‼️Reduction in cerebral blood flow (CBF) is found in various forms of #Dysautonomia and leads to a broad spectrum of symptoms such as dizziness, fatigue, shortness of breath, all the way out to syncope. Yet, CBF is often not monitored.
pubmed.ncbi.nlm.nih.gov/27525257/ sciencedirect.com/science/articl…

We tested the feasibility of a novel continuous monitoring of external carotid blood flow as a proxy for CBF using a novel in-ear device. An in-ear wearable device designed to measure blood flow and more. @HopkinsMedicine @VUMC_heart Tandri, Tripathi

#1 Pressures do not equal volumes

▶️ What are the implications for heart failure management❓ Specific examples in patients co-managed with pressure and volume guided analysis are now online:
onlinelibrary.wiley.com/doi/10.1002/eh…

@ShahzebKhanMD @MGKhouri_md @DukeHeartCenter #2 We previously shown that the most common phenotype of pressure/volume in the HF ambulatory setting are high pressures BUT normal or low blood volume (BLUE BOX)

onlinejcf.com/article/S1071-…

Have you noted that patients with acute #heartfailure (AHF) hyperventilate? @JanBiegus et al. studied hyperventilation (defined by low pCO2 value) AHF and its link with potential triggers and prognosis👏nature.com/articles/s4159… @AlbertoGiannon8 @vbluml @RyanTedfordMD @yulnunezvill 1.Out of 241 AHF patients, 57 (24%) had low pCO2 (pCO2 ≤ 30 mmHg). Low pCO2 group had significantly lower HCO3- (22.3 ± 3.4 vs 24.7 ± 2.9 mmol/L, p < 0.0001) and significantly higher lactate level (2.53 ± 1.6 vs 2.14 ± 0.97 mmol/L, p = 0.03).

I am a cardiologist, and my work place is above the diaphragm?! Why should I care about the #liver and #NAFLD (non-alcoholic fatty liver disease)?
⚡️Our therapies in many cases reach well beyond the heart
⚡️In order to improve outcomes we have to tackle comorbidities
A🧵 🟦NAFLD (prevalence 25%) isn't only a hepatic disease but also a systemic & CV disease w/o effective pharmacotherapy
🟦We discuss the promising role of SGLT2i in NAFLD, propose mechanisms, & suggest future directions.

sciencedirect.com/science/articl…

Great thread on the link of Ehlers Danlos Syndrome (EDS) and Dysautonomia/POTS.

To extend on the observations some additional points 🧵:

#1 EDS is commonly associated with venous abnormalities such as nutcracker physiology of abdominal vessels or May Thurner syndrome.

https://twitter.com/AndrewCAhn2/status/1552715513859436544

#2 The issue with venous distension in the abdomen and pelvis is that it creates venous pooling/obstruction to blood return. Its mostly in the abdomen and not legs!

📢COVID-19 and Incident Heart Failure in @NatureComms

🟥 COVID-19 hospitalization is associated w/ a 45% higher hazard of incident HF
🟥 More pronounced association among pts who are younger, White, or w/ established CVD

nature.com/articles/s4146…
🌟-team @HusamSalah @CaugheyPhD 🚨As of July 4, 2022, there were about 529 million pts who recovered from COVID-19. The association between COVID-19 recovery and incident HF has not been studied in a large scale, nationally representative sample.

🔥🚨Pressures Do Not Equal Volumes🚨
#1
We present ➡️ Discordance of Pressure and Volume: Potential Implications for Pressure-Guided
Remote Monitoring in Heart Failure
➡️We explored pressure-volume relationship
in ambulatory HF pts. managed with CardioMEMS
onlinejcf.com/article/S1071-… #2
⚡️Pulmonary arterial diastolic (PAD)/wedge pressure are surrogate markers for (intra-vascular) blood volume (BV) and are often used to guide volume adjusting therapy (aka diuretics)
⚡️We found no relationship between PAD pressure and intra-vascular BV

1. "Heart" Failure is not only a problem of the heart. The ability to modulate preload (aka Preload Reserve) is central to activity/exercise. Find the review on ⚡️Extracardiac Abnormalities of Preload Reserve in HFpEF⚡️
@sobotka_paul MarkDunlap @CircHF

ahajournals.org/doi/full/10.11… 2. Majority of intravascular blood volume is located in the venous system. Veins are highly innervated (in many instances more so than arteries). The abdomen pools the majority of the blood volume and blood can be recruited quickly in and out of the compartment.