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Reposted by Parag Bawaskar

Chetan Shenoy @cshenoy.bsky.social · Jun 11

Thank you, @toddneale.bsky.social, for your excellent reporting on our EHJ paper!

@tctmd.bsky.social @escardio.bsky.social @paragbawaskar.bsky.social

TCTMD @tctmd.bsky.social · Jun 11

CMR May Improve Assessment of ICD Need in Cardiac Sarcoidosis

CMR May Improve Assessment of ICD Need in Cardiac Sarcoidosis [email protected] Wed, 06/11/2025 - 16:08 Todd Neale The imaging was better than societal recommendations at discriminating long-term risk of ventricular arrhythmias.

www.tctmd.com

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Reposted by Parag Bawaskar

Martin Ugander @mugander.bsky.social · Mar 23

Query sarcoid, normal #WhyCMR, so then should we do FDG-PET? Not much benefit.

Chetan Shenoy @cshenoy.bsky.social · Mar 21

In patients with suspected cardiac sarcoidosis, cardiac FDG-PET is recommended after a normal CMR if there is a high clinical suspicion. What are the data supporting this recommendation? #CardioSky #MedSky #Sarcoidosis

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Reposted by Parag Bawaskar

Chetan Shenoy @cshenoy.bsky.social · Mar 21

Read our accompanying editorial for our thoughts on the important paper –

academic.oup.com/ehjcimaging/...

@paragbawaskar.bsky.social #CardioSky #MedSky #Sarcoidosis

Cardiac FDG-PET imaging in patients with suspected cardiac sarcoidosis and no late gadolinium enhancement on cardiovascular magnetic resonance imaging: the emperor has no clothes!

This editorial refers to ‘The Role of FDG PET/CT in Assessing Cardiac Sarcoidosis with No High-Risk Cardiac Features and Normal CMR’, by F. Shuduyeva et al

academic.oup.com

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Reposted by Parag Bawaskar

Chetan Shenoy @cshenoy.bsky.social · Mar 21

In patients with suspected cardiac sarcoidosis, cardiac FDG-PET is recommended after a normal CMR if there is a high clinical suspicion. What are the data supporting this recommendation? #CardioSky #MedSky #Sarcoidosis

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Reposted by Parag Bawaskar

Chetan Shenoy @cshenoy.bsky.social · Jan 23

This paper reports the coexistence of cardiac sarcoidosis and arrhythmogenic cardiomyopathy in 5 patients.

heart.bmj.com/content/earl...

#CardioSky #MedSky

Coexistence of cardiac sarcoidosis and arrhythmogenic cardiomyopathy-associated genetic variants: a multicentre case-control study

Background Cardiac sarcoidosis (CS) is a chronic inflammatory disease characterised by non-caseating granulomas, while arrhythmogenic cardiomyopathy (ACM) is a genetic condition mainly affecting desmo...

heart.bmj.com

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Reposted by Parag Bawaskar

Pradeep Natarajan @pnatarajanmd.bsky.social · Nov 23

In honor of Dr. Braunwald’s 95th birthday. The number of areas he has touched in cardiology is staggering, and number of cardiovascular professionals is unquantifiable. @harvardmed.bsky.social

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Reposted by Parag Bawaskar

Chetan Shenoy @cshenoy.bsky.social · Nov 17

Amazing achievement by rising star and post-doc in my lab @paragbawaskar.bsky.social, winner of the prestigious 2024 Melvin Judkins Early Career Investigator Award at #AHA24!! Congratulations!!!
@ahascience.bsky.social

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Reposted by Parag Bawaskar

Lars Mølgaard Saxhaug @load-dependent.bsky.social · Nov 13

It’s great that journals are coming over here, but what I have really missed after my departure from Twitter 2 years ago is this, the authors themselves presenting their works and discussing it with peers. #cardiosky #medsky #emimcc

Chetan Shenoy @cshenoy.bsky.social · Nov 12

In 2019, we wrote a paper showing that patients with left ventricular thrombus have a long-term risk of embolism, extending to at least 8 years.

We were puzzled by the finding…

#CardioSky

www.ahajournals.org/doi/10.1161/...

Figure 2 from the paper. Incidence of embolism in left ventricular (LV) thrombus patients compared with matched non-LV thrombus patients. Kaplan-Meier curves demonstrate the cumulative incidence of the composite embolic end point in the LV thrombus (in red) and in the matched non-LV thrombus (in blue) groups. Note the significant difference in the cumulative incidence of embolic events between the 2 groups.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 13

jamanetwork.com/journals/jam...

Prehospital Pulse-Dose Glucocorticoid in STEMI

This randomized clinical trial investigates if prehospital pulse-dose glucocorticoid treatment has a cardioprotective effect in patients with ST-segment elevation myocardial infarction (STEMI).

jamanetwork.com

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Reposted by Parag Bawaskar

Chetan Shenoy @cshenoy.bsky.social · Nov 12

In 2019, we wrote a paper showing that patients with left ventricular thrombus have a long-term risk of embolism, extending to at least 8 years.

We were puzzled by the finding…

#CardioSky

www.ahajournals.org/doi/10.1161/...

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

Finally, many thanks to @cshenoy.bsky.social for his mentorship, our outstanding team for their contributions, and the editors and reviewers at Circulation for all their efforts to make our paper better!

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

Read our paper here –https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.123.067032

And if you will be at #AHA23, come visit the poster session on Monday, Nov 13, 10:00-11.30 am, Zone 2.

eppro01.ativ.me/src/EventPil...

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

An important trial related to this topic was just funded in the UK – Peter Swoboda at the University of Leeds is the PI of an RCT to identify the best initial test for newly diagnosed HF… we look forward to the results of CROSS-HF in a few years.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

And if NICM and dualCM do influence outcomes, the next trial should investigate whether the routine use of CMR to identify the cause of cardiomyopathy improves the selection of patients for coronary revascularization, and overall long-term outcomes.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

We need to investigate whether NICM or dualCM in patients with CAD influences outcomes after coronary revascularization.

An ancillary study of the STICH3C trial by Mario Gaudino and Jonathan Weinsaft at Cornell will give us some answers in about 5 years.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

So what? Patients with CAD+NICM or dualCM should be treated with a statin, aspirin, and guideline-directed HF therapy the same as those with CAD+ICM.

But do patients with CAD+ NICM or dualCM benefit from coronary revascularization in the same manner as those with CAD+ICM?

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

Prior studies have found better outcomes for NICM vs. ICM. What explains worse outcomes for NICM in our study?

We can only speculate, but it may be because patients in our study had 2-3 diseases – CAD+NICM… or CAD+ICM+NICM.

Prior studies compared NICM without CAD to ICM+CAD.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

And we looked at their long-term outcomes.

Patients with CAD+NICM or dualCM had a greater risk of all-cause death or heart failure hospitalization, all-cause death, and heart failure hospitalization compared with CAD+ICM.

The risk of CV death was not different.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

We found NICM or dualCM in 1 of every 6 patients with CAD.

CAD+NoCM - 18.2%
CAD+ICM - 64.8%
CAD+NICM - 9.3%
CAD+dualCM - 7.7%

The prevalence of CAD+NICM or dualCM was 16.9% or 1 in 6 patients with CAD.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

We looked at their CMRs and coronary angiography data and classified them into one of:

1. No cardiomyopathy (CAD+NoCM) – normal LVEF and no LGE
2. Ischemic cardiomyopathy (CAD+ICM)
3. Non-ischemic cardiomyopathy (CAD+NICM)
4. Dual cardiomyopathy (CAD+dualCM) – both ICM and NICM

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

We did a large retrospective observational study of 3,023 patients with obstructive CAD who had CMR for any clinical indication at our health system.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

So how often do patients with CAD have NICM or dual (both ICM and NICM) cardiomyopathy?

How do these patients do compared to patients with ICM?

We tried to answer these questions.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

There has been interest in this topic of late because trials of coronary revascularization other than STICHES have not shown revascularization to be beneficial.

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

Currently, we determine the cause of cardiomyopathy based on coronary angiography findings… CAD=ICM; No CAD=NICM

However, pathology and small CMR studies have shown that

NICM can occur with “bystander” CAD
ICM can occur without CAD
Both ICM and NICM can occur together

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Parag Bawaskar @paragbawaskar.bsky.social · Nov 11

Have you ever wondered whether your patient with CAD and cardiomyopathy truly has ischemic cardiomyopathy, or whether the CAD is a “bystander”?

You might be interested in our paper now out in Circulation

#simultaneouspublication
#AHA23
#cardiosky
#Medsky
#WhyCMR

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