Discover and read the best of Twitter Threads about #heartfailure

Most recents (24)

1) Welcome to a 🆕#accredited #tweetorial from @cardiomet_CE! Earn 0.5hr 🆓 CE/#CME by following this 🧵. Our expert faculty is Sanjiv J Shah MD @HFpEF, Cardiologist & Director, Northwestern HFpEF Program (hfpef.org). Director of Research, @NMCardioVasc
#FOAMed Image
1b) .@HFpEF will be sharing the algorithm he uses to treat #HFpEF based on evidence we have thus far and his anecdotal experience treating patients over the past 16 years in the @NMCardioVasc HFpEF Clinic.
#CardioTwitter #MedEd @MedTweetorials #HeartFailure
2) CE/#CMEcredit for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists 🇺🇸🇨🇦🇬🇧🇪🇺.
Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/.
FOLLOW US for accredited programs in #cardiometabolic space delivered wholly on Twitter!
Read 34 tweets
#HeartFailure (HF) is classified on the basis of ejection fraction (EF) and then into classes and stages. Let's have a look at what each of these mean to a physician in a clinical setting . A 🧵 (1/13)

#MedTwitter #MedEd #medicine
#CardioTwitter #Cardiology
#Heartfailure 💔 is a clinical syndrome that results from a structural or functional impairment of one or both ventricles. Ventricular filling and ejection are thus, hampered.
(2/13)
On the basis of EF, HF is classified into
1️⃣Heart failure with reduced ejection fraction(HFrEF)
2️⃣Heart failure with improved ejection fraction(HFimpEF)
3️⃣Heart failure with mildly reduced ejection fraction(HFmrEF)
4️⃣Heart failure with preserved ejection fraction(HFpEF)
(3/13)
Read 13 tweets
𝗦𝘁𝗮𝘁𝗶𝗻𝘀 destroy your skeletal muscle, why would they be any good for your 𝗵𝗲𝗮𝗿𝘁?

This 🧵 dives deep into mechanisms underlying statin induced cardiomyopathy.

#statins #cardiomyopathy #CHF #heartfailure #health #bigpharma Image
Over 64 million people suffer from heart failure worldwide.

To what extent is statin therapy contributing to the epidemic of congestive heart failure (CHF) worldwide?

Statin cardiomyopathy is a complication that can occur in 1-3% of people. Image
M𝗶𝘁𝗼𝗰𝗵𝗼𝗻𝗱𝗿𝗶𝗮 are once again the linchpin linking statins to CHF.
Read 25 tweets
Acute heart failure management by settings of care

Prof @ShelleyZieroth discussed about the pre-discharge phase of Acute #HeartFailure

#HeartFailure2023 @ESC_Journals @escardio @WilfriedMullens @robmentz @DrMarthaGulati @HFA_President @SotiriaLiori @gcfmd ImageImageImageImage
What are the current evidence for Tx of AHF and prevention of WHF

#HeartFailure2023 @WilfriedMullens @FH_Verbrugge @ShelleyZieroth ImageImageImageImage
Love this slide from the phenomenal presentation by Prof @ShelleyZieroth

#HeartFailure2023 @WilfriedMullens @MarcoMetra @JavedButler1 @BiykemB @gcfmd Image
Read 3 tweets
Read our latest analysis from the #ADVOR trial @JACCJournals. Deeper dive into the relationship of #natriuresis with decongestion & clinical outcomes after diuretic therapy in acute #heartfailure! Tweetorial below...

authors.elsevier.com/a/1h4wr2d9GHwT…

@PieterMartensMD @WilfriedMullens
First, look at detailed #ADVOR protocol below:
onlinelibrary.wiley.com/doi/full/10.10…

We did 2 consecutive urine collections:
1. Randomization => First morning (<24 h)
2. First morning => Second morning (=24 h)

If in those 2 collections, cumulative urine output <3.5 L ➡️ Failed decongestion! Image
Allocation to #acetazolamide clearly increased:
✅total urine output (+12.6%)
✅total natriuresis (+26.9%)

In relative terms: effect on natriuresis > urine output, UO🚫significant after 1st diuretic dose, natriuresis remained high!

*Normalized UO to 24 h for collection 1. Image
Read 20 tweets
2023 update in the diagnosis & management of cardiac amyloidosis. Welcome our friend and colleague Dr. Justin Grodin @JLGrodin @UTSWNews to #HeartFailure Grand Rounds @HarringtonHVI @UHhospitals twitter.com/i/web/status/1… Image
Amyloidosis is a protein misfolding disorder. Dr. Grodin @JLGrodin #HeartFailure Grand Rounds @UHhospitals Image
Myocardium histology and pathology. Thick rubbery myocardium. @JLGrodin ImageImage
Read 22 tweets
Longer daytime napping is associated with new-onset heart failure in older people

1. Disrupted nighttime sleep is associated with heart failure (HF).
A prospective study looked at the association between daytime napping and incident HF during follow up.
#napping #HeartFailure
2. Participants who napped longer than 44.4 minutes (ie, the median daily napping duration) showed a 73% higher risk of developing incident heart failure than participants who napped <44.4 minutes.
3. Participants who napped >1.7 times/day showed a 120% increase in new onset HF compared with participants who napped <1.7 times/day.
These associations persisted after adjustment for covariates, including nighttime sleep, comorbidities, and cardiovascular disease/risk factors.
Read 5 tweets
Out ahead of print in @CircAHA and displaying the first 2.5 years of my DPhil @RDMOxford @UniofOxford : EMPA-VISION RCT, investigating the hypothesis that #sglt2i mediate their benefits in #heartfailure via augmentation of cardiac energy metabolism

doi.org/10.1161/CIRCUL…
As SGLT2i induce glucosuria and thus, increase lipolysis and formation of ketone bodies like b-OHB, it was assumed that this effect might mediate their benefits in HF. But is this true? Well, we’ve tested it
We enrolled 36 patients with #HFrEF and 36 with #HFpEF and randomly assigned them #empagliflozin or placebo. Image
Read 10 tweets
1) Welcome to Part 1 of a new #accredited #tweetorial in our series of educational programs on #hypertrophic #cardiomyopathy #HCM. Previous programs, still available for 🆓CE/#CME, are at cardiometabolic-ce.com/category/hcm/.
Now you can earn another 1.5hr credit by following ALL of this 🧵!
2) Our expert author is Sergio Kaiser MD PhD FACC FESC 🇧🇷🇮🇱 @pabeda1, cardiologist 🫀, Professor 🎓 of #InternalMedicine, Rio de Janeiro State University. He brings the general cardiologist's perspective to our #HCM discussions. Read and learn!
#FOAMed #CardioTwitter
3) This program is supported by an unrestricted educational grant from Bristol Myers Squibb. Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/. Credit for #physicians #nursepractitioners #physicianassociates #nurses #pharmacists from @academiccme.
Read 68 tweets
Excess death in #England 🏴󠁧󠁢󠁥󠁮󠁧󠁿

🟧 50,000 excess deaths in England over the past 52 weeks

🟣4.2 Million doses of ‘Spring Booster’ given to over 75s

🟢 15.2 Million doses of ‘Autumn Booster’ given to over 50s

Followed by spikes in #ExcessDeaths

Does correlation = causation ?

1/
Since the roll out of the first #COVID19 booster in September 2021, there has been 50,000 deaths attributed to ‘Covid’

6,000 #Unvaccinated
44,000 #Vaccinated
30,000 #Boosted

53 Million boosters - and STILL we had 44,000 Covid deaths in the vaccinated!

I see correlation

2/
In January 2023, England suffered 6,632 excess deaths (+12% above average)

#Dementia
+1,219
+17.4%

#HeartFailure
+380
+46.9%

#IschaemicHeartDisease
+394
+7.3%

#Other (Ill defined conditions)
+816
+58.2%

#COVID19
2,106

Note the increase in cardiac deaths & ‘Other’

4/
Read 9 tweets
💡New research from our group @ESC_Journals indicates that #MCS might improve outcomes in patients with #heartfailure related #cardiogenicshock Let me walk you through it!
Actually, #cardiogenicshock has, for many years, been seen as predominantly caused by #myocardialinfarction However, recent evidence suggests that non-ischemic causes match it in frequency and impact on outcomes ‼️
pubmed.ncbi.nlm.nih.gov/30879324/

onlinelibrary.wiley.com/doi/full/10.10…
This is concerning 🧐, as most RCTs on use of #MCS in #cardiogenicshock focus on patients with #myocardialinfarction and exclude those with #heartfailure related #cardiogenicshock resulting in an overall low level of evidence for this patient population
pubmed.ncbi.nlm.nih.gov/34145680/
Read 10 tweets
1a) Welcome to a new #accredited #tweetorial, “MOA and Clinical Trial Data for Novel & Emerging Therapeutic Strategies for #HCM: Can We Target Our Therapy?"
1b) Our expert (and returning @cardiomet_ce) author is Giuseppe Galati MD, MMSc in Heart Failure, FHFA, @GiuseppeGalati_ , Consultant #Cardiologist #HeartFailure & #Cardiomyopathies
2) @GiuseppeGalati_ is in Milan 🇮🇹 This program is intended for #healthcare professionals & is accredited for 0.75h CE/#CME credit for #physicians #physicianassistants #nurses #nursepractitioners #pharmacists.
Read 46 tweets
#FreedomConvoy2023 #FreedomPlanet2 @freeexpress @BROTHERTOFOSCUK I as one of the #freedomfighters has all every single #Intensivstationen to have every single member of @UKParliament #msmenemyofthepeople #MSMLies who have been involved in the the past decade of #abuseofpower
Committed by @Conservatives @UKLabour @LibDems @Greenpeace and even the #LooneyTunes #looneyparty

Official Monster Raving Loony
Who like all are asking for donations #ffstatus.

Hi. Please don't skip this 1 minute read. This Friday December 23rd, we request your support.
Read 56 tweets
1) Welcome to a new #accredited #tweetorial on #hypertrophic #cardiomyopathy #HCM. Our expert author is Ahmad Masri MD @MasriAhmadMD of @OHSUCardio where he leads the Hypertrophic Cardiomyopathy Ctr. See a previous program from him, on #Fabry disease, at cardiometabolic-ce.com/cardiorenal-fa…. Image
2a) This program is intended for #healthcare providers and is supported by an educational grant from Bristol-Myers Squibb. Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/. FOLLOW US for the most timely expert education in #cardiometabolic care!
2b) #Physicians #Nurses #PhysicianAssociates #NursePractitioners #Pharmacists earn a full 1⃣ hour of 🆓CE/#CME credit from following this 🧵. For educational purposes, Twitter still works!! 😁
Read 93 tweets
माननीय प्रधानमंत्री जी,
आज कल अचानक हार्ट फेलियर के कारण काफी लोग,खास कर युवाओं की आकस्मिक/असमय मृत्यु हो रही है।
1)ऐसी असमय मृत्यु का कारण ढूंढने के लिए एक रिसर्च टीम गठित करे जो इन मृत्यु का कारण ढूंढे ओर साथ ही सभी हॉस्पिटल्स को एडवाइजरी जारी करे।
@narendramodi
1/3
2)एक नेशनल पोर्टल बनाये जो ऐसी आकस्मिक मृत्यु को दर्ज करे।
3)देशवासियो से अपील है कि ऐसी घटनाओं को एक जगह एकत्रित करके लगातार सरकार और सोशल मीडिया पर शेयर करे ताकि जागरूकता फैल सके,साथ ही डॉक्टर्स,हॉस्पिटल,रिसर्चर्स,रिसर्च संस्थानों को भी टैग करे ।
@mansukhmandviya
4)कोरोना वैक्सीन ओर कोरोना का इंसान पर क्या प्रभाव पड़ा है इसकी भी रिसर्च होनी चाहिए।
ये रिसर्च जल्द से जल्द प्रकाशित करनी चाहिए।
Read 12 tweets
Top 7 clinical trials in #AHA22 (#AHA2022) on #heartfailure #CardioTwitter

Slides from the brief I'll give today to our team @rambam_hospital

@EricTopol @drjohnm @PSJhund @HeartFailureFrm
You better be strong than sorry - Ultrarapid up-titration vs. Usual care
@AlexMebazaa https://www.thelancet.com/j...
The old Furosemide never loses (if given in the right doses).
A practical study by @robmentz Image
Inter-atrial shunting by Occlutech.
Tailoring shunt size (8/10mm) to LVEDP.
Importantly, identifying the super-responders (high LVEDP, E/e', BNP)
Another solid support for RV safety, though no control yet. Image
Read 7 tweets
In my opinion, the biggest news from #AHA22 for the heart failure community was the results of #STRONGHF. @AlexMebazza, the trial's principal investigator, presented the results. The following thread summarizes his presentation. @AHAScience
#STRONGHF was conducted to determine whether rapid/high-intensity uptitrations of doses of heart failure #GDMT would be safe and effective compared with usual care. @AlexMebazaa @AHAScience #AHA22
Patients received high-intensity care resulting in the successful administration of beta-blockers, RAS inhibitors, & mineralocorticoid receptor antagonists w/in 6 weeks. The primary outcome was hospitalization for HF or all-cause mortality w/in 180 days. @AlexMebazaa #AHA22
Read 10 tweets
Really proud moment for me today, presenting 1st time in a Featured Science session @AHAScience.

Deeper insight in #ADVOR trial with key contributions from @WilfriedMullens @PieterMartensMD @JeroenDauw @petra_nijst @EvelyneMeekers among many others. Proudly 🇧🇪!
Tweetorial below!
From #ADVOR population, we included 462 or 89% of patients with 2 correctly performed consecutive urine collections and urine sodium concentration (UNa) available.

Natriuresis:
- UNa [mmol/L] ~ diuretic efficiency
- Total natriuresis [mmol] ~ ECV & interstitial Na buffer removed
#Acetazolamide, after multivariate adjustment, was strongest predictor of #natriuresis in #ADVOR:
UNa + 16 mmol/L
Total natriuresis +115 mmol

👊 within 2 days !!!
👍 much stronger than effect on urine output itself

"#acetazolamide keeps the urine salted"
Read 9 tweets
Breaking News @AHAScience with #TRANSFORMHF - the largest (N=2859) ambulatory #heartfailure diuretic trial to determine if torsemide would be superior to furosemide to ⬇️ reduce all-cause mortality - what a huge accomplishment of @robmentz et al!!! (1/9)
sciencedirect.com/science/articl…
At first sight 'no need to transform your practice' as both are similarly effective for mortality (2/9)
Also similar for mortality and all-cause hospitalizations (3/9)
Read 9 tweets
The natural history of SMR and its longitudinal progression until the onset of severe #MR

There are two distinct patterns of progression of SMR patients with various implications

academic.oup.com/ehjcimaging/ad… #EHJCVI @GeraldMaurer @denisamuraru @alessia_gimelli @JGrapsa @iamritu Image
Cluster 1 had higher LAV, LVEDV, and #LVESV, along with lower EF and less septal thickness, but slower EF and LVESV progression compared with Cluster 2.

Moderate SMR was more frequent in Cluster 1, whereas Cluster 2 had more non/trivial and mild #SMR

#EchoFirst #EHJCVI Image
On time-to-event analysis, there were no differences in terms of mortality and occurrence of MV interventions, #LVAD , and HTx

A higher likelihood of MV interventions (including Sx and #TEER) was observed in Cluster 2 type with fewer LVAD procedures

#EchoFirst #EHJCVI ImageImageImage
Read 6 tweets
This study shows that more than 1/3 of patients with new-onset #HeartFailure have #RVD

📌During up-titration of #GDMT, 49% show normalization of RV function

📌The improvement is associated with better outcomes, independent of LV function

onlinelibrary.wiley.com/doi/abs/10.100… @ESC_Journals ImageImage
RV dysfunction as a predictor of clinical outcome in newly-Dx #HeartFailure

This analysis demonstrates #RVD at baseline and follow-up was associated with a higher risk of all-cause ☠️ [ HR- 1.66 (1.27-2.16) ] and HF 🏥 [ HR -2.20 (1.51-3.21) ]

onlinelibrary.wiley.com/doi/abs/10.100… #EJHF
Recovery of RV function is associated with better outcomes

This study also stated that improvement of TAPSE to ≥ 17mm during follow-up was associated with a reduction in all-cause ☠️ and #HeartFailure 🏥 (HR- 0.56[0.31-0.99] ), independent of
baseline TAPSE, age, sex, and LVEF
Read 4 tweets
Tweetorial on #vasodilators for low-output #heartfailure
to improve hemodynamics which help to decongest better and allow introduction/uptitration of neurohumorel blockers.
(as addendum to ) (1/10)
Normal heart = preload dependent (2/10)
Vasodilator ⬇️ blood pressure in normal heart through reduction of preload (3/10)
Read 10 tweets
1) Welcome to a new #accredited #tweetorial, Update on New HFrEF Data from ESC 2022 with a Focus on Vericiguat. Our expert author is Giuseppe Galati MD, MMSc in Heart Failure, FHFA, @GiuseppeGalati_ , Consultant #Cardiologist #HeartFailure & #Cardiomyopathies
2) @GiuseppeGalati_ is at San Raffaele Research Hospital, Milan 🇮🇹 @SanRaffaeleMI. This program is intended for #healthcare professionals & is accredited for 0.75h CE/#CME credit for #physicians #physicianassistants #nurses #nursepractitioners #pharmacists.
3) This program is supported by an educational grant from Bayer. See archived programs still open for credit at cardiometabolic-ce.com. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/.🙏 FOLLOW US !
Read 43 tweets
Have you noted that patients with acute #heartfailure (AHF) hyperventilate? @JanBiegus et al. studied hyperventilation (defined by low pCO2 value) AHF and its link with potential triggers and prognosis👏nature.com/articles/s4159… @AlbertoGiannon8 @vbluml @RyanTedfordMD @yulnunezvill
1.Out of 241 AHF patients, 57 (24%) had low pCO2 (pCO2 ≤ 30 mmHg). Low pCO2 group had significantly lower HCO3- (22.3 ± 3.4 vs 24.7 ± 2.9 mmol/L, p < 0.0001) and significantly higher lactate level (2.53 ± 1.6 vs 2.14 ± 0.97 mmol/L, p = 0.03).
2.No differences between groups were observed in respect to following potential triggers: hypoxia (sO2, p = 0.57), infection (CRP, p = 0.47), dyspnea severity and pulmonary congestion
Read 5 tweets

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