Incredibly excited to continue my journey
@UCSFNephrology
and work at the intersection of cardio-renal disorders.
Grateful to my family and mentors for supporting and guiding me through thick and thin.
Updated bio โฌ๏ธ
After graduating from medical school in India, the most significant cultural difference for me as an IMG has been addressing senior Professors by their first name instead of Sir and Maโam. ><
Applying to a competitive fellowship like cardiology is nerve-racking, but I am very appreciative of the journey.
The past couple weeks have been incredible, from reflecting on my growth to learning about different aspects of cardiology fellowship programs and healthsystems!
June 25, 1983, the Indian cricket team created history by winning the World Cup. Watched '83' tonight and reminisced glorious moments watching cricket with my father.
These letters exchanged between my father and Sandeep Patil, and his father, are a treasure, made my eyes sweat
โก๏ธ presented a case of right sided heart failure
โก๏ธ reviewed the HF 2022 guidelines
โก๏ธ introduced our QI initiative to increase SGLT2i prescription
#SQUADHF
We conducted one of the first comparisons of bystander CPR and survival rates between Asian and white adults in the U.S. after an out-of-hospital cardiac arrest.
"I think life is short and we have an obligation to do our best to get closer to the truth, especially in medicine and public health. It is also about saving lives, not just curiosity. I would not be sincere if I silence myself..." - Dr. John Ioannidis
EXCELLENT. EPISODE. ๐
Episode 3.14 is out now!
2 hours w/ Dr. John Ioannidis - COVID-19, meta-research, + more
& cancer clinical trial eligibility w/ Dr. Mary-Elizabeth Percival
Back us on Patreon!
Sign up for our mailing list:
Happy birthday
@AHajduczok
! Thank you for sharing your love and passion for life, cardiology, and fitness with us ๐๐ผ Wishing you the best of everything!
Excited to share our abstracts at
#ASNC2023
evaluating a deep-learning attenuation correction (DLAC) algorithm against CTAC
โก๏ธReaders inspected non-attenuation correction & CTAC images
โก๏ธWe compared supine CTAC against DLAC images using TPD score (> 3% were considered abnormal)
This is truly an incredible resource for preparing for virtual interviews from the UNC IM residency program:
So many wonderful tips from picking colors, body language to picking backgrounds and truly coming across in the virtual environment
@uncimchiefs
Excited to be amongst the Top 5 Scoring 2023 AbstracX at
#HRX2023
๐
Looking forward to presenting the VALENTINE Study on๐ September 22nd at 9:45am
Be sure to register for
@experienceHRX
โจ
Presented an important meta-analysis of CHIEF, DEFINE & PRESERVED on health outcomes of SGLT2i by race at
#AHA22
๐ซ SGLT2i improve health outcomes in Black pts as early as 12-weeks
๐ซ Interaction of race*treatment not significant
๐ซ โฌ๏ธ CV disparities ๐ฐ โฌ๏ธ SGLT2i prescription
โฌ๏ธ best news all week
Incredibly excited to discuss the VALENTINE study at
#HRX2023
An intricate and innovative study design leveraging digital health to augment the benefit of cardiac rehabilitation.
This is the future ๐ฅ
@JRGolbus
@bnallamo
Response to therapies is more heterogeneous at a higher EF, necessitating more phenotyping in HFpEF โ great session on new strategies for HFpEF at
#AHA23
CVCT is one of a kind meeting. Topics discussed are both critically important to the society but not necessarily discussed in other forums. Great insights in innovation with the cardiovascular space from experienced erudite colleagues.
SGLT2i are equally effective in improving health outcomes in Black and White patients with ๐ซheart failure across the EF range.
Reducing disparities in access to ๐ should be a priority.
#THT2023
was a wonderful opportunity to connect, so many wonderful stories exchanged and inspired by each ones โฌ๏ธ journey and passion for HF and digital health. Until the next conference!
Accelerating adoption of innovative CV devices - thought provoking session at
@CVCTForum
#CVCT2023
๐ซ TAVR: one of the most disruptive medical technologies in recent years - yet the US was the 42nd country to approve in 2014. More to think about: โRegulation enables the
@shantsila
@CVCTForum
A terrific and creative trial design: NUDGE-CKD presented by
@TorBiering
at
#CVCT2023
โก๏ธ NUDGE-CKD tests if electronic letters, that highlights the importance of GDMT in CKD, delivered to all CKD patients and GPs in Denmark can increase the use of GDMT
โก๏ธ Primary endpoint is
@hvanspall
on the need to accelerate research into practice with implementation science at
#CVCT2023
Restrictive eligibility criteria in Phase 3 trials:
โฌ๏ธMaximize effect sizes
โฌ๏ธExpose excluded groups to unknown risks
โฌ๏ธMinimize adverse effects
โฌ๏ธMinimize risk to sponsors
Important slide on cardiogenic shock from
@NavinKapur4
and
@rwyeh
at
#CVCT2023
โก๏ธ Are we testing a system, an algorithm, or a device? If we test a device, we will likely fail and observational studies with adjustment for confounders will be biased
โก๏ธ Other outcomes we need to
First session this morning-trials in shock and MCS! Lots of thought provoking discussion-Dr Navin Kapur from
@TuftsMedicalCtr
suggests that our knowledge of shock is too primitive for the primary outcome of trials to be mortality. Lots of open questions left
Few notes from Day 1 of
#HFSA
๐ Treating patients with HF is an art
๐ The future of HF care will be driven by sensor strategies, coupled with automated technologies, and their integration into workflows
@BiykemB
@JagSinghMD
@AHajduczok
@AndrewJSauer
Are treatment effects of SGLT2i on health status by race for patients with heart failure different?
We discuss in the current
@CircAHA
issue โฌ๏ธ alongside incredible contributions by authors on disparities in cardiovascular care, a must read.
@dlanfearMD
@jspertus
@MkosiborodMD
Check out
@CircAHA
#disparities
issue published this week, featuring research on the effects of redlining, racial inequities in CV quality and outcomes, & the untold stories of Jackie Robinson!
Delighted to serve as an editor w/
@kewatson
@MCarnethon
Happy birthday
@hvanspall
! Thank you for your mentorship, guidance, and support. You wear so many hats effortlessly and inspire us all. Wishing you the best of everything!
Thoughtful discussion on addressing the deluge of wearables data with remote patient monitoring (RPM) at
#HRX2022
Three themes that merit further discussion
๐Good AI that sorts noise from actionable RPM data
๐Clinic workflows for RPM
๐RPM technology that is patient-centric
@AndrewJSauer
@mastorismd
๐ A review of the evolution of remote patient monitoring devices and clinical trials in heart failure, future directions, and areas for improvement.
Read here โฌ๏ธ
NEW in
@NEJM
: โTreatment w. a polypill containing aspirin, ramipril & atorvastatin w/i 6 months after myocardial infarction resulted in a significantly โฌ๏ธ risk of major adverse cardiovascular events vs. usual care.โ
What do we think? Polypill for all? ๐
Thought-provoking Q to end a great session: Do you trust wearable devices to generate meaningful information?
#HRX2022
๐Innovation is faster than evidence-based medicine
๐We have wearable data but no outcome data as yet necessitating clinical trials
๐Trust will take time
๐ซ VALENTINE Study is an intricately designed micro-randomized trial by
@JRGolbus
@bnallamo
that studied a just-in-time adaptive intervention to โฌ๏ธ physical activity in cardiac rehab enrollees using ๐ฑmobile phones and โ smartwatches.
The beauty of this trial is in the
An
#RCT
led by
@JRGolbus
&
@bnallamo
from
@umichCVC
with 220 participants showed that contextually-tailored text messages from wearable devices may improve physical activity for some cardiac rehab participants but displayed no sig. difference at 6 months.
With HF trials using patient-reported outcomes such as KCCQ scores as primary endpoints, should we document KCCQ scores when we see these patients in the clinic to track progress?
@hvanspall
@MKIttlesonMD
@AndrewJSauer
'Big Win' for Anti-Obesity Med in Heart Failure... my view on Semaglutide Treatment Effect in People with Obesity (STEP) trial...sharing my view that these drugs treat obesity & have many game-changing salutary health effects.
@medpagetoday
@YaleMed
Started out riding in the third row, and today I taught from the podium โ itโs been a fabulous journey of strength and endurance.
Dream it โก๏ธ Do it!
@MichaelNassifMD
walks us through the hospital in your home program
@MidAmericaHeart
at
#HFSA2022
Decongesting HF patients in their homes is an exciting opportunity Iโm looking forward to learning more about!
Maximize your experience at
#THT2023
1๏ธโฃ Connect to Wi-Fi (heart123)
2๏ธโฃ Download the app: CRF Events
3๏ธโฃ Follow your social media ambassadors
Love Andrew Garfields response - reminded me of
@bnallamo
speech
"When a father dies, the Irish say you lose your umbrella against the storm. You also lose your sense of invincibility. But what you gain is a real understanding of how precious our limited time with each other is."
An amazing session on how trialists navigate the legal and ethical framework at
#CVCT2023
Closing on great audience questions:
โก๏ธ Lots of data not being accessed, how can we get it legally imposed or made pre requisite to share data?
โก๏ธ Is it reasonable or do we need consent
@sarsch79
@AHajduczok
@AndrewJSauer
@BrettSperryMD
@djc795
Could there be other ways to get new comers experience rather than posters? Few reasons I donโt like them
โก๏ธ expensive to print, range from $60-100s
โก๏ธ inconvenient to carry
โก๏ธ time consuming
โก๏ธ donโt always attract an audience
โก๏ธ clutter resumes
Terrific session on heart obesity drug ๐ therapy: GLP1A and the SELECT Trial at
#CVCT2023
Favorite moment was this patient perspective โฌ๏ธ
Take into consideration where your patients live. What their situation is.
Itโs hard to bring adults out of habit, itโs hard to eat
Most valuable piece of tech I invested in 2022 was
@whoop
for 3 reasons
1๏ธโฃ Improved sleep consistency
2๏ธโฃ Awareness of factors affecting my HRV leading to lifestyle changes
3๏ธโฃ Elimination of Apple Watch from my wrist, one less screen to look at & better data to guide my workouts
โWe all agree your theory is crazy, but is it crazy enough?โ
Love this slide and encouragement on thinking big shared at
#HFSA2022
@hvanspall
@AHajduczok
#GeorgeBakris
and
#AmyMottl
on who should screen and prescribe medication for CKD at
#CVCT2023
โก๏ธ Recent
@CircAHA
paper on cardio-renal-metabolic syndrome showing cardiologists have taken the lead
โก๏ธ But by the time cardiologists and nephrologists see patients, itโs too late.
If a pt with atrial flutter in 160s with a BP 180-190/120s is propped up in bed and diaphoretic โ just for semantics would you call this atrial flutter with RVR that is hemodynamically stable or hemodynamically unstable?
@AndrewJSauer
@AHajduczok
@RyanTedfordMD
@JonathanDavisHF
Thought provoking discussion on the intersection of digital health and wellness at
#HRX2023
Few remarks that stuck ๐
๐ฏ you need sensors, you need smart algorithms, and you need WORKFLOWS to make things work
๐ no one is owning the reimbursement for the lifespan of an
We analyzed rates of survival to discharge following in-hospital cardiac arrests in 2020. Rates dropped substantially in all three COVID-19 surges - especially in communities with moderate to high COVID-19 mortality rates.
@bnallamo
@saketgirotra
Today is the last day of classes and my last presentation on infectious disease modeling. I canโt believe I will be graduating with my MPH next week! Thankful for my journey
@umichsph
and excited to be embracing whatever comes next with grit and grace.
#epitwitter
#globalhealth
๐ Time to bystander CPR by patient sex for OHCA
๐ซ We analyzed 78,043 patients with a witnessed OHCA from the CARES database from 2013-2021
โผ๏ธ 1 in 4 patients received bystander CPR after โฅ5 minutes
๐ซ Significant graded inverse association between time to bystander CPR and
One of the most important discussions at
#CVCT2023
for three reasons:
1๏ธโฃ Patients with renal impairment and ESRD are excluded from landmark clinical trials
2๏ธโฃ Consequently, patients with renal disease are exposed to many unknowns (ex, anticoagulation in ESRD)
3๏ธโฃ Nihilistic
95% of Americans support
#organdonation
, but only 56% register as organ donors. Why the gap? โค๏ธ
@umichsph
student Dr.
@KashviGupta
explores the public's perception of transplant surgeries, and popular media's negative impact on it.
READ: ๐ป
Cardiology Fellows and Cardiology Bound Residents:
๐
#THT23
is a fantastic opportunity to learn about HF therapeutics from the best of the best.
๐ Registration is free for fellows/residents!
@AndrewJSauer
Just finished listening to a great
@CardioNerds
episode released yesterday on diagnosing and managing HFpEF - for IM residents, highly recommend.