🧵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/…

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.

❤️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.

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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 👎🏻