Discover and read the best of Twitter Threads about #Tr

Most recents (4)

#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)

jacc.org/doi/10.1016/j.… @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

@JACCJournals
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
Exciting findings exploring different cardiac output states in patients undergoing #TTVR, roping together the role of the liver, kidneys, splanchnic circulation. We were able to gain more insights in this intriguing pathophysiology: bit.ly/3iFlxMZ -explainer thread below
1/5 By analyzing n=132 patients who underwent #TTVR in severe #TR, we assessed Cardiac Output states, hemodynamics, liver and kidney function to understand which mechanisms are triggered and sustained by TR, but also to observe changes made in these organ systems after treatment.
2/5 Tricuspid regurgitation-related backward failure increases central venous pressures, causes liver congestion and dysfunction with portal hypertension and reduced washout of vasoactive substances.
Read 6 tweets
TR and GR held 60 rounds of #exploratory talks over the course of 14 years. During this time, we have only seen a growing difference in parties’ claims, instead of a sign of reconciliation. Let’s hope, this new round of talks will be different and bring the peace the region needs
If TR gives up Libya deal, we might see a compromise. If not, no one should expect something useful from this new round of talks. Those who blindly support the #TR-Libya deal should understand how arbitrarily the Libya #map was evolved by only looking at the historic developments
With a Diplomatic Note on March 2, 2004, Turkey first time declared its continental shelf areas in the west of meridian 32°16’18”E. There was no hint on the Eastern and Western terminus of the boundary by then. Image
Read 20 tweets
#FITSurvivalGuide: The Forgotten Valve-#TricuspidRegurgitation (#TR) #tweetorial for the new #ACCFIT!

1⃣ Anatomy
2⃣ Etiologies
3⃣ Classification
4⃣ Diagnosis
5⃣ Treatment

Resources: @ASE360 @JACCJournals @CircAHA @ACCCardioEd @UMNews @Medtronic

1/10
cc: @dr_chirumamilla
[2/10] Impt to understand #TricuspidValve 1⃣ Anatomy

3 leaflets ⬇️ + fibrous annulus + 2 papillary 💪🏽 + chordae tendinae + RA/RV ❤️

⬛️ Anterior 🍃 (largest)
◾️Posterior
▪️Septal (smallest)

(note: throughout #tweetorial, see image descriptions for more content) TV is largest and most apically displaced valve (normal TV area is between 7 and 9 cm^2).  Tricuspid annulus = complex nonplanar 3D structure w/low posteroseptal portion (towards the RV apex) & high anterolateral portion.TV has 2 distinct pap muscles (ant & post) + 3rd variable septal pap muscle. Largest pap = typically anterior w/chordae supporting ant & post leaflets. Posterior pap supports post + septal leaflets. Septal pap is variable: absent in up to 20% of normal patients or small, or multiple.Note attachments of leaflets/chordae to papillary muscles, RV free wall, moderator band.
[3/10] 2⃣ Etiologies = Structural (1º) vs. Functional (FTR)

Keep chart ⬇️ DDx in mind when reading #EchoFirst

~80% of significant TR = FTR/2º to TA dilatation + leaflet tethering ⬅️ RV remodeling ⬅️ volume and/or pressure overload

Structural (1º) cause = less common
Read 12 tweets

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