1) Should we use the highest beat/signal in AF? Slide shown by Sanjeev Bhattacharyya
1/n
2) Peripartum cardiomyopathy - don't miss it and remember need to counsel/risk stratisfy if considering future pregnancies. Slide shown by @BSE_President Claire Colebourn at #BSEcho2022
2/n
3) The adult ACHD population is larger than the paediatric one, and 86% have biventricular anatomies. Interesting UK data shown by Liam Corbett at #BSEcho2022
2) Revascularization with PCI does not improve event-free survival in pts with severe LVSD over OMT alone
(HF cohort, not acute ACS pts or significant angina)
3) In pts with rheumatic heart disease and AF, RCT evidence supports VKA use over rivaroxaban, with decreased composite of CV events and death with VKA and no increase in bleeding.
The #ESCCongress session started with @FudimMarat discussing how it worked – explaining how pts with HF have poor baroreflex sensitivity, that baroreflex down-regulation is related to worse HF symptoms & barostim provided chronic improvement in muscle sym nerve activity
2/n
Next William Abraham talked about what has been learnt from clinical trials, focusing on BeAT-HF which was an RCT that showed BAT significantly improved exercise capacity, QoL, NYHA class and NTproBNP, and was safe
Indications for referral for surgery for severe asymptomatic AS:
❤️Some match ESC guidelines (Vmax >5m/s, LVEF <55%, symptoms on exercise testing)
❤️lower cut off for raised BNP (2x ULN compared to ESC’s 3x ULN)
❤️include valve area <0.6cm2 (not mentioned by ESC)
2/n
The NICE guidelines for referral for surgery for severe asymptomatic AS do NOT include a couple of criteria mentioned by the ESC guidelines:
▪️ progression ≥ 0.3m/s/yr not included
▪️ Sustained fall in BP >20mmHg on exercise testing not included
3/n
1)The indications for surgery in severe asym AR have changed
- LVEDD has disappeared from the summary table& diagram
- but LVEDD>65mm is mentioned in the text as a possible indicator for surgery (less than previous >70mm) if there is progressive LV size⬆️/⬇️EF