Thread/
There are many new exciting trials in transthyretin
#amyloidosis
– as we continue to enroll patients in the CARDIO-TTRansform trial, I thought I would highlight some of these trials in ATTR-CM
#cardiotwitter
Thread/
This was a great day for
#HCM
patients. The results of EXPLORER-HCM were presented
#ESC2020
and published ( ). This timeline shows some of the major clinical events in
#HCM
@MyoKardia
#cardiotwitter
Excellent example of mitral annular disjunction and its associations. I recall seeing 3 survivors of
#SCD
with
#whycmr
reports conclusion as no abnormal findings (yes, association =/- causation, over a span of 2 years).
#cardiotwitter
We are recruiting! If you are a
#cardiologist
or
#ACCFIT
who likes
#HCM
and/or
#amyloidosis
,enjoys research (RCTs/translational/basic), wants to join an exceptional group, & likes to have fun
#PNW
, please DM me (or refer my way, e mail: masria @ ohsu .edu)
#cardiotwitter
Health care would cost less if we had more public accountability for things like THIS: Stanford's $143,000 BREAST BIOPSY!?! Doctors should be leaders in addressing this problem affecting OUR patients & med societies should speak up rather than be silent.
@ZDoggMD
@SAGES_Updates
What happened between EKG 1 and 2 from the same individual with
#HCM
? No coronary artery disease. No intracranial catastrophe or severe hypertensive episode
Answer below
#CardioTwitter
#MedTwitter
This is a difficult time for all especially those under strict lockdown. But it is a great time to remember that you still have a home, heat, electricity, food, water, TV, internet, and health.
#COVID19
#itwillpass
#stayhome
The REDWOOD
#HCM
Cohorts 1 and 2 data are now published in
@JACCJournals
Congrats to all especially patients who participated during the height of the COVID-19 pandemic.
Follow this thread for a quick overview
#CardioTwitter
Any document published by a society is a guideline written by individuals. Ultimately the decision of what to do lies within the person in charge.
Reducing the whole practice of medicine to a mandated set of tables/algorithms is frequently problematic.
A thread.
So the
@US_FDA
@SGottliebFDA
issued a warning re: Fluoroquinolones (FLQ) and aortic dissection (AD) or aneurysm (AA). Do FLQs cause AD/AA? Not really. Is there an association? Maybe. Let’s go throw the evidence and you can decide for yourself.
#CardioTwitter
#MedEd
Complete plaque regression over a 3 year period in
@ESC_Journals
Impressed?
I am, also with the amount of repeat work up which helped write this nice story.
They dont report on diet/lifestyle changes
#cardiotwitter
An honor to be recognized by
@HFSA
and
@hfcollaboratory
-thank you for your leadership in this space
This award goes to PIs but it represents the sum of hard work by many individuals and the time and effort of our patients who participate
#CardioTwitter
🙌🥳Celebrating the remarkable achievements of Dr. Tariq Haddad &
@MasriAhmadMD
for winning the TOP PI titles in 2023 for their incredible work in clinical trials!🎉
Check out the more research awards at the HFC website
@OHSUNews
@OHSUCardio
#HF
#cardio
This thread will cover the amyloid session from pathogenesis to diagnosis to treatment.
@MyASNC
#ASNC2018
I will highlight some take home point in each tweet
- light chains are directly toxic to myocardium and have a vasomotor component --> decrease flow
#HCM
is in the spotlight today with 2 papers from RCTs in
@JACCJournals
which I had the pleasure to write an editorial for
First-
@AnneDybro
and colleague did what has not been done b4, an RCT of metoprolol in 29 pts w/ obstructive HCM
#CardioTwitter
Despite growing up in the West Bank & knowing what darkness and bombardment mean, I can't begin to imagine the horrors that children and families in Gaza are living now.
Collective punishment and genocide will not work. Every tragedy is a serious chance for peace
Different patients. All sick. All were on hydroxychloroquine.
Simply one need to study this - severity of illness vs drugs.
*shared with permission from another MD.
#covid19
#cardiotwitter
#FOAmed
These are just incredible stories from
#HappyImmigrantDocs
I'll play...
Narrowly escaped being a statistic 4 times (one was an air to ground missile while walking to school).
Volunteered in hospitals since age 12.
Moved here age 23.
8 years later -- academic cardiologist
Born to a refugee father in Jordan🇯🇴.
Diagnosed with stage IV cancer age 6.
Left with mother to Germany🇩🇪 for 2 yrs of (intensive) treatment.
Parents spent most of their life savings on my med school🇮🇪.
Now Interventional Cardiology Fellow
@BrighamWomens
.
#HappyImmigrantDocs
This is an example of the effect of
#aficamten
on top of maximally tolerated BB in obstructive
#HCM
, and where disopyramide didn't improve symptoms.
Baseline: BB
Video 1 (Week 2): BB+aficamten 5 mg
Video 2 (Week 24): aficamten 15 mg, no BB
#cardiotwitter
#echofirst
So proud of our
#HCM
team and our patients. We just evaluated our 50th patient for aficamten, a cardiac myosin inhibitor. & we had a cake with asymmetrical septal hypertrophy, a myectomy and a sarcomere unit - made by the brilliant MLL ( )
#CardioTwitter
5 new
#amyloidosis
patients today in clinic. Every single one with a unique story, phenotype & presentation which were largely non overlapping. Range of delayed diagnosis of 1-7 years. All with significant disease burden. Tons of work to do in disease recognition
#CardioTwitter
An exciting
#ACC22
for
#HCM
and
#Amyloidosis
is in 2 weeks. Here is a quick run through what to look for (trials):
First - VALOR-HCM trial: mavacamten as an alternative to septal reduction therapy (patient referred to SRT, placebo controlled trial, 16 weeks)
#CardioTwitter
Apico-septal bands and abnormal papillary muscles play an important role in
#HCM
This is a case where the apico-septal band was prominent inserting directly on the septum. Check out
#whycmr
and the path in the video
#cardiotwitter
This is an example of why we should explain all LVH.
Here, 60 yo man, 30+ years of uncontrolled HTN (6 meds), uncontrolled DM, obesity, CKD. Recurrent HF hospitalizations. LVH is longstanding and presumed to the above. Reasonable
#echofirst
#CardioTwitter
#medtwitter
Most important - explain all LVH & not just blame HTN without due diligence. Use NTproBNP in stable outpatient settings. If available, teach sonographers to do strain in all LVH or keep an eye on the lateral LV S' wave in LVH (<6 cm/s).
#cardioTwitter
#echofirst
We presented the results of
#PIONEER
#HCM
#OLE
at
#ACC23
This is the longest follow up of mavacamten to date - a 5 year study, average follow up at the time of this data cut was 200 weeks.
#CardioTwitter
Using 15 mm cut off for hypertrophy in
#HCM
@JccmoonMoon
howing the issues and complexities with using non indexed measures
Check out this calculator for personalized limits of hypertrophy
#CardioTwitter
Thread. Our systematic review and MA on LifeVest (WCD) published in
@JACCJournals
(EP) - This was a clinical question that I had as a first year fellow. We prescribed a lot of WCDs at the time.
#ACCFIT
#EPeeps
#CardioTwitter
#MedEd
It is official. Based on the results of the REDWOOD-HCM Cohort 4 ( ), we are progressing with the phase III ACACIA-HCM, aficamten vs placebo in non-obstructive
#HCM
#CardioTwitter
@FilipeAMoura
Happened recently:
Reviewer 1: poor study design analysis not helpful etc. Not a single constructive comment
Reviewer 2: excellent much needed study here are some comments to improve it
A thread. Follow along. Infective Endocarditis (IE) in
#TAVR
.
92 yo, s/p self-expandable valve 4 years ago, presents with fevers. No clear focus.
#EchoFirst
TTE was obtained.
#CardioTwitter
#MedEd
Heading to
#ACC23
It is a busy meeting for
#HCM
LIVE-HCM, REDWOOD-HCM Cohort 4, FOREST-HCM, PIONEER-OLE, MAVA-LTE CMR, post hoc analyses from EXPLORER and VALOR
Stay tuned
#CardioTwitter
Thread/ exciting times for
#HCM
patients and physicians. We randomized the first patient
@OHSUCardio
in the world in the phase II HCM-
#REDWOOD
trial investigating a new small molecule cardiac myosin inhibitor CK-274 $CYTK. What to learn more? follow along
#cardiotwitter
In patients with ATTR
#amyloidosis
, be mindful of the type of bone tracer used. This is a case in
@ESC_Journals
where the patient was thought to have a negative bone scan because Tc-99m MDP was used inappropriately.
#Cardiotwitter
39 year old woman, no PMHx. Presents with chest pain, sudden onset. EKG here. Had also sustained polymorphic VT. Troponin I peaked at 16. LHC in comments. what do you think
#CardioTwitter
?
#ACCFIT
#MedEd
Patient: "I'm short of breath",found to have no pulse.Syncopized briefly after. Was being paced transcut when the EKG was obtained with failure to capture at the time. CHB. Got a pacemaker, did well. There is a reason this is not common.
#cardiotwitter
#MedEd
#EPeeps
#CardioEd
The
@ESC_Journals
guidelines on cardiomyopathies include LVOTO management. Massive effort congrats to all
This is what we do in daily practice, but only 1 thing on this list underwent 2 multicenter phase III RCTs and it got a class IIa recommendation, why? 1/3
#CardioTwitter
On behalf of my co-investigators & the study team, we presented results from
#REDWOOD
#HCM
Cohort 4
#ACC23
This is the first evaluation of aficamten in nonobstructive HCM
Excellent results of this phase 2 trial --> plan to progress to pIII
Tweetorial coming soon
#CardioTwitter
Check out this interview with
@MasriAhmadMD
at
#ACC2023
where he provides further insight into the results of the REDWOOD-HCM cohort 4, which included 41 patients with non-obstructive hypertrophic cardiomyopathy.
#Cardiology
#HCM
Aficamten on top of disopyramide and AVN blocker - REDWOOD-HCM Cohort 3 manuscript is now out in
@JCardFail
Aficamten was safe (3 neg intropes), no interaction with disopyramide, and effective in reducing LVOTO (figures)
Link:
#CardioTwitter
#HCM
Myocarditis in a patient with
#HCM
Temporality and clinical presentation suggests
#COVID19
symptomatic infection as the cause. Can't prove it beyond that.
What's important to remember, myocarditis can be a presenting sign of genetic cardiomyopathies
#Whycmr
#Cardiottwitter