Podcasts about Heart failure

Heart Failure and Hypertension.Welcome to the Hypertension Resistant to Treatment Podcast, the #1 Hypertension Podcast in the world, with listeners from more than 152 countries who depend on our content. We are your primary resource for obtaining straightforward, practical, evidence-based information about high blood pressure management, regardless of your situation as a patient, healthcare provider, or family member. High blood pressure isn't always simple. The condition known as resistant hypertension affects many people who have high blood pressure that does not respond to medication or lifestyle changes. The medical field identifies treatment-resistant hypertension as a demanding yet vital medical condition that doctors encounter in their practice. The Hypertension Resistant to Treatment Podcast, website, and YouTube channel highlight the most challenging cases because these individuals have attempted multiple solutions without achieving any resolution. This podcast is here for them, but also for anyone touched by high blood pressure. Whether you're just starting your journey with prehypertension, you're living with long-standing hypertension, or you're a provider searching for better strategies to help your patients.The right place exists for those seeking answers, motivation, and success tools. The podcast Hypertension Resistant to Treatment presents blood pressure information in an easy-to-understand format that helps people control their condition. The Hypertension Resistant to Treatment podcast is hosted by Dr. Tonya Breaux-Shropshire, PhD, DNP, MPH, FNP-BC. Send us Fan Mail Support the showSupport the podcast by subscribing using this link: click here. We appreciate your support, thank you! Log your blood pressure and share with your provider (click here). Copyright Disclaimer under section 107 of the Copyright Act 1976, allowance is made for “fair use” for purposes such as criticism, comment, news reporting, teaching, scholarship, education, and research.Royalty-free music: Turn on My Swag 2 Epidemic Sound****Disclaimer: This podcast is for educational purposes only and is not medical advice. Always consult your own healthcare provider about your health. The views shared are those of the host and guests, and do not represent any other organization.”

The Central Role of Cardiac MRI in the Management of Heart Failure and Cardiomyopathy Patients   Guest: Gosia Wamil, M.D., Ph.D. Host: Malcolm R. Bell, M.D.   Cardiac MRI is now central to heart failure care, moving beyond imaging to guide diagnosis and treatment. It distinguishes disease causes, identifies fibrosis and scar, and uncovers specific conditions in both HFrEF and HFpEF. By providing prognostic markers, it helps tailor therapies and improve outcomes—delivering the right treatment at the right time. In this episode of "Interviews With the Experts," Dr. Malcolm Bell interviews Dr. Gosia Wamil from Mayo Clinic London practice on the role of cardiac MRI in practice.   Topics Discussed: When does CMR change the management decision? CMR findings Which CMR biomarkers truly predict outcomes—and how should clinicians act on them? From echo-first to CMR-led pathways: what should every HF service implement now?   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.   Recorded on: 14-January-2026  

──────────────────────────────────────── [00:05:00] Hegseth Quotes Psalm 144 as God's Blessing for War — Knight: David Prayed Before Every Battle and Never Assumed God Was With Him David used the Urim and Thummim to ask God's will before war. Hegseth has no such instrument and no declaration of war from God or Congress. ──────────────────────────────────────── [00:15:00] Dispensationalism's Core Error: Treating the Shadow as Greater Than the Reality It Points To Knight: Hebrews was written to people returning to the shadow of Judaism rather than the substance in Christ — Hegseth and Huckabee are the Judaizers of Galatians, replacing Christ with a political state. ──────────────────────────────────────── [00:28:00] Nick Kupper: The COVID Shot Was Never Legally Approved — Pfizer Didn't Manufacture an Approved Version Until January 2022 DOD admitted in Kupper's lawsuit that nothing was fully approved until June 2022 — by which time the Air Force had already kicked people out for the unlawfully mandated product. ──────────────────────────────────────── [00:38:00] Kupper's Base Immunologist Admitted He Had More Antibodies Than the Vaccinated — His Religious Accommodation Was Denied Anyway Kupper had natural immunity; his immunologist confirmed he had more antibodies than someone with both shots. Every single religious accommodation filed was denied. ──────────────────────────────────────── [00:50:00] Kupper Was Given Separation Papers Three Weeks Before His 19-Year Mark — One Year Short of a Full Retirement A class-wide court injunction from attorney Aaron Siri covered Kupper the day after his separation papers arrived — but thousands of others had no such protection. ──────────────────────────────────────── [01:02:00] $6 Billion Was Already Appropriated to These Service Members — the Military Used It for Something Else When It Kicked Them Out Kupper: every dollar was authorized in the NDAA but never spent on the personnel allocated — it could be repaid to the 8,000 dismissed without any new appropriation. ──────────────────────────────────────── [01:12:00] A Technical Sergeant With Both Shots Died of Heart Failure in His Early 30s — the Air Force Stopped Updating Its COVID Death Tracker That Day The Air Force had listed 16 COVID deaths noting none were vaccinated — the day this man died with both shots on record, they stopped updating the tracker. ──────────────────────────────────────── [01:22:00] 'Duty to Disobey' Documentary Releases in AMC Theaters June 30 — dutytodisobeyfilm.com Children's Health Defense produced this with service members from multiple branches; Ron Johnson appears alongside those kicked out for refusing the unlawful emergency use mandate. ──────────────────────────────────────── [01:38:00] Dr. Michael Guillén: 95% of the Universe Is Invisible — Modern Cosmology Has Been in Crisis Since Hubble's Discovery in 1929 Dark matter and dark energy are completely unknown. The steady-state model was destroyed by Hubble's discovery that the universe is expanding — the crisis has deepened since. ──────────────────────────────────────── [01:55:00] Guillén: From Atheist to Christian Through Science — the Universe Had to Hit the Jackpot a Million Times at Every Level for Us to Exist The anthropic principle: from the quantum level to the cosmic web, everything was calibrated precisely for life — either infinite accidents or one designer. ──────────────────────────────────────── Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code “KNIGHT” For high quality made in America products go to HomeSteadProducts.shop and use promo code “Knight” for 10% off your purchases Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-show Or you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.

──────────────────────────────────────── [00:05:00] Hegseth Quotes Psalm 144 as God's Blessing for War — Knight: David Prayed Before Every Battle and Never Assumed God Was With Him David used the Urim and Thummim to ask God's will before war. Hegseth has no such instrument and no declaration of war from God or Congress. ──────────────────────────────────────── [00:15:00] Dispensationalism's Core Error: Treating the Shadow as Greater Than the Reality It Points To Knight: Hebrews was written to people returning to the shadow of Judaism rather than the substance in Christ — Hegseth and Huckabee are the Judaizers of Galatians, replacing Christ with a political state. ──────────────────────────────────────── [00:28:00] Nick Kupper: The COVID Shot Was Never Legally Approved — Pfizer Didn't Manufacture an Approved Version Until January 2022 DOD admitted in Kupper's lawsuit that nothing was fully approved until June 2022 — by which time the Air Force had already kicked people out for the unlawfully mandated product. ──────────────────────────────────────── [00:38:00] Kupper's Base Immunologist Admitted He Had More Antibodies Than the Vaccinated — His Religious Accommodation Was Denied Anyway Kupper had natural immunity; his immunologist confirmed he had more antibodies than someone with both shots. Every single religious accommodation filed was denied. ──────────────────────────────────────── [00:50:00] Kupper Was Given Separation Papers Three Weeks Before His 19-Year Mark — One Year Short of a Full Retirement A class-wide court injunction from attorney Aaron Siri covered Kupper the day after his separation papers arrived — but thousands of others had no such protection. ──────────────────────────────────────── [01:02:00] $6 Billion Was Already Appropriated to These Service Members — the Military Used It for Something Else When It Kicked Them Out Kupper: every dollar was authorized in the NDAA but never spent on the personnel allocated — it could be repaid to the 8,000 dismissed without any new appropriation. ──────────────────────────────────────── [01:12:00] A Technical Sergeant With Both Shots Died of Heart Failure in His Early 30s — the Air Force Stopped Updating Its COVID Death Tracker That Day The Air Force had listed 16 COVID deaths noting none were vaccinated — the day this man died with both shots on record, they stopped updating the tracker. ──────────────────────────────────────── [01:22:00] 'Duty to Disobey' Documentary Releases in AMC Theaters June 30 — dutytodisobeyfilm.com Children's Health Defense produced this with service members from multiple branches; Ron Johnson appears alongside those kicked out for refusing the unlawful emergency use mandate. ──────────────────────────────────────── [01:38:00] Dr. Michael Guillén: 95% of the Universe Is Invisible — Modern Cosmology Has Been in Crisis Since Hubble's Discovery in 1929 Dark matter and dark energy are completely unknown. The steady-state model was destroyed by Hubble's discovery that the universe is expanding — the crisis has deepened since. ──────────────────────────────────────── [01:55:00] Guillén: From Atheist to Christian Through Science — the Universe Had to Hit the Jackpot a Million Times at Every Level for Us to Exist The anthropic principle: from the quantum level to the cosmic web, everything was calibrated precisely for life — either infinite accidents or one designer. ──────────────────────────────────────── Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code “KNIGHT” For high quality made in America products go to HomeSteadProducts.shop and use promo code “Knight” for 10% off your purchases Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-show Or you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.

With Johann Bauersachs, Hannover Medical School, Hannover - Germany and Samira Soltani, Hannover Medical School, Hannover - Germany. Link to European Heart Journal paper Link to European Heart Journal editorial

In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Harriette Van Spall from Hamilton, Ontario, Canada. They discuss her team's comprehensive review paper all about the intersection of heart failure with the preserved ejection fraction and atrial fibrillation. In particular, they cover the diagnostic challenges in this patient group, established and emerging medications, and the potential for conduction system pacing as a treatment option. If you enjoy the show, please leave us a positive review wherever you get your podcasts. It helps us to reach more people - thanks!   Link to published paper: https://heart.bmj.com/content/early/2026/03/06/heartjnl-2025-326954

With Novi Yanti Sari, Siloam Hospitals Group, Jakarta - Indonesia, Sotiria Liori, National & Kapodistrian University of Athens Medical School, Athens - Greece, Sarah Birkhoelzer, University Dorset Hospital, Bournemouth - UK, Joseph Selvanayagam, Flinders University, Adelaide - Australia, Sam Straw, University of Leeds, Leeds - UK, Ida Arentz Taraldsen, Copenhagen University Hospital, Copenhagen - Denmark, Fabian Kerwagen,  University Hospital of Wurzburg, Wurzburg - Germany, Dirk Van Veldhuisen and Kevin Damman, University Medical Centre Groningen, Groningen - The Netherlands. In this episode, we discuss the late-breaking clinical science presented at the Heart Failure Congress 2026 in Barcelona, Spain. First, Sarah Birkhoelzer interviews Joseph Selvanayagam, who presents the results of RESOLVE-HCM, a trial evaluating perhexiline for regression of left ventricular hypertrophy in symptomatic hypertrophic cardiomyopathy. Next, Sam Straw interviews Ida Arentz Taraldsen, who highlights the key findings of REDOX-AHF, a trial comparing restrictive versus liberal oxygenation targets in patients with acute heart failure and pulmonary congestion. Finally, Fabian Kerwagen interviews Dirk Van Veldhuisen and Kevin Damman, who discuss the DECISION trial and the accompanying meta-analysis. DECISION evaluated low-dose digoxin in patients with heart failure with reduced or mildly reduced ejection fraction, while the meta-analysis assessed the efficacy and safety of digitalis glycosides across contemporary heart failure trials. This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

“The Fitness Industry Is Lying To You (Here's The Truth)”What if the biggest problem in modern fitness… isn't motivation? What if it's misinformation? In this powerful conversation on the Live From America Podcast, Coach Alex VanHouten joins Hatem for a deep dive into the psychology, biology, and spiritual side of health and fitness.Together, they unpack:Why the fitness industry keeps failing everyday peopleThe difference between looking fit vs. actually being healthyHow exercise changes your brain chemistry and mindsetWhy belief systems affect physical performanceThe science behind resilience, discipline, and “grit”How visualization improves athletic and mental performanceWhy community matters for transformationThe hidden connection between physical fitness and emotional healthWhat elite operators understand about mindset that most people don'tCoach Alex also shares his personal story of living with a painful genetic disorder and how it shaped his understanding of stewardship, suffering, and discipline.Meanwhile, Hatem shares the incredible story of surviving heart failure, living with an LVAD, undergoing a heart transplant, and rebuilding his life through fitness and mental resilience.This episode is not about six-week transformations.It's about becoming the kind of person who refuses to quit.⏱️ Timestamp Outline00:00 – Intro: Why Health & Resilience Matter01:15 – What Is Exercise Science?03:00 – The Fitness Industry's Biggest Lie05:00 – Why “Quick Fixes” Fail08:00 – Alex's Genetic Disorder & Pain Journey11:00 – Hatem's Heart Failure & Heart Transplant Story14:30 – Why Fitness Saved Hatem's Life15:30 – Bio-Individuality Explained18:30 – Looking Fit vs Actually Being Healthy21:45 – Where Everyday People Should Start24:00 – Why 1% Better Daily Works27:00 – How Health Impacts Relationships & Identity29:00 – Injury, Illness & Recovery Mindset31:00 – The “Lone Wolf Problem”34:00 – Agency: Life Happening TO You vs THROUGH You37:00 – Why Community Changes Everything40:00 – Exercise, Hope Molecules & Mental Health44:00 – Motivation vs Discipline48:00 – Visualization & Athletic Performance52:00 – Grit, Mental Toughness & The Will To Live58:00 – Everyday Spy & Operator Training1:00:00 – Faithful Fitness & Why Alex Wrote The Book1:05:00 – Final Encouragement + Closing

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Comparison of Microcirculation in Chronic Heart Failure, Cardiogenic Shock, LVAD, and Heart Transplantation.

In this episode, Jeffrey Farber, MD, President & CEO of The New Jewish Home, discusses the organization's accredited heart failure program within a skilled nursing facility setting. He shares how specialized cardiac rehabilitation, interdisciplinary care, and close partnerships with academic medical centers are helping medically complex older adults recover safely and regain quality of life after hospitalization.

Are you aware of the latest information on the management of cardiovascular-kidney-metabolic (CKM) syndrome? Hear our expert faculty discuss! Credit available for this activity expires: 5/19/27 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/addressing-intersection-between-heart-failure-and-kidney-2026a1000fj1?ecd=bdc_podcast_libsyn_mscpedu

In this episode of Better Edge, Palak Shah, MD, the new chief of the Section of Heart Failure and medical director of the Heart Transplant Program at Northwestern Medicine Bluhm Cardiovascular Institute, shares how his career has been shaped by the transformation of advanced heart failure care, from LVADs to transplantation. Dr. Shah discusses his clinical training and research, his systems-based vision for delivering advanced heart failure and surgical care closer to patients' communities, and his commitment to equitable access, innovation and multidisciplinary collaboration. The conversation offers referring physicians insight into how Bluhm Cardiovascular Institute is shaping the next era of personalized, longitudinal heart failure care across a regional health system.

Join Liz Cruz M.D. and Tina Nunziato, Certified Holistic Nutrition Consultant, as they discuss a study that was presented at a recent American Heart Association conference.  Learn about the potential connection between long-term melatonin use and heart failure.  Find out the right dosage for adults and children and what to look out for in melatonin supplements.  Discover other strategies, aside from the popular supplement for better sleep.  Watch us on YouTube:   https://youtu.be/cN8ahsaXC8oDr. Cruz is a Board Certified Gastroenterologist who practices in Phoenix, AZ. Along with her wife Tina Nunziato, a Certified Holistic Nutritionist, they have helped tens of thousands of individuals get well from a more holistic standpoint. They focus on issues such as constipation, diarrhea, acid reflux, heartburn, gas, bloating, food sensitivities, IBS, Crohn's disease, and diverticulitis in addition to a person's general overall health. They do this by teaching about real food, water, digestive enzymes, probiotics, detox, greens, electrolytes, food sensitivity testing, and so much more. If you're struggling with finding the answers to your issues, tired of not feeling well, and sick of taking over the counter and prescription medicines, schedule a FREE 30 minute phone consult at www.drlizcruz.com.

Discover how dual sodium-glucose cotransporter 1/2 (SGLT1/2) inhibition can improve outcomes for your patients across the heart failure (HF) spectrum. Credit available for this activity expires: 05/15/27 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/beyond-sglt2-emerging-role-dual-sglt1-2-inhibition-heart-2026a1000es7?ecd=bdc_podcast_libsyn_mscpedu

This episode covers: Cardiology This Week: A concise summary of recent studies Biomarkers in heart failure Digoxin in HFrEF Scientific Highlights from Heart Failure 2026 Host: Wilfried Mullens Guests: Lynne Stevenson, Dirk van Veldhuisen, Theresa McDonagh Want to watch that episode? Go to: https://esc365.escardio.org/event/2565 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. 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. A ny views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel, Dirk van Veldhuisen and Lynne Warner Stevenson 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, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede, Viatris. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report:Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.  Theresa McDonagh has declared to have potential conflicts of interest to report: honoraria from Boeringer Ingelheim. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. 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.

SEASON 4 EPISODE 84: COUNTDOWN WITH KEITH OLBERMANN A-Block (3:00) SPECIAL COMMENT: Back from a week off just in time to put the podcast on health hiatus...details within today's supersized edition. Plus, befitting the time off, some meta pictures on how Democrats should plan for what they want this country to look like on its 300th anniversary, if it lasts that long. Will we have jailed Trump and gotten back the money he took? Undone his damage? Eliminated the anachronistic idea that Wyoming should have as many senators as California? Let the Supreme Court continue to lie, cheat and steal the democracy from under us? As John Candy said in "Splash": Think big, be big, my friend. MORE IMMEDIATELY: Whaddya mean the Governor of Virginia hasn't been BRIEFED on the way to overturn her state's Supreme Court's usurpation of redistricting? Why the hell not Hakeem Jeffries? Anybody notice Trump is simply rotating the same three lies about Iran? Why are only independent journalists like Garrett Graff still covering the WHCD non-shooting when the New York Times is doing 31 paragraphs on the future of the dinner like anybody gave a crap? AND MOST IMPORTANTLY: stop saying Trump is painting everything GOLD. That color is not GOLD. It is the color of WEE WEE. Say it. Use the clinical terms, use the gutter terms. The gutter terms define this idiot president. Stop saying gold when you mean whizzzzzzzzzzzzzz. B-Block (56:00) ON THE PASSING OF TED TURNER: Hard to believe few of the obituaries mentioned how he also invented 7-day-a-week sports on national television. Or how Jane Fonda kept him from destroying himself in, like, 1982. One particularly harrowing saga had him telling the lowest ranking staffer at CNN's Washington Bureau which way, when he finally decided he'd do it, he'd do it. And this is said with admiration and affection for the man who created the place where I and so many of the figures of the last 45 years began our TV careers. C-Block (1:30:00) ALL TED ALL THE TIME: I was holding back until I was certain I wouldn't jinx him. My beloved first rescue dog, Ted, was up against it last fall. I took him to the University of Florida for life-saving open heart surgery and boy, did they! Eight hours on the table, eight hours of SICU, all for an eight pound dog and now - he's not even on any medications! It's a long story and I would insist it's worth hearing it. And if you have a dog (or know of one) moving from Mitral Valve Disease to Heart Failure, maybe this will provide you with hope - and an option.See omnystudio.com/listener for privacy information.

What if one of the most common escalation strategies for acute heart failure doesn't actually improve outcomes? Internal medicine physicians Benjamin P. Geisler, Jeffrey L. Greenwald, and Kathy May Tran, editors of 50 Studies Every Hospitalist Should Know, join the show to break down what the DOSE trial really tells us about managing diuretics on the wards. Based on their KevinMD article "Managing acute heart failure: evidence from the DOSE trial," they explain why continuous furosemide infusions showed no clinical advantage over intermittent boluses for decongestion, and what that means for your daily practice. You will hear how headline-driven medicine can mislead clinicians, why knowing who was excluded from a trial matters as much as the results, and how evidence-based medicine teaching is evolving in the age of AI. Whether you are a hospitalist, a trainee on the wards, or a primary care physician managing heart failure transitions, this episode will sharpen how you read and apply the studies that shape patient care. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

From surviving two strokes, heart failure, and a life-saving transplant to producing a powerful PBS documentary series, Jonathan Scott Bognar shares a raw and inspiring story of resilience, reinvention, and purpose. In this episode, Jonathan opens up about losing his ability to speak due to aphasia, rebuilding his career from the ground up, and how he transitioned from Hollywood film production into meaningful storytelling that educates and serves others. https://www.youtube.com/watch?v=Cg8iomv10Wk We dive into his upcoming documentary Alive But Not Well, which explores major diseases affecting people as they age through the lens of patients, caregivers, doctors, and advocates. Jonathan explains how his own health journey sparked the idea, and why caregiving is one of the most overlooked yet universal human experiences. He also breaks down his philosophy of “rigorous optimism” and “rugged flexibility,” showing how mindset, persistence, and adaptability are critical not just in business but in surviving life itself. If you've ever faced adversity, struggled with reinvention, or wondered how to turn pain into purpose, this conversation will challenge you to rethink your limits and remind you to “die with memories, not dreams.” Quotes: “Everything in life is about how you view what's happening to you—you have to choose a positive attitude, even when it's hard.”  “In order to succeed, you have to be rigid in your commitment but flexible in your approach—that's where real progress happens.”  “Rigorous optimism means you don't always feel positive—you fight to be positive anyway.” Contact Details: Jonathan Scott Bogner Official Website

In this episode of the Heart podcast, Digital Media Editor Professor James Rudd is joined by Dr Elinor Tan from the National University of Singapore. They discuss her team's systematic review and meta-analysis of guideline-directed medical therapies in older patients with heart failure and reduced ejection fraction. They wanted to understand whether this patient group still benefits from such therapies and the profile of adverse events. If you enjoy the show, please leave us a positive review wherever you get your podcasts. It helps us to reach more people - thanks!   Link to published paper: https://heart.bmj.com/content/early/2026/02/11/heartjnl-2025-326305  

In this episode, Pranav Loyalka, MD - Cardiologist, HCA Houston Heart Medical Center, Medical Director of Structural Heart Disease, Heart Failure, Heart Transplant and Mechanical Circulatory Support, HCA Gulf Coast Division, discusses major advancements like transcatheter valve replacement and the evolving role of AI in cardiac care. He also shares insights on training the next generation of cardiologists, balancing specialization, and addressing gaps in access to care.

With Liemena Harold Adrian, Syarifah Ambami Rato Ebu General Academic Hospital, Surabaya - Indonesia and Shelley Zieroth, St. Boniface Hospital, University of Manitoba, Winnipeg - Canada. In this episode,Liemena Harold Adrian and Shelley Zieroth discuss heart failure in post–myocardial infarction patients, covering how myocardial infarction leads to the development of heart failure despite advances in reperfusion and acute care. The conversation addresses the epidemiology and underlying pathophysiology, approaches to early prevention and screening, diagnostic tools, as well as key interventions in the acute and early post-MI phases that may alter heart failure trajectories. They outline management with guideline-directed medical therapy, review current studies on heart failure–modifying therapies (such as the DAPA-MI and EMPACT-MI trials), and address indications for advanced therapies in post-MI populations. The episode also highlights the importance of early diagnosis, prompt recognition, and key evidence gaps in the field. Recommended readings: Akhtar KH, Khan MS, Baron SJ, et al. The Spectrum of Post-Myocardial Infarction Care: From Acute Ischemia to Heart Failurehttps://doi.org/10.1016/j.pcad.2024.01.017. Prog Cardiovasc Dis. (2024); 82: 15-25. DOI: 10.1016/j.pcad.2024.01.017. Butler J, Hammonds K, Talha KM, et al. Incident Heart Failure and Recurrent Coronary Events Following Acute Myocardial Infarctionhttps://doi.org/10.1093/eurheartj/ehae885. Eur Heart J (2025); 46: 1540-50. DOI: 10.1093/eurheartj/ehae885. Butler J, Jones WS, Udell JA. Empagliflozin after Acute Myocardial Infarction. N Engl J Med (2024); 390: 1455-66. DOI: 10.1056/NEJMoa2314051. Fioretti F, Butler J, Udell JA, et al. Empagliflozin after myocardial infarction with or without diabetes and chronic kidney disease: Insights from EMPACT-MI. ESC Heart Failure (2025); 12: 3940-3952. DOI: 10.1002/ehf2.15393. Hernandez AF, Udell JA, Jones WS. Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights From the EMPACT-MI Trial. Circulation (2024); 149: 1627–1638. DOI: 10.1161/CIRCULATIONAHA.124.069217. Jenca D, Melenovsky V, Stehlik J, et al. Heart Failure after Myocardial Infarction: Incidence and Predictors. ESC Heart Failure (2021): 8: 222-237. DOI: 10.1002/ehf2.13144. Lala A, Beavers C, Blumer V, et al. The Continuum of Prevention and Heart Failure in Cardiovascular Medicine: A Joint Scientific Statement from the Heart Failure Society of America and The American Society for Preventive Cardiology. Journal of Cardiac Failure (2026); 32: 75-105. Petrie MC, Udell JA, Anker SD, et al. Empagliflozin in Acute Myocardial Infarction in Patients with and without Type 2 Diabetes: A Pre-specified Analysis of the EMPACT-MI Trial. Eur J of Heart Fail. (2025): 27: 577-588. DOI: 10.1002/ejhf.3548. Zieroth S, Rizi SS. Time Is of the Essence. JACC: Heart Failure (2023): 11(6): 713-714. DOI: 10.1016/j.jchf.2023.03.022 This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

Heart failure (HF) affects more than 64 million individuals worldwide, and 20% to 30% of patients with HF and systolic dysfunction have cardiac dyssynchrony due to conduction system disease. JAMA Review author Mihail Chelu, MD, PhD, of Baylor College of Medicine discusses cardiac resynchronization therapy with JAMA Associate Editor David Simel, MD, MHS. Related Content: Cardiac Resynchronization Therapy Leadless Ultrasound-Based Cardiac Resynchronization System in Heart Failure

The good news is heart failure in people with severe obesity may be reversible with common weight loss drugs. The bad news is both obesity, with BMIs of around 30, and severe obesity, with a BMI of 42 or greater, … Increasing rates of obesity and severe obesity may presage increased rates of heart failure, Elizabeth Tracey reports Read More »

There's a relationship between severe obesity and one type of heart failure, and it looks like it's mediated by adding more phosphate groups, a process known as phosphorylation, to proteins in heart muscle cells, specifically to units within the muscle … Can GLP-1 agonists help in heart failure and severe obesity? Elizabeth Tracey reports Read More »

Heart failure with preserved ejection fraction, so-called HFpEF, is happening more frequently, especially in those with severe obesity. David Kass, a cardiologist and researcher at Johns Hopkins, and colleagues, have looked closely at heart muscle cells from this group of … How is obesity related to a common form of heart failure? Elizabeth Tracey reports Read More »

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Remote Management of Patients With Heart Failure in Medically Underserved Areas.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Dietary Sodium Intake and Risk of Incident Heart Failure in the Southern Community Cohort Study.

Join Laura Peters, NP and Meg Fraser, NP for a discussion of the latest AAHFN scientific statement, developed jointly with the Heart Failure Society of America, on integrative health technologies in heart failure care. The hosts will discuss practical guidance on incorporating digital health tools into heart failure care—shifting from singular devices to coordinated, team-based, and actionable systems of care.

Neph 2 America 4/14/26 – Cultural commentary for the end of days with David Lee Corbo (The Raven / Top Lobsta).In this episode:• New Butler, PA footage appears to show Trump assassination attempt STAGED – photographers positioned, flag lowered into frame, Secret Service moving tables while Trump poses for the iconic photo. Nephilim Death Squad vindicated again.• RFK Jr. admits conspiracy theorists were right: COVID mRNA vaccines linked to turbo cancer, heart failure, extreme blood clotting… and “perhaps gayness.”• “We Wuz” black magic rant claims Black people are extraterrestrial 9-ether beings who were the original Egyptians, Hebrews, Moors, Chinese, Atlanteans, Native Americans, and Gods.• Gospel clowns take the church stage – pastor dresses his kids as full clowns after a missions bet.• Straight Bible study goes live at The Standard Coffee Shop with Matt Hepner cross-referencing scripture on building your foundation in Christ.• Dom Lucre hit with 91 community notes in one day.• Endless shrimping at Red Lobster & Olive Garden explained.• Messages from Mom: Lincoln Park / MK Ultra, new AI Ayatollah, Thor demon exorcism, and more.• Bohemian Grove VIP tickets drop 4/20 – only 50 super-limited tickets for the August event at the Standard Coffee Shop.  Support the show & get early/ad-free episodes + first dibs on Bohemian Grove tickets:https://patreon.com/NephilimDeathSquadMerch & 3D prints: https://toplobster.comSend fan mail / weird stuff: 1552 Bella Cruz Drive, Lady Lake, FL (The Standard Coffee Shop)Timestamps in full video. Drop your thoughts: Was the Trump shooting staged? Is “perhaps gayness” the wildest RFK moment yet?00:00 Intro & Patreon Reminder – Bohemian Grove VIP Tickets Drop 4/2003:45 Trump Assassination STAGED? New Butler PA Footage Analysis (Photographers Positioned, Flag Lowered)12:20 Nephilim Death Squad Vindicated – Secret Service Moves Tables While Trump Poses18:50 RFK Jr. Bombshell: COVID mRNA Vaccines Cause Turbo Cancer, Heart Failure & “Perhaps Gayness”26:10 “We Wuz Everything” Black Magic Rant – Extraterrestrial 9-Ether Beings Claim34:40 Dom Lucre Community Noted 91 Times – Endless Shrimping Explained42:15 Gospel Clowns Take Church Stage – Pastor Dresses Kids as Clowns for Missions Bet50:30 Straight Bible Study LIVE at Standard Coffee Shop with Matt Hepner58:45 Messages from Mom: Lincoln Park MK Ultra, Chester Bennington & Child Trafficking1:05:20 Messages from Mom: New AI Ayatollah & Thor Demon Exorcism1:12:10 Bohemian Grove Event Details – Only 50 VIP Tickets, August Hang at Standard Coffee Shop1:20:30 Hebrew National Tank Top Giveaway + Fan Mail1:25:00 Wrap-Up & Final ThoughtsBecome a supporter of this podcast: https://www.spreaker.com/podcast/nephilim-death-squad--6389018/support.☠️ Nephilim Death Squad — New episodes 5x/week.Join our Patreon for early access, bonus shows & the private Telegram hive.Subscribe on YouTube & Rumble, follow @NephilimDSquad on X/Instagram, grab merch at toplobsta.com. Questions/bookings: chroniclesnds@gmail.com — Stay dangerous.

If you're managing patients with heart failure, you already know the medication landscape has evolved quickly over the past decade. From traditional volume management with furosemide to newer, guideline-driven therapies like sacubitril/valsartan and empagliflozin, staying up to date is essential—but not always easy. In this episode, we break down three cornerstone medication classes you'll encounter every day in practice: loop diuretics, ARNI therapy, and SGLT2 inhibitors. We start with the fundamentals of loop diuretics—how they work, when to use them, and key monitoring parameters—before shifting into the mortality-reducing benefits of ARNI therapy. Finally, we explore the rapidly expanding role of SGLT2 inhibitors, which have transformed both heart failure and chronic kidney disease management. Whether you're a pharmacist, nurse, or student, this episode focuses on practical, real-world application. We highlight clinical pearls, common pitfalls, and monitoring strategies to help you feel more confident when optimizing therapy. Tune in to sharpen your understanding of these essential therapies and walk away with actionable insights you can use right away in patient care. Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE! Support The Podcast and Check Out These Amazing Resources! NAPLEX Study Materials BCPS Study Materials BCACP Study Materials BCGP Study Materials BCMTMS Study Materials Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated) Guide to Drug Food Interactions (Amazon Best Seller) Pharmacy Technician Study Guide by Meded101

This episode covers: Cardiology This Week: A concise summary of recent studies Time for physiological pacing in heart failure? Same-day discharge after EP procedures: from evidence to practice EHRA 2026 Scientific Highlights Host: Gerd Hindricks Guests: Haran Burri, Emma Svennberg, Julia Vogler Want to watch that episode? Go to: https://esc365.escardio.org/event/2555    Disclaimer ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. 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. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video.  The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.   Declarations of interests Stephan Achenbach, Yasmina Bououdina 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. Haran Burri has declared to have potential conflicts of interest to report: institutional research and fellowship support or speaker honoraria from Abbott, Biotronik, Boston Scientific, Medtronic, Microport. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honorary from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Gerd Hindricks has declared to have potential conflicts of interest to report: institutional research and fellowship support or speaker honoraria from Abbott, Biotronik, Boston Scientific, Medtronic, Microport. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Helmut Puererfellner has declared to have potential conflicts of interest to report: speaker fees, honoraria, consultancy, advisory board fees, investigator, committee member, etc., including travel funding related to these activities for the following companies: Abbott, Biotronik, Biosense Webster, Boston Scientific, Daiichi Sankyo, Medtronic. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson. Julia Vogler has declared to have potential conflicts of interest to report: honoraria for talks: Abbott.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors transformed HF care. Meet SGLT1, a transporter that may unlock even greater CV protection. Credit available for this activity expires: 4/10/27 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/science-sglt1-and-sglt2-unpacking-dual-inhibition-heart-2026a1000axj?ecd=bdc_podcast_libsyn_mscpedu

A fascinating step forward in Nature—where immunology meets cardiology.

Dr. Jenna Skowronski, Dr. Shazli Khan, and Dr. Alix Barnes discuss the involvement of palliative care throughout the heart failure spectrum with Dr. Sarah Chuzi. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. In this episode, we discuss utilizing palliative care principles while caring for patients with heart failure, particularly those being considered for advanced therapies. We emphasize utilization of communication frameworks when discussing prognosis and making decisions on pursuing therapies such as palliative inotropes, left ventricular assist devices (LVADs), and heart transplant. Additionally, we discuss when to involve specialty palliative care services. Finally, we highlight the difference between palliative care and hospice and how to help patients navigate the transition from life-prolonging care to hospice. Dr. Jenna Skowronski is the Chair for the CardioNerds Heart Failure Council. Dr. Jenna Skowronski and Dr. Shazli Khan are the Co-chairs for the CardioNerds Advanced Heart Failure Therapies Series. Dr. Alix Barnes is the CardioNerds FIT Ambassador at UPMC and member of the CardioNerds Critical Care Cardiology Council. Enjoy this Circulation Paths to Discovery article to learn more about the CardioNerds mission and journey. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscripts here. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Primary palliative care is care provided by a clinician that is not a palliative care specialist, such as a heart failure clinician having a conversation with a patient about their goals and values in clinic.  Taking time to get to know a patient as an individual and learning their goals and values prior to diving into conversations about prognosis and change in treatment plan facilitates more effective goals of care discussions.   Utilizing and practicing a communication framework can improve our skills at goals of care discussions.   Palliative inotropes should be reserved for patients experiencing symptomatic benefit from the therapy that outweighs the associated risks including arrhythmias and infections. The burden of managing these therapies at home should also be considered. Partnerships between cardiologists and hospice agencies can improve the experience for patients with heart failure who enroll in hospice. Cardiologists can continue to see their patients even after hospice enrollment and help with symptom management.   Notes Notes: Notes drafted by Dr. Barnes. 1. What is the difference between primary palliative care and specialty palliative care? Primary palliative care is the delivery of palliative care services that any clinician can deliver. This includes aligning treatment with a patient's goals and basic symptom management. For heart failure patients, symptom management can include cardiac symptoms such as dyspnea and chest pain as well as managing comorbid mood disorders such as adjustment disorder, depression, and anxiety. Advanced palliative care skills take additional training and time to develop. These include leading a difficult family meeting, managing symptoms that are not controlled with standard therapies and responding to emotional and spiritual distress. When these situations are encountered, referral to a specialty palliative care service should be considered. 1 2. How is palliative care integrated throughout the disease trajectory of a patient with heart failure? Heart failure clinicians deliver primary palliative care when assessing a patient's preferences, goals and values or managing symptoms. As a patient's disease progresses, the heart failure team also engages in primary palliative care when delivering news about prognosis. When advanced therapies are being considered, utilization of shared decision-making (SDM) should be employed (see question 3 for further discussion on SDM). For patients being considered for LVAD, the Centers for Medicare and Medicaid Services (CMS) mandates that patients are seen by a palliative care specialist prior to implantation. 2 Despite this, there remains variability in how institutions involve specialty palliative care in this decision-making process. Thoughtful consideration of what palliative care resources are available at your institution should guide how best to integrate specialty palliative care teams into the LVAD decision tree. One example of a model for meeting this mandate is having a small team of heart failure clinicians with additional palliative care training meet all patient's being evaluate for LVAD. 3. What is shared decision-making (SDM) and how is it utilized when evaluating a patient for advanced therapies? SDM is a collaborative process where patients and clinicians work together to make medical decisions that are aligned with a patient's goals and values.3 There are a variety of communication frameworks that can be used to engage in effective SDM. One framework is the Serious Illness Conversation guide. This is an evidenced based framework that can be used to deliver the news about a patient's current condition and then assess their goals, values and preferences for next steps in their treatment plan.4  This framework can be helpful when discussing prognosis prior to introducing the idea of an evaluation for advanced therapies. REMAP is a second commonly used framework which stands for Reframe, Expect Emotion, Map What's Important, Align, and Plan.5 This framework is similarly helpful when starting a discussion about advanced therapies with a patient. Both frameworks prioritize learning about a patient's goals, values, and preferences prior to making a recommendation for a treatment plan. Listening more than speaking and accepting that a patient and their family may choose a path that is different than what you personally might choose for yourself or your loved ones are vital pillars to engaging in these conversations effectively. When discussing LVAD, it is important to avoid framing the decision as “LVAD or no LVAD,” rather LVAD versus best supportive care. The “Best Case, Worst Case” framework is an effective way to create choice awareness for patients when they are faced with making this decision. This is a way to discuss both the best outcomes after LVAD implantation as well as the potential complications so a patient is better able to understand the full spectrum of possible outcomes. 6 4. How do you select which patients would benefit from home inotrope therapy? There is no data demonstrating a survival benefit with use of palliative inotropes. There may be subsets of patients who derive a survival benefit, such as patients whose renal function worsens when the agent is withdrawn, however there is no concrete data proving this. 7 Therefore, the benefit of home inotrope therapy should be based on if the patient derives symptomatic benefit from these agents. Additionally, risks of the therapy such as arrhythmias and infection as well as the burden of managing these therapies at home should also be weighed in the decision.8 Life expectancy for patients being initiated on palliative inotropes likely ranges from 6 to 9 months. Given this prognosis, concordant palliative care efforts should be intensified when starting patients on these agents. This can either be through involvement in specialty palliative care or increasing primary palliative care interventions. 9 5. How do you determine if a patient would be a candidate for hospice and how do you discuss hospice with patients and their families? Hospice is a comprehensive program that provides supportive care to patients at end of life. This includes a team of physicians, nurses, aids, social workers and chaplains that can deliver care in the home, at a nursing facility, or in an inpatient hospice facility. 10 Patients with a prognosis of 6 months or less can qualify for hospice services. Even if a patient qualifies for hospice based on their prognosis, it is important to assess if a patient's goals and values align with hospice. Introducing hospice to patients who still desire life prolonging care can cause mistrust between the patient and their health care team. When introducing hospice, it is helpful to describe the services hospice offers in addition to naming the service as some patients may have a negative connotation with the word “hospice.” 6. How can cardiologists partner with hospice agencies to provide better care for these patients? Heart failure specialists can continue to see their patients even after they enroll in hospice. Partnering in hospice agencies in this way can help improve symptom management for patients while also allowing them to continue meaningful relationships with providers with whom they've developed a longitudinal relationship with. Guideline directed medical therapy (GDMT) and diuretics can be continued while enrolled in hospice as long as they are offering symptomatic benefit. Heart failure specialists can help with adjusting GDMT to cheaper formulations, such as exchanging angiotensin receptor-neprilysin inhibitors (ANRIs) for angiotensin receptor blockers (ARBs). Many hospice agencies cannot accept patients receiving palliative inotropes due to the resources and training required to safely care for these patients. Understanding what hospice agencies in your area can and cannot support allows heart failure specialists to have informed discussions with patients and make appropriate referrals. References Quill TE, Abernethy AP. Generalist plus Specialist Palliative Care — Creating a More Sustainable Model. N Engl J Med. 2013;368(13):1173-1175. doi:10.1056/NEJMp1215620. https://www.nejm.org/doi/full/10.1056/NEJMp1215620 Ventricular Assist Devices for Bridge-to-Transplant and Destination Therapy. Published online August 1, 2013. https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&NCAId=268 Godfrey S, Barnes A, Gao J, Katz JN, Chuzi S. Shared Decision-making in Palliative and End‑of‑life Care in the Cardiac Intensive Care Unit. US Cardiol Rev. 2024;18:e13. doi:10.15420/usc.2024.03. https://pubmed.ncbi.nlm.nih.gov/39494405/ Baxter R, Pusa S, Andersson S, Fromme EK, Paladino J, Sandgren A. Core elements of serious illness conversations: an integrative systematic review. BMJ Support Palliat Care. 2024;14(e3):e2268-e2279. doi:10.1136/spcare-2023-004163. https://pmc.ncbi.nlm.nih.gov/articles/PMC11671901/ Childers JW, Back AL, Tulsky JA, Arnold RM. REMAP: A Framework for Goals of Care Conversations. J Oncol Pract. 2017;13(10):e844-e850. doi:10.1200/JOP.2016.018796. https://ascopubs.org/doi/10.1200/JOP.2016.018796 Kruser JM, Nabozny MJ, Steffens NM, et al. “Best Case/Worst Case”: Qualitative Evaluation of a Novel Communication Tool for Difficult in-the-Moment Surgical Decisions. J Am Geriatr Soc. 2015;63(9):1805-1811. doi:10.1111/jgs.13615. https://pmc.ncbi.nlm.nih.gov/articles/PMC4747100/ Tolia S, Khan M, Khan S, et al. Mortality and long-term outcomes of palliative inotropes in ischemic and non-ischemic cardiomyopathy. Eur Heart J.  2021;42(Supplement_1):ehab724.0915. doi:10.1093/eurheartj/ehab724.0915. https://academic.oup.com/eurheartj/article/42/Supplement_1/ehab724.0915/6392681 Chuzi S, Allen LA, Dunlay SM, Warraich HJ. Palliative Inotrope Therapy: A Narrative Review. JAMA Cardiol. 2019;4(8):815. doi:10.1001/jamacardio.2019.2081. https://jamanetwork.com/journals/jamacardiology/article-abstract/2737414#google_vignette Chuzi S, Gao J, Thariath J, et al. Characteristics and Outcomes of Palliative Continuous Intravenous Inotrope Support Among Medicare Beneficiaries With Heart Failure. J Am Heart Assoc. 2025;14(14):e039397. doi:10.1161/JAHA.124.039397. https://www.ahajournals.org/doi/10.1161/JAHA.124.039397 What is hospice? Published online September 24, 2024. https://hospicefoundation.org/what-is-hospice/

A heart transplant at 44 could have ended Mark Durante's story, but it became the start of something far bigger. I had the chance to sit down with Mark, who went from facing end-of-life decisions to building a company focused on regenerative medicine and helping others heal in new ways. His journey through heart failure, recovery, and innovation shows what can happen when you stay curious and take action even in the hardest moments. You will hear how Mark rebuilt his life after transplant, why he believes the body can heal itself with the right support, and how regenerative medicine is changing the future of healthcare. We also explore entrepreneurship, discipline, and why being your own advocate matters more than ever. I believe you will find this conversation both inspiring and practical as you think about your own health, mindset, and what it means to truly live unstoppable. Highlights: 00:10 Discover how a life-threatening diagnosis sparked a whole new path 13:19 Learn why waiting too long can hold you back from real growth 27:47 Hear how a routine check uncovered something far more serious 30:00 Experience what it's like to face a life-or-death decision 40:59 Find out what finally helped him reclaim his life and function 1:03:48 Understand why taking action is the difference maker in success Bottom of Form About the Guest: Mark Durante is the founder and CEO of Rize Up Medical, a company dedicated to empowering medical practitioners to incorporate cutting-edge regenerative therapies into their practices, enhancing patient care and transforming lives. Mark helps practitioners identify and integrate innovative biologic products into their practices, focusing on delivering exceptional patient outcomes while maximizing profitability. Mark's journey began when he experienced a debilitating health crisis, culminating in a life-saving heart transplant. While grateful for a second chance, he found himself battling relentless pain caused by severe neuropathy. The turning point came when he discovered the transformative power of regenerative medicine, experiencing firsthand its ability to alleviate pain and restore functionality. Through his journey, Mark developed a unique approach to help medical practitioners integrate these cutting-edge therapies into their practices through the RIZE Method, a framework that focuses on recognizing potential, innovating solutions, zeroing in on implementation, and educating for sustainable success. Ways to connect with Mark: https://www.rizeupmedical.com/https://www.instagram.com/rizeupmedical/ https://www.linkedin.com/in/mark-durante/ mark@rizeupmedical.com About the Host: Michael Hingson is a New York Times best-selling author, international lecturer, and Chief Vision Officer for accessiBe. Michael, blind since birth, survived the 9/11 attacks with the help of his guide dog Roselle. This story is the subject of his best-selling book, Thunder Dog. Michael gives over 100 presentations around the world each year speaking to influential groups such as Exxon Mobile, AT&T, Federal Express, Scripps College, Rutgers University, Children's Hospital, and the American Red Cross just to name a few. He is Ambassador for the National Braille Literacy Campaign for the National Federation of the Blind and also serves as Ambassador for the American Humane Association's 2012 Hero Dog Awards. https://michaelhingson.com https://www.facebook.com/michael.hingson.author.speaker/ https://twitter.com/mhingson https://www.youtube.com/user/mhingson https://www.linkedin.com/in/michaelhingson/ accessiBe Links https://accessibe.com/ https://www.youtube.com/c/accessiBe https://www.linkedin.com/company/accessibe/mycompany/ https://www.facebook.com/accessibe/ Thanks for listening! Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below! Subscribe to the podcast If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can subscribe in your favorite podcast app. You can also support our podcast through our tip jar https://tips.pinecast.com/jar/unstoppable-mindset . Leave us an Apple Podcasts review Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts. Transcription Notes:

Beyond Sports is the ESPN public affairs show. Airing Sunday mornings, from 5-6am, Beyond Sports presents topical guests and stories in an entertaining and comfortable format. Each week your host, Hannah Stanley, brings a new show covering a current issue, news item, upcoming event, or local charity. About Hannah Hannah Stanley is the Public Affairs Manager for ESPN AM 1000. She is co-chair of the Chicago Chapter of the Disney VoluntEars, and involved with TEAM ESPN. She resides in the western suburbs with her husband and children. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠ ⁠⁠⁠Dr. Raj on Instagram⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

We discuss the diagnosis and treatment of one of EM's paradoxes: High-Output Heart Failure. Hosts: Nicolas Gonzalez, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/HOHF.mp3 Download Leave a Comment Tags: Cardiology Show Notes Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below.  Course Highlights: Credit: 12.5 AMA PRA Category 1 Credits™ Curriculum: Comprehensive coverage of Core Emergency Medicine,  with 12 modules spanning from Critical Care to Pediatrics. Cost: Free for NYU Learners $250 for Non-NYU Learners Click Here to Register and Begin Module 1 1. Core Definition & Hemodynamic Profile Clinical Paradox: Congestive symptoms (pulmonary edema, JVD, peripheral edema) in the setting of a hyperdynamic, supranormal cardiac function. Hemodynamic Criteria: Cardiac Index (CI): >4.0 L/min/m2. Cardiac Output (CO): >8 L/min. Systemic Vascular Resistance (SVR): Pathologically low (vasodilated or shunted state). The “Warm” Phenotype: Unlike standard HFrEF/HFpEF (often “Cold and Wet”), HOHF presents as “Warm and Wet” due to low SVR and bounding pulses. 2. Pathophysiology: The Hemodynamic Paradox Primary Insult: Decreased SVR (either via peripheral vasodilation or arteriovenous shunting). Effective Arterial Blood Volume: Paradoxically low despite high total CO. Neurohormonal Cascade: Activation of Renin-Angiotensin-Aldosterone System (RAAS). Increased Sympathetic Nervous System tone. Increased Antidiuretic Hormone (ADH) secretion. Resultant State: Avid renal salt and water retention leading to massive plasma volume expansion. Cardiac Response: Chronic volume overload → eccentric remodeling → chamber dilation → eventual secondary myocardial failure/dilated cardiomyopathy. 3. Differential Diagnosis: Etiological “Buckets” Category A: Increased Metabolic Demand (Systemic) Hyperthyroidism/Thyrotoxicosis: Direct T3 effects: increased chronotropy/inotropy. Indirect effects: metabolic byproduct accumulation causing peripheral vasodilation. Myeloproliferative Disorders: High cell turnover and increased oxygen consumption drive compensatory CO increase. Sepsis (Hyperdynamic Phase): Cytokine-mediated global vasodilation. Note: Often transient; may transition to sepsis-induced myocardial depression. Category B: Peripheral Vascular Effects (Shunting/Vasodilation) Arteriovenous Fistulas (AVF) / Malformations (AVM): Most Common Cause: Iatrogenic AVF for Hemodialysis (ESRD population). Bypasses high-resistance capillary beds, dumping arterial blood directly into venous circulation. Chronic Liver Disease (Cirrhosis): Formation of “spider angiomata” and internal AV shunts. Impaired clearance of endogenous vasodilators (e.g., Nitric Oxide). Thiamine Deficiency (Wet Beriberi): Accumulation of pyruvate/lactate → systemic vasodilation. Histopathology: Vacuolation, myofiber hypertrophy, and interstitial edema. Chronic Lung Disease: Hypoxia/Hypercapnia-driven systemic vasodilation. Concomitant pulmonary HTN (RV remodeling) but preserved/high LV output. Others: Paget's disease of bone (extensive micro-shunting), Carcinoid syndrome, Mitochondrial diseases, Acromegaly, Erythroderma. 4. Special Focus: Hemodialysis Access-Induced HOHF Physiologic Phases of AVF Creation: Acute Phase: Immediate ↓ SVR. ↑ Stroke volume and Heart Rate (SNS-mediated). Endothelial shear stress → Nitric Oxide release → further arterial dilation. Subacute Phase (Days to 2 Weeks): RAAS-driven volume expansion. ↑ Right Atrial, Pulmonary Artery, and LV End-Diastolic Pressures (LVEDP). Natriuretic peptide surge (BNP/ANP) peaks around Day 10. Chronic Phase (Weeks to Months): Adaptive hypertrophy. Decompensation occurs when dilation exceeds contractility limits. 5. Point-of-Care Physical Exam & Maneuvers Nicoladoni-Branham Sign (Pathognomonic for Shunt-driven HOHF): Maneuver: Manually compress the AVF (or inflate cuff to >50 mmHg above SBP) for 30 seconds. Positive Result: Reflexive bradycardia or a transient rise in systemic BP. Significance: Confirms the shunt is a major contributor to the cardiac workload. Peripheral Pulse Assessment: Water Hammer Pulses: Rapid upstroke and collapse. Quincke's Pulse: Visible capillary pulsations in the nail beds. Traube's Sign: “Pistol-shot” sounds auscultated over the femoral arteries. Volume Status: Rales, S3 gallop, peripheral edema (standard HF signs). 6. Diagnostic Workup (Technical Targets) POCUS / Echocardiography: Left Ventricle: Hyperdynamic function; EF typically >60%. Left Atrium: Significant dilation (Left Atrial Volume Index >34 mL/m2; Case study noted 72 mL/m2). IVC: Plethoric with minimal respiratory variation. Doppler: High flow velocities across the AV access if applicable. Laboratory Evaluation: BNP/NT-proBNP: Often markedly elevated (e.g., >70,000 in severe cases), though mean values in literature hover around 700–800 pg/mL. Hematology: CBC to evaluate for severe anemia (trigger for HOHF if Hgb7–8 g/dL to reduce demand. Beriberi: High-dose IV Thiamine (100–500 mg). Thyrotoxicosis: Beta-blockers (Propranolol) + Antithyroid meds (PTU/Methimazole). Phase 3: Surgical/Interventional Salvage (Refractory AVF Cases) Closure of Accessory Sites: If multiple fistulas exist, close the non-dominant/unused sites. Flow Reduction (Banding): Surgical narrowing of the fistula to target flow

CardioNerds (Dr. Hamza Patel, Dr. Jenna Skowronski, and Dr. Apoorva Gangavelli) discuss advanced heart failure and LVAD management with Dr. Mark Belkin, Advanced Heart Failure & Transplant Cardiologist, and Dr. Chris Salerno, Cardiothoracic Surgeon. They explore the nuances of right ventricular (RV) physiology, perioperative hemodynamic optimization, long-term complications, sensitization and transplant considerations, and the evolving role of GDMT in LVAD patients.  This episode highlights the delicate interplay between surgical and medical management in achieving optimal outcomes for patients living with durable mechanical circulatory support.Audio editing by CardioNerds Academy intern, student doctor, Pace Wetstein. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls “The right ventricle sets the stage.” — LVAD success hinges on RV performance; a struggling RV can turn a perfect LVAD surgery into a perfect storm.  “Watch the ratios.” — A PAPi < 2 and RA:PCWP >0.6 signal high risk for RV failure post-implant; trends and response to optimization matter more than static numbers.  “From hemocompatibility to hemodynamics.” — The LVAD field has moved from fighting pump thrombosis to mastering long-term RV failure and aortic insufficiency.  “Not all antibodies are created equal.” — LVAD-related sensitization often resolves post-transplant, reminding clinicians to interpret PRA trends in context.  “Recovery is possible.” — The RESTAGE-HF trial and emerging SGLT2 data hint at a new era: not just sustaining life with LVADs but restoring native heart function.  Notes Notes drafted by Dr. Hamza Patel. 1. Hemodynamic & Vasoactive Management of the RV  Use norepinephrine and vasopressin for pressor support; consider dobutamine as inotrope of choice.  Consider avoiding early milrinone due to hypotension and reduced coronary perfusion.  Use inhaled NO or epoprostenol selectively; institutional variation depends on cost and supply.  Key hemodynamic markers:  PAPi = (PA systolic – PA diastolic) / RA pressure.  PAPi < 2 → increased RV failure risk.  RA:PCWP ratio ≈ 0.6 normal; ≈ 1 → severe RV dysfunction.  RV reserve—the ability to improve these indices with optimization—is a stronger predictor of outcomes than baseline numbers alone.  NOTE: there is no robust data to guide vasoactive medical decision-making and there is substantial institutional variability in practive.  2. Long-Term LVAD Complications  MOMENTUM 3 trial: HeartMate 3 reduced pump thrombosis (10 → 1 %), stroke (14 → 5%), and GI bleed (77 → 43 %).  Persistent issues: driveline infections, RV failure, and aortic insufficiency.  Driveline care: silver sulfadiazine (Silvadene) cream linked to lower infection rates (Cowher & Kenmore 2025).  Field now focuses on hemodynamic-related adverse events—the next frontier in LVAD outcomes.  Innovation ahead: smaller drivelines and fully implantable LVADs to eliminate infection risk.  3. Sensitization and Transplant Candidacy  LVADs may induce de novo HLA antibodies, complicating transplant matching.  These antibodies tend to be transient and less cytotoxic, often resolving post-transplant.  Sensitization degree varies by device and patient; management strategies are center-dependent.  The field is redefining which antibodies are truly LVAD-induced versus incidental.  4. GDMT & Myocardial Recovery  GDMT data in LVAD patients limited—excluded from major HFrEF trials.  RESTAGE-HF: aggressive GDMT post-LVAD yielded 52% explant rate within 18 months.  SGLT2 inhibitors: emerging evidence of reverse remodeling and reduced LV size (Belkin et al., THT 2025).  GDMT promotes recovery but requires cautious titration to avoid hypotension and RV strain.  5. Future of LVAD Therapy  The fully implantable LVAD remains the goal—wireless energy, no driveline, and fewer infections.  Short-term focus: device miniaturization, improved energy efficiency, and better hemocompatibility.  HeartMate 3 remains gold standard until next-generation systems mature.  References Mehra MR et al. NEJM 2018 — MOMENTUM 3 Final Report.  Takeda K et al. JHLT 2020 — Predictors of RV Failure After LVAD.  Imamura T et al. Circ Heart Fail 2017 — Hemodynamics and RV Adaptation Post-LVAD.  RESTAGE-HF Trial, JHLT 2019.  Cowher J, Kenmore C et al. 2025 — Driveline Care & Infection Outcomes.  Belkin M et al. THT 2025 — SGLT2 Inhibition and Reverse Remodeling Post-LVAD. 

Samantha Mitchell shares her story of postpartum heart failure, open-heart surgery, heartbreak, faith, and learning how to keep living when everything changed.In this episode of Between Me and You, Samantha opens up about being diagnosed with postpartum cardiomyopathy after giving birth and what it has been like to live for years with severe heart failure. She shares the reality of raising children while fighting for her life, facing the possibility of transplant, and adjusting to a completely different version of everyday life than the one she expected.She also talks honestly about the emotional side of this journey. From panic attacks and depression to abandonment and heartbreak, Samantha shares what it felt like when the people around her could not carry the weight of what she was facing. She speaks candidly about the pain of someone she loved leaving when her sickness became real, how that affected the way she saw herself, and what it has taken to begin healing physically and emotionally at the same time.But this conversation is also full of faith. Samantha shares how God sustained her through surgery, what it looked like to trust Him when the miracle did not come in the way she expected, and how prayer, fasting, and dependence on God became her safe place. She also opens up about angelic encounters, spiritual sensitivity, and the ways her children have witnessed God's hand in their family's story.This episode is for anyone who has ever struggled to reconcile what God promised with what life looks like right now. It is for the person trying to hold on while their body is tired, their heart is heavy, and their faith is being tested in real time. Samantha's story is a reminder that even when healing does not look the way you imagined, God can still be present, faithful, and deeply involved in every step.

In this episode, Dr. Carolyn Lam and Dr. Harlan Krumholz break down key studies from this week's JACC issue, including new evidence on Chagas‑related heart failure, updated diastolic function guidelines, and the connection between cardiomyopathy gene variants and atrial fibrillation. They also discuss findings on racial and ethnic disparities in England's universal health system and reflect on how emerging AI tools could transform cardiovascular care. A concise, insightful look at major advances shaping modern cardiology and global heart‑health practice.

In this episode, Fr. John and Mary continue their series on Jesus' words to the 7 Churches in the Book of Revelation. Today, they look at Jesus' devastating words to the Church in Sardis, reminding us all that He knows us through and through. Connect with us and our community on our websites and social media. Or simply reach us via email at [mission@actsxxix.org](mailto: mission@actsxxix.org) ACTS XXIX - Mobilizing for Mission Web: https://www.actsxxix.org Instagram: @acts.xxix Facebook: @ACTSXXIXmission The Rescue Project Web: https://rescueproject.us Instagram: @the.rescue.project Our Streaming Channels Web: https://watch.actsxxix.org/browse YouTube: @actsxxix (https://youtube.com/actsxxix)

What does it take to go from standing at the edge of a highway at 2 a.m.—ready to end your life… to receiving a miracle heart transplant and living with radical faith?In this powerful episode, we sit down with our dear friend Phillip Gornail to unpack a story that honestly left us in awe of God's grace.Phil opens up about the night he drove the wrong way onto a highway after losing his marriage, his identity, and what he believed was his purpose. Divorce. Financial collapse. Shame. The kind of dark night of the soul that many people silently walk through. And then—God intervened.But that wasn't the end of the story.Years later came cancer. Kidney failure. Chemotherapy. Heart failure. And eventually, a heart transplantAnd yet through every diagnosis, every loss, every moment where fear could have taken over, Phil chose something different: surrender. Trust. Faith in God's authority over his life.This conversation isn't just about survival. It's about transformation.Chapters00:00 Podcast Preview01:33 Topic and Guest Introduction04:46 Meet Phillip Gornail: A “Recovering Know-It-All”07:04 Landmark Forum & The Blind Spots We Can't See09:38 Reflections on Early Life and Family Dynamics13:55 The Mask of Arrogance & Feeling “Not Enough”15:38 Faith Lessons from the Roman Centurion18:35 Marriage, Trauma, and Learned Behaviors24:04 Divorce, Financial Collapse & Identity Loss28:24 The Night God Intervened on the Highway30:44 Men's Ministry and Spiritual Recovery31:50 Reconcile Your Past, Navigate Your Present33:08 Coping Mechanisms & Emotional Awareness35:27 Cancer Diagnosis & Refusing Chemo38:39 Kidney Failure & Radical Forgiveness39:44 Heart Failure at 15% & Transplant Stats42:30 Why He Asked People Not to Pray for Him44:50 Meeting His Donor's Family46:08 Trusting God's Bigger Story48:42 Men's Ministry & Living With a New Heart49:58 Give Away AnnouncementResources mentioned:

Host: Darryl S. Chutka, M.D.  Guests: Jae K. Oh, M.D., Tahir S. Kafil, M.D.  Diastolic heart failure is also known as heart failure with preserved ejection fraction. Although we don't hear the term all that often, it actually represents a fairly large percentage of all cases of heart failure. Some studies suggest it represents the majority of heart failure cases. Older adults are most commonly affected with symptoms similar to those of systolic heart failure. So how do we suspect diastolic heart failure? How should the diagnosis be established, and how does the treatment differ from systolic heart failure? Finally, what role do primary care providers play in the management of the condition? These are some of the questions I'll be asking my guests, Dr. Jae Oh and Dr. Tahir Kafil, both cardiologists in the Department of Cardiovascular Disease at the Mayo Clinic as we discuss “Diastolic Heart Failure”.   Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

CardioNerds (Dr. Jenna Skowronski [Heart Failure Council Chair], Dr. Shazli Khan, and Dr. Josh Longinow) are joined by renowned leaders in the field of AHFTC (Advanced Heart Failure and Transplant Cardiology) and mechanical circulatory support, Dr. Jeff Teuteberg and Dr. Mani Daneshmand to continue the discussion of advanced heart failure therapies by taking a deep dive into the world of durable LVADs (Left Ventricular Assist Devices). In this episode, we will review the history of ventricular assist devices, the basics of LVAD function, selection criteria for LVAD therapy, and surgical nuances of LVAD implantation. Audio Editing by CardioNerds intern, Joshua Khorsandi. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls There have been significant advances in the field of MCS/LVAD therapy since the first implanted LVAD in the 1960s, to the first FDA approved device in the early 2000's, to now the HM3 LVAD, with the most important change being a centrifugal flow/magnetically levitated design that led to minimized hemocompatibility-related adverse events (HRAE's) (MOMENTUM 3 trial comparing HM2 and HM3).  The REMATCH trial in 2001 was a pivotal trial for LVAD therapy, demonstrating that in a population of patients with advanced HF (70% IV inotrope dependent), LVAD therapy significantly improved survival at both 1 and 2 years as compared to medical therapy alone.    MOMENTUM 3 trial was a landmark trial for the HM3 device, showing that in a population of end stage HF patients (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.  There are both patient-specific factors and surgical considerations when it comes to candidacy for LVAD therapy.  RV function prior to LVAD is a key determinant for success post-LVAD  Many patients being considered for LVAD may not have robust RV function, however, predicting RV failure after LVAD is exceedingly difficult.   In general, it doesn’t matter how bad the RV may look on imaging; we care more about the pre-LVAD hemodynamics (look at the PAPi and RA/wedge ratio).   What happens in the OR may be the most important determinant of how the RV will do with the LVAD!  Notes Notes drafted by Dr. Josh Longinow.  1. Historical background of heart pumps and LVADs  LVAD Evolution   FDA approval year  2001  2008  2012  2017  Pump  HeartMate XVE   HeartMate II  Heartware HVAD  HeartMate III  Flow/Design Features  Pulsatile Technology   Continuous flow Axial design  Continuous flow  Centrifugal design  Continuous flow   Full MagLev + Centrifugal design  The 1960's ushered in the first ‘LVADs', when the first air-powered ‘LVAD' was implanted. It kept the patient alive for four days before the patient expired.   The first generation of LVADs were pulsatile pumps   The first nationally recognized, FDA approved LVAD was the HeartMate XVE (late 1990s to early 2000s, REMATCH trial). The XVE pump used compressed air (pneumatically driven) to power the pump.   Prior to the XVE, OHT was the standard of care for patients with advanced, end-stage heart failure.   The second and third generations of LVADs were non-pulsatile, continuous flow devices and included the HVAD, HM2, and HM3 devices.   MOMENTUM 3 was a landmark trial for the HM3 device, showing that in a population of sick patients with end stage HF (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.   The only pump that is currently FDA approved for implant is the HM3, although other pumps are in clinical trials (BrioVAD system, INNOVATE Trial).  2. What are LVADs, and how do they work?   In simplest terms, the LVAD is a heart pump comprised of several key mechanistic components:   Inflow cannula  Mechanical pump   Outflow cannula  Driveline  Controller/Power source  The HM3 differs from its predecessors (HM2 and HVAD) in several key ways;   HM3 is placed intrapericardial whereas the HM2 was placed pre-peritoneal.   Perhaps most importantly, the HM3 is a fully magnetically levitated, centrifugal flow pump, whereas the HM2 is an axial flow device.  Axial flow pumps are not magnetically levitated, leading to more friction produced between the ruby bearing's contact with the pump rotors, and higher rates of hemocompatibility related adverse events (HRAEs, i.e. pump thrombosis) and the HM2 was ultimately discontinued in favor of the HM3 (MOMENTUM 3 trial).  3. What do the terms ‘Destination Therapy' (DT) or ‘Bridge to Transplant' (BTT) mean when it comes to LVADs?   When LVADs first came on the stage, EVERYONE was a BTT; these early pumps weren't designed for long term use (I.e. REMATCH Trial, Heartmate XVE)  Destination therapy means the LVAD was placed in leu of transplant because there are contraindications to transplant   REMATCH trial brought about the concept of “Destination therapy”, comparing outcomes in patients (with contraindications for transplant) who received an LVAD vs optimal medical therapy  Bridge to transplant means we are placing the LVAD in a patient who may not be a transplant candidate at this moment in time (is too sick, or conversely, not sick enough), but may be down the line   Bridge to recovery is another term used when the LVAD is being placed for a patient we think may have a recoverable cardiomyopathy  4. What are some factors we should consider when assessing a patient’s candidacy for LVAD, in general, and from a surgical perspective?   Patient factors   Older age might push us towards thinking LVAD rather than transplant  In general, age > 70 is the cutoff for transplant, but this is not a hard cut off and varies institution to institution    In general, think about things that help predict recovery after a major surgery; Frailty and Nutritional status are important, we try to optimize these prior to LVAD implant   Right ventricular function remains the Achilles heel of LV support  We know that needing temporary RV support post LVAD puts you on a different survival curve than patients who don’t need RVAD support  Studies have not been able to successfully predict who will develop RV failure after LVAD implantation  What happens in the time between when the patient goes to the OR and when they get back to the ICU is an important determinant who might develop RV failure post LVAD   Surgical techniques such as implanting the HM3 in the intra-thoracic cavity, rather than intra-pericardial may help maintain LV/RV geometry to help optimize the RV post LVAD   Surgical considerations for LVAD candidacy  Small, hypertrophied LV: HM3 inflow cannula is small, but small hypertrophied ventricles tend towards chamber collapse during systole causing suction, needing to run slower with lower flow rates  Chest size/diameter: pumps have gotten so small now, that for adults, these have become less of a consideration  BMI: low BMI used to be more of a concern with the older pumps due to where they were placed, and the relative size of the pump itself, not so much now with the smaller HM 3 pumps  Calcified LV apex: would increase risk of stroke, bleeding   Driveline tunneling becomes a concern in the super obese population, higher risk for driveline infections (might tunnel these driveline's shorter, and to a less fatty region of the abdomen, could even tunnel out the thoracic cavity in the super obese to limit skin motion)    5. Is there a role for MCS (i.e. temporary LVAD such as Impella) in pre-habilitation of patients prior to LVAD surgery?   The theory of being able to improve systemic perfusion, decongest the organs, and make the patient feel better prior to surgery makes sense, but becomes problematic due to the lack of a hard end point/time for prehabilitation which might risk delays in surgery   More likely that it can lead to delay in the surgery, with less-than-optimal benefit; you don't want to prolong the wait for surgery and increase the risk for complications prior to surgery    An Impella 5.5 is currently FDA approved for 2 weeks of support, not 2 months so timing is important to keep in mind  It’s unlikely that you will take a patient and convert them from a malnourished, cachectic person in 2 weeks’ time   6. Is there a role for LVAD therapy in the younger patient population? Should we be thinking of LVAD up front for these patients, with the goal of transplanting down the line?   Recovery may be more likely in certain populations, particularly younger females with smaller LV's; in those populations, perhaps bridge to recovery should be the focus, optimizing them on GDMT etc.   The replacement of transplant, with MCS (LVAD) in young patients has become a topic of discussion, because these pumps have become better and better, with the thinking that an LVAD could bridge a patient for 10 years or so, and they could get a transplant later   It is still a big unknown, but several concerns exist  Patients who get LVADs might end up with complications that become contraindication to transplant down the line (stroke, sensitization etc)   Patients and providers are more hesitant because of the more recent iteration for the UNOS criteria for OHT listing which no longer gives patients with an uncomplicated LVAD higher priority, and therefore they could end up waiting a longer time for a heart after undergoing LVAD  References Rose EA, Gelijns AC, Moskowitz AJ, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345(20):1435-1443. doi:10.1056/NEJMoa012175  Mehra MR, Uriel N, Naka Y, et al. A Fully Magnetically Levitated Left Ventricular Assist Device – Final Report. N Engl J Med. 2019;380(17):1618-1627. doi:10.1056/NEJMoa1900486  Mancini D, Colombo PC. Left Ventricular Assist Devices: A Rapidly Evolving Alternative to Transplant. J Am Coll Cardiol. 2015;65(23):2542-2555. doi:10.1016/j.jacc.2015.04.039  Mehra MR, Goldstein DJ, Cleveland JC, et al. Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. JAMA. 2022;328(12):1233-1242. doi:10.1001/jama.2022.16197  Rose EA, Moskowitz AJ, Packer M, et al. The REMATCH trial: rationale, design, and end points. Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure. Ann Thorac Surg. 1999;67(3):723-730. doi:10.1016/s0003-4975(99)00042-9  Kittleson MM, Shah P, Lala A, et al. INTERMACS profiles and outcomes of ambulatory advanced heart failure patients: A report from the REVIVAL Registry. J Heart Lung Transplant. 2020;39(1):16-26. doi:10.1016/j.healun.2019.08.017  Mehra MR, Netuka I, Uriel N, et al. Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial. JAMA. 2023;330(22):2171-2181. doi:10.1001/jama.2023.23204  Mehra MR, Nayak A, Morris AA, et al. Prediction of Survival After Implantation of a Fully Magnetically Levitated Left Ventricular Assist Device. JACC Heart Fail. 2022;10(12):948-959. doi:10.1016/j.jchf.2022.08.002  Bhardwaj A, Salas de Armas IA, Bergeron A, et al. Prehabilitation Maximizing Functional Mobility in Patients With Cardiogenic Shock Supported on Axillary Impella. ASAIO J. 2024;70(8):661-666. doi:10.1097/MAT.0000000000002170 

This week, in partnership with British Heart Foundation, we explore heart failure. Leading experts from the UK's largest independent funder of cardiovascular research tell us about the condition, the symptoms to look out for, what happens when a heart fails, how heart failure has traditionally been managed, and whether it is possible to regenerate a damaged heart... Like this podcast? Please help us by supporting the Naked Scientists

Heart failure management has evolved dramatically, and nurses are central to optimizing outcomes and preventing hospital readmissions. In this episode, we break down the core medication classes used in heart failure, including ACE inhibitors, ARBs, beta blockers, mineralocorticoid receptor antagonists, diuretics, and newer agents like ARNIs and SGLT2 inhibitors. You'll learn how these medications improve symptoms and survival, key monitoring parameters such as blood pressure, potassium, and renal function, and common adverse effects to watch for. We'll also review practical bedside considerations and patient education pearls that improve adherence and safety. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Master inpatient heart failure management! Learn key tips for initiating guideline-directed medical therapy, diuretic therapy pearls, and ensuring smooth transitions of care. We are joined by Dr. Gurusher Panjrath @PanjrathG (GW School of Medicine and Health Sciences-Dr. Panjrath)Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CMEShow Segments Intro Rapid Fire Questions/Picks of the Week Case Aliquot 1 Defining Heart Failure POCUS in Heart Failure Timing/Indications for Echocardiography Initiating Diuretic Therapy Adjusting Diuretic Therapy/Drip vs Bolus Adjunct Diuretic Therapy Afterload Reduction Monitoring Diuretic Response Inpatient Sodium and Fluid Restriction Case Aliquot 2 Classifying Heart Failure Pharmacotherapy for HFrEF Pharmacotherapy for HFpEF Ischemic Evaluation Interval Summary/Highlights Case Aliquot 3 Considerations for Initial Care of Cardiogenic Shock Choosing Inotrope/Vasopressor Right Heart Catheterization Case Aliquot 4 Discharge Medications for Heart Failure Titration of Goal Directed Medical Therapy Post Discharge Follow Up Washout Period for ACEi/ARB Cost/Barriers of ARNI Patient Education Take Home Points Outro Credits Writer, Producer, and Show Notes by: Reaford Blackburn, Jr., MD Infographic & Cover Art: Caroline Coleman MD Hosts: Monee Amin, MD and Meredith Trubitt, MD    Reviewer: Rahul Ganatra MD Technical Production: PodPaste Guest: Gurusher Panjrath, MD Sponsor: MDProgressEnjoy your first month free at mdprogress.ca/promo/curbsidersSponsor: QuinceGo to Quince.com/curb for free shipping on your order and 365-day returns. Now available in Canada, too.Sponsor: Sanford Guide Curbsiders listeners can get 20% off the already very moderately priced yearly subscriptions directly at sanfordguide.com.Sponsor: Babbel  Here's a special, (limited time) deal for our listeners. Right now get up to 55% off your Babbel subscription – at Babbel.com/CURB.

Dr. Dawn Mussallem shares her inspiring journey of overcoming significant health challenges, including a battle with stage four cancer. She discusses the importance of a supportive community, the role of spirituality in her healing process, and the lessons learned from adversity. Dr. Mussallem emphasizes the significance of nutrition and healthy living, advocating for both women's and men's health, and the need for personalized medical care. Her story is a testament to resilience, love, and the power of human connection. Kimberly and Dawn Mussallem discuss the importance of nutrition for healthy aging, emphasizing the need to eliminate processed foods and increase fiber intake. They explore the significance of protein, particularly plant-based sources, and debunk myths surrounding soy consumption. Dawn shares her transition from the Mayo Clinic to Fountain Life, focusing on advanced diagnostics and personalized wellness strategies.Chapters00:00 Introduction and Background03:02 Overcoming Adversity: Dawn's Health Journey05:51 The Impact of Cancer Diagnosis09:02 Navigating Treatment and Finding Meaning11:59 Spirituality and Connection in Healing15:01 The Role of Support and Community17:49 Life After Cancer: Motherhood and Challenges21:09 Advanced Heart Failure and Resilience23:59 The Gift of Life and Family28:40 The Unexpected Loss31:41 Men's Health Advocacy35:44 Integrating Lifestyle and Medicine39:42 Food as Medicine47:57 The Path to Healthy Aging52:58 Navigating Food Safety and Additives53:54 Plant-Based Proteins and Dining Out56:24 Debunking Soy Myths and Breast Cancer58:47 The Role of Soy in Cancer Prevention01:00:38 Red Meat vs. Plant Proteins01:02:26 Healthy Eating Guidelines for Families01:04:35 The Importance of Whole Foods01:07:44 Innovations in Plant-Based Proteins01:10:38 Dawn's Transition to Fountain LifeSponsors: LMNTOFFER: Right now, for my listeners LMNT is offering a free sample pack with any LMNT drink mix purchase at DrinkLMNT.com/FEELGOOD. That's 8 single serving packets FREE with any LMNT any LMNT drink mix purchase. This deal is only available through my link so. Also try the new LMNT Sparkling — a bold, 16-ounce can of sparkling electrolyte water.USE LINK: DrinkLMNT.com/FEELGOODFATTY15 OFFER: Fatty15 is on a mission to replenish your C15 levels and restore your long-term health. You can get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/KIMBERLY and using code KIMBERLY at checkout.USE LINK: fatty15.com/KIMBERLY Dr. Dawn Mussallem Resources: Website: fountainlife.com Instagram: @drdawnmussallem Bio: Dr. Dawn Mussallem is a distinguished consultant in the Division of Hematology Oncology at Mayo Clinic, where she has served as a clinician for over 20 years, and an Assistant Professor of Medicine.She is also a board-certified lifestyle medicine breast specialist at The Robert and Monica Jacoby Center for Breast Health and founded the Integrative Medicine and Breast Health Program at Mayo Clinic Florida.A stage IV cancer survivor diagnosed three months into medical school, Dr. Mussallem's personal journey is a testament to resilience and determination.In 2021, she underwent a heart transplant and remarkably became the first person to run a marathon one year post-transplant. Internationally recognized for her work in cancer prevention and integrative oncology, she is a prolific speaker and author. Her dedication to patient care and innovative approaches align perfectly with IM8's mission, making her an invaluable addition to the Medical Advisory Board.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. Martin Picard, PhD, is a professor of behavioral medicine at Columbia University and an expert on how our behaviors and psychology shape cellular energy production and rates of aging. He explains that your mitochondria don't just “make energy”; they translate what you do—your mindset and your relationships—into the energy you experience as vitality or lack thereof. He explains how exercise, nutrition, sleep, meditation, and even certain thought patterns and our sense of purpose can charge our cells like batteries. He also shares findings that hair greying is the result of cellular stress and is reversible. This episode links physical and mental ‘energy' with cellular energy and provides science-supported tools to improve your physical and mental health. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman Helix: https://helixsleep.com/huberman Lingo: https://hellolingo.com/huberman Function: https://functionhealth.com/huberman Waking Up: https://wakingup.com/huberman Timestamps (00:00:00) Martin Picard (00:03:50) What is Energy?, Energy Flow & Transformation (00:07:53) Energy, Vitality, Emotions, Sensory Perception (00:14:18) Sponsors: Helix Sleep & Lingo (00:17:19) “Mito-Centric” View of World, Mitochondrial Energy & Information Patterns (00:25:26) Organelles, Mitochondria & Energy Transformation; Maternal Genes (00:31:12) Mitotypes & Differentiation, Mitochondria as “Social Organisms” (00:36:52) Food & Dysfunctional Energy Transformation (00:40:02) Lifestyle Choices & Interests, Physiological Growth (00:46:39) Pregnancy, Amenorrhea; Illness & Tiredness (00:51:07) Sponsor: AG1 (00:52:29) Energy Transformation & Distribution; Body's Wisdom, Feeling Sick (00:56:27) Tool: Feel Your Energy; Breath & Energy (01:02:31) Flow of Energy; Trade-Offs, Life Purpose & Enjoyment (01:10:15) Biology, Meaningful Experiences & Energy Flow (01:16:27) Sponsor: Function (00:18:15) Inflammation, Energetic Flow (01:20:43) Child Prodigies, Species Lifespan & Mitochondrial Metabolism; Aging (01:28:56) Lifestyle & Aging: Exercise, Fasting; Inflammation, Sleep, Stimulants (01:37:06) Energetic Stress Signals, GDF-15, Cancer, Heart Failure (01:42:18) Genes, Lifestyle & Aging (01:47:54) Gray Hair Reversal, Stress; Inflammation & Aging (01:57:37) Energy Recovery, Sleep & Mitochondrial Function, Stress, Meditation (02:05:16) Tools: Yoga Nidra, NSDR; Pre-Sleep Relaxation, Energy & Restorative Sleep (02:10:58) Diet & Individualization, Clinical Trials; Mitochondria & Nutrition, Keto (02:20:14) Alcohol & Energy Budget; Stress (02:25:02) Exercise, Increase Mitochondria, Overtraining; Resistance & Growth (02:33:06) Sponsor: Waking Up (02:34:41) Supplements & Mitochondria Health, Deficiencies, SS31, Methylene Blue (02:41:31) Energy Flow & Experiences, Balance (02:49:13) Transform Through Resistance, Energetic Awareness, Connection (02:56:05) Food Overconsumption & Mitochondria Disruption; Tissues & Mitochondria (03:01:02) Mitochondrial Health Test; Tool: Ways to Increase Energy; Meditation (03:06:10) Peptides; Fertility Supplements, Urolithin A; Electromagnetic Fields (03:12:16) Acknowledgements (03:14:15) Zero-Cost Support, YouTube, Spotify & Apple Follow, Reviews & Feedback, Sponsors, Protocols Book, Social Media, Neural Network Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices