@SIAC_cardio

@SIAC_cardio

@DanielPiskorz

@FranklinCuevaMD

@cardiomet_CE

@HFpEF

@escardio

@WilfriedMullens

https://twitter.com/escardio/status/1659922054307520512?s=20

Henry Han , MBBS, MD

@HanCardiomd

@escardio

#HFA_ESC @escardio scientific updates

Patient profiling in HFpEF

What are therapeutic options for #HFpEF in 2023 ?

#HeartFailure2023 @NicolasGirerd @DrMarthaGulati @Marta33717088 @LauraMeems @CharlesFauvel @Giccardio_fr @HFA_President @WilfriedMullens @escardio

@markcpetrie20

Numbers of emerging treatments are under investigation for HFpEF

#HeartFailure2023 @markcpetrie20 @DrMarthaGulati @Marta33717088 @LauraMeems @CharlesFauvel @Giccardio_fr @HFA_President @WilfriedMullens

@MarcoMetra

📍#SGLT2i should be initiated in all HFpEF patients without contraindications, ideally once stable during hospitalization for index event.

#HeartFailure2023 @MarcoMetra @HFA_President @WilfriedMullens

Read 4 tweets

Henry Han , MBBS, MD

@HanCardiomd

@lamcardio

State of the art: Are #HFpEF phenotypes, a needed classification?

#Hypertension phenotype by Dr. Michele Senni

#HeartFailure2023 @lamcardio @JavedButler1 @JamalRanaMD @AHajduczok @WilfriedMullens @FH_Verbrugge @ShelleyZieroth

Has #hypertension a greater prognostic impact in HFpEF than #HFrEF?

Should we treat HTN differently in
#HFpEF patients compared to patients without HF?

What are the current evidences ?

#HeartFailure2023

@escardio

#Spironolactone Use and Improved
Outcomes in Patients With #HFpEF With Resistant #Hypertension

#HeartFailure2023 @escardio

Read 4 tweets

Consejo de Cardiología Clínica y Terapéutica SAC

@clinicasac

📌#HFpEF. 2023 Consenso de Expertos en toma de decisión.
💡 Definición FEVI ≥50%
⚠️Disfunción diastólica x #echofirst no es suficiente.
🩺No hay un único test para establecer el dx.

🔸#HFpEF 50% de los casos de HF.
🔹Outcomes comparables con #HFrEF

📌Definiciones:
🔸HFpEF: Diagnóstico clínico de IC🩺 con FEVI ≥ 50% en ausencia d otras causas como MCH, miocardiopatías infiltrativas, valvulopatías,
e. pericárdicas o IC con alto gasto.

🩺El rol del cardiólogo es excluir los dx alternativos en caso de disnea, edema y BFSVI

📌Aproximación #HFpEF
Interacción entre atención primaria y especialistas cardiovasculares

Read 10 tweets

Sanjiv J. Shah, MD

@HFpEF

@NMCardioVasc

1/ #HFpEF treatment algorithm #tweetorial. This is the algorithm I currently use to treat HFpEF based on evidence we have thus far and my anecdotal experience treating patients over the past 16 years in the @NMCardioVasc HFpEF Clinic.

@JACCJournals

2/ This treatment algorithm was recently published in @JACCJournals with my friends and co-authors Barry Borlaug, @KSharmaMD, and @JenHoCardiology (who provided great feedback!). jacc.org/doi/abs/10.101…

3/ Step 1: Start by confirming the #HFpEF diagnosis. In equivocal cases, remember to use provocative testing, preferably exercise testing! ncbi.nlm.nih.gov/pmc/articles/P…

Read 27 tweets

MJ Hundertmark🫀MD, PhD

@MJHundertmark

@CircAHA

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.

Read 10 tweets

Frederik H. Verbrugge

@FH_Verbrugge

@VerwerftJan

Teaming up again with the great @VerwerftJan to share our experience with #echoCPET in #HFpEF. This hot-of-the-press paper @ESC_Journals demonstrates myriad of opportunities for diagnosis & treatment, far beyond #SGLT2i only. Tweetorial below!

@SarahStroobant2 @HerbotsLieven

@JACCJournals

We have recently described our set-up for a dedicated #dyspnoeaclinic in detail @JACCJournals

https://twitter.com/FH_Verbrugge/status/1622711913909026828

In #HFpEF, early & correct diagnosis are important, #phenotyping is everything. There are a lot of mechanisms for dyspnoea involved

@ESC_Journals

Current @ESC_Journals paper goes one step further: "In patients with confirmed HFpEF or probability >90% according to well-validated HFpEF scores (both are complimentary in our view), why #echoCPET within a dedicated #dyspnoea clinic? What is the impact of findings?"

Read 9 tweets

cardio-met

@cardiomet_CE

1a) Welcome to a new #accredited #tweetorial, “MOA and Clinical Trial Data for Novel & Emerging Therapeutic Strategies for #HCM: Can We Target Our Therapy?"

@cardiomet_ce

1b) Our expert (and returning @cardiomet_ce) author is Giuseppe Galati MD, MMSc in Heart Failure, FHFA, @GiuseppeGalati_ , Consultant #Cardiologist #HeartFailure & #Cardiomyopathies

@GiuseppeGalati_

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

Giuseppe Galati

@GiuseppeGalati_

@gcfmd

🔥 Short tweetorial on #HFpEF diagnostic scores/criteria
👉 #HFA_PEFF works well in diagnosing #HFpEF when the score is high >4 points
👉 High #HFA_PEFF predictes poor outcome
@gcfmd @DrRajivsankar @iamritu @gbiondizoccai @KTamirisaMD @JJheart_doc @KardiologieHH @FrancescoPaneni

@RC_HeartFailure

👆👇 🔥 #HFpEF diagnostic criteria tweetorial

👉 Among the 3 domains of #HFA_PEFF morfological + biomarkers works very well, while functional is the “Achille’s heel”
👉 #HF2_PEFF is simple to use, good correlation with NTproBNP & outcome
@RC_HeartFailure @JavedButler1 @mpsotka

@JJheart_doc

👆👇 🔥 #HFpEF diagnostic criteria tweetorial

👉 #HFA_PEFF vs #H2_PEFF show significantly ⬆️ sensitivity e slightly ⬆️ specificity, but is significantly more complex & requiring high effort in clinical practice
@JJheart_doc @FH_Verbrugge @TomLuscher @AndrewJSauer @GianluSava

Read 4 tweets

cardio-met

@cardiomet_CE

@GiuseppeGalati_

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

@GiuseppeGalati_

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

Erik Rafflenbeul

@KardiologieHH

Follow this #CardioTwitter #Thread
to get an overview of ALL
🚨#ESCcongress #HotLineSessions🚨

Including:
➡️14 #OnePager #CongressCards
➡️Links to on-demand stream
➡️Jorunal weblinks
➡️Hashtag of the author/presenter

PART 1 ⬇️

1/ HOT LINE SESSION 1
On-demand ESC 📺: bit.ly/3AQuvkB

#ESCcongress

1.1./ #TIME trial - The Treatment in Morning versus Evening study.

📕🔗:: NOT YET PUBLISHED
On-demand ESC 📺: bit.ly/3AQuvkB

#ESCcongress

Read 25 tweets

@CKD_ce

@ckd_ce

@ERAkidney

1) Welcome to our new #accredited #tweetorial which is Part 1 of a 2-part "highlights" program on new #SGLT2i & #DKD data presented at @ERAkidney #ERA22. #Physicians #nurses #pharmacists #PAs and #NPs can all earn 0.5h CE/#CME by following this thread!

@ERAkidney

2) @ERAkidney #ERA22 is a primary international scientific symposium for interaction and exchange among basic scientists and clinicians working in #Nephrology. It was held in May. Our expert author is Dr. Sheila Bermejo (@shbermejo) from @vallhebron in Barcelona, Spain.

3) This program is #accredited for CE/#CME & is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance. It is not intended for US- or UK-based based HCPs. Accreditation statement & faculty disclosures at ckd-ce.com/disclosures/.

Read 43 tweets

Henry Han, MBBS, MD

@HanCardiomd

@CircHF

Medical Therapy for Functional #MR

#GDMT is the first step and prevails as the mainstay in the treatment of #FMR

This review addresses the medical Tx options for FMR Mx and highlight a targeted approach for each FMR category

#HeartFailure #VHDs ahajournals.org/doi/10.1161/CI… @CircHF

#GDMT plays a pivotal role in LV reverse remodeling (LVRR) in FMR and leads to reduction in severity and improved outcomes for both atrial and ventricular #FMR

#GDMTWorks #VHDs #HeartFailure

Studies report 28% to 50% reduction in grade of #FMR from baseline in patients receiving optimal or maximally tolerated doses of #GDMT (including diuretics) in both ischemic #cardiomyopathy and non-ischemic CMP

#GDMTWorks #VHDs #MR

Read 8 tweets

Karl-Philipp Rommel

@kp_rommel

@CircAHA

Excited to see our paper in @CircAHA online ahead of 🖨️!

Multimodal approach including #PVloops and #MRI shows differences in physiology between #HFpEF pts w/ ⬆️ vs. ⬇️ LVEF ! - implications for therapy?!

🔑messages in the 🧵 below...

ahajournals.org/doi/10.1161/CI…

1/7

2/7 Problem:

💊responses attenuated in #HFpEF pts w/ ⬆️ versus ⬇️ LVEF.

Differential pathophysiologic considerations elusive.

3/7 Approach:

#HFpEF pts w/ LVEF 50-60% (n=21) and LVEF≥60% (n=35)

Multimodal characterization including #MRI, #PVloops (rest/preload⬇️/🏋️), EBM (in subset).

Read 8 tweets

cardio-met

@cardiomet_CE

@GiuseppeGalati_

1) Welcome to a new #accredited #tweetorial, Prevention and Management of Heart Failure in T2 Diabetes: The Cardiologist’s Perspective! Our expert author is Giuseppe Galati MD, MMSc in Heart Failure, @GiuseppeGalati_ , Consultant #Cardiologist #HeartFailure & #Cardiomyopathies

@GiuseppeGalati_

@cardiomet_CE

3) @cardiomet_CE is supported by educational grants from AstraZeneca, Bayer, Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company, & Chiesi. Earn credit from archived programs at cardiometabolic-ce.com. Disclosures at cardiometabolic-ce.com/disclosures/.🙏 FOLLOW US !

Read 56 tweets

cardio-met

@cardiomet_CE

@profmjdavies

1) Welcome to a new #accredited #tweetorial, Prevention and Management of Heart Failure in T2 Diabetes: The Diabetologist’s Perspective! Our expert author is Melanie J Davies CBE FMedSci @profmjdavies, Prof of Diabetes Medicine, U Leicester, Leicester Diabetes Unit @LDC_Tweets

@academiccme

2) This program is intended for #healthcare professionals and is accredited by @academiccme for 0.75h CE/#CME credit for #physicians #physicianassistants #nurses #nursepractitioners #pharmacists 🇺🇸🇨🇦🇬🇧🇪🇺. FOLLOW US for #cardiometabolic education from expert authors!

@cardiomet_CE

3) @cardiomet_CE is supported by educational grants from AstraZeneca, Bayer, Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company, and Chiesi. See archived programs still available for credit at cardiometabolic-ce.com. Disclosures at cardiometabolic-ce.com/disclosures/

Read 43 tweets

Giuseppe Galati

@GiuseppeGalati_

@ShelleyZieroth

🎖 #ACC_AHA_HFSA #HF Guidelines are out
Short Tweetorial
🍀 Congrats to the authors for the huge effort : 108 pgs covering multiple aspects including #CardiacAmyloid
@ShelleyZieroth @hvanspall @carlosguizars @ValleAlfonso @JavedButler1 @gcfmd @JJheart_doc
rb.gy/ocnlb7

1️⃣ #HFrEF tx
✅ Pros: Clear 4 pillar 1st line 1 day ( No wait)
❌ Cons: NYHA is not fixed very changeable : Better using Hypotension (SBP<100 mmHg) as choice criteria for ACE/ARB vs ARNI
❌ Cons: After 1 + 1/2 year from #GALACTIC_HF Omecamtiv Mecarbil still not in GD

@DrNasrien

2️⃣ #HFmrEF
✅ Pros: Concur with HFmrEF recom.
⭕️ Probably a 2a in this class for #ARNI is more EBM
@DrNasrien @dranulala @robmentz @MicheleSenni @DrDEliaEmilia @gbiondizoccai @torresviera @JavierdeJuan1 @global_meded @Filippatos @YuriLopatin1
#ACC22

Read 6 tweets

American College of Cardiology

@ACCinTouch

@American_Heart

Check out Top 10🔑points from the 🆕ACC/@American_Heart/@HFSA Guideline for the Management of #HeartFailure #CardioTwitter #ClinicalGuidelines #ACC22

🧵Key Points👇

1⃣ Guideline-directed medical therapy for #HeartFailure w/ reduced ejection fraction #HFrEF now incorporates four medication classes that include #SGLT2i. #ClinicalGuidelines

2⃣ #SGLT2i have a Class of Recommendation 2a in #HFmrEF. Weaker recommendations (COR 2b) are made for ARNi, ACEi, ARB, MRA & beta blockers in this population. #ClinicalGuidelines

Read 11 tweets

Henry Han, MBBS, MD

@HanCardiomd

@JACCJournals

In patients with #HFpEF, treatment with #empagliflozin improves clinical outcomes regardless of background #MRA therapy

jacc.org/doi/10.1016/j.…
@JACCJournals #JACC @unic_cardiovasc @JavedButler1 @FaiezZANNAD #MiltonPacker @robmentz @BiykemB @HFpEF @ShelleyZieroth

#MRAs were used in 37% of EMPEROR-Preserved study participants. MRA use was higher in those with a more congested clinical picture, with more HF🏥 within the past 12 months, worse HF symptoms, mildly reduced EF, higher NT-proBNP levels, and more use of loop diuretic agents

@HFpEF

The effect of empagliflozin to reduce HF 🏥 was more pronounced in MRA nonusers than in MRA users, particularly in the subgroup of patients with LVEFs ≥50% @HFpEF @DrRyanPDaly @AndrewJSauer @AnastasiaSMihai @DrMarthaGulati @ErinMichos @ShelleyZieroth @mvaduganathan

Read 8 tweets

Jan Verwerft

@VerwerftJan

@AndreasGevaert

Excited to share our paper with @AndreasGevaert and @FH_Verbrugge @HartcentrumH @HerbotsLieven @guido_claessen @PaulDendale
doi.org/10.3389/fcvm.2…
We know that systolic reserve is reduced in #HFpEF; but can systolic reserve help in the diagnosis🤔?

22 pts with simultaneous #iCPET and #ExerciseEchocardiography: Elevated
exPAWP (≥25 mmHg = elevate LVFP) was present in 14 patients, and was best identified by peak septal systolic annular velocity <9.5 cm/s (exS’) with an AUC of 0.97

second best non-invasive mPAP/CO slope ≥3.2 mmHg/L with AUC 0.88 (with systematic use of agitated colloid for determining TR gradient

Read 14 tweets

Henry Han, MBBS, MD

@HanCardiomd

@HFpEF

Fantastic presentation on Physiological Phenotyping of HFpEF by @HFpEF #THT2022 @crfheart

@ShelleyZieroth @AHajduczok @a_h_ghoneem
@karanpdesai @KevinShahMD
@GiuseppeGalati_ @ShashankSinhaMD @docbhardwaj
@crfheart
#THT2022

@HFpEF

Phenotyping #HFpEF: beyond EF and Future treatment of obese HFpEF

@HFpEF @JJheart_doc @JavedButler1 @NirUrielMD @SantosGallegoMD @mmamas1973 @pabeda1 @VietHeartPA @docbhardwaj @hvanspall @ShelleyZieroth @aayshacader @AndrewJSauer @crfheart @rachkataria

@HFpEF

Interesting case of 74 yr old women with BMI 46 kg/m2 with HFpEF

HFpEF: A BNP deficiency syndrome @HFpEF #THT2022 @crfheart @mmamas1973 @pabeda1 @VietHeartPA @docbhardwaj @hvanspall @ShelleyZieroth @aayshacader @AndrewJSauer @crfheart @rachkataria @rachkataria @DrMarthaGulati

Read 4 tweets

Henry Han, MBBS, MD

@HanCardiomd

@JavedButler1

Very insightful discussion on Spectrum of SGLT2-Inhibitor Benefits: Clinical to Symptoms to Quality of Life by @JavedButler1 in #THT2022

@LindenfeldJoa @TheHeartBeat3 @LiviuKlein @HFpEF @RyanTedfordMD @GreggWStone @SKumar_UTHealth @gtsayer @SrihariNaiduMD @purviparwani

@JavedButler1

📌SGLT2i clinical benefits is seen irrespective of baseline health status

#SGLT2i improve health status and quality of life early and sustained in both patients with #HFrEF and #HFpEF
@JavedButler1
@ShelleyZieroth @SeguraCardio @docbhardwaj @docbhardwaj @KevinShahMD #THT2022

@JavedButler1

#Canagliflozin Improves Quality of Life in HF Patients in #CHIEF-HF

One of the strengths of CHIEF-HF is the diversity of participants, noting that 14% of patients were Black and 45% were female @JavedButler1 #THT2022 @JamalRanaMD @crfheart @SantosGallegoMD @ShelleyZieroth

Read 4 tweets

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