Discover and read the best of Twitter Threads about #gdmt

Most recents (8)

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
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
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
Presented today as late-breaking data at #HFSA2022 and posted online @CircAHA, new data from PROVE-HF regarding impact of #sacubitril/valsartan on #mitralregurgitation in #HFrEF.

Thanks to @DukeHFDoc for presenting in my absence.

What did we find? A 🧵...
It is well-known that MR severity is an important determinant of symptoms and prognosis in those with HFrEF.

Thanks to work from @LindenfeldJoann and @GreggWStone in the COAPT trial, it is also known that repair of MR may improve outcome in HFrEF.
Based on the COAPT and MITRA-FR results, current recommendations are to "optimize" #GDMT prior to decisions on repair of MR. Why?

Thanks to the reverse remodeling effects of #GDMT, MR severity may be reduced, avoiding need for MV repair.

What is known about sac/val and MR?
Read 19 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
A patient with heart failure that you have been following for the last five years no longer has a low EF. What changed ? What medications do you add/stop ?

A #MedTwitter #Tweetorial on HFimpEF (HF with improved EF).

First let’s talk the nuances of calculating EF. 🧮

EF = (EDV-ESV)/EDV or the percentage of EDV ejected by the LV. This volumetric analysis is performed by echocardiography. However in some cardiac diseases, the EF calculated can be falsely ⬆️/⬇️.
This can happen in which of the following conditions ?
That’s right ! Both MR and AR can produce a wrong EF reading. The calculation fails to account for the portion of blood that is ejected into the LA in MR (⬆️EF) and the regurgitant back flow from Aorta in AR (⬇️EF).
Cardiac MRI can more accurately predict EF in these patients.
Read 18 tweets
Women are not smaller men! #Atherosclerosis genesis, progression & sequelae different in women. Plaque erosion causing ACS more common in women. Women have unique #SDOH, are undertreated with #cvPrev therapies & #GDMT, leads to worsening outcomes in women. @lesleejshaw #SCCT2021 ImageImageImage
Women’s CVD risk can be underestimated. Female specific risk enhancers help. #CAC if risk uncertain. Women have lower #CAC prevalence than men but prevalence increases after menopause. CAC when present confers greater risk of incident CVD in women than men. @lesleejshaw #SCCT2021 ImageImageImage
Prevalence of non-obstructive #CAD is higher in women but is prognostic of risk. @lesleejshaw #SCCT2021 ImageImageImage
Read 6 tweets

Related hashtags

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!