a)-lowering therapies, particularly antisense oligonucleotides and siRNA agents, are now under development and may redefine lipid management by targeting residual risk beyond LDL-C.
This session will review current PCSK9-targeted therapies, summarize emerging issues in Lp(a) measurement and treatment, and discuss future directions in lipid management.

The updated hemodynamic definitions of pulmonary hypertension (PH) have expanded the diagnostic horizon, bringing earlier and more heterogeneous disease states within clinical reach. This evolution raises a parallel practical challenge: in routine cardiovascular care, which patients warrant diagnostic investigation, which tests should guide clinical confidence, and when is referral to specialized care or clinical trial appropriate?
This plenary session aims not only to review basic research and current definition of PH, but also to provide an overview of ongoing studies and clinical trials that have the potential to evolve into future Late-Breaking—randomized controlled trials, large-scale registries, advanced imaging and digital diagnostics, and therapeutic interventions. The aim is to examine the process itself: how unresolved questions are framed, how populations, endpoints, and analytical strategies are designed, and how findings feed back into clinical practice and healthcare systems.
Transcending disease-specific categories—PAH, CTEPH/CTEPD, and PH associated with left heart or congenital disease—we will reframe the clinical development continuum: from early detection through phenotyping, treatment selection, and assessment of right ventricular–pulmonary vascular coupling, to long-term outcome evaluation and implementation strategies. By placing a state-of-the-art international lecture alongside the questions posed by ongoing research, we hope to chart how next-generation PH care can move from defining the disease to building the evidence base it deserves.

With the increasing number and aging of patients with adult congenital heart disease (ACHD), the management of aortic root lesions has become an increasingly important clinical issue. Traditionally, aortic root dilatation has been recognized as a characteristic manifestation of connective tissue disorders such as Marfan syndrome. However, aortic root dilatation and aortic valve regurgitation are also encountered in various forms of congenital heart disease, including Tetralogy of Fallot and double-outlet right ventricle. The underlying mechanisms, progression, and natural history of these lesions remain incompletely understood.
Furthermore, dilatation and dysfunction of the systemic root, particularly in patients who have undergone an arterial switch operation for transposition of the great arteries or a Ross procedure, have emerged as important long-term challenges in the contemporary ACHD population. As the number of such patients continues to grow, the establishment of appropriate treatment strategies has become increasingly relevant.
At present, it remains uncertain whether the surgical indications and timing of intervention established for acquired aortic diseases or connective tissue disorders can be directly applied to congenital heart disease–associated root pathology. In addition, a variety of surgical options are available, including valve-sparing root replacement, composite root replacement with a prosthetic valve, and reconstructive procedures aimed at preserving the native valve. Determining the optimal treatment strategy for each individual patient therefore remains a significant challenge.
In this session, we aim to discuss the natural history of congenital heart disease–associated aortic and systemic root disease, the timing of therapeutic intervention, surgical indications, and the selection of operative techniques. Through multidisciplinary discussion among adult cardiac surgeons, congenital cardiac surgeons, ACHD specialists, and cardiologists, we hope to share current knowledge and clinical experience and contribute to the development of future treatment strategies and evidence-based clinical guidelines.

In recent years, the role of immunity and inflammation in the onset and progression of cardiovascular disease has been rapidly elucidated, and Cardioimmunology has matured into a field that defines the frontier of cardiovascular medicine. Its reach now extends across a broad range of conditions—from heart failure, arrhythmia, and structural heart disease to congenital/pediatric and adult disease—and from innate and adaptive immunity to neuro-immune and inter-organ communication.
This rapid progress rests on the convergence of two forces: molecular biological techniques, exemplified by genetically engineered animal models and single-cell and spatial omics, and the quantitative sciences—AI, foundation models, mathematical data analysis, mathematical modeling, and quantum computing. The complexity of immune-mediated cardiovascular disease yields only when the wet and dry approaches are brought together.
This plenary session takes Cardioimmunology in its broadest sense and invites studies that harness state-of-the-art molecular biology, computational science, and mathematical science to transform our understanding of the field, at any stage—basic, translational, or clinical. Bold, early-stage challenges that depart from established methods are equally welcome, and submissions from early-career investigators are especially encouraged. Together with leading and emerging investigators from Japan and abroad, we hope to project from this session, to the world, a new vision of cardiovascular medicine. We look forward to your active participation.

We have repeatedly witnessed moments when advances in medical devices have transformed the clinical landscape. The introduction of intra-aortic balloon pump (IABP) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provided powerful means to maintain hemodynamics and safely performing coronary interventions, helping save the lives of many patients. At the same time, cardiogenic shock (CS) complicating acute myocardial infarction (AMI) remains one of the most formidable challenges in cardiovascular medicine, and the evidence that these forms of mechanical circulatory support (MCS) clearly improve survival in CS remains insufficient.
In recent years, a percutaneous left ventricular assist catheter has shown the potential to improve survival in a selected cohort, bringing a new perspective to MCS strategies in CS. In parallel, as represented by the STEMI-DTU trial, efforts are ongoing to redefine the role of MCS in non-shock AMI. What is now needed is a new way of thinking: MCS should no longer be regarded merely as a means of maintaining hemodynamics or coronary perfusion, but as a next-generation therapeutic strategy that integrates myocardial protection and end-organ protection to improve clinical outcomes.
In this session, we will revisit the hemodynamic and myocardial protective effects of MCS from both basic and clinical perspectives, and aim to move the discussion one step further. We will discuss a broad and forward-looking range of topics, including new MCS strategies for myocardial protection, advanced MCS strategies that combine pharmacological therapy and other devices, and optimization of management, including monitoring, weaning, and prevention of complications. We hope to explore more fundamental questions: What is the essence of acute-phase treatment when improvement in long-term outcomes is the ultimate goal? Where should next-generation MCS therapy be headed?
We look forward to deepening this energetic and meaningful discussion together with all of you.

Cardioembolic stroke caused by atrial fibrillation is a devastating disease leading to severe disability and high mortality, making its prevention an urgent issue in our super-aging society. Although oral anticoagulant therapy is established as the standard of care for prevention, there is an unmet need for novel preventive strategies for patients at high risk of bleeding or those who experience recurrent stroke despite appropriate medical therapy.
Recently, the role of non-pharmacological therapies in preventing cardioembolic stroke has garnered significant attention. One approach is early rhythm control through catheter ablation. Recent clinical trials have demonstrated that early maintenance of sinus rhythm reduces stroke and cardiovascular events, prompting a paradigm shift for ablation from “symptom relief” to “stroke prevention.” Another approach is percutaneous left atrial appendage closure (LAAC) is currently considered a crucial mechanical prophylaxis against thromboembolism for patients who are unsuitable for long-term oral anticoagulant therapy.
In this symposium, we will invite experts to discuss the frontiers of cardioembolic stroke prevention using catheter ablation and LAAC. From the perspective of the “Brain-Heart Team” – a collaboration approach between cardiologists and stroke physicians – we will deeply explore the latest evidence, optimal patient selection, and future directions. We eagerly anticipate sharing innovative strategies that prioritize proactive prevention of cardioembolic stroke and are committed to engaging in constructive and productive dialogue.

Catheter ablation targeting arrhythmogenic substrates has become an established therapeutic strategy for scar-related ventricular tachycardia (VT) associated with structural heart disease, and substantial clinical evidence supporting its efficacy has accumulated over the past decade. Nevertheless, a subset of patients remains refractory to conventional therapies, particularly those with deeply located intramural substrates or extensive myocardial scarring. In such cases, even advanced approaches including radiofrequency ablation and adjunctive ethanol ablation may fail to achieve satisfactory arrhythmia control.
Stereotactic Arrhythmia Radioablation (STAR) has emerged as a promising noninvasive treatment option for these challenging VT cases and has attracted growing global attention. Clinical experience and research data are rapidly accumulating in the United States, Japan, and Europe, demonstrating the potential of STAR to target arrhythmogenic substrates without the need for invasive procedures. However, several important challenges remain, including accurate target delineation, multimodality image integration, treatment planning, radiation delivery precision, and the management of both acute and late adverse events. Successful implementation therefore requires close collaboration among electrophysiologists, radiation oncologists, medical physicists, cardiovascular imaging specialists, and radiation therapists.
This session will bring together leading experts from the World and Japan to share their practical experiences with STAR and discuss key aspects of implementation, including target identification, treatment planning, multidisciplinary team organization, clinical workflow development, and safety management. In addition, speakers will address current challenges and future directions for evidence generation, clinical adoption, and potential expansion of indications.
Through interactive discussion and exchange of real-world experience, this session aims to provide participants with practical guidance for establishing and refining STAR programs while promoting the safe and effective dissemination of this innovative therapy. We hope this symposium will offer valuable insights into the future of noninvasive VT treatment and foster international collaboration in this rapidly evolving field.

Inherited arrhythmias, including Long QT syndrome, Brugada syndrome, and Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT), are major causes of sudden death and syncope in young people. In recent years, advances in molecular biology have led to dramatic progress in our understanding of these diseases, resulting in significant changes in diagnosis, risk stratification, and treatment strategies.
In 2026, the “JCS/JHRS 2026 Guideline on Diagnosis and Management of Inherited Arrhythmias“ were released. These guidelines included major updates to recommendations regarding diagnostic algorithms integrating genetic findings and clinical evidence, genetic testing, risk stratification, and patient education.
Furthermore, regarding treatment, while the importance of standard guideline-based therapies—such as beta-blockers, implantable cardioverter-defibrillators (ICDs), left cardiac sympathetic denervation, and catheter ablation—has been reaffirmed, personalized medicine tailored to specific pathologies and genetic backgrounds is also advancing. Furthermore, advances in whole-exome and whole-genome sequencing are advancing our understanding of the disease mechanism, leading to the exploration of new therapeutic targets and the development of nucleic acid therapeutics and gene therapy.
In this symposium, leading experts active at the forefront of basic and clinical research will present the latest findings, ranging from current standard clinical practice based on the 2026 revised guidelines to the elucidation of pathophysiology through whole-genome research, and even future gene therapy. We hope this will serve as an opportunity to reflect on the present and future of the management of inherited arrhythmias.

A growing number of patients are affected by arrhythmias and conduction disorders since Japan is facing an unprecedented super-aging society. Consequently, the clinical importance of cardiac implantable electronic devices, including pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT), continues to increase. However, in elderly patients, treatment decisions are becoming increasingly complex because of frailty, cognitive decline, and multiple comorbidities, extending beyond conventional device indications alone.
Recent advances in device technology have rapidly transformed the field. Improvements in dual-chamber function and atrioventricular synchronization technologies have expanded the applicability of leadless pacemakers. In addition, conduction system pacing, including left bundle branch area pacing, has emerged as a physiologic pacing strategy with potential benefits for heart failure prevention and as an alternative to CRT. Bachmann bundle pacing has also shown promise in preventing atrial fibrillation. Novel defibrillation strategies that avoid transvenous leads, such as subcutaneous ICDs and extravascular ICDs, are also evolving; however, evidence regarding clinical outcomes and appropriate patient selection in elderly populations remains limited. Furthermore, left atrial appendage closure devices are increasingly being used for stroke prevention in patients with atrial fibrillation and high bleeding risk, potentially altering anticoagulation strategies in aging societies.
Real-world data from Japan, one of the world’s most rapidly aging countries, are expected to play an important role in shaping future global device therapy strategies. We are now at a critical turning point in the era of the super-aging society and emerging technologies.

The disease category of HFpEF originated from epidemiology and research design. Within that context, guideline-based treatment has been applied to individual HFpEF patients, essentially providing an average-based approach. However, how well do we truly understand HFpEF, a term we use routinely in daily practice? For example, what is the primary cause of HFpEF? Left ventricular diastolic dysfunction, vascular sclerosis, microvascular damage, or skeletal muscle abnormalities? Is the definition of a left ventricular ejection fraction of 50% or higher appropriate? Is 52% or 65% better? Why do so many studies, such as CHARM-Preserved, I-PRESERVE, TOPCAT, and PARAGON-HF, end in failure? Is it sufficient to target only obesity-oriented cases? How should we address the coexistence of amyloidosis?
Now it must be time to move beyond viewing HFpEF as a single phenotype and begin considering it as an endotype. In this session, we’d like to engage in such essential discussions described above.

The outcomes of heart transplantation in Japan are among the best in the world, with a 10 year survival rate of 88.7%. On the other hand, a major problem has been the extremely long waiting period due to donor shortage. The average waiting period has already reached approximately five years, and there had been concern that it would become even longer in the future.
However, the number of heart transplants has been steadily increasing in recent years, reaching 115 cases in 2023 and exceeding 100 procedures per year for the first time. This upward trend is expected to continue. As a result, the number of patients on the waiting list, which was once projected to exceed 1,000, has begun to decline and has recently decreased to 790.
Because the total number of transplants in Japan had long been limited, it was not feasible to introduce an “urgent list” system that would prioritize critically ill patients for transplantation. In response to the recent increase in transplant volume, a new category equivalent to an urgent list, Status 1A, was introduced this year, and there are already cases in which transplantation has been performed from Status 1A.
Given the prolonged waiting period, patients supported with bridge to transplant LVADs (BTT LVADs) in Japan have in practice been managed in a manner close to destination therapy. Conversely, this situation has allowed us to accumulate extensive experience in the long term management of implantable LVADs. This experience has been directly applied to contemporary destination therapy LVAD (DT LVAD) care, and the outcomes of DT LVAD therapy in Japan are now also among the best worldwide, with a 3 year survival rate of 81%.
Meanwhile, patients receiving DT LVAD therapy in Japan have long faced various restrictions, such as being unable to drive a car and having difficulty traveling. As DT LVAD has become more widespread, discussions are now underway to relax some of these limitations.
In this session, experts in each field will discuss various aspects of heart transplantation and DT LVAD therapy in Japan, which are now moving closer to the global standard.

Aldosterone plays a pivotal role in the pathogenesis of cardiovascular diseases, including hypertension, chronic kidney disease, and heart failure. As a cornerstone of cardiovascular medicine, beyond its well-known association with primary aldosteronism, this hormone has been the subject of extensive research for many years. With recent advancements in the elucidation of its molecular mechanisms, we are now entering a dramatic turning point in our understanding of aldosteronology. This evolution has brought a significant paradigm shift to the clinical setting. The emergence of non-steroidal MRAs, the rise of novel aldosterone synthase inhibitors, and innovations in diagnostic technologies have propelled aldosterone management into a new era. Clinicians are now expected to implement "personalized medicine," tailoring optimal clinical solutions for individual patients based on a profound understanding of pathophysiology. The core of this session lies in a rigorous discussion at the intersection of "pathophysiology" and "treatment." Amidst expanding therapeutic options, we must determine our guiding principles and the clinical philosophy behind our choices. We aim to gather expertise from across the globe and look forward to your sincere and candid insights. We are confident that this dialogue will serve as a guide for tomorrow's clinical practice and mark a milestone in establishing the next generation of standards. We eagerly look forward to your active participation as we take a new step forward in the field of aldosteronology.

The Cabinet Office has long advocated for the promotion of digital transformation (Dx), but at least for the chairpersons, there is absolutely no clear path forward regarding what will be introduced into heart failure treatment through Dx, who will be targeted, how the costs will be covered, and who will ultimately benefit.
Telemedicine encompasses a wide range of technologies, and in the field of heart failure, several remote monitoring devices for detecting exacerbations of heart failure have been developed.
As one actually involved in their development, we wonder why the government hasn't shown much interest in their introduction? The reasons given are hardly valid, such as the lack of cost-effectiveness demonstrations or the absence of reimbursement category corresponding to monitoring.
It is often pointed out that digital literacy among the elderly in Japan is considerably lower than in other developed countries (especially compared to South Korea), but using this as an excuse only amounts to giving up on Dx altogether.
Artificial intelligence (AI)-based analysis of electrocardiograms, heart sounds, and echocardiograms is one direction of Dx, and it should play a significant role in environments where heart failure specialists are scarce.
This symposium will feature experts discussing the current status and future prospects of various Dx modalities in heart failure treatment, as well as exploring potential bottlenecks.

Valvular heart disease (VHD) management is currently undergoing a major transformation. In addition to conventional surgical interventions, transcatheter therapies such as transcatheter aortic valve implantation (TAVI) have rapidly expanded, while minimally invasive treatment options for mitral and tricuspid valve diseases continue to evolve. As therapeutic strategies become increasingly diverse, the importance of cardiovascular imaging in selecting the optimal treatment approach for each patient has never been greater.
Echocardiography remains the cornerstone of VHD evaluation and management. In recent years, imaging has become indispensable throughout the entire clinical pathway, from accurate characterization of valve pathology and assessment of disease severity to determination of treatment indications, procedural planning, and post-intervention follow-up. Understanding the strengths and limitations of each imaging modality and integrating them appropriately into clinical practice are essential for optimal patient management.
This symposium will focus on the current status and future directions of imaging in VHD. Topics will include recent advances in echocardiography, the complementary roles of multimodality imaging, practical applications of imaging in transcatheter interventions, and emerging technologies that may shape the future of VHD care.
We hope this symposium will provide an opportunity to explore the evolving role of imaging in VHD, deepen our understanding of its potential and limitations, and stimulate discussion on future challenges and opportunities in this rapidly advancing field.

Sudden cardiac death (SCD) remains a major cause of mortality in patients with heart failure. Advances in cardiovascular imaging now allow comprehensive assessment of the structural, functional, and biological substrates underlying SCD, providing new opportunities for risk stratification and prevention. This symposium, entitled “Unraveling Sudden Cardiac Death in Heart Failure Through Cardiovascular Imaging,” invites submissions highlighting innovative applications of echocardiography, cardiac MRI, CT, and nuclear imaging. Topics of interest include disease mechanisms, risk prediction, novel imaging biomarkers, artificial intelligence, quantitative image analysis, and imaging-guided therapeutic strategies. We welcome contributions spanning basic, translational, and clinical research and look forward to a stimulating discussion on the role of multimodality imaging in advancing SCD prevention in heart failure.

With the aging population, cases of severe coronary artery disease (CAD) complicating aortic stenosis (AS) are becoming increasingly common. In recent years, expanding indications for TAVI and advances in device technology have dramatically shifted the treatment landscape for AS. However, numerous challenges remain regarding the optimal management strategy for concurrent coronary lesions.
For instance, definitive evidence is still lacking regarding whether PCI should be performed before, during, or after TAVI; which lesions should undergo revascularization; whether complete revascularization should be pursued; and how to select between PCI and CABG. Additionally, methods for assessing myocardial ischemia to determine intervention indications can be confounded by severe AS. Consequently, traditional assessments using nuclear imaging, fractional flow reserve (FFR), or non-hyperemic pressure ratios (NHPRs) may not be directly applicable. Furthermore, the frequent presence of heavily calcified lesions, which pose significant therapeutic challenges, further complicates clinical decision-making. Incorporating a lifetime management perspective—including coronary access post-TAVI and potential future reinterventions—is also essential.
In this symposium, we aim to discuss optimal treatment strategies for severe CAD complicating AS from multiple perspectives through a Heart Team approach, drawing on the latest evidence and real-world clinical experience. We hope this session will provide practical insights directly applicable to daily clinical practice and serve as a meaningful platform for future evidence generation and guideline updates.

Tricuspid regurgitation has long been regarded as a “forgotten valvular disease.” However, with advances in heart failure management, progress in imaging modalities, and the advent of an aging society, its importance as a determinant of prognosis has been increasingly recognized.
Recently evidence for transcatheter tricuspid valve interventions—particularly transcatheter tricuspid edge-to-edge repair (T-TEER)—has been accumulating rapidly in addition to medical therapy and surgical treatment. Moreover, enrollment in clinical trials of transcatheter tricuspid valve replacement (TTVR) in Japan (TRISCEND Japan) has been completed, and treatment options are undergoing substantial change.
In this symposium, we discuss the assessment of pathophysiology, indications for surgical and transcatheter therapies, and decision-making by the multidisciplinary Heart Team.

Treatment-resistant hypertension is defined as a condition in which blood pressure （BP）remains difficult to control despite the use of ３or more antihypertensive agents, including a diuretic. Its underlying mechanisms are diverse and include salt sensitivity and volume expansion, activation of the renin–angiotensin–aldosterone system, particularly aldosterone excess, sympathetic nervous system activation, chronic kidney disease, obesity and sleep apnea, arterial stiffness, medication adherence, and white-coat or masked effects. Among these phenotypes, “true” treatment-resistant hypertension, in which BP remains elevated not only in the office but also on home BP monitoring or ambulatory BP monitoring, represents one of the highest-risk conditions, with a marked accumulation of target organ damage and cardiovascular events.
Based on this pathophysiological understanding, it is important to determine how emerging therapies such as mineralocorticoid receptor antagonists, angiotensin receptor–neprilysin inhibitors, aldosterone synthase inhibitors, GLP-1/GIP receptor agonists, and renal denervation should be optimally applied: which patients should receive them, at what stage, and guided by which BP indices. In addition, the Japanese Renal Denervation Council, in which the Japanese Society of Hypertension, the Japanese Association of Cardiovascular Intervention and Therapeutics, and the Japanese Circulation Society participate, is promoting the development of an organized framework for appropriate patient selection and proper use of renal denervation. This framework is centered on Hypertension Renal Denervation Treatment (HRT) teams composed of hypertension specialists, cardiovascular and interventional specialists, nurses, pharmacists, registered dietitians, and other professionals.
Establishing specialized hypertension clinics led by full-time hypertension specialists is essential for the expert evaluation of uncontrolled and treatment-resistant hypertension, including lifestyle and medication counseling, assessment of secondary hypertension, out-of-office BP evaluation, and the appropriate introduction of next-generation therapies, including renal denervation. In this session, we will discuss treatment-resistant hypertension, a field in which the clinical care system is undergoing major transformation, with a focus on its pathogenesis, risk stratification, 24-hour BP management, and implementation of novel therapies.

Japanese National Plan for Promotion of Measures Against Cerebrovascular and Cardiovascular Disease, enacted in Japan in 2018, serves as a key policy framework for establishing a seamless continuum of cardiovascular care, spanning prevention, acute care, rehabilitation, and long-term management. Furthermore, the Second version, launched in 2023, set ambitious goals of extending healthy life expectancy and reducing cardiovascular mortality, while emphasizing the importance of reducing regional disparities, strengthening multidisciplinary collaboration, and leveraging digital technologies.
Cardiac rehabilitation is an essential intervention for achieving these goals. Its effectiveness has been well established not only through exercise training but also through comprehensive approaches that include lifestyle modification, disease management, secondary prevention, frailty prevention, and patient education. However, the availability of outpatient and long-term cardiac rehabilitation remains insufficient in Japan, and many patients do not receive continuous support after hospital discharge. This challenge is particularly evident among older adults and patients with limited access to healthcare facilities.
As Japan faces rapid population aging and a growing burden of heart failure, establishing a rehabilitation (medical care) network and remote rehabilitation supported by information and communication technology (ICT) and digital health solutions is expected to play an increasingly important role. To reduce disparities in access to care and achieve seamless cardiovascular care, policy support—including appropriate reimbursement systems and insurance coverage—is essential.
This symposium will explore the future direction of cardiac rehabilitation in light of the principles outlined in Japanese National Plan for Promotion of Measures Against Cerebrovascular and Cardiovascular Disease. We hope to share perspectives on the challenges and opportunities ahead and discuss strategies for ensuring that all patients with cardiovascular disease, regardless of age or place of residence, have access to appropriate rehabilitation services and ongoing support.

Ensuring continuity of care for patients who developed heart disease in childhood and have survived through surgery and long-term treatment is one of the most pressing challenges facing cardiovascular medicine today. Managing the wide spectrum of complications that emerge in adulthood — including coronary artery sequelae from Kawasaki disease and Fontan-associated liver disease (FALD) unique to post-Fontan patients, in addition to congenital heart disease — requires multidisciplinary involvement not only from pediatric cardiologists but also from adult cardiologists, cardiovascular surgeons, and hepatologists. In Japan, the number of adults living with congenital heart disease now exceeds that of pediatric patients; yet the institutional framework supporting transitional care remains markedly uneven across prefectures.
In this symposium, we aim to share innovative transitional care initiatives from across the country and engage in frank discussion of the challenges surrounding the training of adult congenital heart disease specialists in both cardiology and cardiovascular surgery. We also look forward to active exchange of experience-based insights on patient education to foster disease literacy and autonomous healthcare participation, the development of multidisciplinary and inter-institutional care networks, and comprehensive approaches to supporting employment and social integration.
We hope this symposium will serve as a catalyst for accumulating practical knowledge and strengthening nationwide collaboration toward establishing a formal transitional care support system in Japan.

Transcatheter therapy for adult congenital heart disease (ACHD) has expanded beyond standard procedures such as closure of atrial septal defects and patent ductus arteriosus. Its current scope includes reintervention after repair of complex congenital heart disease, closure of interventricular communications, treatment of aortic coarctation and pulmonary artery or pulmonary vein stenosis, right ventricular outflow tract lesions, and transcatheter pulmonary valve implantation. The target population ranges from young adults to elderly patients, including those requiring late reintervention after childhood surgery, those first diagnosed in adulthood, and those at high risk for repeat surgery. In recent years, as the ACHD population continues to age, an increasing number of patients present with challenges commonly encountered in adult cardiovascular medicine, including heart failure, arrhythmias, pulmonary hypertension, and valvular heart disease. In this evolving landscape, transcatheter interventions are expected to play a role beyond that of minimally invasive treatment alone, becoming an integral component of lifelong, comprehensive management strategies for ACHD patients.
In Japan, CP stents and Covered CP stents, now entering clinical use, are important devices that may broaden treatment options for postoperative pulmonary artery stenosis and aortic coarctation. Internationally, newer stent technologies for congenital heart disease are also evolving, with attention to growth, redilatation, long-term durability, and adaptation to complex cardiovascular anatomy. Their application is extending to the reconstruction of complex three-dimensional cardiovascular structures.
In this symposium, we will share the latest insights from an outstanding international speaker, as well as experiences from Japan and abroad, and discuss the current status and future perspectives of transcatheter therapy for ACHD. We hope this session will provide an opportunity to consider the next era of treatment, including patient selection, device choice, the complementary roles of catheter and surgical therapy, safe implementation, and long-term follow-up.

Twenty years have passed since the generation of mouse induced pluripotent stem cells (iPSCs) in 2006 and human iPSCs in 2007. Over these two decades, iPSC research has brought about transformative advances not only in basic life sciences but also in the field of cardiovascular medicine.
In recent years, regenerative therapies using iPSC-derived cardiomyocytes have progressed toward clinical application, raising expectations for new therapeutic options for patients with refractory cardiovascular diseases, including advanced heart failure.
In addition, the development of iPSC-based disease models has dramatically advanced our understanding of the pathophysiology of cardiovascular diseases and has made substantial contributions to the identification of novel therapeutic targets and the acceleration of drug discovery research.
At the same time, several important challenges remain to be addressed, including the maturation of iPSC-derived cells and immune rejection associated with cell transplantation.
This symposium, entitled “Beyond 20 Years of iPSCs: New Frontiers in Disease Modeling, Drug Discovery, and Regenerative Medicine for Cardiovascular Diseases,” will provide an opportunity to reflect on the achievements of the past two decades of iPSC research and to explore the latest advances in disease modeling, drug discovery, and regenerative medicine in the cardiovascular field. Distinguished experts at the forefront of these areas will share their insights, spanning basic science, translational research, and clinical applications. Through these discussions, we hope to deepen our understanding of the future directions of next-generation cardiovascular medicine.

Remarkable advances in cancer therapy, including pharmacotherapy, immunotherapy, and radiotherapy, have significantly extended the long-term survival of cancer patients. Concurrently, overcoming "cardiotoxicity" has emerged as a pressing clinical challenge. Traditional assessment of cardiotoxicity has primarily relied on a decline in left ventricular ejection fraction (LVEF). However, real-world clinical practice increasingly demands early intervention for subclinical myocardial injury before overt functional decline occurs, as well as personalized management for complex cardiovascular complications induced by diverse novel anticancer agents. Consequently, existing definitions and frameworks are no longer sufficient to meet these demands.
This symposium aims to "fundamentally redesign" the definition of cardiotoxicity itself, aligning it with the realities of modern oncology, with the ultimate goal of implementing "HF-free Cancer Care"—preventing the onset of heart failure without interrupting cancer treatment. We will facilitate multidisciplinary discussions from diverse perspectives, focusing on risk stratification for heart failure development incorporating genomic information, the potential of ultra-early diagnosis using cutting-edge biomarkers and advanced imaging modalities, and the optimal structure of collaborative onco-cardiology teams comprising cardiologists, oncologists, and healthcare professionals.
By breaking through the limitations of conventional definitions, we hope this session will serve as a catalyst for a new paradigm shift to establish a future standard of care where patients can safely complete their optimal cancer treatment with peace of mind.

As the environment surrounding healthcare systems continues to undergo profound changes, fostering outstanding cardiologists and building organizations in which they can fully realize their potential are essential for the sustainable advancement of cardiovascular medicine.
At the same time, the evaluation of healthcare professionals requires a multifaceted perspective that encompasses clinical performance, research achievements, educational activities, and contributions to organizational management.
Ensuring fairness and transparency in such evaluations remains a significant challenge.
Furthermore, with the progress of work-style reforms and increasing diversity in personal values, creating an environment that enables healthcare professionals to achieve both work–life balance and career development has become an important issue.
In particular, promoting the career advancement and leadership development of women cardiologists is an urgent priority in the field of cardiovascular medicine.
Many women physicians still face challenges in sustaining their careers and attaining leadership positions due to life events such as childbirth, child-rearing, and caregiving responsibilities.
There is a growing need for systems that appropriately recognize individual abilities and contributions while respecting diverse work styles and fostering the next generation of leaders. This session will explore evaluation systems, approaches to talent development, and leadership strategies that balance fairness, recognition of achievement, and work–life balance.
Through sharing experiences from a variety of healthcare settings including university hospitals, regional core hospitals, and community-based practices, we will discuss how to create organizations in which diverse healthcare professionals, including women physicians, can thrive and continue to grow while maximizing their capabilities.
We hope that this session will serve as an opportunity to explore talent management strategies that support the future of cardiovascular medicine, moving from a culture of “developing those who are evaluated” to one of “evaluating and rewarding those who develop others.”

The declining number of cardiologists is beginning to have a serious impact on the sustainability of regional healthcare systems and advanced cardiovascular care. Contributing factors include long working hours, frequent emergency duties, the risk of medical litigation, and changing values among younger physicians. In addition, while cardiovascular medicine has become increasingly specialized, particularly in catheter-based interventions, the associated educational and clinical workload has also increased, leading to a decline in the number of physicians choosing cardiology as a career. Going forward, it will be important not only to secure workforce numbers, but also to establish a sustainable healthcare system that incorporates work-style reform and improved work-life balance. In this context, cardiovascular societies are expected to play broader roles beyond promoting advanced techniques and academic research, including the education and mentorship of young physicians, support for regional healthcare, multidisciplinary collaboration, and support for female physicians. Furthermore, there is a need to reconsider current education and certification systems so that they better reflect real-world clinical practice, rather than emphasizing excessive competition or credentialism. Improving efficiency through digital technology and AI utilization is also an important challenge. In this session, we aim to review the current status and underlying causes of the decline in cardiologists and to discuss, from multiple perspectives, the future role and responsibilities of cardiovascular societies.

The explosive emergence of generative artificial intelligence (AI) is beginning to impact all facets of society. In healthcare, while generative AI is being utilized to interpret symptoms and test results, access to medical expertise—once monopolized by physicians—is being democratized, ushering in an era where patients directly consult generative AI about their symptoms and treatments.
This shift has a profound impact on cardiovascular medicine, which encompasses a broad spectrum of care from high-urgency acute management to daily chronic care. When patients consult generative AI regarding symptoms like chest pain, palpitations, or shortness of breath, appropriate recommendations from the AI to seek medical attention could lead to the early detection and treatment of life-threatening conditions such as myocardial infarction and heart failure. Conversely, there is a risk that AI could provide inaccurate information, delaying critical medical consultations, or stoking unnecessary anxiety that strains healthcare resources.
In this new era, cardiologists need to understand the current capabilities of AI, including generative AI, and build a new paradigm of clinical practice premised on patient AI usage. In this session, we will explore Japan’s cutting-edge generative AI, share case studies of AI application in cardiovascular medicine, and discuss the future of cardiovascular care, including shared decision-making involving patients, generative AI, and healthcare professionals.

The increasing frequency of large-scale natural disasters has highlighted the growing importance of disaster medicine. While medical responses during disasters often focus on trauma and infectious diseases, cardiovascular conditions—including hypertension, heart failure, acute coronary syndromes, arrhythmias, and venous thromboembolism—frequently develop or worsen due to evacuation-related hardships, disruption of healthcare access, and psychological stress. Prevention and early intervention for these disaster-related cardiovascular diseases are therefore essential to protect both survival and long-term health outcomes among affected populations.
In Japan, valuable lessons have been learned from major disasters such as the Great Hanshin-Awaji Earthquake, the Niigata Chuetsu Earthquake, the Great East Japan Earthquake, and the Kumamoto Earthquakes. More recently, the Noto Peninsula Earthquake and the subsequent torrential rainfall disaster provided an unprecedented experience in which the same region was affected by multiple disasters within a short period. These experiences underscore the importance of establishing resilient healthcare systems through collaboration among regional healthcare institutions, governmental agencies, DMATs, and multidisciplinary healthcare professionals.
This symposium will address the clinical challenges of disaster-related cardiovascular diseases, cardiovascular care support systems during disasters, multidisciplinary and inter-organizational collaboration, and emerging approaches utilizing digital technologies. Through these discussions, we aim to share knowledge and experiences that will contribute to preparedness for future large-scale disasters.

Twenty years have passed since the Fire and Disaster Management Agency (FDMA), Ministry of Internal Affairs and Communications, Japan, initiated data collection for the All-Japan Utstein Registry. This registry has accumulated large-scale, long-term data on out-of-hospital cardiac arrest (OHCA). Furthermore, linkage with other medical and public health databases has provided a wide range of epidemiological and clinical insights. These data constitute a critical foundation for elucidating the epidemiological characteristics of OHCA in Japan and temporal trends in patient outcomes.
Over the past two decades, improvements have been achieved through the wider implementation of bystander cardiopulmonary resuscitation and advancements in emergency medical services. However, significant challenges remain in further improving survival and favorable neurological outcomes, which represent the ultimate goal of care.
In this symposium, we will focus on the integration of prehospital care and cardiology expertise. Drawing on the accumulated evidence, we will review the current status and challenges of OHCA and discuss strategies to improve favorable neurological outcomes from the perspectives of epidemiology, clinical practice, and healthcare systems.

The DanGer Shock trial has provided new evidence regarding the role of mechanical circulatory support in cardiogenic shock, stimulating substantial discussion not only on treatment strategies but also on the organization of care delivery systems. While the need for standardized cardiac critical care, efficient patient triage and referral networks, and dedicated cardiogenic shock centers capable of managing advanced mechanical circulatory support is increasingly recognized, their definition, required infrastructure, and feasibility of implementation in Japan remain uncertain. In this session, we will discuss the challenges and future directions of cardiogenic shock center development from both cardiology and critical care perspectives in light of the latest evidence.

In daily practice, physicians often encounter situations in which decisions need to be made over the course of a few days, or sometimes within hours. These situations range from the longitudinal management of dyslipidemia and hypertension to the initial evaluation and management of acute pulmonary embolism, infective endocarditis, myocarditis, and pericarditis. In such settings, clinical practice guidelines serve as an important framework for decision-making. In recent years, however, relevant documents, including the ACC/AHA guidelines on lipid management, the AHA/ACC statements on acute pulmonary embolism and hypertension, the JCS guidelines on infective endocarditis in Japan, and the ESC guidelines on myocarditis and pericarditis in Europe, have been updated in rapid succession. As a result, recommendations regarding diagnosis, risk assessment, and treatment are undergoing substantial change.
Guidelines provide a map for standardizing care, yet real-world outpatient decision-making must also account for aging populations, comorbidities, local medical resources, and patients’ values and preferences. Which decisions can reasonably be made in the outpatient setting, and at what point should patients be referred to specialized centers? How should standardized recommendations be applied within the structure of the Japanese healthcare system and the clinical backgrounds of Japanese patients? Through discussion among chairs, speakers, and participants, this symposium aims to explore the practical meaning of “Beyond Guidelines” in contemporary clinical care.

In Japan, the number of patients with heart failure (HF) is increasing in tandem with the aging population, and preventing readmissions has become a critical challenge in the management of HF. In particular, while the elderly population is projected to peak around 2040, the working-age population is expected to decline, leading to a severe shortage of healthcare and long-term care personnel. In light of this “2040 Problem,” there is a pressing need to establish a sustainable system for the management of HF within limited healthcare resources. To prevent readmissions among patients with HF, comprehensive disease management—including self-care support, nutritional management, exercise therapy, and social support in addition to drug therapy—is essential. Multidisciplinary collaboration among physicians, nurses, pharmacists, registered dietitians, physical therapists, and medical social workers plays a crucial role in implementing this approach. Against this backdrop, the “Heart Failure Rehospitalization Prevention and Continuous Management Fee” was newly established in the 2026 medical fee revision, reaffirming the importance of HF disease management and multidisciplinary collaboration. However, many challenges remain to be addressed, including disparities in support systems across regions and facilities, securing personnel, and improving the quality of multidisciplinary collaboration. Furthermore, as the population ages, patient-centered support that respects patients’ values and outlook on life will become increasingly important, extending beyond mere rehospitalization prevention. In this symposium, we aim to share the outcomes of multidisciplinary HF care guidance and discuss the future direction of HF disease management with a view toward 2040, taking into account the new medical fee system. We hope this session will contribute to the establishment of a sustainable, high-quality HF care system.