Podcasts about Echocardiography

Clinical trials face challenges with variability in echo images, protocol adherence, and data quality. This discussion focuses on strategies to improve trial integrity, operational efficiency, and regulatory approval of transcatheter devices.

In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research. Tinestamps: 00:45 – PAH management 03:05 – Hypoxia 06:42 – Decompensated PAH 10:06 – At-home treatments 12:44 – Multidisciplinary teams 14:50 – Novel therapies

In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research. Timestamps: 01:05 – Diagnostic workflows 03:58 – Non-invasive tools 05:37 – Right heart catheterisation values 09:05 – Vasoreactivity testing 11:10 – Genetic testing 13:08 – Innovative diagnostics

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Artificial Intelligence for Detection of Prognostically Significant Left Ventricular Dysfunction From Echocardiography.

In this episode, CardioNerds Dr. Gurleen Kaur, Dr. Richard Ferraro, and Dr. Jake Roberts are joined by Cardio-Rheumatology expert, Dr. Monica Mukherjee, to discuss the role of utilizing multimodal imaging for cardiovascular disease risk stratification, monitoring, and management in patients with chronic systemic inflammation. The team delves into the contexts for utilizing advanced imaging to assess systemic inflammation with cardiac involvement, as well as the role of imaging in monitoring various specific cardiovascular complications that may develop due to inflammatory diseases. Audio editing by CardioNerds academy intern, Christiana Dangas. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Cardiovascular Multimodality Imaging & Systemic Inflammation Systemic inflammatory diseases are associated with an elevated CVD risk that has significant implications for early detection, risk stratification, and implementation of therapeutic strategies to address these risks and disease-specific complications. As an example, patients with SLE have a 48-fold increased risk for developing ASCVD compared to the general population. They may also develop disease-specific complications, such as pericarditis, that require focused imaging approaches to detect. In addition to increasing the risk for CAD, systemic inflammatory diseases can also result in cardiac complications, including myocardial, pericardial, and valvular involvement. Assessment of these complications requires the use of different imaging techniques, with the modality and serial studies selected based on the suspected disease process involved. In most contexts, echocardiography remains the starting point for evaluating cardiac involvement in systemic inflammatory diseases and can inform the next steps in terms of diagnostic study selection for the assessment of specific cardiac processes. For example, if echocardiography is completed in an SLE patient and demonstrates potential myocardial or pericardial inflammation, the next steps in evaluation may include completing a cardiac MRI for better characterization. While no current guidelines or standards of care directly guide our selection of advanced imaging studies for screening and management of CVD in patients with systemic inflammatory diseases, our understanding of cardiac involvement in these patients continues to improve and will likely lead to future guideline development. Due to the vast heterogeneity of cardiac involvement both across and within different systemic inflammatory diseases, a personalized approach to caring for each individual patient remains central to CVD evaluation and management in these patients. For example, patients with systemic sclerosis and symptoms of shortness of breath may experience these symptoms due to a range of causes. Echocardiography can be a central guiding tool in assessing these patients for potential concerns related to pulmonary hypertension or diastolic dysfunction. Based on the initial echocardiogram, the next steps in evaluation may involve further ischemic evaluation or right heart catheterization, depending on the pathology of concern. Show notes - Cardiovascular Multimodality Imaging & Systemic Inflammation Episode notes drafted by Dr. Jake Roberts. What are the contexts in which we should consider pursuing multimodal cardiac imaging, and are there certain inflammatory disorders associated with systemic inflammation and higher associated CVD risk for which advanced imaging can help guide early intervention? Systemic inflammatory diseases are associated with elevated CVD risk, which has significant implications for early detection, risk stratification, prognostication, and implementation of therapeutic strategies to address CVD risk and complicat...

Commentary by Kazuhiro Sase.

In our May episode, we marked Hypertension Awareness Month with Dr. Robert Ostfeld, a cardiologist at Montefiore Medical Center. Dr. Ostfeld shared how his patients naturally lowered their blood pressure by adopting a plant-based diet and offered tips for eating more plant-based foods. In this month's Key Note, he explains how getting proper sleep can reduce stress hormones that contribute to high blood pressure. The Takeaway We want to hear from you! Please complete our survey: org/member-feedback. Drop us a line at our social media channels: Facebook// Instagram // YouTube. Get started on your health journey by making an appointment with your primary care physician to know your numbers. Get to know your numbers at 1199SEIUBenefits.org/healthyhearts. Find healthy recipes and meal-prep tips at 1199SEIUBenefits.org/food-as-medicine. Visit the Healthy Living Resource Center for wellness tips, information and resources; 1199SEIUBenefits.org/healthyliving. Get inspired by fellow members through our Members' Voices series: 1199SEIUBenefits.org/healthyliving/membervoices. Stop by our Benefits Channel to join webinars on building healthy meals, managing stress and more: 1199SEIUBenefits.org/videos. Visit our YouTube channel to view a wide collection of healthy living videos: youtube.com/@1199SEIUBenefitFunds/playlists. Sample our wellness classes to exercise body and mind: 1199SEIUBenefits.org/wellnessevents. Robert Ostfeld, MD, MSc, FACC, is the Director of Preventive Cardiology at Montefiore Health System and a Professor of Medicine at the Albert Einstein College of Medicine. Dr. Ostfeld treats patients with adult cardiovascular disease, including coronary artery disease, hypertension, hyperlipidemia and erectile dysfunction with a focus on prevention and treatment through lifestyle change. He works closely with his patients to help them adopt a plant-based diet. Dr. Ostfeld received his Bachelor of Arts in the Biologic Basis of Behavior from the University of Pennsylvania, graduating Summa Cum Laude and Phi Beta Kappa and his Doctor of Medicine from Yale University School of Medicine. He then did his medical internship and residency at the Massachusetts General Hospital and his Cardiology Fellowship and Research Fellowship in Preventive Medicine at Brigham and Women's Hospital, both teaching hospitals of Harvard Medical School. During his Cardiology Fellowship, he earned a Master's of Science in Epidemiology from the Harvard School of Public Health. Dr. Ostfeld's research focus is on cardiovascular disease prevention and reversal through lifestyle modification. Ongoing topics he investigates include the impact of plant-based nutrition on erectile function, coronary artery disease, angina and heart failure. His work has been published in peer-reviewed journals, books, articles, and clinical statements and has been presented nationally. Dr. Ostfeld is board certified in Cardiovascular Disease and Echocardiography, and he is a member of numerous professional societies, including the Physician's Committee for Responsible Medicine and the American College of Cardiology.

Commentary by Dr. Jian'an Wang.

For Hypertension Awareness Month, we are fortunate to have Dr. Robert Ostfeld, a cardiologist at Montefiore Medical Center, join us to talk about lifestyle approaches for treating – and preventing – high blood pressure. In this episode, Dr. Ostfeld explains the numbers, the symptoms – or lack of symptoms – and the associated risks. A self-confessed “reformed cardiologist,” he talks about how he saw his patients who adopted a plant-based diet significantly lower their blood pressure. Not ready to go totally plant-based? Dr. Ostfeld says simply adding more fruits, vegetables and whole grains to your diet can help lower not only your blood pressure but also your risk for heart disease, stroke and dozens of other conditions.   The Takeaway We want to hear from you! Please complete our survey: org/member-feedback. Drop us a line at our social media channels: Facebook// Instagram // YouTube. Get started on your health journey by making an appointment with your primary care physician to know your numbers. Get to know your numbers at 1199SEIUBenefits.org/healthyhearts. Find healthy recipes and meal-prep tips at 1199SEIUBenefits.org/food-as-medicine. Visit the Healthy Living Resource Center for wellness tips, information and resources; 1199SEIUBenefits.org/healthyliving. Get inspired by fellow members through our Members' Voices series: 1199SEIUBenefits.org/healthyliving/membervoices. Stop by our Benefits Channel to join webinars on building healthy meals, managing stress and more: 1199SEIUBenefits.org/videos. Visit our YouTube channel to view a wide collection of healthy living videos: youtube.com/@1199SEIUBenefitFunds/playlists. Sample our wellness classes to exercise body and mind: 1199SEIUBenefits.org/wellnessevents. Robert Ostfeld, MD, MSc, FACC, is the Director of Preventive Cardiology at Montefiore Health System and a Professor of Medicine at the Albert Einstein College of Medicine. Dr. Ostfeld treats patients with adult cardiovascular disease, including coronary artery disease, hypertension, hyperlipidemia and erectile dysfunction with a focus on prevention and treatment through lifestyle change. He works closely with his patients to help them adopt a plant-based diet. Dr. Ostfeld received his Bachelor of Arts in the Biologic Basis of Behavior from the University of Pennsylvania, graduating Summa Cum Laude and Phi Beta Kappa and his Doctor of Medicine from Yale University School of Medicine. He then did his medical internship and residency at the Massachusetts General Hospital and his Cardiology Fellowship and Research Fellowship in Preventive Medicine at Brigham and Women's Hospital, both teaching hospitals of Harvard Medical School. During his Cardiology Fellowship, he earned a Master's of Science in Epidemiology from the Harvard School of Public Health. Dr. Ostfeld's research focus is on cardiovascular disease prevention and reversal through lifestyle modification. Ongoing topics he investigates include the impact of plant-based nutrition on erectile function, coronary artery disease, angina and heart failure. His work has been published in peer-reviewed journals, books, articles, and clinical statements and has been presented nationally. Dr. Ostfeld is board certified in Cardiovascular Disease and Echocardiography, and he is a member of numerous professional societies, including the Physician's Committee for Responsible Medicine and the American College of Cardiology.

In this podcast, Dr. Valentin Fuster discusses a groundbreaking study from the Orbiter 2 trial, which explores how dobutamine stress echocardiography (DSE) can predict the efficacy of percutaneous coronary intervention (PCI) in relieving angina in patients with stable coronary artery disease. The study reveals that the degree of ischemia, as measured by DSE, is strongly correlated with improvement in symptoms, offering new insights into patient selection for PCI treatment.

In this episode, Dr Bleri CELMETA takes us on a powerful journey through the history of open-heart surgery — from the pioneering work of John Gibbon and C. Walton Lillehei to the evolution of minimally invasive and robotic approaches. Discover how cardiac surgery progressed from experimental beginnings to life-saving daily procedures, and how innovation continues to shape the operating room. Dr. Bleri Celmeta is a cardiac surgeon operating on the Minimally Invasive Cardiac Surgery Unit in Galeazzi-Sant'Ambrogio Hospital (Milan, Italy). He graduated in Medicine and Surgery at the University of Padova-Italy in 2014, then completed his residency program in Cardiac Surgery in the same university in 2020. His professional background included also a fellowship in Cardiac and Thoracic Surgery in the University Hospital of Nantes-France (2019-2020).   He is the author of numerous publications and conference presentations with particular interest in minimally invasive cardiac surgery, and review editor of various international Journals (Frontiers in Cardiovascular Medicine, Frontiers in Surgery, Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, Journal of Cardiothoracic Surgery, among others). Dr. Celmeta is a member of the Working Group on Cardiovascular Surgery - European Society of Cardiology (ESC), Italian Cardiac Surgery Society (SICCH) and Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI).  LinkedIn profile: Bleri Celmeta | LinkedIn     About Behind the OR Behind the OR is the official podcast channel by Peters Surgical. Here, we invite you to step into the world of surgery, where we uncover what happens behind the closed doors of the operating room and beyond. Each episode features in-depth conversations with expert surgeons, providing insights into the latest surgical techniques, innovations, and the daily lives of those who dedicate themselves to saving lives. Founded in 1926, Peters Surgical is a French company with a global presence in over 90 countries. As a reference group for surgical practices worldwide, we are dedicated to improving surgical outcomes through innovative medical devices, including surgical sutures, hemostatic clips, and surgical glue. Our expertise lies in designing, manufacturing, and distributing these devices.  Visit our website here : https://peters-surgical.com/

This week we review a recent work from the team at Seattle Children's Hospital about obstetrical sonography and referral of fetuses with 'suboptimal imaging' for fetal echocardiography. Should all 'suboptimal imaging' cases be referred? How can fetal cardiologists parse out who needs a fetal cardiac scan and when? How does the fetal team in Seattle practically serve a geographic region exceeding 2,000 miles and properly triage the referrals, particularly when 'suboptimal imaging' is the rationale for referral? Associate Professor of Pediatrics at The University of Washington, Dr. Bhawna Arya provides deep insights into her recent work on how to think about fetuses referred for 'suboptimal imaging' as a rationale for fetal consultation. https://doi.org/10.1007/s00246-024-03495-9

In this episode, Dr. Sergio Zanotti explores one of medicine's fastest-evolving frontiers: artificial intelligence (AI). From predictive analytics to decision-support tools, AI is beginning to influence how we deliver critical care — but what does that actually mean for frontline clinicians? Dr. Zanotti is joined by Dr. Sharad Patel, a critical care physician with additional board certification in nephrology and Echocardiography. He is a Critical Care Intensivist at Cooper University Health Care, the assistant program Director for the Internal Medicine Residency Program, and an Assistant Professor of Medicine at Cooper Medical School of Rowan University. Dr. Patel is deeply interested in applying artificial intelligence and technology at the bedside. Additional resources: Landing page for New England Journal of Medicine – AI in Medicine section. A multitude of articles and resources on the topic: https://www.nejm.org/ai-in-medicine Attention Is All You Need. A Vaswani et al. NIPS 2017: https://proceedings.neurips.cc/paper_files/paper/2017/file/3f5ee243547dee91fbd053c1c4a845aa-Paper.pdf Artificial Intelligence Courses Online: https://www.coursera.org/courses?query=artificial%20intelligence UDEMY landing page for AI courses. https://www.udemy.com/AI Books mentioned in this episode: Meditations. By Marcus Aurelius (Author), Gregory Hayes (Translator): https://amzn.to/4iLvfLA Thinking Fast and Slow. By Daniel Kahneman: https://bit.ly/4c6pANu

Andrea Scotti, MD, JACC: Case Reports Deputy Editor, is joined by authors Richard Carrick, MD, PhD and Drew Bidmead, BS discussing this study from Carrick et al presented at ACC.25 and published in JACC: Case Reports. Left atrial dissection is a rare, but potentially serious, complication that most commonly arises following mitral valve surgeries. In this report, we describe an unusual case of left atrial dissection that occurred after multi-valve surgical replacement in a patient with hypertrophic cardiomyopathy. While permanent pacemaker placement was required due to recurrent episodes of complete heart block, the patient was otherwise managed safely using a conservative approach without surgical re-intervention.

POCUS Basic Echocardiography

CardioNerds (Dr. Rick Ferraro and Dr. Dan Ambinder) join Dr. Sri Mandava, Dr. David Meister, and Dr. Marissa Donatelle from the Columbia University Division of Cardiology at Mount Sinai Medical Center in Miami. Expert commentary is provided by Dr. Pranav Venkataraman.   They discuss the following case involving a patient with cardiac sarcoidosis presenting as STEMI:  A 57-year-old man with a history of hyperlipidemia presented with sudden onset chest pain. On admission, he was vitally stable with a normal cardiorespiratory exam but appeared in acute distress and was diffusely diaphoretic. His ECG revealed sinus rhythm, a right bundle branch block (RBBB), and ST elevation in the inferior-posterior leads. He was promptly taken for emergent cardiac catheterization, which identified a complete thrombotic occlusion of the mid-left circumflex artery (LCX) and large obtuse marginal (OM) branch, with no underlying coronary atherosclerotic disease. Aspiration thrombectomy and percutaneous coronary intervention (PCI) were performed, with one drug-eluting stent placed. An echocardiogram showed a left ventricular ejection fraction (EF) of 31%, hypokinesis of the inferior, lateral, and apical regions, and an apical left ventricular thrombus. The patient was started on triple therapy. A hypercoagulable workup was negative. A cardiac MRI was obtained to further evaluate non-ischemic cardiomyopathy. In conjunction with a subsequent CT chest, the results raised suspicion for cardiac sarcoidosis with systemic involvement. In view of a reduced EF and significant late-gadolinium enhancement, electrophysiology was consulted to evaluate for ICD candidacy. A decision was made to delay ICD implantation until a definitive diagnosis of cardiac sarcoidosis could be established by tissue biopsy. The patient was started on HF-GDMT and discharged with a LifeVest. Close outpatient follow-up with cardiology and electrophysiology was arranged.  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! Pearls - Cardiac Sarcoidosis Presenting as STEMI Cardiac sarcoidosis can present with a variety of symptoms, including arrhythmias, heart block, heart failure, or sudden cardiac death. Symptoms can be subtle or mimic other cardiac conditions.  Conduction abnormalities, particularly AV block or ventricular arrhythmias, are common and may be the initial indication of cardiac involvement with sarcoidosis.  The additive value of Echocardiography, FDG-PET, and cardiac MR is indispensable in the diagnostic workup of suspected cardiac sarcoidosis.  Specific role of MRI/PET: Both cardiac MRI and FDG-PET provide a complementary role in the diagnosis of cardiac sarcoidosis. Cardiac MRI is an effective diagnostic screening tool with fairly high sensitivity but is limited by its inability to decipher inflammatory (“active” disease) versus fibrotic myocardium. FDG-PT helps to make this discrimination, refine the diagnosis, and guide clinical management. Ultimately, these studies are most useful when interpreted in the context of other clinical information.  Primary prevention of sudden cardiac death in cardiac sarcoidosis focuses on risk stratification, with ICD placement for high-risk patients. For patients awaiting definitive diagnosis, a LifeVest may be used as a temporary measure to protect from sudden arrhythmic events until an ICD is placed.  Notes - Cardiac Sarcoidosis Presenting as STEMI 1. Is STEMI always a result of coronary artery disease?  By definition, a STEMI is an acute S-T segment elevation myocardial infarction. This occurs when there is occlusion of a major coronary artery, which results in transmural ischemia and damage,

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Safety and Feasibility of 3D Intracardiac Echocardiography in Guiding Left Atrial Appendage Occlusion With WATCHMAN FLX

Read the article here: https://journals.sagepub.com/doi/full/10.1177/30494826241296671

Recent randomized trials, including EARLY TAVR, AVATAR, RECOVERY, and EVOLVED, suggest benefits of early aortic valve replacement (AVR) in asymptomatic severe aortic stenosis (AS). Early AVR reduces stroke, heart failure hospitalizations, and cardiovascular events, with a trend toward improved survival. The data support shifting from clinical surveillance to early intervention?

The Tri.Fr Randomized Clinical Trial evaluated the efficacy of Transcatheter Edge-to-Edge Repair (T-TEER) + Optimized Medical Therapy (OMT) versus OMT alone in 300 patients with severe, symptomatic tricuspid regurgitation (TR) across 24 centers in France and Belgium. At 1-year follow-up, 74.1% of patients in the T-TEER group improved, compared to 40.6% in the OMT-alone group (P < .001). T-TEER significantly reduced TR severity, improved NYHA class, patient global assessment (PGA), and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores, and had a high procedural success rate (97.3%) with a low 30-day major adverse event rate (0.7%). The findings support T-TEER as an effective intervention for symptomatic severe TR, warranting long-term follow-up to assess mortality and hospitalization impact.

CardioNerds (Dr. Colin Blumenthal and Dr. Saahil Jumkhawala) join Dr. Rohan Ganti, Dr. Nikita Mishra, and Dr. Jorge Naranjo from the Rutgers – Robert Wood Johnson program for a college basketball game, as the buzz around campus is high. They discuss the following case involving a patient with ventricular tachycardia:  The case involves a 61-year-old man with a medical history of hypothyroidism, hypertension, hyperlipidemia, seizure disorder on anti-epileptic medications, and major depressive disorder, who presented to the ER following an out-of-hospital cardiac arrest. During hospitalization, he experienced refractory polymorphic ventricular tachycardia (VT), requiring 18 defibrillation shocks. Further evaluation revealed non-obstructive hypertrophic cardiomyopathy (HCM). We review the initial management of electrical storm, special ECG considerations, diagnostic approaches once ischemia has been excluded, medications implicated in polymorphic VT, the role of multi-modality imaging in diagnosing hypertrophic cardiomyopathy, and risk stratification for implantable cardioverter-defibrillator (ICD) placement in patients with HCM.  Expert commentary is provided by Dr. Sabahat Bokhari.   Episode audio was edited by CardioNerds Intern and student Dr. Pacey Wetstein.   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! Pearls - A Curious Case of Refractory Ventricular Tachycardia - Rutgers-Robert Wood Johnson Diagnostic Uncertainty in VT Storm: In VT storm, ischemia is a primary consideration; when coronary angiography excludes significant epicardial disease, alternative causes such as cardiomyopathies, channelopathies, myocarditis, electrolyte disturbances, or drug-induced arrhythmias must be explored.  ST elevations in ECG lead aVR:  ST elevations in lead aVR and diffuse ST depressions can sometimes represent post-arrest oxygen demand and myocardial mismatch rather than an acute coronary syndrome. This pattern may occur in the context of polymorphic VT (PMVT), where myocardial oxygen demands outstrip supply, especially after an arrest. While these ECG changes could suggest myocardial ischemia, caution is needed, as they might not always indicate coronary pathology. However, PMVT generally should raise suspicion for underlying coronary disease and may warrant a coronary angiogram for further evaluation.  Medication Implications in PMVT and HCM: Certain medications, including psychotropic drugs (e.g., antidepressants, antipsychotics) and anti-epileptic drugs, can prolong the QT interval or interact with other drugs, thereby increasing the risk of polymorphic VT in patients with underlying conditions like HCM. Careful management of these medications is critical to avoid arrhythmic events in predisposed individuals.  Multi-Modality Imaging in HCM: Cardiac MRI with late gadolinium enhancement (LGE) is invaluable in assessing myocardial fibrosis, a key predictor of arrhythmic risk, and can guide decisions regarding ICD implantation. Echocardiography and contrast-enhanced CT can provide additional insights into structural abnormalities and risk assessment.  Polymorphic VT in Nonobstructive HCM: Polymorphic ventricular tachycardia (PMVT) can occur in nonobstructive hypertrophic cardiomyopathy due to myocardial fibrosis and disarray, even in the absence of significant late gadolinium enhancement and left ventricular outflow tract obstruction.  ICD Risk Stratification in HCM: Risk stratification for ICD placement in HCM includes assessment of clinical features such as family history of sudden cardiac death, history of unexplained syncope, presence of nonsustained VT on ambulatory monitoring,

This week we review a work from the department of cardiology and department of cardiac surgery at Boston Children's Hospital on late hypertension in patients following coarctation repair. Late hypertension has been associated previously with late transverse aortic arch Z score but can this be predicted by the immediate postoperative transverse aortic arch Z score also? What factors account for late hypertension in the coarctation patient? Should more patients have their aorta repaired from a sternotomy? Dr. Sanam Safi-Rasmussen, who is a PhD candidate at Copenhagen University, shares her insights from a work she performed while a research fellow at Boston Children's Hospital. DOI: 10.1016/j.jtcvs.2024.08.049

N Engl J Med 2006;355:2395-407Am Heart J 2011;161:611-21Background: Registry data suggests that 10-20% of patients with a STEMI present more than 12 hours after the onset of symptoms. The optimal treatment for such patients is unknown. In some cases, the inciting event may have occurred weeks prior and been mistaken for indigestion or another non-life threatening condition. Such patients may present to the hospital with a new diagnosis of congestive heart failure or atrial fibrillation. Echocardiography often reveals a a large wall motion abnormality, perfusion testing demonstrates an infarct with peri-infarct ischemia and an occluded vessel is seen on angiography. Should we try to open it? On the one hand, the damage has been done. Attempting to open an occluded vessel is associated with higher procedural risks and the patient's themselves are more often than not sub-optimal candidates for intervention; often having some combination of heart failure, LV dysfunction, older age, multimorbidity and hemodynamic instability. But on the other hand, revascularization restores blood flow and that has to count for something, right?The Occluded Artery Trial (OAT) tested the hypothesis that a strategy of routine PCI for total occlusion of the infarct-related artery 3 to 28 days after AMI would improve cardiac outcomes compared to medical therapy alone.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients: Patients were eligible if coronary angiography, performed 3 to 28 days after MI, showed a total occlusion of the infarct-related artery with poor antegrade flow and either an EF less than 50% or the occlusion was in the proximal portion of a major coronary vessel with a large risk region, or both. The qualifying period of 3 to 28 days was based on calendar days with day 1 being the onset of symptoms and thus, the minimal time from the AMI to angiography was just over 24 hours. [This is important, readers should not take the inclusion criteria of 3 to 28 days to mean that patients were not eligible if angiography was performed 2.5 mg/dl, left main or 3 vessel disease, angina at rest, and severe ischemia on stress testing (stress testing was required if the infarct zone was not akinetic or dyskinetic).Baseline characteristics: The trial included 2,166 patients - 1,082 randomized to PCI and 1,084 to medical therapy. The average age of patients was 59 years and 78% were men. Over 80% were white. The median time between AMI and randomization was 8 days. Patients had normal kidney function with an average GFR of 81 ml/min. The mean EF was 48% with 20% of patients having an EF

"POCUS Spotlight: Assessment of Right Ventricle with Echocardiography" From ASRA Pain Medicine News, November 2024. See the original article at www.asra.com/november24news for figures and references. This material is copyrighted. Support the show

Show notes: (2:21) Dr. Kedan's journey to becoming a leader in cardiology innovation (6:12) The broader applications of handheld ultrasound in patient care (15:15) The cholesterol debate: Is inflammation the bigger issue? (21:37) The role of ultrasound in preventive cardiology (27:31) The importance of balancing lifestyle changes with medical interventions (31:17) Factors predicting adverse events in cardiovascular health (36:49) How to find the right cardiologist and leveraging new technologies (38:56) The cholesterol vs. inflammation debate (43:18) Ultrasound vs. other imaging technologies (46:54) Key lifestyle tips for maintaining heart health (52:09) Where to find Dr. Kedan (54:57) Outro Who is Dr. Ilan Kedan?   Dr. Ilan Kedan is a distinguished cardiologist with a career marked by an unwavering commitment to patient care, academic excellence, and technological innovation. He embarked on his journey in medicine at Tulane University School of Medicine, where he honed his skills in cardiovascular health and patient-centered care.   Dr. Kedan's professional journey led him to Cedars Sinai Medical Group, where he cared for over 10,000 patients, fostering a culture of excellence and growth. During this time, he became a leader in the adoption of handheld ultrasonic cardiology technology, performing over 40,000 point-of-care ultrasound exams (POCUS).   Dr. Kedan's dedication to advancing patient care through technology earned him recognition as a Fellow of the American Society of Echocardiography and membership in esteemed organizations such as the National Lipid Association and the American College of Cardiology.   Beyond clinical practice, Dr. Kedan is deeply engaged in research, focusing on clinical cardiology, handheld ultrasound, and cardiometabolic disease. He has authored numerous publications on topics ranging from cardiac imaging to COVID-19, contributing to the advancement of cardiovascular medicine. Committed to shaping the next generation of medical professionals, Dr. Kedan mentors trainees and students, sharing his expertise and drive for excellence. Connect with Dr. Kedan: Website: https://www.cardiolucent.com/ Links and Resources: Peak Performance Life Peak Performance on Facebook Peak Performance on Instagram  

Sivatharshini Ramalingam, MD, and Charlotte Manisty, MBBS, PhD, discuss JACC: CardioOncology Expert Panel Recommendations for cardiovascular risk evaluation prior to cancer treatment, cardiac nuances of therapy and highlight evidence gaps for future direction of research.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on cardiovascular adaptation in normal pregnancy with 2D and 3D-echocardiography, speckle tracking and radial Artery tonometry.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on technique and outcomes of intracardiac echocardiography to assist anatomical isthmus ablation in repaired Tetralogy of Fallot patients with ventricular tachycardia.

JACC: Case Reports Associate Editor Maurizio Taramasso, MD, PhD, joins author Brinder S Kanda, MD, FACC to discuss their case presented at AHA and published in JACC: Case Reports. In this case, an 83-year-old female with decompensated heart failure was found to have HOCM with SAM of the mitral valve and a large P2 flail segment with ruptured cords. TEER was performed resulting in mild MR and resolution of the prior LVOT gradient. The case supports TEER for patients with medication-refractory HOCM.

Nicholas Wilcox, MD, MHS, Darryl Leong, MBBS, MPH, M.Biostat, PhD discuss

JACC: Case Reports Associate Editor Maurizio Taramasso, MD, PhD, joins author Brinder S Kanda, MD, FACC to discuss their case presented at AHA and published in JACC: Case Reports. In this case, an 83-year-old female with decompensated heart failure was found to have HOCM with SAM of the mitral valve and a large P2 flail segment with ruptured cords. TEER was performed resulting in mild MR and resolution of the prior LVOT gradient. The case supports TEER for patients with medication-refractory HOCM.

Many significant medical discoveries were accidents, such as Fleming's discovery of penicillin in 1929. Similarly, in 1958, Dr. Mason Sones from the Cleveland Clinic accidentally injected contrast into a patient's right coronary artery, leading to a cardiac arrest. However, this incident allowed the first detailed visualization of the coronary artery, eventually leading to the development of coronary angiography, which remains the gold standard today. Dr Bleri CELMETA highlight these advancements, and explains the evolutions from open procedures to minimally invasive and robotic techniques.   Dr. Bleri Celmeta is a cardiac surgeon operating on the Minimally Invasive Cardiac Surgery Unit in Galeazzi-Sant'Ambrogio Hospital (Milan, Italy). He graduated in Medicine and Surgery at the University of Padova-Italy in 2014, then completed his residency program in Cardiac Surgery in the same university in 2020. His professional background included also a fellowship in Cardiac and Thoracic Surgery in the University Hospital of Nantes-France (2019-2020).   He is the author of numerous publications and conference presentations with particular interest in minimally invasive cardiac surgery, and review editor of various international Journals (Frontiers in Cardiovascular Medicine, Frontiers in Surgery, Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, Journal of Cardiothoracic Surgery, among others). Dr. Celmeta is a member of the Working Group on Cardiovascular Surgery - European Society of Cardiology (ESC), Italian Cardiac Surgery Society (SICCH) and Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI).  LinkedIn profile: Bleri Celmeta | LinkedIn     About Behind the OR Behind the OR is the official podcast channel by Peters Surgical. Here, we invite you to step into the world of surgery, where we uncover what happens behind the closed doors of the operating room and beyond. Each episode features in-depth conversations with expert surgeons, providing insights into the latest surgical techniques, innovations, and the daily lives of those who dedicate themselves to saving lives. Founded in 1926, Peters Surgical is a French company with a global presence in over 90 countries. As a reference group for surgical practices worldwide, we are dedicated to improving surgical outcomes through innovative medical devices, including surgical sutures, hemostatic clips, and surgical glue. Our expertise lies in designing, manufacturing, and distributing these devices.  Visit our website here : https://peters-surgical.com/

An AI-ECG Algorithm for Left Ventricular Diastolic Dysfunction   Guest: Jae Oh, M.D.  Host: Anthony H. Kashou, M.D.    Diastolic function assessment is crucial in diagnosing, managing, and predicting outcomes in various cardiac conditions. It provides insight into heart health, particularly in diagnosing heart failure. Shortness of breath, a common patient complaint, often indicates elevated diastolic filling pressure if linked to a cardiac condition. Echocardiography is the primary method for assessing diastolic function, but it is operator-dependent and not always available. In contrast, ECGs are standardized and widely accessible. Although subtle changes in ECGs are not easily detectable by the human eye, artificial intelligence can identify specific conditions reflected in the ECG. By training an AI model with labeled ECGs based on diastolic function determined through echocardiography, researchers achieved high accuracy in detecting diastolic dysfunction. AI-enhanced ECGs can significantly impact the identification of both asymptomatic and symptomatic cardiac conditions, potentially streamlining diagnostic strategies and reducing costs. Future developments may enable patients to monitor their heart health using simple wearable devices, enhancing the management of heart failure and other conditions.   Topics Discussed: Your special clinical academic interest is echocardiography. Why are you interested in ECG AI in diastolic function? What is diastolic function and why is it important to assess diastolic function in clinical practice? Why did you decide to create AI-ECG for diastolic function assessment? What did you find and how do you envision AI ECG for diastolic function be used in clinical practice? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.

In this episode, Efstratios Koutroumpakis discusses a critical study on autonomic dysfunction among adult survivors of childhood cancer, highlighting its prevalence and functional significance compared to community controls. The research underscores the complex etiologies of autonomic dysfunction linked to cancer treatments and stresses the importance of early detection and standardized testing to improve cardiovascular health and quality of life in this growing survivor population.

In this episode of the JACC: CardioOncology Podcast, Antonio Cannata discusses the PROACT clinical trial, which investigated the effectiveness of enalapril in preventing cardiac damage in breast cancer and lymphoma patients undergoing anthracycline therapy. Despite neutral results, the conversation delves into the challenges of defining myocardial injury and emphasizes the need for improved risk stratification and innovative trial designs in future research.

This week we listen in on a wonderful review lecture on fetal arrhythmias by noted fetal cardiologist Professor Bettina Cuneo. In this lecture Dr. Cuneo reviews the basics of fetal tachycardias and bradycardias and how these arrhythmias are diagnosed and sometimes treated. This is a lecture that was delivered on 9/20/24 by Dr. Cuneo at the Pedirhythm XI meeting in Rome, Italy. Thanks go to Dr. Fabrizio Drago and the organizers of Pedirhythm for allowing us to listen in on this wonderful lecture by a world-wide authority. 

ESC TV Today brings you concise analysis from the world's leading experts, so you can stay on top of what's happening in your field quickly. This episode covers: Cardiology this Week: A concise summary of recent studies Strategic decisions in atrial fibrillation Critical evaluation of clinical trials Snapshots Host: Perry Elliott Guests: Stephan Achenbach, Carlos Aguiar, Jane Armitage, Isabel Deisenhofer Want to watch that episode? Go to: https://esc365.escardio.org/event/1720 Disclaimer ESC TV Today is supported by Bristol Myers Squibb. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsor. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests Stephan Achenbach, Jane Armitage and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Sanofi Aventis, Novo Nordisk, Terumo. Isabel Deisenhofer has declared to have potential conflicts of interest to report: speaker honoraria and travel grants from Abbott Medical, Biosense-Webster, Boston Scientific, BMS, Volta Medical, and research grant (for the institution) from Abbott Medical and Daiichi Sankyo. Perry Elliott has declared to have potential conflicts of interest to report: consultancies for Pfizer, BMS, Cytokinetics, AstraZeneca, Forbion. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging, Inc., Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on echocardiogram vector embeddings via R3D transformer for the advancement of automated echocardiography.

N Engl J Med 2020;382:1395-407 - ISCHEMIAN Engl J Med 2020;382:1608-16 - ISCHEMIA-CKDBackground: The COURAGE trial, published in 2007, represented a major reversal in cardiovascular medicine. In patients with stable CAD an initial strategy of revascularization plus medical therapy did not reduce the chance of dying or having a heart attack compared to an initial strategy of medical therapy alone. Prior to these results, patients with stable CAD were routinely managed with an initial invasive approach and the field of cardiology was intensely focused on finding coronary blockages and “fixing” them in symptomatic and asymptomatic patients alike. Thus, it's not surprising that following results from COURAGE, the practice continued to be vigorously defended and applied routinely in the management of patients with stable CAD.The first major attempt to reverse the results of COURAGE came from the FAME 2 trial, published in 2012, which tested the hypothesis that patients with stable CAD and an abnormal fractional flow reserve (FFR) in the cath lab would do better with an initial invasive strategy compared to medical therapy alone. The trial was stopped early for efficacy but the positive results were driven entirely by revascularization during follow up - not death or heart attack. The trial was criticized for being stopped inappropriately without providing an answer to whether an early invasive strategy improved hard endpoints compared to initial medical therapy alone. The concepts of “faith healing” and “subtraction anxiety” are useful for understanding the results and limitations of the FAME 2 trial.The ISCHEMIA trial which began enrolling patients in 2012 sought to overcome limitations of COURAGE and FAME. The investigative aim of the study was to test the hypothesis that in patients with stable CAD and moderate to severe ischemia on provocative testing, an initial invasive strategy reduced a composite of major cardiac events compared to initial medical therapy alone. The ISCHEMIA-CKD trial was performed in conjunction with the ISCHEMIA Research Group to address an important knowledge gap in managing patients with CAD. Patients with advanced chronic kidney disease (CKD) experience a higher rate of cardiac events than their counterparts without CKD; however, they are also at a higher risk of procedural complications. The standard of care at the time was generally to manage a patient with stable CAD and CKD like any other patient with CAD despite the fact that such patients were historically excluded from participation in clinical trials and thus, there was really no data from clinical trials to guide decision making.The ISCHEMIA-CKD investigators sought to test the hypothesis that in patients with advanced CKD and stable CAD and moderate to severe ischemia on stress testing, an initial invasive strategy reduced death or MI compared to initial medical therapy alone.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients: For the ISCHEMIA trial, eligible patients had to be at least 21 years of age or older with at least moderate ischemia on a qualifying stress test based on the following criteria:* Nuclear perfusion with SPECT or PET with >/= 10% ischemic myocardium* Echocardiography with >/= 3/16 segments with stress-induced severe hypokinesis or akinesis* Cardiac MRI with >/= 10% ischemic myocardium on perfusion imaging and/or >/= 3/16 segments with stress-induced severe hypokinesis or akinesis on wall motion assessment* Exercise treadmill test without imaging that met all 4 following criteria* clinical history of typical angina or typical angina during the stress test* absence of resting ST depression > 1.0 mm or confounders that render exercise EKG non-interpretable (LBBB, LVH with repolarization, pacemaker, etc.)* exercise-induced horizontal or downsloping ST depression >/= 1.5 mm in 2 leads or >/= 2.0 mm in any lead or ST elevation >/= 1.0 mm in a non-infarct territory* either of the following:* workload at which ST segment criteria are met is NOT to exceed completion of stage 2 of a standard Bruce protocol or 7 METS if a non-Bruce protocol is used* ST segment criteria are met at

In this podcast, Dr. Tim Markmann discusses a groundbreaking method for treating cardiac tumors using echocardiography-guided transapical radiofrequency ablation. This innovative approach from Dr. Liwen Liu and his team, which involves delivering thermal energy to the tumor via a percutaneous needle, shows promising results in reducing tumor size and alleviating heart failure symptoms, though it requires further study to address potential risks such as ventricular arrhythmias.

Send us a Text Message.Impact of early screening echocardiography and targeted PDA treatment on neonatal outcomes in "22-23" week and "24-26" infants.Giesinger RE, Hobson AA, Bischoff AR, Klein JM, McNamara PJ.Semin Perinatol. 2023 Mar;47(2):151721. doi: 10.1016/j.semperi.2023.151721. Epub 2023 Mar 5.PMID: 36882362As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Today, we're thrilled to have Board Certified Cardiologist and Director of Echocardiography and Cardiac Rehabilitation at Holy Name Hospital, Dr. David Wild with us. We'll be discussing the best practices for screening for heart disease, the role of doctors on social media, and debunking common heart myths. Stay tuned for an enlightening conversation that will help you take better care of your heart!

On King's Birthday, the Governor-General announced Honours and Awards for 737 Australians in recognition for conspicuous service. Professor Konstantin Yastrebov has been awarded Member of Order of Australia for significant service to intensive and critical care medicine. - В честь Дня Рождения Короля генерал-губернатор объявил о награждении более 700 австралийцев, включая Орден Австралии за выдающиеся заслуги. Среди них — профессор Константин Ястребов, специалист в области интенсивной терапии и реанимации.