Podcasts about jacc

  • 95PODCASTS
  • 3,033EPISODES
  • 15mAVG DURATION
  • 5WEEKLY NEW EPISODES
  • Jul 10, 2026LATEST

POPULARITY

20192020202120222023202420252026

Categories



Best podcasts about jacc

Latest podcast episodes about jacc

Cardionerds
458. The Golden Age of Pulmonary Embolism Randomized Controlled Trials with Dr. Jay Giri

Cardionerds

Play Episode Listen Later Jul 10, 2026 29:09


CardioNerds co-chairs Dr. Dinu Balanescu and Dr. Billy Joe Mullinax, along with FIT lead Dr. Shiavax Rao, discuss the evolving landscape of randomized controlled trials in pulmonary embolism with Dr. Jay Giri, interventional cardiologist, Associate Professor of Medicine, and Director of the Cardiovascular Catheterization Laboratories at the Hospital of the University of Pennsylvania. This episode examines the historical evidence behind systemic thrombolysis, the emergence of catheter-directed therapies and mechanical thrombectomy, and the landmark RCTs – STORM-PE, PEERLESS, HI-PEITHO, and PEERLESS II – that are reshaping intermediate-risk PE management. The discussion highlights challenges in PE trial design, the critical importance of clinical deterioration as an endpoint, and why this era represents an unprecedented wave of evidence generation in PE. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium.   Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Pulmonary Embolism PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls: Systemic thrombolysis in intermediate-risk PE reduces hemodynamic decompensation but at the cost of ~1.5–2% intracranial hemorrhage risk – a near-zero net benefit that has driven the search for safer catheter-based alternatives. “Focus on clinical deterioration, not mortality” – Due to crossover design in contemporary PE RCTs, control-arm patients who decompensate are rescued with advanced therapies, biasing mortality toward the null. Clinical deterioration is the most informative endpoint to watch in HI-PEITHO, PRAGUE-26, and PEERLESS II. HI-PEITHO is the first large RCT to demonstrate that catheter-directed fibrinolysis plus anticoagulation significantly reduces the composite of PE-related death, cardiorespiratory decompensation, or PE recurrence versus anticoagulation alone (RR 0.39; 95% CI 0.20–0.77; P=0.005), with no intracranial hemorrhage in either arm. The four major upcoming/recently reported PE RCTs (HI-PEITHO, PRAGUE-26, PEERLESS II, PE-TRACT) enroll progressively different risk populations – from the most enriched (HI-PEITHO) to the most permissive (PE-TRACT, which includes intermediate-low risk patients) – enabling a nuanced understanding of which patients benefit most from intervention. PE device clearance follows a fundamentally different FDA pathway than structural heart devices (single-arm safety/efficacy studies vs. mandated RCTs), yet market forces and clinical need have ultimately driven industry and government to sponsor large-scale RCTs – a lesson in how evidence development can evolve organically alongside regulatory frameworks. Notes: Notes drafted by Dr. Shiavax Rao. Question #1: What is the current evidence behind advanced PE therapies? Systemic thrombolysis: Sixteen RCTs over 40 years (1972–2014) enrolling nearly 2,000 patients have studied systemic thrombolysis in intermediate-risk PE. The landmark PEITHO trial (n=1,006) showed that tenecteplase reduced the composite of death or hemodynamic collapse (2.6% vs. 5.6%; P=0.015), driven primarily by reduced hemodynamic decompensation (1.6% vs. 5.0%; P=0.002). However, this came at the cost of increased major bleeding (6.3% vs. 1.5%; P

Ta de Clinicagem
TdC 342: Vacinas no adulto - quais e quando indicar?

Ta de Clinicagem

Play Episode Listen Later Jul 8, 2026 54:43


1º Encontro TdC - Simpósio Anual de Atualização em Clínica Médica Um dia inteiro de Clínica Médica, com temas cuidadosamente selecionados para responder à pergunta que mais importa: o que muda minha prática?Se você é residente, médico recém-formado, especialista ou estudante de Medicina e gosta da forma como o TdC discute medicina baseada em evidências, esperamos você em São Paulo no dia 22 de agosto.Garanta sua vaga através do link: https://www.tadeclinicagem.com.br/eventostdc/1-encontro-tdc/Joanne Alves e Marcela Belleza convidam Raphael Barreto para discutir sobre a vacinação no adulto, dividindo o tema de forma prática em 4 pontos: conceitos básicos de vacinação, vacinação no jovem hígido, vacinação no idoso e vacinação no paciente imunossuprimido.Referências:1. https://www.gov.br/saude/pt-br/vacinacao/publicacoes/instrucao-normativa-que-instrui-o-calendario-nacional-de-vacinacao-2026.pdf2. https://sbim.org.br/images/files/notas-tecnicas/informe-sbim-esclarecimentos-vacinas-hpv-240415-v2.pdf3. Gagneur, Arnaud et al. “From vaccine hesitancy to vaccine motivation: A motivational interviewing based approach to vaccine counselling.” Human vaccines & immunotherapeutics vol. 20,1 (2024): 2391625. doi:10.1080/21645515.2024.23916254. A. Heidenreich, P, Bhatt, A, Nazir, N. et al. 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on Adult Immunizations as Part of Cardiovascular Care: A Report of the American College of Cardiology Solution Set Oversight Committee. JACC. 2025 Nov, 86 (21) 2085–2098. https://doi.org/10.1016/j.jacc.2025.07.0035. Johansen, Niklas Dyrby et al. “Electronic nudges to increase influenza vaccination uptake in Denmark: a nationwide, pragmatic, registry-based, randomised implementation trial.” Lancet (London, England) vol. 401,10382 (2023): 1103-1114. doi:10.1016/S0140-6736(23)00349-56. Larson, Heidi J et al. “The Vaccine-Hesitant Moment.” The New England journal of medicine vol. 387,1 (2022): 58-65. doi:10.1056/NEJMra21064417. Dinga, Jerome Nyhalah et al. “Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries.” Vaccines vol. 12,1 34. 28 Dec. 2023, doi:10.3390/vaccines12010034

Your Checkup
120: Can Lifting Weights Help Prevent a Heart Attack?

Your Checkup

Play Episode Listen Later Jul 6, 2026 20:52 Transcription Available


Cardio has been the default prescription for heart health for decades, but a growing body of evidence suggests we've been overlooking a major protective tool: strength training. We dig into a large, long-running research dataset that followed more than 117,000 women for nearly 15 years and found a powerful link between resistance training and lower heart attack risk. The number that stops people in their tracks: at least two hours of weekly strength training was associated with a dramatically lower risk of heart attack, with meaningful reductions in major cardiovascular events too.We also slow down and explain what those results do and don't mean. Because the study is observational, it can't prove that lifting weights directly prevents heart attacks. So we talk through why associations can still be useful, what “dose dependent” patterns add to the story, and how lifestyle factors like sleep, nutrition, and smoking can blur the picture. Then we connect the dots on plausible mechanisms, including better blood pressure control, improved insulin sensitivity, healthier body composition, less visceral fat, and protection against age-related muscle loss and declining function.If lifting feels intimidating, we make it practical. You don't need to live in the gym or become a powerlifter to get benefits. We share an achievable weekly target (think 90 to 120 minutes), simple ways to start with dumbbells, resistance bands, machines, or bodyweight movements, and why pairing strength training with aerobic exercise may be the best overall approach for cardiovascular disease prevention.If this helped you rethink your workout plan, subscribe, share the episode with a friend, and leave a review so more people can find the show. What's one strength move you could start this week?Study Citation:Zhang, T, Zhang, Y, Lee, D. et al. Resistance Training, Aerobic Activity, Television Viewing, and Risk of Major Cardiovascular Events in U.S. Women. JACC. null2026, 0 (0) .https://doi.org/10.1016/j.jacc.2026.04.036Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply.Support the showProduction and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RNArtwork Rebrand and Avatars:Vantage Design Works (Vanessa Jones) Website: https://www.vantagedesignworks.com/Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qrOriginal Artwork Concept: Olivia Pawlowski

JACC Speciality Journals
Integrated Hemodynamic Measures of Cardiac Function and Association With Clinical Outcomes | JACC: Advances

JACC Speciality Journals

Play Episode Listen Later Jun 24, 2026 2:44


Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Integrated Hemodynamic Measures of Cardiac Function and Association With Clinical Outcomes.

JACC Speciality Journals
Sex Differences in Heart Transplantation Outcomes: A 5-Year Review of the 2018 U.S. Allocation Policy | JACC: Advances

JACC Speciality Journals

Play Episode Listen Later Jun 24, 2026 2:33


Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Sex Differences in Heart Transplantation Outcomes: A 5-Year Review of the 2018 U.S. Allocation Policy.

JACC Speciality Journals
Audiovisual Distraction During Mitral Transcatheter Edge-to-Edge Repair: A Sedation-Sparing Randomized Trial | JACC: Advances

JACC Speciality Journals

Play Episode Listen Later Jun 24, 2026 2:44


Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Audiovisual Distraction During Mitral Transcatheter Edge-to-Edge Repair: A Sedation-Sparing Randomized Trial.

JACC Speciality Journals
SGLT2 Inhibitors in Cardio-Oncology: A Systematic Review and Meta-Analysis | JACC: Advances

JACC Speciality Journals

Play Episode Listen Later Jun 24, 2026 2:36


Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on SGLT2 Inhibitors in Cardio-Oncology: A Systematic Review and Meta-Analysis.

JACC Speciality Journals
Brief Introduction - Exercise and Exercise Stress Testing in Brugada Syndrome: Diagnostic, Prognostic, and Safety Implications | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 0:55


JACC Speciality Journals
Brief Introduction - Novel Allogeneic Mitochondria and Associated Organelle Complex Treatment Prevents Myocardial Ischemia-Reperfusion Injury Through Anti-Apoptotic Effects | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 1:19


JACC Speciality Journals
Brief Introduction - Myocardial Infarction Without Standard Modifiable Risk Factors From 2025-2040: Forecast Analysis of Multinational, Population-Based Study | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 1:17


JACC Speciality Journals
Brief Introduction - Design of IKISS-LM Randomized Controlled Trial: Impact of Kissing Balloon Inflation on Provisional Left-Main Bifurcation PCI | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 1:05


JACC Speciality Journals
Artificial Intelligence-Enhanced Electrocardiography and Health Records to Predict Cardiac Arrest | JACC: Advances

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 2:34


Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Artificial Intelligence-Enhanced Electrocardiography and Health Records to Predict Cardiac Arrest.

JACC Speciality Journals
Trends in the Co-Occurrence of Alcohol Use and Cardiovascular Disease Among U.S. Adults, 1999 to 2023 | JACC: Advances

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 2:54


Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Trends in the Co-Occurrence of Alcohol Use and Cardiovascular Disease Among U.S. Adults, 1999 to 2023.

JACC Speciality Journals
Associations of Central Adiposity With Subclinical Coronary Calcification and Disease Progression: Meta-Analysis of 68,629 Participants | JACC: Advances

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 3:09


Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Associations of Central Adiposity With Subclinical Coronary Calcification and Disease Progression: Meta-Analysis of 68,629 Participants.

JACC Speciality Journals
Brief Introduction - Procedural Pattern, Clinical Outcomes, and Cost Analysis of Transcatheter Aortic Valve Replacement in Korea | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 1:30


Commentary by Dr. Jian'an Wang.

JACC Speciality Journals
Brief Introduction - Single Versus Double Perclose Devices for TF-TAVR Access Closure: A Noninferiority Randomized Controlled Trial | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 1:11


JACC Speciality Journals
Brief Introduction - SGLT2 Inhibition as a Novel Therapeutic Strategy in Rheumatic Heart Disease | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 1:01


JACC Speciality Journals
Brief Introduction - Updated Wilkins Score Predicting Success of Balloon Mitral Valvuloplasty in Rheumatic Mitral Stenosis | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 1:04


JACC Speciality Journals
Single Versus Double Perclose Devices for TF-TAVR Access Closure: A Noninferiority Randomized Controlled Trial | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 3:37


JACC Speciality Journals
Brief Introduction - Association Between Cardiovascular-Kidney-Metabolic Syndrome and Myocardial Injury After Noncardiac Surgery: A Retrospective Cohort Study | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 1:08


JACC Speciality Journals
Transcatheter Aortic Valve Replacement in Functionally Dependent Patients: Analysis Using a Government-Adjudicated Long-Term Care Certification | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 2:46


Commentary by Dr. Mark Tuttle.

JACC Speciality Journals
Brief Introduction - Transcatheter Aortic Valve Replacement in Functionally Dependent Patients: Analysis Using a Government-Adjudicated Long-Term Care Certification | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 1:13


JACC Speciality Journals
Novel Allogeneic Mitochondria and Associated Organelle Complex Treatment Prevents Myocardial Ischemia-Reperfusion Injury Through Anti-Apoptotic Effects | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 3:10


Commentary by Dr. Chrishan Ramachandra.

JACC Speciality Journals
Updated Wilkins Score Predicting Success of Balloon Mitral Valvuloplasty in Rheumatic Mitral Stenosis | JACC: Asia

JACC Speciality Journals

Play Episode Listen Later Jun 23, 2026 5:20


Dr. Chapa’s Clinical Pearls.
MOPP & PP BP Control

Dr. Chapa’s Clinical Pearls.

Play Episode Listen Later Jun 21, 2026 18:46


More than 60% of maternal deaths occur during the postpartum period, and hypertensive disorders of pregnancy are a major, preventable driver of that statistic. For too long, the transition from labor and delivery to home has been a vulnerable blind spot—leading to high rates of avoidablereadmissions. But the landscape has shifting. In this episode, we are diving deep into why OB providers must optimize blood pressure control before and after postpartum discharge. We'll be breaking down the landmark 2025 MOPP study, which shook up our traditional targets by examining tight versus standard blood pressure control, alongside the recently released May 2026 ACC Expert ConsensusDecision Pathway.What is the actual "goal BP" for a safe postpartum discharge? When should we initiate outpatient tight control, and how do we prevent these patients from bouncing back to the ED? Grab your coffee and pull up a chair. Let's look at the evidence.20% DISCOUNT: https://strongcoffeecompany.com/discount/CHAPANOSPINOBG1.          Gibson K, Hameed A. Society for Maternal-Fetal Medicine Special Statement: Checklist forpostpartum discharge of women with hypertensive disorders. AJOG, 2020. 2.          Farahi N, Oluyadi F, Dotson AB. Hypertensive Disorders of Pregnancy. American Family Physician. 2024. 4.          Lindley KJ, Bello NA, Berlacher KL, et al. Optimization of Postpartum Care for Patients With and at Risk for Premature and Long-Term Cardiovascular Disease: 2026 ACC Expert Consensus. Journal of the American College of Cardiology. May 2026. 5.          ACOG Task Force on Hypertension in Pregnancy, 20136.          Rosenfeld EB, Sagaram D, Lee R, et al. Management of Postpartum Preeclampsia and Hypertensive Disorders (MOPP): Postpartum Tight vs Standard Blood PressureControl. JACC. Advances. 2025.

JACC Speciality Journals
Association Between Clonal Hematopoiesis and Cardiometabolic Disease: A Systematic Review and Meta-Analysis | JACC: CardioOncology

JACC Speciality Journals

Play Episode Listen Later Jun 16, 2026 3:06


This podcast by Dr. Marie Pigeyre explores emerging evidence on clonal hematopoiesis, highlighting its role as a systemic driver of inflammation and its association with increased risk of cardiovascular disease, stroke, and type 2 diabetes. The discussion emphasizes the growing importance of clonal hematopoiesis in cardiometabolic risk, precision prevention, and aging biology, while noting that routine clinical screening is not yet recommended.

JACC Speciality Journals
Immune Profiling Identifies Inflammatory Signatures in Immune Checkpoint Inhibitor– Related Myocarditis | JACC: CardioOncology

JACC Speciality Journals

Play Episode Listen Later Jun 16, 2026 3:00


This podcast by Dr. Dan Zlotoff reviews new research on immune checkpoint inhibitor–associated myocarditis, a rare but serious complication of cancer immunotherapy, focusing on emerging inflammatory biomarkers such as interleukin‑6 and immune cell signatures. The study highlights potential pathways for risk stratification and targeted therapies, while underscoring the need for larger trials to develop reliable diagnostic and treatment strategies in cardio‑oncology.

JACC Speciality Journals
Differential Transthyretin Stabilization in Patients With Wild-Type and Variant Transthyretin Amyloidosis | JACC: CardioOncology

JACC Speciality Journals

Play Episode Listen Later Jun 16, 2026 6:19


This podcast by Dr. Ron Witteles reviews new data on transthyretin amyloid cardiomyopathy (ATTR‑CM), highlighting differences in transthyretin stabilization between acoramidis and tafamidis across wild-type and variant disease. The discussion underscores the clinical importance of TTR stabilization, emerging biomarkers such as serum transthyretin, and the expanding therapeutic landscape in cardiac amyloidosis.

JACC Speciality Journals
A Bleeding Risk Score for Cancer-Associated Venous Thromboembolism in Patients Receiving Direct Oral Anticoagulants | JACC: CardioOncology

JACC Speciality Journals

Play Episode Listen Later Jun 16, 2026 3:21


This podcast by Dr. Larissa Araújo de Lucena discusses the development of the ONCO‑DOAC BLEED score for predicting major bleeding in patients with cancer‑associated venous thromboembolism (VTE) receiving direct oral anticoagulants. The findings support a more personalized, risk‑based approach to anticoagulation in cardio‑oncology, integrating cancer type, comorbidities, and clinical factors while highlighting the need for broader validation.

JACC Speciality Journals
August 2026 Full Issue Summary | JACC: CardioOncology

JACC Speciality Journals

Play Episode Listen Later Jun 16, 2026 20:43


Audio summary of JACC: CardioOncology's June issue.

JACC Speciality Journals
Upper Extremity Deep Vein Thrombosis in Cancer Patients: Clinical Course by Cancer Site | JACC: CardioOncology

JACC Speciality Journals

Play Episode Listen Later Jun 16, 2026 3:31


This podcast by Dr. António Araújo highlights new insights from a large international registry study showing that cancer‑associated upper extremity deep vein thrombosis (UEDVT) carries increased risks of recurrent venous thromboembolism and bleeding. The findings emphasize tumor‑specific risk patterns and support more personalized anticoagulation strategies in cardio‑oncology.

JACC Speciality Journals
Conceptual Reconsideration of the Classification of Pulmonary Hypertension: From 5 Groups to 2 Groups | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:30


JACC Speciality Journals
Development of a Noninvasive Prediction Score for Post-Capillary Pulmonary Hypertension in a Multi-Ethnic Asian Population | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:34


JACC Speciality Journals
Association Between Cardiac Acceleration Capacity and Susceptibility to Vasovagal Syncope: Autonomic Dysregulation in Vasovagal Syncope | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:24


JACC Speciality Journals
Cardio-Kidney-Metabolic Phenotypes and Adverse Clinical Outcomes in Patients With Atrial Fibrillation | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:22


JACC Speciality Journals
Postoperative New-Onset Heart Block in Noncardiac Surgery: Model Development, Validation, and Long-Term Prognostic Analysis | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:25


JACC Speciality Journals
The Associations Between Heart Rate, Deformational Echocardiographic Parameters, and Outcomes in Patients With Atrial Fibrillation | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:31


JACC Speciality Journals
Sex Differences in Antiarrhythmic Effects of Empagliflozin: The EMPA-ICD Trial Subanalysis | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:30


JACC Speciality Journals
Prognostic Value of Murray's Law–Based Quantitative Flow Ratio in Multi-Arterial Coronary Artery Bypass Grafting | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:33


JACC Speciality Journals
Ambrisentan for Early-Stage Low-Risk Pulmonary Arterial Hypertension: Design of the Randomized, Double-Blind, Placebo-Controlled ALEPH Trial | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:30


Commentary by Dr. Jian'an Wang.

JACC Speciality Journals
Persistent Atrial Fibrillation With Conduction System Pacing or Pulmonary Vein Isolation: A Prospective Cohort Study | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:29


JACC Speciality Journals
Comparison of Flow Ratio Derived From IVUS With CAG in Complex Lesions: Correlation With FFR | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:31


JACC Speciality Journals
Comparison of Clinical Outcomes Between Incomplete and Complete Revascularization in NSTEMI Patients With Multivessel Disease | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:37


JACC Speciality Journals
Comparison of Flow Ratio Derived From IVUS With CAG in Complex Lesions: Correlation With FFR | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:31


JACC Speciality Journals
CRP Cutoff Value in East Asians With Coronary Heart Disease: A Systematic Review and Meta-Analysis | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:35


JACC Speciality Journals
Validation and Recalibration of PCE, China-PAR and PREVENT Models for Estimating ASCVD Risk in China | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:45


JACC Speciality Journals
Sex Differences in Antiarrhythmic Effects of Empagliflozin: The EMPA-ICD Trial Subanalysis | JACC Asia

JACC Speciality Journals

Play Episode Listen Later Jun 2, 2026 0:30


Cardionerds
451: CCTA, CT-FFR, and AI Plaque Analysis to Personalize CAD Detection, Prevention, and Management with Dr. Michael Gallagher

Cardionerds

Play Episode Listen Later May 27, 2026 46:23


CardioNerds Dr. Joseph Kassab, Dr. Mariana Garcia-Arango, and Dr. Christopher Mason explore the technological revolution of Coronary CT Angiography (CCTA) with expert faculty Dr. Michael Gallagher. The discussion details how CCTA has evolved into a frontline diagnostic and preventive tool, moving beyond simple anatomy to incorporate physiology via CT-FFR and biology through AI-driven plaque quantification. The episode reviews landmark evidence like the SCOT-HEART and PROMISE trials, the nuances of CAD-RADS 2.0 reporting, and the emerging role of AI in monitoring treatment response and personalizing cardiovascular care. Critically, they also discuss some of the assumptions and limitations of these techniques. Stay tuned for a matching review article to be submitted to US Cardiology Review, the official Journal of CardioNerds. This episode was supported by an independent medical education grant from HeartFlow. All CardioNerds education is planned, produced, and reviewed solely by CardioNerds.  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 Multimodality Cardiovascular Imaging PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll Pearls Shift in Paradigm: CCTA is no longer just an anatomic test; with some key limitations, it can provide anatomy, physiology (CT-FFR), and plaque biology (AI-CPA) in a single non-invasive scan. The “Power of Zero” vs. Plaque: While a normal CCTA has a >95% negative predictive value, future MIs often arise from non-obstructive plaque that traditional stress tests might miss. CAD-RADS 2.0 Utility: The addition of plaque burden modifiers (P1–P4) is a “game changer,” allowing clinicians to identify high-risk patients who need aggressive lipid-lowering despite having only mild stenosis. CT-FFR as a Virtual Stress Test: CT-FFR uses computational fluid dynamics to simulate blood flow, potentially reducing unnecessary invasive catheterizations by approximately 61% without sacrificing safety. Seeing the Invisible: AI-based quantitative plaque analysis (QCPA) can identify “subvisual” plaque and low-attenuation (lipid-rich) components that are the primary drivers of acute coronary syndromes. Show Notes How has the role of CCTA changed compared to traditional functional testing? Historically, stress testing answered “is there ischemia today?”, which often reflects late-stage disease. CCTA identifies disease across the entire spectrum, asking “is there atherosclerosis and how much plaque is present?”. Landmark evidence: SCOT-HEART showed a 41% relative risk reduction in MI at 5 years attributed to intensified preventive therapies, and PROMISE showed CCTA was better at selecting patients who truly needed invasive angiography. Diagnostic CCTA imaging depends on the protocol, contrast timing, heart rate, heart rhythm, breathholding, scanner quality, and several patient factors (obesity, prior stents, heavy calcification, complex bypass anatomy, and motion artifact all may limit imaging). “CCTA is exceptional for the right patient, with the right scanner, and the right team.” What are the key modifiers introduced in CAD-RADS 2.0, and why do they matter? CAD-RADS 2.0 moved beyond stenosis severity to include plaque burden (P0 to P4), high-risk plaque (HRP) features, and the presence of ischemia based on CT-FFR. It serves as a clinical decision support tool: a patient with mild (25-49%) stenosis but “extensive” (P4) plaque burden is considered high risk and warrants aggressive risk factor modification. How is CT-FFR calculated, and when is it most useful in clinical practice? CT-FFR uses resting CCTA data and computational fluid dynamics to create a 3D model of coronary flow during simulated maximal hyperemia. It is often used for intermediate lesions (40–90% stenosis) to predict if they are  ischemia-producing, guiding the decision whether to proceed with invasive angiography.  The assumptions necessary for this computational modeling may not apply well to patients with microvascular dysfunction, significant myocardial scar or prior infarction, or ventricular hypertrophy. Still, data indicate that CT-FFR performs similarly to PET in predicting hemodynamically significant lesions.  CT-FFR performs well at the extremes (either clearly normal or clearly abnormal). Accuracy dips, however, in the intermediate range (~0.75-0.80), where decision-making is most critical. In this grey zone, additional factors can help guide the approach, including the amount of myocardium supplied, translesional gradient, and plaque features.   CT-FFR has not been validated in distal segments, stented segments, heavily calcified coronary arteries, or in patients with severe aortic stenosis. Caution with CT-FFR should be utilized in very calcified coronary segments.  What is AI-based quantitative plaque analysis (QCPA), and what metrics are ready for clinical use? This is potentially a paradigm shift, moving away from stenosis-centric thinking to a more disease burden and plaque biology focus. QCPA uses deep learning algorithms to automatically segment the vessel wall and quantify plaque volume in mm³. Ready for “prime time” metrics include: Total Plaque Volume (TPV), non-calcified plaque volume, and Low-Attenuation Plaque (LAP) burden. Can serial CCTA be used to monitor the effectiveness of medical therapies like statins? While not yet a routine guideline-driven practice, trials like PARADIGM and EVAPORATE show that therapies can stabilize plaque; notably, CCTA is better for monitoring than CAC scores, which can be misleading as statins often increase plaque calcification as part of the stabilization process. There are no randomized trials that serial CCTAs improve outcomes. Cost and radiation exposure will be notable limitations. Serial scan timing, scan acquisition and interpretation standardization would be key. Dr. Gallagher notes that we are moving toward a world in which plaque burden may become a “treatment biomarker,” similar to tumor burden in oncology.  References 1. Coronary Computed Tomography Angiography From Clinical Uses to Emerging Technologies: JACC State-of-the-Art Review. Abdelrahman KM, Chen MY, Dey AK, et al. Journal of the American College of Cardiology. 2020;76(10):1226-1243. doi:10.1016/j.jacc.2020.06.076. 2. Non-Invasive Imaging in Coronary Syndromes: Recommendations of the European Association of Cardiovascular Imaging and the American Society of Echocardiography, in Collaboration With the American Society of Nuclear Cardiology, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. Edvardsen T, Asch FM, Davidson B, et al. Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2022;35(4):329-354. doi:10.1016/j.echo.2021.12.012. 3. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Gulati M, Levy PD, Mukherjee D, et al. Journal of the American College of Cardiology. 2021;78(22):e187-e285. doi:10.1016/j.jacc.2021.07.053. 4. Contemporary, Non-Invasive Imaging Diagnosis of Chronic Coronary Artery Disease. van der Bijl P, Gulati M, Saraste A, et al. Lancet (London, England). 2025;406(10519):2577-2587. doi:10.1016/S0140-6736(25)01586-7. 5. State of the Art: Evaluation and Medical Management of Nonobstructive Coronary Artery Disease in Patients With Chest Pain: A Scientific Statement From the American Heart Association. Slipczuk L, Blankstein R, Bucciarelli-Ducci C, et al. Circulation. 2025;152(23):e443-e466. doi:10.1161/CIR.0000000000001394. 6. Diagnostic Performance of Fractional Flow Reserve Derived From Coronary CT Angiography: The ACCURATE-CT Study. Li C, Hu Y, Jiang J, et al. JACC. Cardiovascular Interventions. 2024;17(17):1980-1992. doi:10.1016/j.jcin.2024.06.027. 7. Clinical Outcomes Based on Coronary Computed Tomography-Derived Fractional Flow Reserve and Plaque Characterization. Sato Y, Motoyama S, Miyajima K, et al. JACC. Cardiovascular Imaging. 2024;17(3):284-297. doi:10.1016/j.jcmg.2023.07.013. 8. Clinical Use of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve: Expert Consensus by an International Working Group. Tang CX, Leipsic JA, Nørgaard BL, et al. European Radiology. 2026;:10.1007/s00330-025-12313-6. doi:10.1007/s00330-025-12313-6. 9. Diagnostic accuracy of computed tomography–derived fractional flow reserve: a systematic review. Cook CM, Petraco R, Shun-Shin MJ, et al. JAMA Cardiol. 2017;2(7):803-810. Doi:10.1001/jamacardio.2017.1314 10. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). Nørgaard BL, Leipsic J, Gaur S, et al. J Am Coll Cardiol. 2014;63(12):1145-1155. Doi:10.1016/j.jacc.2013.11.043 11. Comparison of coronary computed tomography angiography, fractional flow reserve, and perfusion imaging for ischemia diagnosis. Driessen RS, Danad I, Stuijfzand WJ, et al. J Am Coll Cardiol. 2019;73(2):161-173. Doi:10.1016/j.jacc.2018.10.056. 12. 1-year outcomes of FFRCT-guided care in patients with suspected coronary disease: the PLATFORM study. Douglas PS, De Bruyne B, Pontone G, et al. J Am Coll Cardiol. 2016;68(5):435-445. Doi:10.1016/j.jacc.2016.05.057. 13. Comparison of an initial risk-based testing strategy vs usual testing in stable symptomatic patients with suspected coronary artery disease: the PRECISE randomized clinical trial. Douglas PS, Nanna MG, Kelsey MD, et al; PRECISE Investigators. JAMA Cardiol. 2023;8(10):904-914. Doi:10.1001/jamacardio.2023.2595. 14. Diagnostic and clinical value of FFRCT in stable chest pain patients with extensive coronary calcification: the FACC study. Mickley H, Veien KT, Gerke O, et al. JACC Cardiovasc Imaging. 2022;15(6):1046-1058. doi:10.1016/j.jcmg.2021.12.010. 15. Low-Attenuation Noncalcified Plaque on Coronary Computed Tomography Angiography Predicts Myocardial Infarction: Results From the Multicenter SCOT-HEART Trial (Scottish Computed Tomography of the HEART). Williams MC, Kwiecinski J, Doris M, et al. Circulation. 2020;141(18):1452-1462. doi:10.1161/CIRCULATIONAHA.119.044720. 16. AI-Guided Quantitative Plaque Staging Predicts Long-Term Cardiovascular Outcomes in Patients at Risk for Atherosclerotic CVD. Nurmohamed NS, Bom MJ, Jukema RA, et al. JACC. Cardiovascular Imaging. 2024;17(3):269-280. doi:10.1016/j.jcmg.2023.05.020. 17. Interaction of AI-Enabled Quantitative Coronary Plaque Volumes on Coronary CT Angiography, FFRCT, and Clinical Outcomes: A Retrospective Analysis of the ADVANCE Registry. Dundas J, Leipsic J, Fairbairn T, et al. Circulation. Cardiovascular Imaging. 2024;17(3):e016143. doi:10.1161/CIRCIMAGING.123.016143. 18. Prognostic Value of AI-Based Quantitative Coronary CTA vs Human Reader-Based Visual Assessment: Results From the CONFIRM2 Registry. van Rosendael A, Nakanishi R, Bax JJ, et al. JACC. Cardiovascular Imaging. 2026;19(3):345-359. doi:10.1016/j.jcmg.2025.09.021.13. Pericoronary Adipose Tissue as a Marker of Cardiovascular Risk: JACC Review Topic of the Week. Tan N, Dey D, Marwick TH, Nerlekar N. Journal of the American College of Cardiology. 2023;81(9):913-923. doi:10.1016/j.jacc.2022.12.021. 19. Effect of Icosapent Ethyl on Progression of Coronary Atherosclerosis in Patients With Elevated Triglycerides on Statin Therapy: Final Results of the EVAPORATE Trial. Budoff MJ, Bhatt DL, Kinninger A, et al. European Heart Journal. 2020;41(40):3925-3932. doi:10.1093/eurheartj/ehaa652. 20. Coronary CT Angiography Evaluation With Artificial Intelligence for Individualized Medical Treatment of Atherosclerosis: A Consensus Statement From the QCI Study Group. Schulze K, Stantien AM, Williams MC, et al. Nature Reviews. Cardiology. 2026;23(2):100-115. doi:10.1038/s41569-025-01191-6.

Mind & Matter
How to Lie With Science: Seed Oils & Inflammation | M&M Livestream 1

Mind & Matter

Play Episode Listen Later May 27, 2026 72:50


Send us Fan MailDeep-dive into a 2026 cardiology review paper claiming seed oils reduce inflammation, exposing misrepresentations of cited clinical trials, and detailing how oxidized Ω-6 fats trigger inflammation.Companion article: Click HERETOPICS DISCUSSED:Seed Oil Profiles: Typical seed oils like sunflower are high in linoleic acid (omega-6 PUFA), while canola is higher in monounsaturated fats and resembles olive oil.Review Paper Critique: The 2026 JACC review falsely claims sunflower oil reduce inflammation like olive oil, citing an RCT that showed benefits only for canola and olive.RCT Analysis: In Iranian women with metabolic issues, switching to canola or olive oil lowered CRP by increasing MUFA and decreasing PUFA intake; sunflower oil produced no change.CRP Biology: CRP responds to oxidized lipids and cellular damage patterns, rising with exercise or infection and marking oxidized Ω-6 metabolites in modern diets.Oxidized Lipids: Ω-6 fats in LDL and cardiolipin oxidize easily, generating 4-HNE, MDA, and other signals that trigger immune clearance, similar to bacterial threats.Sterile Inflammation: High dietary linoleic acid causes chronic immune activation without pathogens, potentially contributing to metabolic and cardiovascular issues.PRACTICAL TAKEAWAYS:Prioritize monounsaturated fats from olive or avocado oil over high-linoleic seed oils like standard sunflower or soybean for lower oxidative stress potential.Check labels for high-oleic versions of sunflower oil, which shift the profile toward monounsaturated fats.Evaluate nutrition claims by examining original studies and fatty acid compositions rather than accepting review summaries at face value.Support the showHealth Products by M&M Partners:AquaTru: Water filtration devices that remove microplastics, metals, bacteria, and more from your drinking water. Through link, $100 off AquaTru Carafe, Classic & Under Sink Units; $300 off Freestanding models.OmegaQuant: At-home blood testing to see fatty acid profiles, including omega-3 fatty acids. Use link to see options and support M&M.SiPhox Health: Comprehensive, cost-effective bloodwork from the comfort of home. Use code TRIKOMES for 20% off.KetoCitra—Ketone body BHB + electrolytes formulated for kidney health. Use code MIND20 for 20% off any subscription (cancel anytime)SporesMD: Premium mushrooms products (gourmet mushrooms, nootropics, research). Use code 'nickjikomes' for 20% off.For all the ways you can support my efforts