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Kardioklick

@kardioklick.bsky.social

870 followers 640 following 550 posts

Imagining heart in any modality but #echofirst! Also: Interventional, EKG, structural heart, congenital, heart failure. Based in Hamburg, Germany Come join the #cardiosky. @medsky.social #medsky 🫀🏃‍♂️🚴

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Kardioklick @kardioklick.bsky.social · Dec 17

The #echofirst #echosky is still a bit in its infancy but we‘re slowly growing! Please join the conversation and suggest more accounts for the starter pack.

#cardiosky

go.bsky.app/DVTHMoh

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Kardioklick @kardioklick.bsky.social · 2d

Imagine unlimited heart bypass graft material…!

#cardiosky

Hao Yin @haoyin.bsky.social · 2d

#TissueEngineeredVascularGraft

#hiPSC #SmoothMuscleCell on 3-mm PGA tubular scaffold

Decellularized

Rupture pres 1200 mmHg
Suture retent str 120 g

Re-endothelialized⏩rat aortic graft 30 d
❎thrombus
Repop by host EC

#CircRes 2022 @ahajournals.bsky.social
www.ahajournals.org/doi/10.1161/...

Kardioklick @kardioklick.bsky.social · 2d

Article is paywall-protected. Can you give us #cardiosky gang a summary? How ist LACI measured, what's normal, and in which clinical situations can it help?

Kardioklick @kardioklick.bsky.social · 3d

Great case. Must remember this as a "typical" location. The few that I've seen were all aortic valve cusp tips located.

Kardioklick @kardioklick.bsky.social · 4d

Sotarecept is a revolution in PAH.

NNT=3!

Disease modifying drug.

www.nejm.org/doi/full/10....

Kardioklick @kardioklick.bsky.social · 4d

www.jacc.org/doi/10.1016/...

Central Adiposity or Hypertension: Which Drives Heart Failure With a Preserved Ejection Fraction?

www.jacc.org

Kardioklick @kardioklick.bsky.social · 8d

www.jacc.org/doi/10.1016/...

Milton Packer is still on a mission!
#adipokinehypothesis
#cardiosky

www.jacc.org

Kardioklick @kardioklick.bsky.social · 8d

Both of your comments are spot-on. There's a zillion papers about parameters that correlate with bad prognosis but the questions ramains: Is it just a surrogate and what can I do with this information. In this case I think we can "learn" about valve durability and we can anticipate degeneration.

Kardioklick @kardioklick.bsky.social · 9d

That's the right question to ask about almost every echo parameter.
I'd say one piece in the puzzle to understand prosthethic valve function and deterioation in the follow ups?

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Kardioklick @kardioklick.bsky.social · 9d

Acceleration Time/Ejection Time Ratio has not made it into my standard-protocol after TAVI. Maybe it should.

#echofirst

www.jacc.org/doi/10.1016/...

Acceleration Time/Ejection Time Ratio Compared to Mean Gradient as a Predictor of Clinical Outcomes Post-TAVR:

www.jacc.org

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Kardioklick @kardioklick.bsky.social · 12d

Haha - same when PISA and volumetric RV match in MR. ( they rarely do)

Kardioklick @kardioklick.bsky.social · 12d

Yes! My experience is that AR often looks impressive in color Doppler but just isn’t. Another challenge is that in mixed valve disease, TAVR/PVL or other situations with hypertrophy you won’t get the LV dilatation but patients tolerate regurgitant volume stress even less.

Kardioklick @kardioklick.bsky.social · 12d

Wow. Rate case and great imaging. I assume you have histology?

Kardioklick @kardioklick.bsky.social · 24d

I've read opinions that see a BB-indication for postMI and EF < 50%, if you take this trial together with the others on the same question.

Kardioklick @kardioklick.bsky.social · Sep 9

This is interesting. For our congested HF patients nurses often refuse to give iv furosemide when BP is low, to which I object, but does seem reasonable.
The n in this historic trial however looks a bit low, given that the submax does hardly changes anything while 210 makes it go down 20 mmHg.

Kardioklick @kardioklick.bsky.social · Sep 9

I‘m sorry to say that a diet with skim milk and low fat cheese are surely not the reason the bypass grafts are still working fine. If you believe in this simplistic causality you heavily underestimate the complexity of biological processes.

Kardioklick @kardioklick.bsky.social · Sep 9

It keeps popping up and will probably persist as long as people think that spinach has a lot of iron.

PS. I’m trying to promote the term „monkey heart“ instead: heavy trabecularisation is the standard in apes! www.eurekalert.org/news-release...

Research into structures of ape hearts provide insight into human evolution

UBC Okanagan researchers have discovered new insights into the human heart’s structure, revealing its evolutionary history. This study enhances understanding of heart development and its implica...

www.eurekalert.org

Kardioklick @kardioklick.bsky.social · Sep 8

Hmm. Most time is spent getting a patient to the echolab, into the right position and a qualified person to do the study. Then it doesn’t really matter if you spend 5 minutes, or like me 10 minutes on a standard protocol. But I see your point!

Kardioklick @kardioklick.bsky.social · Sep 8

A lot of competitors for the title „fifth Pilar“ of HF therapy: Elektrophysiologists say it’s PVI, Hannover is rooting for Digitoxin and this paper says Vericiguat. Why not just make it the magnificent 7…?

#cardiosky

Taco subo @averagedoc.bsky.social · Sep 7

Convincing enough for me. Throw Vericiguat on the pile with the rest of the gdmt @thelancet.com @jaccjournals.bsky.social #cardiosky

Vericiguat for patients with heart failure and reduced ejection fraction across the risk spectrum: an individual participant data analysis of the VICTORIA and VICTOR trials

Vericiguat reduced the risk of hospitalisation for heart failure and cardiovascular death in patients with HFrEF across a broad range of clinical severity, including those receiving contemporary guide...

www.thelancet.com

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Kardioklick @kardioklick.bsky.social · Sep 7

Do you have evidence for these assumptions? Maybe a paper?

Reposted by Kardioklick

Lars Mølgaard Saxhaug @load-dependent.bsky.social · Sep 5

Finally some good evidence for whether DOACs can be effective in treatment of left ventricular thrombus. Is this generalisable to all DOACs? #cardiosky #cccsky www.jacc.org/doi/10.1016/...

Rivaroxaban vs Warfarin in Acute Left Ventricular Thrombus Following Myocardial Infarction: RIVAWAR, An Open-Label RCT

www.jacc.org

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Kardioklick @kardioklick.bsky.social · Sep 5

You may be right - you’d really need to do both measurements right after each other. Incidentally we did just that with a patient last week and even with great echo quality and 3D and measuring the CMR myself using AI - we got almost 10% EF difference. 🤷‍♂️

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Kardioklick @kardioklick.bsky.social · Sep 4

We all knew it, but it's still sad that #echofirst and #whycmr values don't match. They all have to be evaluated in their own environment. There's no one truth.

academic.oup.com/ehjcimaging/...

Discordance in left ventricular assessment by CMR vs. echocardiography and potential impact on management of ischaemic left ventricular dysfunction

Echocardiography-derived left ventricular ejection fraction (LVEF) provides a quantitative method for grading left ventricular function and is utilized ext

academic.oup.com

Kardioklick @kardioklick.bsky.social · Sep 4

McConnell sign in PE - quantified with free-wall strain. (Doesn’t always work out this way) #echofirst

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Kardioklick @kardioklick.bsky.social · Sep 3

Dr. Smith and friends are continuing their journey to generate evidence for non-STEMI OMIs. This paper is very diligent work to characterize hyper-acute T-waves.

Fantastic.

#cardiosky

www.jacc.org/doi/10.1016/...

Hyperacute T Waves are specific for Occlusion Myocardial Infarction, even without diagnostic ST elevation:

www.jacc.org

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Kardioklick @kardioklick.bsky.social · Sep 3

>1800 references! Packer seems to be working on his legacy. Let’s see if it catches on. I see HfPEF patients every day, and yes it seems as if >90% do have abdominal obesity.