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Rachna Kataria, MD Profile picture
@rachkataria
Sep 12, 2020 • 5 tweets • 5 min read • Read on X
❤️Enjoyed watching the #HeartFailure: Looking Back and Moving Forward webinar.
❤️Dr. Braunwald summarized his 70 years of experience in ~20 minutes.
❤️So much has happened before I was even born!
❤️Yet, so much more to look forward to! Thank you for a tour back in time!
❤️I thoroughly enjoyed Dr. John McMurray’s overview of “the five alive” & his emphasis on moving away from vertical integration approach.
❤️Up-titrating each medication should not interfere w/ adding meds w/ complimentary benefits.
❤️No excuses, because #GDMTworks.
❤️Loved how Dr. Milton Packer went back in time to highlight the origin of LVEF cut-offs & the confusion that followed.
❤️He then advised using strain & myocardial contraction fraction, compared & contrasted common diseases using the same.
❤️HFpEF:disease of something else!
❤️Enjoyed listening to Dr. Lynn Stevenson talk about advances in durable MCS & continued challenges w/ congestion & lack of donor organs.
❤️How can we intervene and interrupt this cascade?
❤️Right heart failure is most commonly the tipping point & we know so little about RV!
❤️Last but not the least was a fantastic panel discussion re:
🎯screening for early detection of HF
🎯treat HTN, prevent HF
🎯know more abt RV.
🎯paradigm shift in the way we conduct HF trials—>move away from LVEF?
🎯adopt 💊🧪for diseases causing HFpEF (HCM, amyloidosis etc).

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More from @rachkataria

Rachna Kataria, MD Profile picture
Jan 14, 2022
🧵Pleased to share our comprehensive review "#HFpEF: recent concepts in diagnosis, mechanisms & management", co-authored with @AndreasGevaert, incredible mentor @hvanspall, &⭐️collaborators @FaiezZANNAD @AndrewJSauer @HFpEF @kevin_damman @KSharmaMD

heart.bmj.com/content/early/…
🧵First, we discuss the evolving definition of #HFpEF--> from LV hypertrophy with diastolic HF to arbitrary LVEF cut points of > 40% the > 50% to evolving concepts of HF phenotypes, beautifully illustrated in the figure below. @Heart_BMJ
heart.bmj.com/content/early/…
🧵We then review various approaches to making a diagnosis of #HFpEF--> symptoms and signs, utility of NT-proBNP, rest and exercise hemodynamics. We discuss existing diagnostic algorithms (H2FPEF and HFA-PEFF scores) and their applicability. @Heart_BMJ
heart.bmj.com/content/early/…
Read 6 tweets
Rachna Kataria, MD Profile picture
Oct 17, 2020
Brilliant presentation by Dr. @PPibarot on Aortic Valve Calcium Score @MonteHeart CT/CMR Lecture on 10/16/20.
💥Important to begin by appreciating burden of AS.
💥#echofirst remains primary modality to assess HEMODYNAMIC severity.
💥Need other tools to assess ANATOMIC severity!
💥JACC 2019➡️Review non-contrast CT to measure AVC in AS.
💥An example protocol by Dr. @PPibarot ⬇️ measuring calcium burden in en-face view of AV.
💥Pitfalls: inclusion of LVOT, sorta, mitral annulus & cors. Multi-planar reconstruction helps carefully exclude non-AV calcium.
💥Women & Men are different! For a given amount of AVC, 🚺 have a ⬆️ peak jet vel. by #echofirst. For a given peak vel. by #echofirst 🚹 have higher iAVC.
💥AVCd didn’t help resolve the discordance.
💥2017 ESC guidelines for severe AVC ➡️>1200 AU 🚺,>2000AU🚹.
Read 10 tweets
Rachna Kataria, MD Profile picture
Sep 4, 2020
1/
Comprehensive talk by Dr. @JoaoLCavalcante who who patiently walked us through #WhyCMR in Mitral Regurgitation.
First: different etiologies of MR where #WhyCMR may be applicable:
🧲Primary MR
🧲Arrhythmogenic MVP phenotype (including MAD)
🧲Secondary MR (work in progress)
2/
 Limitations of #echofirst:
🧲overestimation of MR by PISA, underestimation of eccentric MR.
🧲poor reproducibility if MR severity (inter- and intra-observer)
🧲Alas, there is no accuracy without reproducibility 👎🏻
3/
#WhyCMR for Primary MR➡️
🧲CIRC ‘17➡️CMR severe-TTE moderate MR outcomes similar to CMR severe-TTE-severe MR.
🧲JACC ‘15➡️👎🏻correlation of MR estimates by #whycmr & #echofirst in pts referred to MV Sx.
🧲💪🏻 correlation b/w post-op LV remodeling & baseline MR severity by CMR
Read 11 tweets

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