Exciting news! The
#MINT
trial is here, addressing anemia in acute MI patients.
@cardioNerds
Should we opt for restrictive or liberal transfusion strategies?
#AHA23
Comparing risk of death/MI at 30 days in acute MI patients. Restrictive (Hb 7-8) vs. liberal (Hb 10) transfusion.
Transformation in Acute MI Care: Door to Balloon or Door to Unload?
#STEMI
#DTU
#RCT
is currently enrolling.
We discussed what we have learned about LV unloading prior to revascularization in acute MI at
#THT2023
via
@mydocwire
Excited to share my interview from
#AHA2023
diving deep into the MINT trial on transfusion strategies post-AMI with Dr Jeffrey Carson.
The results open intriguing possibilities for redefining transfusion thresholds in MI. Don’t miss the compelling discussion here
@CardioNerds
🎙️NEW
#AHA23
Discussion in partnership with
@CardioNerds
💫Dr Jeffrey Carson and CardioNerds Ambassador Dr
@nazliokumus
discuss findings from the MINT trial comparing liberal and restrictive red blood cell transfusion strategies in anaemic patients with AMI.
📽️Watch here👉
Excellent talk from
@NavinKapur4
about new approaches to limit complications on VA-ECMO
#THT2023
❣️ Hyperoxemia on VA-ECMO is associated with lower survival
❣️Timing of Impella insertion for LV unloading is critical
🌟Impella before ECMO limits myocardial damage
🚨👀 Looking for a way to stay up on the breaking news and info from
#AHA23
?!
Look no further! 😎
Follow the
@CardioNerds
Conference Scholars 🤓⬇️ for live updates and 🔥 important points during the AHA 🫀 Scientific Session this weekend.
🫀When managing Valvular shock, a comprehensive understanding of hemodynamics and nuances in temporary MCS devices is crucial.
🫀
@PedroMDMSc
delves into this complex subject, providing examples from challenging cases at
@miamivalves
@CardioNerds
Lifetime management of AS: coronary artery protection im TAVR in valve or TAVR in TAVR
@miamivalves
@CardioNerds
🫀ShortCut has been used in multiple bioprosthetic valves invluding TAVR valves
Nightmares at CICU: HOCM with cardiogenic shock
#critcarecards23
@nyulangone
❣️It’s crucial to recognize patients with Takotsubo Syndrome at risk for SAM
❣️ Review prior echo to look for those at risk for LVOT obstruction
❣️ If doing a LHC, obtain the post-PVC LVOT gradients
Giving their awards to the Poster Session Winners of the SIM section
@kathrynchadason
and
@jducanto
#CRITCARECARDS23
“Modified Cadaver Technique to Simulate Contaminated Airway Scenarios to Train Medical Providers in Suction Assisted Laryngoscopy Airway Decontamination
MCS in PAH/RV shock
#THT2023
🫀Once PAH patient is in ICU with RV shock, mortality is high
🫀Very narrow window to transition to MCS
🫀we still have a lot more to learn about the optimal MCS strategy in this patient population
@CardioNerds
@sonuabrahammd
#THT2023
Executing the optimal Cardiogenic Shock trial
🫀Details matter
🫀Need for RCT’s in more specific populations
🫀Patient selection is critical and using SCAI stages can be the key
🫀What happens within the first 24 hours predicts outcomes
#SMART
Trial
#ACC24
the largest trial comparing the hemodynamic performance and clinical outcomes of SEV to BEV with more than 85% female representation
🫀SEV was superior to BEV for bioprosthetic valve dysfunction at 12 months for all definitions tested
@CardioNerds
#TAVR
ORBITA-2: Exploring the Power of Placebo-Controlled PCI in stable angina
The original ORBITA trial turned heads with its findings. Now, ORBITA-2 steps up to assess the placebo-controlled efficacy of PCI on angina frequency.
#AHA23
@CardioNerds
Closing an inspiring conference journey
@miamivalves
Grateful for the journey so far and thrilled about what’s on the horizon in transcatheter therapies.
Big thanks to the incredible
@CardioNerds
team for making this experience unforgettable
@saahilaj
@a_h_ghoneem
@catweneboah
Changing the paradigm from DTB to DTU in management of AMI
#THT2023
🫀HF after AMI is common
🫀Deapote rapid revascularization, residual myocardial damage is seen in these patients
🫀Uncoupling the ventricle from vasculature can improve oxygen delivery and limit ischemic injury
The 3rd NYU Langone Critical Symposium kicks off with a great opening session and attendance of champions in the field. Time to nerd out
@CardioNerds
#critcarecards23
In depth with ORBITA-2
#AHA23
@CardioNerds
❓Why eliminate antianginals?
❣️In ORBITA, patients were on high antianginal doses. However, real-world data doesn't reflect widespread use of 2-3 anti-anginals. Patients faced adherence and side effect challenges.
What you think you see in a coronary angiogram vs. the real deal with IVUS. Knowing what you’re dealing with makes all the difference
❣️Best practice: intracoronary imaging before and after PCI
#AHA23
@CardioNerds
To wean or not to wean tMCS
❣️assess readiness to wean everyday
❣️keep in mind potential complications
❣️initial illness severity matters!
❣️don’t forget the value of echo
- LVOT VTI
-lateral e’ during ECMO weaning
❣️create your algorithm with clinical, hemodynamic and lab data
#DAPAMI
#AHA23
Evaluating the effect of dapagliflozin on cardiometabolic outcomes in acute MI without DM or chronic HF
🫀significant benefit in cardiometabolic outcomes
@CardioNerds
Acute MI CS at 2023 Western Pennsylvania Cardiogenic Shock Initiative Symposium
Highlights from the amazing discussions:
-risk atratification with SCAI staging
-culprit vs multivessel revasc
-LV support prior to revasc may lead to better outcomes
#shocksaturday
@AHN_CVI
Can’t imagine
#critcarecards23
without an acute PE case from
@jameshorowitzmd
Risk stratification of acute PE with high-inintermdiate risk remains to be a big challenge in clinical oractoce. Check out the Conposite Shock Score
Excited to announce the publication of our latest research article! Research is tough during training, but the mentorship and teamwork made it possible. Grateful for the opportunity to be part of such an incredible group.
@skarim01
@MHMedRes
@AHN_CVI
@GSAMRA12
@SCAI_WIN
#ACCFIT
🚨New
#FreeRead
Article in
@JICE_EP
3-Year Incidence of Pacemaker Implantation in Pts with Atrial Fibrillation & Sinus Node Dysfunction Receiving Ablation vs. Antiarrhythmic Drugs
📖🧐
by
@nazliokumus
,
@EmilyZeitler
, Abdelmoniem Moustafa, Maximiliano
Challenges in CS from
@manreetkanwar
#ACC23
#WCCardio
1. Definining Shock Stages 2. Focus on AMI-CS now we are starting to realize that HF-CS is the leading cause of CS 3. Phenotyping CS: identifying hemodynamic vs hemodynamic shock 4.Transitioning from drips to devices
@AHN_CVI
#THT23
is only 7 days away! Can’t wait to learn more about the latest technologies and treatments in heart failure and cardiogenic shock from the experts in their fields. Take a look at the schedule here:
No longer the forgotten valve! Great presentation about how our understanding of tricuspid valve has changed
@miamivalves
@CardioNerds
The valvular structure is more variable then we thought in the past
Patient with 4 leaflets may have more residual TR than those with 3 leaflets
Vasoactive Meds in CS
@JasonKatzMD
#critcarecards23
❣️little data to guide the choice of agent
❣️Caution with epinephrine given initial lactate rise
❣️Know your agents and their mevhanism of action well
❣️Try to leverage pathophysiology to guide pharmacology
@CardioNerds
Great start to day 2
#THT2023
by discussing the role of shunts in HF
Ideal shint candidate:
🫀normal to borderline elevated LAP at rest with significant increase during exercise
🫀normal RV/RA function
🫀elevated LAP that leads to dyspnea
If you missed out on
#ACCLegConf
this year or have never been, look no further!
@nazliokumus
eloquently narrates her experience and talks about the joys of advocacy! Next year’s conference is 9/29-10/1/24
#ACCFIT
@ACCinTouch
Big news from
#TCT2023
! Partner 3 and Evolut Low-Risk data for 5 and 4 years reveal promising outcomes in the low-risk population. 🩺📈 The real excitement? The 10-year follow-up will be the key test for valve durability and performance
#CardioTwitter
@crfheart
#TAVR
#SAVR
Future of TAVR from Dr. Eberhard Grube
@miamivalves
❣️Deep dive into the explosive growth in TAVR worldwide
🫀extended indications
🫀Accelarated innovation platforms
🫀lifetime management: planning the future
🫀valve remodeling technologies
Patient phenotyping and prognostication in cardiogenic shock: not all shock is created equal!
@manreetkanwar
#THT23
🫀phenotyping comes first to know what you treat
🫀CS phenotyping at admission predict the odds of reaching more severe SCAI STAGES
Amazing discussion
#THT23
Decongestion matters but is it sufficient?
New ways to approach HF therapy
🫀Combination of decongestion with rapid uptitration of multiple drugs
🫀Therapies targeting neurohormonal, inflammatory adrenergic activation at acute and chronoc phase
PV Loops: the gold standard approach
#THT2023
🫀Simultaneous measurement of RV pressure and volume
🫀Can be used in assessment of RV contractility, afterload, response to preload reduction as well as RV diastolic function
🫀Helpful to predict long term clinical outcomes
@CardioNerds
gearing up for
#AHA23
. Get ready to catch insights from the key trial investigators behind LBCT’s and hot topics.
I have so many questions about the MINT and ORBITA-2 trials. What LBCT’s are you most excited about?
2⃣
@nazliokumus
&
@AKansalMD
interview
@BenediktSchrage
& Dr. Alastair Proudfoot about the American vs European Cardiogenic Shock experience & need for ⬆️registry/trial data.
🔗
🧵(cont.)...
Role of balloon valvuloplasty in MAC MS Excellent case presentation
@miamivalves
@CardioNerds
-MAC MS with mean gradient of 14 mmHG
-significant improvement in hemodynamics and functional capacity with Balloon Valvuloplasty
-patient comes back with worsening symptoms…
TAVI for AR
#TCT2023
ALIGN AR trial of
@JenaValve
meets prespecified efficacy and safety criteria! 🫀Significantly improved LV remodeling on echocardiography and enhanced heart failure functional status observed over one year for patients. 🌟
@crfheart
@TCTMD
#CardioTwitter
What are we learning?
🫀unloading LV with Impella stabilizes hemodynamics
🫀reduce ischemia
🫀protect from reperfusion injury
More to come with STEMI- DTU Pivotal trial!
@CardioNerds
@NavinKapur4
@sonuabrahammd
What an amazing line of speakers. Thank you all our amazing speakers helping us make this session amazing addressing the importance of virtual domain in training, building a community and advocatting for the underserved populations
#CRITCARECARDS23
@nyulangone
@AHN_CVI
Clinical trials every CICU physician should know from
@AnnGageMD
Most of us assume that tube feeds must be held prior to extubation. I’m guilty of that too! Here is an excellent study questioning this approach:
Does this change your practice?
#critcarecards23
@CardioNerds
#THT23
kicks off with an amazing opening session!
- An interactive forum for stake holders involved in the care HF patients
- Latest innovations
- Challenge conventional wisdom, inspire collaborations and drive new innovation
Feeling incredibly lucky and humbled to be part of an amazing team! Learning so much from each member, and enjoying their company. Can’t wait to reunite! Big thanks to
@AmitGoyalMD
and
@Dr_DanMD
for creating an invaluable learning space for trainees worldwide.
@CardioNerds
#AHA23
Thrilled to be a FIT expert at tonight’s journal club on the ORBITA-2 trial! Join us for a stimulating discussion with experts in the field.
#ORBITA2
#CardsJC
@CardioNerds
It's almost⏲️for this months
#CardsJC
! Come hang out and discuss
#ORBITA2
with this stellar group of nerds.
When: Tomorrow, 2/29, at 8PM EST.
Where: Here!
#CardsJC
We can't wait to 👀you there
❣️Valvular shock with Severe AI managed with LAVA ECMO
❣️significant improvement in hemodynamics following the insertion of LAVA ECMO shown in a case series
@CardioNerds
ORBITA-2 in context: PCI relieves angina in symptomatic patients with chronic CAD and is safe
It can he used as an alternative monotherapy to antianginal medications in patients that are unable to or unwilling to take antianginals
#AHA23
@CardioNerds
❣️Valve in Valve for the lifetime management of AS
🫀the number of TAVR in SAVR is increasing
🫀Planning ahead is crucial: think about the second valve while implanting the first one
🫀 more to learn about leaflet modification procedures
Great read about bioprosthetic aortic valve hemodynamics
#cardiotwitter
@JACCJournals
Bioprosthetic Aortic Valve Hemodynamics: Definitions, Outcomes, and Evidence Gaps: JACC State-of-the-Art Review | Journal of the American College of Cardiology
New valves in the treatment of AI from Dr Santiago Garcia
@miamivalves
@CardioNerds
Why do we need a different design for AI❓
🫀less calcification
🫀higher risk of valve embolization
🫀We’re expecting approval of Jenna Valve in US for AI soon
🫀Encouraging results with J-Valve
Valvular shock with severe AS
🫀Impella as the tMCS of choice 🫀Consider BAV with Impella in place for critical AS
🫀significant improvement in transvalvular gradients shown
@CardioNerds
@GreggWStone
addressed the ongoing RCT’s in Cardiogenic Shock and Impella
#THT2023
An exciting era in the use of Impella is coming up with the following trials:
🫀DanGer Shock
🫀RECOVER IV Trial
@CardioNerds
@sonuabrahammd
RENOVATE-COMPLEX-PCI Trial-Deep Dive
#ACC23
#WCCardio
Discussion points:
Imaging guidance showed fewer cardiac death compared to angiography guidance
Patients with complex coronary lesions are more likely to benefit from intravascular imaging