#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

#HeartFailure
#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 academic.oup.com/eurheartj/adva…
After 6 months of #immunosuppressive Tx, #LGE was less extensive and more slight in virus-negative inflammatory #CMP

#WhyCMR 4-chamber apical view showing severe reduction of cardiac function (A - LVEF 30%) that improves after therapy (B - LVEF 55%)

#HeartFailure #CardioImmuno
The position statement of the @escardio recommends the individualized use of #immunosuppression in infection-negative lymphocytic myocarditis refractory to standard Rx, as well as in patients with proven #autoimmune forms of #myocarditis

#HeartFailure #CardioImmuno #CardioEd

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More from @HanCardiomd

Jul 14
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
Mar 21
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
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
Feb 1
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
📌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
#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
Nov 4, 2021
Multimodality imaging in patients with HFpEF: an expert consensus document of the European Association of Cardiovascular Imaging #EACVI #MMI #HFpEF academic.oup.com/ehjcimaging/ad… @ESC_Journals @Cosyns @alessia_gimelli @ThorEdvardsen @VDelgadoGarcia @bogdan_popescu1 @JaeKOh2
This expert consensus document from the #EACVI provides recommendations regarding how to determine elevated LV filling pressure in the setting of suspected #HFpEF and how to use multimodality imaging to determine specific aetiologies in patients with HFpEF @EACVIPresident
📌Mechanisms of LV diastolic dysfunction include impaired relaxation, attenuated restoring forces, and increased passive elastic stiffness that leads to elevated LV filling pressure

📌The presence of LV hypertrophy and dilated LA provides support for the #HFpEF diagnosis
Read 5 tweets
Aug 30, 2021
Iron deficiency as a therapeutic target in heart failure - new evidence, new guidelines

New evidence from AFFIRM-AHF ‒ implications for clinical practice with ⬆️QoL
#ESCCongress @ESC_Journals @escardio @ShelleyZieroth @hvanspall @DrNasrien @SilCastelletti @DrMarthaGulati
New evidence from AFFIRM-AHF ‒ implications for clinical practice on cost effectiveness and QoL

#ESCCongress @ESC_Lavinia @escardio @ESCardioNews @ShelleyZieroth @JavedButler1 @rachkataria @AndreasGevaert @AndrewJSauer @pabeda1 @BSHeartFailure @FH_Verbrugge @DrRyanPDaly
Very insightful presentation by @JavedButler1 on New evidence from meta-analyses ‒ lessons to learn on the benefits of intravenous ferric carboxymaltose in HF

#ESCCongress @JavedButler1 @DrNasrien @MihaiTrofenciuc @pabeda1 @AndrewJSauer @NMHheartdoc @hvanspall @MajaCikes
Read 5 tweets

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