Discover and read the best of Twitter Threads about #HeartFailure

Most recents (24)

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 ?

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

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




#Other (Ill defined conditions)


Note the increase in cardiac deaths & ‘Other’

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 ‼️…
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
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…. 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 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।
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 ।
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
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.

- 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)…
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… #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… @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) ]… #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 Statement of accreditation & faculty disclosures at🙏 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👏… @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
What is your take on #vasodilators in acute #HeartFailure? The upcoming November issue of #EHJACVC will bring you a PRO/CON "Vasodilator therapy in acute heart failure revisited"

As our PRO paper was published in advanced access, a sneak preview Tweetorial below...

First some background...
Current @escardio guidelines state (IIb, B): "In patients with AHF and a systolic blood pressure (SBP) >110 mmHg, intravenous vasodilators may be considered as an initial therapy to improve symptoms and reduce congestion."
Only 1 flowchart has them in...
So far, I consider this a fair recommendation... In hyper/normotensive pulmonary oedema, they might be helpful in some cases, with their main benefit a reduced need for (non-)invasive ventilation!

Beautiful (older) trial by Gad Cotter on this:…
Read 14 tweets
#COAPT Risk Score for Death or #HeartFailure 🏥

📍Simple risk score using 4 clinical (COPD, #NYHA class, Afib/Aflut, and #CKD)

📍4 #EchoFirst (#LVEF, LVESD, RVSP, and #TR) variables + 1 treatment-related variable (#TEER)… @JACCJournals @GreggWStone ImageImageImageImage
Using data from the #COAPT trial, a simple risk score using 4 clinical and 4 Echo parameters + 1 treatment-related variable (#TEER), which provides prognostic insight into the 2-year rates of ☠️ or #HeartFailure 🏥 in patients with symptomatic #HF and severe #FMR

There was consistent benefit from TEER with MitraClip across all risk strata

FMR and HF pts are at ⬆️ risk for ☠️ and recurrent HFH, despite best Med Rx & invasive Tx including MV TEER

👉🏻Future studies are needed to externally validate the COAPT risk score in pts with HF & FMR
Read 6 tweets
September is #AFibAwarenessMonth!
A🧵on the basics of #AFib

#ACCEP #EPeeps #CardioTwitter
#AFib is the most common sustained heart rhythm problem in the world. 🌎
#AFib increases the risk of #stroke & #heartfailure. It causes symptoms like fatigue, dizziness & shortness of breath and can reduce patients’ quality of life.
Read 14 tweets
1) Welcome to our new #accredited #tweetorial on the Pathophysiology of #DKD in #T2D: Traditional Teaching and New Insights. Our expert author is Hans-Joachim Anders, MD, @hjanders_hans from @LMU_Uniklinikum of @LMU_Muenchen
2) This #accredited #tweetorial series on the foundations of #kidneydisease #DKD through the lens of #T2D is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance and is intended for healthcare providers.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists. Past programs still eligible for credit can be found at Faculty disclosures & accreditation statement are at FOLLOW US!
Read 48 tweets
For those who can't get enough from #ADVOR, below the promised Tweetorial!

Acetazolamide in acute #HeartFailure w volume overload on background high-dose loop diuretics:
👍Increases diuresis & natriuresis
👍More euvolemia after 3 days & discharge
#ESCCongress #Cardiology
First, the unsung hero's of this trial, done with a little bit over 2 million €, bargain for largest diuretic #RCT ever!
@KatrienTartagl2 & her team, with only 3FTE, they ran the most successful trial in #AHF
@PieterMartensMD & @JeroenDauw who did most fieldwork
How did we come up with the idea? Actually, cause we all love #physiology. Credits go to Prof. Em. Paul Steels who teached us all how kidneys work.

65% of sodium is reabsorbed in the proximal tubules, can be up to 85% in #HeartFailure
Read 12 tweets
1a) Welcome to one of our favorite events on the @academiccme #accredited #tweetorial feeds: a takeover of our programming from @GoggleDocs! The focus of this tweetorial is data from #ADA2022 on #SGLT2i beyond cardiac disease. Our expert author is @GoggleDocs' @drpatrickholmes. Image
1b) Check out our other #ADA2022 recap #tweetorial by new @GoggleDocs family member @Ines_VFonseca who focused on the cardiac data presented:
2) This program is #accredited for CE/#CME #physicians #physicianassociates #nurses #pharmacists #nursepractitioners & is supported by an educational grant from the Boehringer Ingelheim Pharmaceuticals Inc and Eli Lilly Company. It is intended for healthcare professionals.
Read 59 tweets
1) Welcome to our new #accredited #tweetorial which is Part 2 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 🧵!
2a) @ERAkidney #ERA22 is a primary international scientific symposium for interaction and exchange among basic scientists and clinicians working in #Nephrology. Our expert author is Dr. Clara García Carro (@ClaraGCarro) from San Carlos Clinical Hospital (Madrid, Spain).
2b) Be sure to check out the first half of this #ERA22 recap from my colleague @shbermejo, and get MORE 🆓CE/#CME at Join me in following @ckd_ce for the BEST in #cardiorenal education delivered entirely by #tweetorial!
Read 48 tweets
#Immunosuppressive therapy in virus-negative inflammatory CMP : 20-year follow-up of the #TIMIC trial

Immunosuppressive Tx of virus-negative inflammatory #CMP is associated to a persistent improvement of LV
function and better outcomes during long-term follow-up

#Immunosuppressive Tx promoted an improvement in cardiac function in 88% of the cases compared the placebo group

A persistent ⤴️ in the #LVEF is seen in long -term (up to 20 years) clinical outcomes of the whole cohort of 85 patients originally enrolled in the #TIMIC trial
Recurring virus-negative myocarditis responding to #immunosuppressive therapy

EKG showing LBBB (A) resolving after therapy (B)

(C and D) Echo apical view showing recovery of LV dysfunction from EF -28% ➡️ up to 51%

#HeartFailure #EchoFirst @ESC_Journals…
Read 6 tweets
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… @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

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