Podcasts about angiography

N Engl J Med 2022;386:128-137Background: Patients with three-vessel coronary artery disease have better outcomes when revascularization is performed using coronary artery bypass grafting (CABG) compared to percutaneous coronary intervention (PCI), as seen in the SYNTAX and FREEDOM trials. Fractional flow reserve (FFR) was not required and was not routinely performed in these trials.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.The Fractional Flow Reserve versus Angiography for Multivessel Evaluation (FAME) 3 trial sought to compare the outcomes of FFR-guided PCI vs CABG in patients with three-vessel coronary artery disease.Patients: Eligible patients had three-vessel coronary artery disease defined as 50% or more stenosis, by visual estimation, in any of the three major coronary arteries or major branches. Lesions had to be amenable to revascularization by PCI and CABG as determined by the heart team.Major exclusion criteria were left main disease, cardiogenic shock, STEMI within 5 days, active NSTEMI with cardiac troponin still rising, left ventricular ejection fraction

In this episode, Dr. Abdullah Al-Abcha and Dr. Shao-Liang Chen, discusses the groundbreaking findings of the Ivis ACS trial, which compares Ivis-guided versus angiography-guided PCI in diabetic patients with acute coronary syndrome. The results reveal a significant reduction in target vessel failure for Ivis-guided procedures, underscoring the need for updated guidelines and future research to improve outcomes in this high-risk population.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on AI-derived left ventricular mass from noncontrast cardiac CT including a correlation with contrast CT angiography and CMR.

OCT vs. Angiography for Guidance of Calcified Lesions PCI: The CALIPSO Trial

Gregg Stone and C. Michael Gibson discuss an updated meta-analysis addressing intravascular imaging in DES implantation.

Abdullah Al-Abcha, MD, social media editor of JACC: Cardiovascular Interventions, and Jun Jiang, MD, discuss a recently published original research paper on a study that aimed to evaluate the prognostic impact of coronary microvascular function in patients with NSTEMI, as determined by angio-IMR.

Combining Angiography and Pre-Specified Intracoronary Testing in Patients with Chronic Coronary Syndromes: the AID-ANGIO Study

Audio Commentary by Dr. Valentin Fuster, Emeritus Editor in Chief

Prof. Stefan Neubauer and Dr. Thomas Nero discuss two recent papers on the utility of coronary inflammation imaging on CT coronary angiography with Fat Attenuation Index (FAI)FAI score.  The Orfan study demonstrated a 29 fold increased risk in CV event rates with low vs high FAI score and a 10 fold increased event rate in patients with elevated FAI score who have no coronary plaque. FAI score re-categorized 40% of patients in their follow-up studies. Prof. Neubauer is the head of the Division of Cardiovascular Medicine and Director of the Oxford Centre for Clinical Magnetic Resonance Research (OCMR) at the University of Oxford and Past President of the Society for Cardiovascular Magnetic Resonance (SCMR).  He co-authored two recently published landmark papers:Farina NH, Mehta NN, Teague HL, et al. Inflammatory risk and cardiovascular events in patients without obstructive coronary artery disease: the ORFAN multicentre, longitudinal cohort study. Lancet. 2024;403(10392):1823-1835. doi:10.1016/S0140-6736(24)00596-8Farina, C. J., Davidson, M. H., Shah, P. K., Stark, C., Lu, W., Shirodaria, C., Wright, T., Antoniades, C. A., & Nilsson, J. (2024). Inhibition of oxidized low-density lipoprotein with orticumab inhibits coronary inflammation and reduces residual inflammatory risk in psoriasis: a pilot randomized, double-blind placebo-controlled trial. Cardiovascular Research, European Society of Cardiology, March 25, 2024.

Comparison of Intravascular Ultrasound-Guided versus Angiography-Guided Angioplasty on the Outcomes of Drug-Coated Balloon Treatments in Femoropopliteal Artery Disease

Intravascular Ultrasound-Guided versus Angiography-Guided Percutaneous Coronary Intervention in Acute Coronary Syndromes: The Multicenter, Randomized, Blinded, IVUS-ACS Trial

CardioNerds Dr. Josh Saef and Dr. Tommy Das join Dr. Omkar Betageri, Dr. Andrew Geissler, Dr. Philip Lacombe, and Dr. Cashel O'Brien from the Maine Medical Center in Portland, Maine to enjoy an afternoon by the famous Portland headlight. They discuss a case of a patient who presents with obstructive cardiogenic shock. Dr. Bram Geller and Dr. Jon Donnelly provide the Expert CardioNerd Perspectives & Review segment for this episode. Dr. Maxwell Afari, the Maine Medical Center cardiology fellowship program director highlights the fellowship program. Audio editing by CardioNerds Academy Intern, student doctor Tina Reddy. This is the case of a 42 year-old woman born with complicated Tetralogy of Fallot repair culminating in a 29mm Edwards Sapiens (ES) S3 valve placement within a pulmonary homograft for graft failure who was admitted to the cardiac ICU for progressive cardiogenic shock requiring vasopressors and inotropic support. Initial workup showed lactic acidosis, acute kidney injury, elevated NT-proBNP, and negative blood cultures. TTE showed at least moderate biventricular systolic dysfunction. She was placed on furosemide infusion, blood cultures were drawn and empiric antibiotics initiated. Right heart catheterization demonstrated elevated right sided filling pressures, blunted PA pressures with low PCWP, low cardiac index, and low pulmonary artery pulsatility index. Intracardiac echocardiography (ICE) showed a large mass within the ES valve apparatus causing restrictive valve motion with a low gradient across the pulmonic valve in the setting of poor RV function. Angiography revealed a large filling defect and balloon valvuloplasty was performed with immediate hemodynamic improvement. Blood cultures remained negative, she was gradually weaned off of inotropic and vasopressor support, and discharged. Despite empiric treatment for culture negative endocarditis and ongoing anticoagulation, she was readmitted for recurrent shock one month later at which time the pulmonic mass was revisualized on ICE. A valve-in-valve transcatheter pulmonary valve (29mm ES S3) was placed to compress what was likely pannus, with an excellent hemodynamic result and no visible mass on ICE. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media Pearls - Obstructive Cardiogenic ShocK Tetralogy of Fallot is the most common cyanotic defect and can lead to long term complications after surgical repair including chronic pulmonary insufficiency, RV dysfunction, residual RVOT obstruction and branch pulmonary artery stenoses. Chronic RV failure may be more indicative of a structural defect and therefore require interventional or surgical management. Valve thrombosis, infective endocarditis and obstructive pannus formation should be considered in the differential of a patient with obstructive shock with a prosthetic valve. Bioprosthetic pulmonic valve obstruction may be effectively managed with balloon valvuloplasty in patients who present in acute extremis but TCPV will likely provide a more lasting result. While valvular gradients are typically assessed via echocardiography, invasive hemodynamics can serve as a critical adjunctive tool in its characterization. Show Notes - Obstructive Cardiogenic ShocK Notes were drafted by Drs. Omkar Betageri, Philip Lacombe, Cashel O'Brien, and Andrew Geissler. What are the common therapies and management for Tetralogy of Fallot? Tetralogy of Fallot is the most common cyanotic defect in children beyond the age of one year Anatomic Abnormalities: Anterior and Superior deviation of the conal septum creating a SubAo VSD and encroachment on the RVOT.

In this episode of Medmastery's Cardiology Digest, we delve into a trio of intriguing cardiology studies that raise as many questions as they answer. Whether you're a seasoned clinician or a medical student, these studies have implications that could influence your approach to patient care. STUDY #1: First, we turn our attention to the role of GLP-1 agonists in cardiovascular disease prevention among non-diabetic patients who are overweight or obese. With a focus on injectable semaglutide this study examines its cost-effectiveness and potential side effects. The findings might alter how we manage cardiovascular risk in these patients!  Lincoff AM et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023 Nov 11; [e-pub]. (https://doi.org/10.1056/NEJMoa2307563) STUDY #2: Next, we'll explore a compelling meta-analysis that could sway future guidelines and recommendations. They evaluated the outcomes of physiologic guidance and intravascular imaging in percutaneous coronary interventions (PCI), to see if these techniques improve patient outcomes beyond what's possible with angiographic guidance alone. Kuno T et al. Comparison of intravascular imaging, functional, or angiographically guided coronary intervention. J Am Coll Cardiol 2023 Dec 5; 82:2167. (https://doi.org/10.1016/j.jacc.2023.09.823) STUDY #3: Finally, we're going to examine the nuances of anticoagulation in patients with subclinical atrial fibrillation. The balance between preventing strokes and avoiding bleeding complications is a delicate one. With new data suggesting nuanced approaches, this segment will provide valuable insights for us when we're prescribing or considering anticoagulation therapies. Healey JS et al. Apixaban for stroke prevention in subclinical atrial fibrillation. N Engl J Med 2023 Nov 12; [e-pub]. (https://doi.org/10.1056/NEJMoa2310234) Svennberg E. What lies beneath the surface — Treatment of subclinical atrial fibrillation. N Engl J Med 2023 Nov 12; [e-pub]. (https://doi.org/10.1056/NEJMe2311558) Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions. Learn more with these courses: Percutaneous Coronary Intervention Essentials (6 CME) Percutaneous Coronary Intervention Essentials Workshop (6 CME) Show notes: Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

Computed Tomography Cardiac Angiography Prior to Invasive Coronary Angiography in Patients with Previous Bypass Surgery

N Engl J Med 2012;367:1297-1309Background: In patients with acute coronary syndrome, clinical guidelines recommend early angiography particularly in those deemed moderate to high risk. However, a proportion of patients do not undergo revascularization, and these patients have poorer outcomes compared to those who do undergo revascularization.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.The TRITON-TIMI 38 trial demonstrated that prasugrel, when compared to clopidogrel, reduces ischemic events in patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI). Notably, in the TRITON-TIMI 38 trial, 99% of the patients underwent PCI at the time of randomization.Expanding upon the findings of TRITON-TIMI 38, the TRILOGY ACS trial sought to test the hypothesis that aspirin plus prasugrel is superior to aspirin plus clopidogrel in patients with acute coronary syndrome, without ST segment elevation, who are managed medically without revascularization.Patients: Patients were enrolled if they had unstable angina or non-ST elevation myocardial infarction and were treated medically without revascularization, within 10 days of the index event. Patients with non-ST elevation myocardial infarction had elevated cardiac biomarkers. Patients with unstable angina had ST-segment depression of more than 1 mm in two or more electrocardiographic leads and negative cardiac biomarkers. Patients had to have one of the following: age of 60 years or older, diabetes mellitus, prior myocardial infarction or prior revascularization with either PCI or coronary-artery bypass grafting (CABG). Main exclusion criteria were history of stroke or TIA (this group had net harm with prasugrel in TRITON-TIMI 38), renal failure requiring dialysis and patients taking oral anticoagulants.Baseline characteristics: The trial enrolled 9,326 patients at 966 sites in 52 countries. The average age of patients was 66 years, with 78% were below 75 years old, and 61% were men. About 70% of the patients had non-ST elevation myocardial infraction as their index event. The average GRACE score was 122. About 82% had hypertension, 59% had hyperlipidemia, 38% had diabetes, 43% had prior myocardial infarction and 20% were current or recent smokers. The majority of patients were stable, with 88% classified as Killip class I.Angiography before randomization was performed in 41% of the patients. Medications at randomization included beta-blockers in 78% of the patients, ACEi or ARB in 75%, statins in 83% and proton pump inhibitors in 25%.Procedures: The trial was conducted as double-blind double-dummy study. Patients who underwent randomization within 72 hours after the first medical contact received a loading dose of 30mg of prasugrel followed by 10mg daily. The maintenance dose of prasugrel was 5mg daily for patients aged 75 years or older or patients who weighed less than 60 kg. Patients who underwent randomization after 72 hours of the first medical contact received open label clopidogrel before randomization and the maintenance study drug after randomization. Clopidogrel was given as a loading dose of 300mg followed by a maintenance dose of 75mg daily. Aspirin was given in all patients and the recommended dose was 100mg per day or less. Study drugs were given for a minimum of 6 months and a maximum of 30 months.Endpoints: The primary efficacy endpoint was a composite of death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke among patients < 75 years old. Safety endpoints were bleeding not related to CABG based on Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) criteria for severe or life-threatening bleeding and Thrombolysis in Myocardial Infarction (TIMI) criteria for major bleeding, and neoplasms.Analysis was performed based on the intention-to-treat principle. The trial was event-driven. To ensure 90% power to detect 22% relative risk reduction of prasugrel over clopidogrel with a two-sided alpha of 5%, a total of 688 patients,

Today we dive into three cardiology papers with important insights for cardiac care. STUDY #1: We explore an analysis that compares Coronary CT Angiography (CCTA) with stress modalities like SPECT-MPI. We see if CCTA has the potential to reduce the need for invasive angiography, and how it stacks up against other testing strategies. Zito, A, Galli, M, Biondi-Zoccai, G, et al. 2023. Diagnostic strategies for the assessment of suspected stable coronary artery disease: A systematic review and meta-analysis. Ann Intern Med. 6: 817–826. (https://www.acpjournals.org/doi/10.7326/M23-0231) STUDY #2: We discuss the approval of a dual-chamber leadless pacemaker system by the FDA. Although this study supports the efficacy of this innovative approach in certain scenarios, it also raises important concerns.  Knops, RE, Reddy, VY, Ip, JE, et al. 2023. A dual-chamber leadless pacemaker. N Engl J Med. 25: 2360–2370. (https://www.nejm.org/doi/10.1056/NEJMoa2300080) STUDY #3: We look at a comprehensive retrospective study that evaluates aggressive management of hypertension in hospitalized adults. What are the ramifications of minimizing the use of BP-lowering agents, particularly intravenous ones, in certain inpatient scenarios? Anderson, TS, Herzig, SJ, Jing, B, et al. 2023. Clinical outcomes of intensive inpatient blood pressure management in hospitalized older adults. JAMA Intern Med. 7: 715–723. (https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2805021) Join us as we dissect these studies, unpacking their methodologies, outcomes, and the intriguing questions they raise.  For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast Learn more with these courses: Pacemaker Essentials: https://www.medmastery.com/courses/pacemaker-essentials Pacemaker Essentials Workshop: https://www.medmastery.com/workshops/pacemaker-essentials-workshop Coronary Angiography Essentials: https://www.medmastery.com/courses/coronary-angiography-essentials

Darshan Shah, MD, is a renowned surgeon, published author, tech entrepreneur, wellness specialist, and founder and CEO of Next Health.  A graduate of esteemed institutions such as Mayo Clinic, Harvard Business School, and Singularity University, Dr. Shah has an expansive medical and business background that allows him to connect with patients on a more profound level. He's also a five-time guest who first appeared on the podcast in 2019 when he and I discussed the opening of his first Next Health clinic, and again later when the two of us co-hosted a panel during my Boundless book tour in 2020, where we delved into topics ranging from sleep biohacks to spiritual disciplines and parenting strategies. Having performed over 10,000 surgeries, his dexterity and expertise are unquestionable, yet what sets Darshan apart is his unwavering commitment to optimizing health and extending lifespan, a mission that finds its manifestation in Next Health. Each clinic offers a comprehensive array of cutting-edge health services, from genetic testing to biohacking technologies, all tailored to meet individual health needs. By harnessing the power of modern medical advancements, Next Health's clinics are designed not just to treat disease but to foster optimal wellness and extend the healthy human lifespan. Dr. Shah is a wellness specialist and an advocate for health optimization. He weaves these passions together to inspire a broader audience as a published author and through the innovative health solutions offered by Next Health. Embark on a riveting journey as I, alongside Dr. Shah, delve into the transformative effects of therapeutic plasma exchange. Navigate the nuanced cholesterol debate, gain insights from CT angiography adventures, and discuss strategies for tackling a stubborn calcium score. You'll also learn essential diagnostic measures for cancer and the impact of responsible red meat choices. Plus, don't miss out on exciting information about Next Health's new Maui Four Seasons location, and much more! For the full show notes, visit: https://bengreenfieldlife.com/nexthealthlife Episode Sponsors: Apollo: Go to apolloneuro.com/bengreenfield and use code BG15 for 15% off LeelaQ: Visit http://leelaq.com/ben and use code BEN10 for 10% off. Organifi Shilajit Gummies: Get 20% off at organifi.com/Ben. HVMN: Visit hvmn.com/BENG and subscribe upon checkout for 30% off. Jigsaw Health: Visit JigsawAC.com and use “Greenfield10” to get 10% off on your order.See omnystudio.com/listener for privacy information.

Dr. Thomas Nero speaks with Dr. Mathew Budoff about Coronary Calcium Scoring, CT Coronary Angiography and cardiovascular outcomes.  The discussion goes beyond basic risk factor enhancement, highlighting its role to help evaluate disease progression, power future clinical trials and determine efficacy of therapy.  Along the way, they discuss coronary inflammation, perivascular adipose tissue imaging and fat attenuation index (FAI) as well as diving into the plaque stabilizing effects of EPA.   

ESC23 LBT - ILUMIEN IV OCT Versus Angiography

ESC23 LBT- OCT vs. IVUS vs. Angiography Guidance - a Real-Time Updated Network Meta-Analysis

Carolyn Majcher, OD, FAAOJoseph Allen, OD, FAAO, Diplo ABOFluoreSCENE Media Eye Give a Damn hosted by Dr. Joseph Allen is produced by FluoreSCENE Media.For more information on Dr. Joseph Allen visit https://doctoreyehealth.com/Visit https://odcommunity.com/ to learn more about FluoreSCENE Media.

Overview Troponin I Normal value range Pathophysiology Special considerations Elevations in lab values Nursing Points General Normal value range Typically, less than 0.035 ng/mL or less Can vary among institutions Has to be greater than the 99th percentile Pathophysiology Troponin is released during myocardial cell damage Decreased perfusion causes myocardial cell damage Causes of myocardial cell damage Myocardial infarction Demand ischemia Cardiogenic ACS Noncardiogenic Sepsis Renal failure Extreme exercise Special considerations Submitted in green top tube Value peak Detection 6-12 hours after acute injury Peaks 24 hours after injury Can stay elevated for a week Knowing patient history is critical Increased values Any elevated value is typically considered critical Acute elevations warrant immediate investigation Typically PCI (percutaneous coronary intervention)/Angiography and EKG to rule out MI or ACS (acute coronary syndrome) Other elevations CABG Extreme exercise End Stage Renal Failure Assessment Assess for: Acute chest pain Symptoms of MI Nausea Vomiting Angina in any form Reflux (especially in women) Therapeutic Management EKG Angiography or PCI Management of non-cardiogenic etiology Nursing Concepts Lab Values Perfusion Patient Education Educate patient on keeping history of elevated levels or cardiac disease for future reference Educate patient on duration of elevated troponin levels, post injury

Drs. Safa Rahmani, Akshay Thomas, and Priya Vakharia join to discuss four recent publications in major ophthalmology journals.Fluorescein Angiography Cost (https://ophthalmologyretina.org/article/S2468-6530(23)00227-0/fulltext)Intravitreal Biosimilar Cost Impact (https://www.aaojournal.org/article/S0161-6420(23)00295-6/fulltext)Practice Consolidation in Ophthalmology (https://www.aaojournal.org/article/S0161-6420(23)00311-1/fulltext)Physician Turnover in Ophthalmology (https://www.aaojournal.org/article/S0161-6420(23)00308-1/fulltext)Relevant Financial Disclosures: Dr. Rahmani is an investigator for Regeneron. Dr. Thomas is a consultant for Allergan and Novartis. Dr. Vakharia is a consultant for Genentech and Regeneron. Dr. Sridhar is a consultant for Genentech and Regeneron.You can claim CME credits for prior episodes via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audi

06/05/2023 | State of the Art 3DCT Angiography Assessment of Upper Extremity Trauma: Pearls, Pitfalls, and Study Design Optimization

We the discuss the use of wide field OCT angiography in the management of diabetic retinopathy, retinal vein occlusion, and pediatric retinal disease with Dr. Amir Kashani, Associate Professor of Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine

June 2023 Journal Club Podcast Title: MRI/MRA Versus Catheter Angiography for Annual Follow-up of Pediatric Moyamoya Patients: a Cost Outcomes Analysis To read journal article: https://journals.lww.com/neurosurgery/Fulltext/2023/06000/Magnetic_Resonance_Imaging_Angiography_Versus.17.aspx Author: Edward R. Smith Guest Faculty: Cormac O. Maher Resident Planner: Katherine G. Holste Moderator: Rafael A. Vega

03/13/2023 | Typical and Atypical Appearances of Pancreatic Neuroendocrine Tumors (PNETs): Role of CT Angiography (CTA) and Cinematic Rendering (CR) - Part 2

Intravascular Imaging-guided Versus Angiography-guided Procedural Optimization In Complex Percutaneous Coronary Intervention

03/06/2023 | Typical and Atypical Appearances of Pancreatic Neuroendocrine Tumors (PNETs): Role of CT Angiography (CTA) and Cinematic Rendering (CR) - Part 1

Commentary by Dr Yunshan Cao

Dr. Edmund Tsui interviews author Dr. David Sarraf on his recent Ophthalmology Retina article, “Clinical and Morphologic Characteristics of Perivenular Fernlike Leakage on Ultrawide-field Fluorescein Angiography” Clinical and Morphologic Characteristics of Perivenular Fernlike Leakage on Ultrawide-field Fluorescein Angiography. Ramtohul, Prithvi et al. Ophthalmology Retina, Volume 6, Issue 11, 1070 - 1079.

In this episode we are joined by Drs. Lisa Faia and Sumit Sharma to discuss the utility of fundus photography, fluorescein angiography, indocyanine green angiography and autofluorescence in the management of patients with uveitis.The discussants report no relevant financial disclosures.

Commentary by Dr. Valentin Fuster

The Journal RETINA is devoted exclusively to diseases of the retina and vitreous.  These podcasts are intended to bring to its listeners summaries of selected articles published in the current issue of this internationally acclaimed journal.

Editor's Summary by Gregory Curfman, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the September 6, 2022 issue.

This recording features audio versions of September 2022  Journal of Vascular and Interventional Radiology (JVIR) abstracts:Uterine Artery Embolization for Pedunculated Subserosal Fibroids: A Systematic Review and Meta-Analysis ReadMicrowave Ablation as Bridging to Liver Transplant for Patients with Hepatocellular Carcinoma: A Single-Center Retrospective Analysis ReadPhase 0 Study of Vandetanib-Eluting Radiopaque Embolics as a Preoperative Embolization Treatment in Patients with Resectable Liver Malignancies ReadPredictors of Major Hemorrhage After Spleen Core Biopsy in Cancer Patients ReadThe Use of an Inflatable Adhesive External Compression Device for Maintenance of Hemostasis following Angiography in Children ReadVascular Pathology and Impact of Stent Eccentricity for Stent Restenosis in Femoropopliteal Endovascular Therapy ReadPercutaneous Sclerotherapy for Budd-Chiari Syndrome Secondary to Giant Hepatic Venous Malformations (Hemangiomas) ReadJVIR and SIR thank all those who helped record this episode:Host:Daniel Kim, Edward Via College of Osteopathic Medicine, VirginiaAudio editor:Patrick Bryan, Rocky Vista University College of Osteopathic Medicine Southern Utah CampusAbstract readers:Jonathan Dzielski, Kansas City University, MissouriKonrad Kozlowski, University of Miami Miller School of MedicineAna Gonzalez, University of Illinois College of Medicine at ChicagoLyanne Lu, University of California at Davis School of MedicineRommell Noche, MS, Frank H. Netter MD School of Medicine at Quinnipiac University, ConnecticutJacob Knittel, Creighton University School of Medicine, Phoenix Regional CampusTalia Fradkin, MHA, Florida Atlantic University College of Medicine©  Society of Interventional RadiologySupport the show

AF screening; sodium, potassium, BP, and CV outcomes; drug prices; and cardio-respiratory fitness are the topics John Mandrola, MD, covers in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. AF Screening - Using Wearable Devices to Detect AF Is 'Cost Effective' https://www.medscape.com/viewarticle/978861 - Cost-effectiveness of Screening for Atrial Fibrillation Using Wearable Devices https://jamanetwork.com/journals/jama-health-forum/fullarticle/2794835 - Screening for Atrial Fibrillation in Asymptomatic Older Adults https://www.nejm.org/doi/full/10.1056/NEJMclde2203726 II. Salt Substitutes - More Evidence Salt Substitutes Lower Risk of CVD and Death https://www.medscape.com/viewarticle/978999 - Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis https://heart.bmj.com/content/early/2022/07/21/heartjnl-2022-321332 - Effect of Salt Substitution on Cardiovascular Events and Death https://www.nejm.org/doi/10.1056/NEJMoa2105675 - Settling the controversy of salt substitutes and stroke: sodium reduction or potassium increase? https://doi.org/10.1093/eurheartj/ehac160 - Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia https://www.nejm.org/doi/full/10.1056/nejmoa1812792 - Fractional Flow Reserve versus Angiography for Guiding Percutaneous Coronary Intervention https://www.nejm.org/doi/full/10.1056/nejmoa0807611 III. Drug Prices - House Could Soon Give Biden Win on Medicare Drug Negotiations, Insulin Costs https://www.medscape.com/viewarticle/978988 IV. Fitness is Under-rated - Cardiorespiratory Fitness Key to Longevity for All? https://www.medscape.com/viewarticle/978854 - Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex https://www.jacc.org/doi/full/10.1016/j.jacc.2022.05.031 - Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation https://doi.org/10.1016/j.ijcha.2022.101083 You also may like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Dr. Ebell and Dr. Wilkes discuss the POEM titled ' Long-term risks are similar for CT and invasive coronary angiography as initial diagnostic strategy for stable chest pain '

See Video Episode Here ---> MR Angiography (MRA) Explained ---> https://youtu.be/7zUSU13qhvQ** Please do not watch while Driving ** In This Episode, Reggie and Robert talk about different MR Angiography techniques, with guest Matthew Hayes RT(R)(MR), Creator and President, ScanLabMR, and Professor of MRI, Adventist University of Health Sciences. Matthew opens by explaining the Time of Flight (TOF), and the pros and cons of each 2D and 3D Technique.  Then explains contrast enhancement techniques and the importance of understanding Time to Center (TTC). He also shares a few tricks to help with missing the bolus.To wrap up, Matthew breaks down, Time Resolve, Phase Contrast, Velocity encoding (Venc), and the difference between Visualization and Quantification. Thanks for Joining Us here in Zone 3!

The Journal RETINA is devoted exclusively to diseases of the retina and vitreous. These podcasts are intended to bring to its listeners summaries of selected articles published in the current issue of this internationally acclaimed journal.

The LIFE study, multimorbidity and evidence translation, cardiac arrest and therapeutic fashion, diabetes and cardiology, and EP cuts are the topics John Mandrola, MD, tackles in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – LIFE Study and Substudy - LIFE: ARNI Does Not Best Valsartan in Advanced Heart Failure https://www.medscape.com/viewarticle/952681 - Tolerability of Sacubitril/Valsartan in Patients With Advanced Heart Failure: Analysis of the LIFE Trial Run-In https://www.jacc.org/doi/10.1016/j.jchf.2022.04.013 - Effect of Treatment With Sacubitril/Valsartan in Patients With Advanced Heart Failure and Reduced Ejection FractionA Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2785700 II – Early Angiography and Therapeutic Fashion - Emergency Angiography for Cardiac Arrest Without ST Elevation? https://www.medscape.com/viewarticle/975434 - Emergency vs Delayed Coronary Angiogram in Survivors of Out-of-Hospital Cardiac ArrestResults of the Randomized, Multicentric EMERGE Trial https://jamanetwork.com/journals/jamacardiology/article-abstract/2793310 - Immediate Coronary Angiography in Survivors of Out-of-Hospital Cardiac Arrest https://www.nejm.org/doi/full/10.1056/NEJM199706053362302 - Coronary Angiography after Cardiac Arrest without ST-Segment Elevation https://www.nejm.org/doi/10.1056/NEJMoa1816897 - Randomized Pilot Clinical Trial of Early Coronary Angiography Versus No Early Coronary Angiography After Cardiac Arrest Without ST-Segment Elevation https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049569 - Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation https://www.nejm.org/doi/10.1056/NEJMoa2101909 - Most healthcare interventions tested in Cochrane Reviews are not effective according to high quality evidence: a systematic review and meta-analysis https://www.jclinepi.com/article/S0895-4356(22)00100-7/fulltext III – Diabetes and Cardiology - Medicare Advantage Tied to Less Use of Pricey Diabetes Drugs https://www.medscape.com/viewarticle/977181 - Diabetes Care Among Older Adults Enrolled in Medicare Advantage Versus Traditional Medicare Fee-For-Service Plans: The Diabetes Collaborative Registry https://doi.org/10.2337/dc21-1178 IV – EP Cuts - EP Ablation Rate Changes in 2022 Physician Fee Schedule https://www.acc.org/Latest-in-Cardiology/Articles/2021/11/18/01/44/EP-Ablation-Rate-Changes-in-2022-Physician-Fee-Schedule You also may like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

The Journal RETINA is devoted exclusively to diseases of the retina and vitreous.  These podcasts are intended to bring to its listeners summaries of selected articles published in the current issue of this internationally acclaimed journal.

Interview with Alison G. Abraham, MHS, MS, PhD, author of Association of Optical Coherence Tomography and Optical Coherence Tomography Angiography Retinal Features With Visual Function in Older Adults. Hosted by Neil Bressler, MD.

CommonSpirit Health physicians discuss CT or Invasive Coronary Angiography in Stable Chest PainThe panel includes:Dr. Juan Plana Gomez, Baylor St. Luke's Medical Center, Cardiovascular HealthDr. Ankita Sagar, System Vice President for Clinical Standards and Variation Reduction, CommonSpirit HealthDr. Nezar Falluji, System Vice President, Cardiovascular Service Line, CommonSpirit HealthDr. Gary Greensweig, System Senior Vice President / Chief Physician Executive, CommonSpirit Health Physician Enterprise

Dr. Nero discusses evaluation of  coronary artery disease and coronary inflammaiton with Dr. Cheerag Shirodaria from the University of Oxford.  Dr. Shirodaria along with Prof. Charalambos Antonidies at Caristo Diagnostics have developed a ground breaking technology that allows us to evaluate not just the severity of a coronary artery lesion, but also how inflamed it is and how likely it is to cause fatal and non-fatal myocardial infarction.  In addition, since it is a biologically active "marker" the Fat Attenuation Index (FAI) can also be used a a way to evaluate success of medical intervention.  Using computer post processing from standard 64 or 128 slice CT coronary angiography, they have been able to evaluate not just the vulnerable patient but also (possibly) the vulnerable plaque.

Full article: https://www.ajronline.org/doi/abs/10.2214/AJR.21.27147  Early diagnosis and treatment of pulmonary hypertension are crucial to prevent chronic progression and a poor prognosis. The nonspecific presenting symptoms and need for right heart catheterization may contribute to a delay in diagnosis. In this episode, Sara Tedla MD, discusses a recently published study in AJR, which evaluates the utility of cardiac chamber volumetric measurements based on non-gated CT pulmonary angiography and the updated 2018 pulmonary hypertension criteria.

Today we have Dr. Brian Locke back on to talk about asthma management and a new trial  of reliever-triggered inhaled glucocorticoids for Black and Latinx patients with asthma. Other questions we try to answer: Does methenamine prevent recurrent UTIs in women? Should CT coronary scan be done before invasive coronary angiography? Does melatonin prevent delirium in ICU patients? How good are patients at interpreting home COVID tests? What is the most common cause of type 2 NSTEMI? Give it a listen and find out! Reliever Triggered Inhaled Glucocorticoid Therapy in Black and Latinx Asthma PatientsMethenamine vs Antibiotics for Urinary Tract Infection Prophylaxis CT vs Invasive Coronary Angiography for Stable Chest Pain Melatonin for Delirium Prevention in ICU Patients Consumer Interpretation for At-Home COVID TestsBinax Rapid Test vs PCR for Sars-CoV-2 InfectionCharacteristics of Type 2 NSTEMIsMusic from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

Date: September 8th, 2021 Reference: Desch et al. The TOMAHAWK Investigators. Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation. NEJM 2021. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. He heads curriculum and conference for the academic year and is passionate about resident […]