Chief, Heart Failure; Med Director, Cardiac Transplant; Prof of Medicine & P. Gazes Chair
@MUSChealth
; Father and Husband; RV Centric Views and Hemodynamicist
Come watch me and the
@cardionerds
"nerd" out on pulmonary hypertension, heart failure and hemodynamics - some great cases to be presented! March 9th at Noon EST!
Do you love hemodynamics & RHCs?
@ShengFuMD
@chakri0012
& I do too! BUT, hemodynamic evaluation of donor hearts may not be helpful. Abnormal hemos, particularly high filling pressures, did not correlate w/ post-transplant outcomes in our UNOS analysis.
ISHLT CONSENSUS STATEMENT: Peri-operative Management of Patients with Pulmonary Hypertension and Right Heart Failure Undergoing Surgery - The Journal of Heart and Lung Transplantation
@ISHLT
#PeoplesVentricle
Just gave one of my favorite lectures to
@MUSCCardFellows
: “The ‘Right’ way to do a Right Heart Catheterization”.
1) Know what you will find before you start
2) Proper Level
3)
#getthepawpright
(it matters)
4) TDCO>indirect Fick
5) Vasodilator testing in select cases
Do no harm! No benefits of sildenafil in HFrEF-PH and numerically more AE's: The SilHF study: a randomized placebo‐controlled multicentre trial
and outstanding editorial by
@yreddyhf
Many thanks to
@AndrewJSauer
for delivering an incredible
@MUSChealth
cardiology grand rounds morning. One of the most important and thought provoking discussions I have witnessed.
#worklifeharmony
Our 2 AHFTX fellows Eric Bonno and
@MichaelCViray1
share their experience on proper RHC hemodynamic assessment
@MUSChealth
Modern Right Heart Catheterization: Beyond Simple Hemodynamics | Advances in Pulmonary Hypertension | Allen Press
We are happy to consider outstanding candidates for
@MUSCCardFellows
Advanced Heart Failure and Transplant Fellowship in July 2023. Candidates who have completed US IM Residency but not yet ACGME approved cardiology fellowship may apply for non-ACGME position. PM me w/interest!
🔥We’re growing & hiring outstanding early/mid-career AHFTC faculty
@MUSC_Cardiology
. Cardio-onc interest is a bonus. Join 1 of the most clinically-balanced (61 HTx & 52 LVAD in 2023) & academically productive teams in the country! Live in Charleston! DM or email me!
@VishalNRao
In honor of
@AHajduczok
combined EP/IC fellowship application: 75 y/o M underwent exercise RHC for unexplained dyspnea. During exercise, PAWP increased modestly. CO fell & PVR increased significantly. The patient was diagnosed with exercise-induced PAH and referred to you.
Dilated left atrium means left heart disease, right? LA size = HgA1C of PAWP/LVEDP? While an important observation if evaluating PH or valve disease, we found LA enlargement in end-stage liver disease is common & not necessarily suggestive of occult LHD.
Excited to share the results of our multi-center collaboration lead by
@MUSChealth
superstar resident
@JakeReadMD
which investigates the role of pharmacologic LV unloading with nitroprusside to predict post-LVAD RV failure.
@TheJHLT
🔥🔥🔥 It's time to register for the 3rd annual Charleston HFpEF Conference July 28-30th. Incredible speaker line up & content. New this year: submit your research w/ travel awards for the top scoring abstracts (submission opens in May)! Don't delay!
Congrats to the MUSC Heart Failure, MCS and Transplant team on a great 2019: 26 transplants, another year of 40+ LVADs, significant academic and research contributions, and training the next generation with our AHFTX fellowship. Here's to a even better 2020!
🔥🚨Pressures Do Not Equal Volumes🚨
#1
We present ➡️ Discordance of Pressure and Volume: Potential Implications for Pressure-Guided
Remote Monitoring in Heart Failure
➡️We explored pressure-volume relationship
in ambulatory HF pts. managed with CardioMEMS
Congrats to our 2 AHFTC fellows
@heartsuccessMD
@ShengFuMD
on a terrific year! You did a lot: 59 transplants, 49 LVADs, lots of RHCs, and caught some big fish (all released). Best of luck in your faculty roles! We look forward to a great year ahead
@Jgrewal_12
@RofaelMichael
!
A home run for sortatercept for PAH in the STELLAR trial presented at
#ACC23
. Look forward to studying this impactful drug in PH-LHD (CpcPH) in CADENCE.
The RV responds differently to increases in HR than the LV. Potential therapeutic strategy?
@hopkinsheart
@MUSChealth
@ATSBlueEditor
Right Atrial Pacing to Improve Acute Hemodynamics in PAH | American Journal of Respiratory and Critical Care Medicine
How do you risk stratify candidates for LVADs? Former
@MUSChealth
AHFTC fellow
@Jgrewal_12
led this Multi-Center Evaluation of the HeartMate 3 Risk Score
@TheJHLT
While HM3RS was less predictive in non-trial populations, outcomes were still excellent.
And we’re off! Dan Judge kicking off the Charleston HFpEF conference with an update on Cardiac Amyloid. And a pleasant 84 degrees in Charleston today! Hope y’all are here!
@JanMGriffin
@MUSChealth
@Amyloid_MUSC
The results are in! In my opinion, the most appropriate recommendation is repeat iCPET.
As many suggested, an indirect Fick estimate of cardiac output was used not only a rest but during exercise, accounting for the non-physiologic hemodynamics.
In honor of
@AHajduczok
combined EP/IC fellowship application: 75 y/o M underwent exercise RHC for unexplained dyspnea. During exercise, PAWP increased modestly. CO fell & PVR increased significantly. The patient was diagnosed with exercise-induced PAH and referred to you.
Yesterday we established that the fall in CO and increase in PVR was not real. Can we establish a diagnosis based on available data? Does the patient have exercise induced left atrial hypertension (HFpEF)? Why might the second answer (lasix/spiro/SGLT-2i) be incorrect?
The results are in! In my opinion, the most appropriate recommendation is repeat iCPET.
As many suggested, an indirect Fick estimate of cardiac output was used not only a rest but during exercise, accounting for the non-physiologic hemodynamics.
From
#HFSA2020
, work from
@MichaelCViray1
@RyanTedfordMD
indicates that obtaining a PAWP saturation during right heart catherization results in significantly lower PAWP, higher PVR, and clinically relevant disease reclassification
#AHAJournals
|
Really provocative work from
@MarkusMeyerMD
@DNSilvermanMD
&
@MaggieInfeld
in
@JAMACardio
today: Effect of Personalized Accelerated Pacing on Quality of Life, Physical Activity, and Atrial Fibrillation in HFpEF
HR modulation in HFpEF appears promising!
Consider reading this new work from
@MUSChealth
AHFTC fellow
@heartsuccessMD
and
@PittSurgery
@NicholasHessMD
which explores simultaneous heart-kidney transplant (sHKT) compared with isolated OHT (iOHT) in LVAD patients. We welcome your thoughts!
Congratulations to my friend and colleague
@Brian_Houston12
for winning the
@MUSChealth
Teaching Excellence Award. Super competitive with all the great educators here!
To say it was a privilege to host
@hvanspall
for
@MUSC_Cardiology
grand rounds would be the understatement of 2023! So many critical messages delivered: burden of HF and inequities,
#GDMT
implementation, & redefining eligibility criteria/clinical trial design. Simply amazing!
Congratulations to my
@MUSChealth
colleague
@DNSilvermanMD
who is this year’s winner of the
@ISHLT
O.H. Frazier Grant in MCS Translational Research! Dan is studying the impact of pulsatilty on fibroblasts - implications for myocardial recovery in MCS patients!
@Brian_Houston12
Pleased to share our SOA review where we attempt to standardize the RHC and highlight the future of hemodynamic assessment including a deep dive into advanced parameters and dynamic testing.
@JCardFail
@RyanTedfordMD
@Brian_Houston12
@BryanSmithMD
At
#ACC23
/
#WCCardio
you will find 100s of cutting-edge educational sessions spanning 11 clinical pathways, along with a not-to-miss lineup of LBCTs & Featured Clinical Research!
Don't miss out on this year's exciting program! Advanced reg ends Wednesday!
Proud of this retrospective multi-center, international effort to study the impact of a less invasive surgical implant strategy and right heart failure following LVAD implantation
#peoplesventricle
🔥Abstract submission is now open for the 3rd Annual Charleston HFpEF Conference July 28-30. Travel awards available 4 top abstracts. Submit your best science today! Deadline for abstracts in June 2nd @ 5pm ET!
#MedTwitter
#HFpEF
@LitwinSheldon
#MikeZile
Do NOT miss the first annual Charleston HFpEF conference April 16-17! We were delayed by 1 year but our revised program is even more exciting. We welcome a remarkable group of faculty from around the country to share their expertise. Register today!
Cleveland here we come.
A bunch of fresh science to present and discuss
@MidAmericaHeart
And always the best part is connecting with colleagues.
#HFSA2023
Don’t miss a great
#PulmonaryHypertension
Academy! Hemodynamics, compensated & failing RV discussions, dx and treatment of Group 1-5 PH, periop considerations, & PH in pregnancy to name a few topics! All delivered by world expert faculty!
#ThePeoplesVentricle
@ISHLT
@acchurch1
The
#ISHLTAcademies
will return with a modular, virtual core course on
#PulmonaryHypertension
— learn online at your pace! Co-Chairs
@RyanTedfordMD
&
@acchurch1
developed a program designed for junior faculty & anyone needing a refresher on the field. Watch for more information!
Fired up to start reviewing applications for
@MUSCCardFellows
Advanced HF & Transplant fellowship this Wednesday! 12 HF faculty; balanced, high volume center; equal time inpatient/outpatient w/ 9 weeks of research time. And it���s Charleston!
@Brian_Houston12
#DanJudge
@DhariniRamu
Congrats to our 2 AHFTC fellows
@heartsuccessMD
@ShengFuMD
on a terrific year! You did a lot: 59 transplants, 49 LVADs, lots of RHCs, and caught some big fish (all released). Best of luck in your faculty roles! We look forward to a great year ahead
@Jgrewal_12
@RofaelMichael
!
Register now for the 2nd annual Charleston HFpEF conference. Amazing faculty, cutting edge content and discussions, and Charleston in the spring. What could be better?
Our new study (just in print) adds validity to the new WSPH PH definition and reminds us that PVR matters even in the setting of lower pulmonary pressures.
Impact of the New Pulmonary Hypertension Definition on Heart Transplan...