Sanjiv J. Shah, MD
@HFpEF
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Cardiologist. Director, Northwestern HFpEF Program. Director of Research, @NMCardioVasc. Stone Professor, Northwestern University (https://t.co/sUtwQVF6Q0)
Chicago, IL
Joined December 2010
@IM_Crit_ Best I can tell there is minimal LV systolic function and no discernible e' velocity. IVCT and IVRT are very long and ejection time very short consistent with severe LV dysfunction. Atrial contractility is in tact. Here is where I think a' (red arrows) and s' (yellow arrows) are
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RT @MarkBelkinMD: Looking forward to seeing full results out of #ESC24
@mvaduganathan @HFpEF @MkosiborodMD @RyanTedfordMD @dranulala @rob…
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@MasriAhmadMD @Ron_Witteles Great thread. Super exciting. But important Q's that the trial won't be able to answer: (1) Once on silencer is TTR stabilizer needed? (2) sequencing of TTR meds? Silencer for dz progression on stabilizers? No data, but impt in terms of getting these $$$ drugs covered for our pts
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RT @AmiBPatelMD: 🎉Congratulations to my brother @RBPatelMD who just received the NOA for his first R01!!! 👏🏾👏🏾👏🏾 @NMCardioVasc @NUFeinbergM…
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@ezmanshariff @jdrwilcox @nat_echo @GE_IanMc 4/ But her very low a' velocity does suggest an intrinsic LA problem that is primary. I would do a bike stress echo and see what happens to her LA strain, A, and a' with exercise. Also Holter monitor to look for occult AF/AFL and consider genetic testing
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@ezmanshariff @jdrwilcox @nat_echo @GE_IanMc 3/ In high output states, the first chamber to dilate is typically the LA. We see it all the time in pregnancy and in end-stage liver disease, for example. LA typically dilates first. LA strain can be abnormal simply because LA is overloaded (⬆️LAP)
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@ezmanshariff @jdrwilcox @nat_echo @GE_IanMc 2/ I had a case just like this when I first started my #HFpEF program in 2007. Very similar presentation with elevated LA volume but LVOT VTI was high. She ended up having vitamin B1 deficiency and resolved with diuretics and B1 supplementation
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@GBittarMD @ACCinTouch If you're at the ACC meeting come to the clinical trial deep dive session tomorrow where we will discuss RELIEVE-HF vs REDUCE LAP-HF II. I'll try to post my slides here after my talk.
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RT @AndrewJSauer: What a special day visiting mentors, friends, colleagues for CGR at @NorthwesternMed
@NMHheartdoc and @HFpEF arranged a…
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@AndrewJSauer @EricAdler17 I'm currently pre-eating pizza at the airport in preparation for KC steakhouse dinner #vegetarian
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@TheRealJamael @MarthaGrogan1 @MasriAhmadMD @MKIttlesonMD @MathewMaurer @frederickruberg @Ron_Witteles @bhtrachtenberg @KSharmaMD @ParagGoyalMD @SumeetMitter @YevgeniyBr @Amyloid_MUSC @MayoAmyloid @BU_Amyloidosis @Amyloidosis_ARC What's the LVOT VTI and HR? Is the pt on an AV nodal blocker? Stroke volume is usually low and fixed in cardiac amyloid so HR ideally 80s at rest and HR ideally ⬆️approp with exertion. If BP low could see if midodrine ⬆️SV. Is the pt anemic+iron deficient? If so would do IV iron.
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