Podcasts about tte

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Best podcasts about tte

Latest podcast episodes about tte

EVOQ.BIKE Cycling Podcast
4 Ways to Increase Threshold Power in 2026

EVOQ.BIKE Cycling Podcast

Play Episode Listen Later Aug 24, 2026 16:44


Brendan Housler explains that FTP isn't one system but reflects aerobic base, VO2 max “ceiling,” lactate handling, durability, and time to exhaustion, so raising threshold requires targeting your specific limiter instead of doing random FTP workouts. He prioritizes first building an endurance foundation (2–3 hour rides feeling fresh), then using VO2 max and over-unders, followed by supra-threshold work (just above FTP), and lastly steady-state TTE workouts (e.g., 3x20, 2x30, 1x45). He suggests using 5-minute power as a rough VO2 proxy and comparing FTP/5-min power (fractional utilization) to decide whether to focus on VO2 work or threshold, while noting anaerobic riders can skew 5-minute results. He emphasizes fueling key sessions, adjusting focus around race season, and maintaining year-round purpose by stacking training across seasons and years.Chapters:00:00 Stop Surviving Intervals00:47 FTP Is Multiple Systems02:59 Four Buckets Framework03:25 Base Before Intensity05:05 Find Your Limiter05:42 Ceiling Test With 5-Minute07:14 VO2 Max Workout Menu08:21 Supra Threshold Bridge09:41 Over Unders For Surges10:32 Build Time To Exhaustion11:54 Recap And Next Steps12:52 Sample Week And Caveats13:56 Fueling And Coaching Plugs15:14 Offseason Purpose And Wrap

Zacks Market Edge
Buy the Big Oil Stocks Now

Zacks Market Edge

Play Episode Listen Later Aug 21, 2026 47:55


ExxonMobil, Chevron, and TotalEnergies are cash generating machines.  (0:15) - Where In The Energy Industry Should You Be Looking To Invest Right Now? (11:10) - Tracey's Top Stock Picks For Your Watchlist (43:00) - Episode Roundup: XOM, CVX, TTE, VLO, MPC

Cardionerds
462. Tricuspid Regurgitation with Dr. Sunil Mankad

Cardionerds

Play Episode Listen Later Aug 13, 2026 18:44


CardioNerds (Dr. Apoorva Gangavelli, Dr. Cory Sejo, and Dr. Joseph Kassab), discuss tricuspid regurgitation evaluation and management with Dr. Sunil Mankad. This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course.  Audio editing by CardioNerds intern Emma Winakur. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Key Points: Tricuspid regurgitation is common and associated with increased mortality at every stage, regardless of etiology. Outcomes are worse with worsening severity, so accurate grading is critical. Etiology is critical to guide treatment decisions. Etiology includes primary vs secondary (atrial or ventricular) vs CIED-related TR. 3D echocardiography can be very helpful in determining TR etiology, especially in CIED-related TR. Diuresis with the goal of euvolemia is step one. Additionally, underlying contributory conditions (eg. pulmonary HTN, HFrEF, atrial fibrillation) should be addressed, if appropriate, and then TR severity reassessed. The choice between T-TEER and TTVR hinges on anatomy, RV function, pulmonary hypertension, and the ability to tolerate anticoagulation. T-TEER is generally first line in atrial functional TR with appropriate anatomy, in patients with poor RV function who cannot tolerate a sudden increase in RV afterload, or in patients who cannot tolerate the necessary anticoagulation with TTVR. TTVR is preferred with wide coaptation gaps and CIED-related TR. This is a team sport. Multidisciplinary discussions utilizing imaging (TTE/TEE, CT), risk scores (TRI-SCORE or TRIO), patient preference, and prior institutional experience are essential for the effective treatment of severe TR. Notes: What is the clinical importance of tricuspid regurgitation? TR is very common with approximately 4% of people over 75 having moderate or greater severity. TR (even mild) is associated with increased mortality. Those outcomes worsen as the TR severity worsens, and this phenomenon is independent of the mechanism of regurgitation. What is unique about the tricuspid valve compared to the other cardiac valves? It is at an anterior location which allows it to be imaged well with transthoracic echocardiography It is the largest valve and composed generally of 3 leaflets (but very often can have 4+ leaflets). Importantly, the RV is compliant and changes size and shape readily based on loading conditions. The TV annulus similarly changes size and shape based on hemodynamic conditions such as preload. What is a good framework for approaching the causes of tricuspid regurgitation? Determine the presence and define the severity of TR. Using TTE, we want to measure the right atrial size, the RV size, and any other concomitant valvular lesions.  Use TTE (2D and 3D) to characterize leaflet anatomy and characteristics. Subtypes of TR mechanisms (many times etiology is mixed). Primary: primary leaflet abnormality, occurs in ~10% of cases. Look for prolapse, flail, endocarditis, etc. Secondary/functional: leaflets normal but surrounding structures are abnormal. Atrial: RA and tricuspid annular dilation but normal RV size/shape, and can be related to arrhythmias like atrial fibrillation. Ventricular: RV dilated and/or dysfunctional with leaflet tethering. Can be related to pulmonary hypertension or primary RV disease. Cardiac implantable electronic device (CIED): Related to device (usually pacemakers or ICD) interaction with TV leaflets. Includes perforation, entanglement in subvalvular apparatus, impingement, etc. 3D TTE particularly helpful to evaluate How do we grade TR severity? It is very important to grade the severity of TR, and this is generally done with echocardiography. There are both quantitative and qualitative methods which use Doppler and various equations to estimate TR severity. Current recommendations have expanded TR severity beyond mild/moderate/severe to include “massive” and “torrential” categories. The most important parameters measured/calculated are vena contracta width, regurgitant volume, regurgitant fraction, and effective regurgitant orifice area. Helpful qualitative metrics include hepatic venous flow reversal. When should additional studies beyond transthoracic echocardiography, such as transesophageal echocardiography (TEE), cardiac computed tomography (CT), and cardiac magnetic resonance imaging (MRI) be pursued? TEE is particularly helpful if TTE views are poor. Since TEE is used during transcatheter intervention, a pre-procedure TEE to define anatomy, determine procedure candidacy, and plan for the procedure is critical.  CT is also helpful for procedure planning and has particular strengths in defining annulus size and geometry. A CT is required prior to transcatheter tricuspid valve replacement (TTVR). MRI is helpful for measuring RV volumes and function, but is not generally used to assess TR severity.  What is the approach to the treatment for severe tricuspid regurgitation? The first step is to try to determine the etiology. For secondary TR, treating the underlying condition is indicated. For example, pulmonary vasodilators for pulmonary HTN or guideline therapy for heart failure with reduced ejection fraction. Diuretics are the mainstay for treatment, with the goal to obtain euvolemia. This may require inpatient admission to optimize volume status and medication regimen. Once reversible etiologies are addressed, if the patient is still symptomatic from TR, additional therapies can be considered. What is the role of right heart catheterizations (RHC) in patients with severe TR? RHC is very helpful for many reasons. We use it in TR to help determine volume status, cardiac output, and RV function. Additionally, identifying and characterizing pulmonary hypertension (with pulmonary artery pressures and calculating pulmonary vascular resistance) is an important factor when choosing future therapies.  With severe tricuspid regurgitation, when should we refer for intervention (either with surgery or transcatheter repair or replacement)? Once reversible etiologies are addressed and euvolemia has been achieved, if the patient is still symptomatic from TR despite aggressive medical optimization, additional therapies can be considered. Once euvolemic, a repeat TTE should be ordered to reassess the severity of the TR. Use calculators (for example, either the TRI-SCORE or TRIO score) to predict operative mortality for isolated TR surgery. What are our transcatheter treatment options in severe tricuspid regurgitation, and how do we choose between them? The primary approved transcatheter treatment options for severe TR include transcatheter tricuspid edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR), of which the Edwards EVOQUE valve is the only one currently approved by the FDA. There are other TTVR device under investigation. These decisions should be made with a multi-disciplinary team including representation from cardiac imaging, interventional cardiology, and cardiothoracic surgery. Factors that go into the decision between T-TEER and TTVR include anatomy (annulus width, coaptation gap, leaflet length), RV reserve, pulmonary hypertension presence, ability to tolerate anticoagulation, patient preference, and institutional experience.  T-TEER is generally the first line with atrial functional and suitable anatomy. It is successful at reducing TR but does not generally eliminate it.  TTVR with EVOQUE is preferred in certain anatomic considerations like a large coaptation gap or when there is CIED-related TR (as this was excluded in T-TEER trials). Patients must be suitable for anticoagulation to receive TTVR as there is risk of leaflet thrombosis without it. If moderate/severe pulmonary hypertension is present, or there is poor RV function, TTVR may be avoided as the sudden elimination of TR causes a sudden increase in RV afterload which may not be tolerated. What is the role in advanced metrics for evaluating RV function? Advanced metrics like RV/PA coupling are under investigation but have not made it into the guidelines. The clinical utility is not yet known.  Assessing the RV function is important as stated above. Dr. Mankad prefers using 3D TTE to calculate an RVEF, or tracking RV longitudinal free wall strain. If you do encounter CIED-related TR, how do you treat it? Evaluate with TTE or TEE. 3D is very helpful to identify relative anatomy and leaflet-device interactions. There is no clear consensus about treatment if CIED-related TR is the primary mechanism of severe TR. If recently implanted, repositioning may be a valid option, but requires discussions with multiple teams including electrophysiology, advanced cardiac imaging, CT surgery, and interventional cardiology. References O’Gara PT, Lindenfeld J, Hahn RT, et al. 10 Issues for the Clinician in Tricuspid Regurgitation Evaluation and Management: 2025 ACC Expert Consensus Decision Pathway. J Am Coll Cardiol. 2025;S0735-1097(25)07047-0. O’Gara PT, Little SH, Badhwar V, et al. Operator and Institutional Recommendations and Requirements for Tricuspid Interventions: 2026 ACC/AHA/ASE/HRS/STS Expert Consensus Systems of Care Document. J Am Coll Cardiol. 2026;S0735-1097(26)05481-1. Hahn RT. Tricuspid Regurgitation. N Engl J Med. 2023;388(20):1876-1891. Davidson LJ, Tang GHL, Ho EC, et al. The Tricuspid Valve: A Review of Pathology, Imaging, and Current Treatment Options: A Scientific Statement From the American Heart Association. Circulation. 2024;149(22):e1223-e1238.

The Tilehurst End - A Reading FC Podcast
The Tilehurst End Podcast Episode 467: The Pre-Season Review-Preview

The Tilehurst End - A Reading FC Podcast

Play Episode Listen Later Aug 11, 2026 51:29


It's not the season preview. That's what the title means. You'll be getting that on Saturday! Instead, Ross interrupts Ben's Greek holiday to discuss the League Cup win over new League One side Bromley.  The boys debate where the mistakes were made in the Bromley goal, but have lots of good things to say about Reading's wide options. Thank you to The Amazons for providing the theme song. Thank you to Siren Brewing - Get 10% off your next Siren order. Use code TILEHURST10 at the checkout on a minimum spend of £30.  Follow The Tilehurst End on Twitter @thetilehurstend  Follow Ross on Bluesky @webberross.bsky.social Follow Ben on Twitter @mrblthomas Did you enjoy this episode of the podcast? Please consider dropping a few quid into our tip jar on Buy Me a Coffee or supporting TTE on Patreon. We're hugely grateful for anything you can spare.

The Trance Empire
THE TRANCE EMPIRE 434 with Rodman

The Trance Empire

Play Episode Listen Later Aug 8, 2026 119:33


Two hours of the best Trance music, this is episode 434 of The Trance Empire with your host, Rodman.     Choose your player

empire trance buuren rodman dyk tte alexander komarov dauby
The Trance Empire
THE TRANCE EMPIRE 433 with Rodman

The Trance Empire

Play Episode Listen Later Aug 3, 2026 120:29


Two hours of the best Trance music, this is episode 433 of The Trance Empire with your host, Rodman.     Choose your player

Les matins
Léa Lansade, la chercheuse qui lit dans la tête des chevaux

Les matins

Play Episode Listen Later Jul 29, 2026 4:37


durée : 00:04:37 - Les Matins de France Culture - À l'INRAE de Nouzilly (Indre-et-Loire), la chercheuse en éthologie Léa Lansade observe depuis une vingtaine d'années tout ce qui se passe dans la tête des chevaux. Son équipe est aujourd'hui capable de cerner la personnalité d'un cheval mais aussi d'évaluer combien il perçoit les émotions humaines. - équipe : La Rédaction de France Culture Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Le Reportage de la rédaction
Léa Lansade, la chercheuse qui lit dans la tête des chevaux

Le Reportage de la rédaction

Play Episode Listen Later Jul 29, 2026 4:37


durée : 00:04:37 - Le Reportage de la rédaction - À l'INRAE de Nouzilly (Indre-et-Loire), la chercheuse en éthologie Léa Lansade observe depuis une vingtaine d'années tout ce qui se passe dans la tête des chevaux. Son équipe est aujourd'hui capable de cerner la personnalité d'un cheval mais aussi d'évaluer combien il perçoit les émotions humaines. - équipe : La Rédaction de France Culture Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Autant en emporte l'histoire
1979. Khomeiny 4/5 - L'ayatollah Khomeiny prend la tête de la révolution

Autant en emporte l'histoire

Play Episode Listen Later Jul 26, 2026 11:38


durée : 00:11:38 - Le Fil de l'histoire - 31 janvier 1979. L'ayatollah Khomeiny pénètre dans l'aéroport Charles-de-Gaulle accompagné par une foule de sympathisants brandissant son portrait. Le regard toujours impassible, l'homme de 77 ans, accompagné de sa famille et d'une cinquantaine de fidèles, monte dans l'avion que le mènera à Téhéran. Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Les matins
Anne-Claire Legendre : une diplomate à la tête de l'Institut du monde arabe

Les matins

Play Episode Listen Later Jul 20, 2026 39:28


durée : 00:39:28 - Les Matins de France Culture - par : Bérengère Bonte - Ancienne conseillère Afrique du Nord-Moyen-Orient du président Macron, elle est le nouveau visage de l'Institut du monde arabe qui fêtera l'année prochaine ses 40 ans : Anne-Claire Legendre est notre invitée dans Les Matins d'été. - équipe : Félicie Faugère, Mathilde Thon-Fourcade, Victoria Géraut-Velmont, Inès Bouffartigue Sebastia, Rodi Eken, Romain Rincon Hernandez, Salomé Erbs - invités : Anne-Claire Legendre Haute-fonctionnaire française, présidente de l'Institut du monde arabe Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Les interviews d'Inter
Coupe du monde de football : la "force collective" de l'équipe de France "entre dans la tête des adversaires"

Les interviews d'Inter

Play Episode Listen Later Jul 10, 2026 19:32


durée : 00:19:32 - Les interviews d'Inter - par : Céline Asselot - Nathalie Iannetta, directrice des Sports de Radio France, Claude Askolovitch, journaliste à France Inter, et Grégoire Margotton, journaliste sportif, décryptent la victoire de la France contre le Maroc (2-0), jeudi soir, en quart de finale du mondial et analysent le parcours des Bleus. Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

The Imperfect show - Hello Vikatan
Karur Visit: அரசுப் பணிக்கு எதிர்ப்பு - முடிவை மாற்றுவாரா முதல்வர் Vijay? | VCK Vs MDMK | TVK ADMK

The Imperfect show - Hello Vikatan

Play Episode Listen Later Jul 9, 2026 23:52


* "லாரி டயர் சரியில்லை" - ஸ்ரீவைகுண்டம் MLA ஆய்வு? * எம்.எல்.ஏ திமுக மேல் வைத்த குற்றச்சாட்டு என்ன? * சென்னை எழும்பூர் குழந்தைகள் மருத்துவமனையில் முதல்வர் விஜய் திடீர் ஆய்வு* பள்ளியில் ஆய்வு செய்த அமைச்சர் கீர்த்தனா குறித்த கேள்விக்கு துரை வைகோ எம்.பி கொடுத்த பதில்* தேர்தல் வழக்கில் முதல்வர் விஜய்க்கு நோட்டீஸ் அனுப்பிய நீதிமன்றம்?* மரிய வில்சன்: நேரில் ஆஜராவதில் இருந்து விலக்கு?* கரூர் விசிட் : 32 நபர்களுக்கு கருணை அடிப்படையில் பணி நியமன ஆணை வழங்குகிறார் முதல்வர் விஜய்!* இந்திய கம்யூனிஸ்ட் எம்பி சுப்பராயன் எதிர்ப்பு?* திருமா Vs வைகோ?* விசிக: 'எந்த அரசியலும் இல்லை'; அமைச்சரவை பெயர் மாற்றம் - ரவிக்குமார் எதிர்ப்புக்கு வன்னி அரசு பதில்!* செந்தில் பாலாஜி ஜாமீன்?* மகாராஷ்டிராவில் கனமழை: ஆற்று வெள்ளத்தில் அடித்துச்செல்லப்பட்ட 3000 கேஸ் சிலிண்டர்கள்* 'காவல்துறை பாஜக தொண்டர்களைப் போல.!' - சொந்த கட்சி தொண்டரை அறைந்த மம்தா பானர்ஜி - என்ன நடந்தது?* முதலிரவு செட்டப்பில் ரயில் பெட்டியை அலங்கரித்து ஹனிமூனுக்கு சென்ற ஜோடி! டெக்கரரேஷனுக்கு அனுமதித்த TTE தற்காலிக பணிநீக்கம்* இந்தியாவுக்கு யுரேனியம்: ஆஸி. பிரதமர் அறிவிப்பு #* ஈரான் துறைமுகம், விமான நிலையம் மீது அமெரிக்கா தாக்குதல்?

Soft Power
Dans la tête d'Orange, le géant des télécoms français

Soft Power

Play Episode Listen Later Jul 5, 2026 108:09


durée : 01:48:09 - Soft Power - par : Frédéric Martel - Opérateur majeur en France, Orange est un véritable empire des télécoms. Du rachat de SFR aux défis de cybersécurité, du développement de l'infrastructure numérique dans le monde à la concurrence des flottes satellitaires, comment fonctionne et réagit le groupe ? - équipe : Peire Legras, Alexandra Malka, Emmanuel Paquette, Romain Gueugneau, Quentin Le Van - invités : Christel Heydemann PDG d'Orange, Sophie Lévy Directrice du Voyage à Nantes Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Cardionerds
457. Insights into INOCA and ANOCA with Dr. Claire Raphael

Cardionerds

Play Episode Listen Later Jul 3, 2026 9:25


 CardioNerds (Drs. Apoorva Gangavelli, Rebecca Garber, and Tina Reddy discuss INOCA with Dr. Claire Raphael. Audio editing by CardioNerds Academy intern, student doctor Pacey Wetstein. This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli, and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. Non-obstructive coronary artery disease (CAD) is more common than often recognized, particularly in women and individuals with risk factors like diabetes or hypertension. Conditions such as INOCA, ANOCA, and MINOCA can cause ischemia and chest pain despite “clean” angiograms, often due to microvascular dysfunction, coronary spasms, or subtle plaque. Diagnosing these conditions requires advanced imaging or invasive studies to assess blood flow and vessel function. Treatment focuses on reducing cardiovascular risk with aspirin, statins, ACE inhibitors, or ARBs, and managing symptoms with beta-blockers or calcium channel blockers. The key takeaway: A normal angiogram doesn't rule out disease, and these patients need a comprehensive, evidence-based approach to care. 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: When patients present with chest pain but do not have obstructive coronary artery disease, the story does not end there! Other pathologies that must be ruled out include spontaneous coronary artery disease (SCAD), coronary vasospasm, microvascular disease, Takotsubo, and cardiomyopathy. A TTE can help rule out other pathologies. Cardiac MRI can help identify myocardial fibrosis, scarring, or edema that may suggest prior events or alternative diagnoses.  About 60-70% of INOCA cases are in women. However, it is estimated that about half of the patients with so-called “normal” angiograms actually have positive stress tests. Patients with elevated troponins are more likely to have recurrent events. Patients with INOCA are more likely to come back to the ER multiple times before getting diagnosed. These patients have a 1.4x increased risk of adverse cardiovascular events (such as HFpEF, MI, and recurrent hospitalizations for cardiac chest pain).  INOCA is a complex condition with a variety of causes, primarily linked to microvascular disease. Within microvascular disease, there are different “endotypes” (types or subcategories) classified by specific characteristics. In centers that conduct microvascular testing, patients are categorized as endothelium-independent or endothelium-dependent, based on their responses to adenosine or acetylcholine during testing. Additionally, microvascular disease can be classified as either structural or functional, depending on the results of tests measuring microvascular resistance. The field is moving towards the term ANOCA, or angina with non-obstructive coronary arteries, to include patients with anginal symptoms without objective ischemia.  The field is moving toward using genotyping and hemodynamic testing to guide first-line therapies for microvascular disease, a heterogeneous condition. Current treatments mostly come from obstructive coronary artery disease, but specialized approaches—like the coronary sinus reducer—may offer unique benefits for microvascular disease. Treatment includes sublingual nitroglycerin, ACE inhibitors/ARBs, and beta-blockers. Remember to also treat any additional comorbidities, such as diabetes, hypertension, and hyperlipidemia. Unfortunately, many of these patients may still have refractory chest pain, so it is important to reassure them. These patients can still exercise, but they may be hesitant to do so for fear of having chest pain. Cardiac rehab may be helpful for these patients as it helps them build up their tolerance. References Lawton JS, Tamis-Holland JE, Bangalore S, et al; Writing Committee Members. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(3):e18-e114. doi:10.1161/CIR.0000000000001039 Hwang D, Park S, Koo B-K. Ischemia with nonobstructive coronary artery disease. JACC: Asia. 2023;3(2):169-180. doi:10.1016/j.jacasi.2023.01.004 Yukselen Z, Majmundar V, Dasari M, Kumar PA, Singh Y. Chest pain risk stratification in the emergency department: current perspectives. Open Access Emerg Med. 2024;16:29-43. doi:10.2147/OAEM.S419657

Les p't**s bateaux
Quand les poules auront des dents : Pourquoi pigeons, poules et autres volatiles balancent-ils leur tête quand ils marchent ?

Les p't**s bateaux

Play Episode Listen Later Jul 1, 2026 3:28


durée : 00:03:28 - Les P'tits Bateaux - par : Camille Crosnier - Les pigeons ou poules ont une bien curieuse manie quand ils marchent : ils dodelinent de la tête, balançant leur cou tantôt en avant, tantôt en arrière. La jeune Clara l'a bien remarqué et se demande quelle en est la raison. Cécile Arnould, spécialiste du comportement des oiseaux lui répond. - équipe : Stéphanie Texier, Marjorie Devoucoux Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Neurology Minute
Comparative Accuracy of TCD, TTE, TEE, and Cardiac CT for Detecting Right-to-Left Shunt in ESUS

Neurology Minute

Play Episode Listen Later Jun 12, 2026 2:04


Dr. Dan Ackerman and Dr. Reza Bavarsad Shahripour discuss the diagnostic performance of 4 major modalities: TCD, TTE, TEE, and cardiac CT in patients with embolic stroke of undetermined source.  Sho citation:  Read the related article in Neurology® Clinical Practice.     

left tee accuracy detecting comparative sho tte tcd shunt esus dan ackerman cardiac ct neurology clinical practice
Neurology® Podcast
Comparative Accuracy of TCD, TTE, TEE, and Cardiac CT for Detecting Right-to-Left Shunt in ESUS

Neurology® Podcast

Play Episode Listen Later Jun 11, 2026 20:16


Dr. Dan Ackerman talks with Dr. Reza Bavarsad Shahripour about the diagnostic performance of 4 major modalities: TCD, TTE, TEE, and cardiac CT in patients with embolic stroke of undetermined source.  Read the related article in Neurology® Clinical Practice.  Disclosures can be found at Neurology.org. 

The Trance Empire
Rodman Live from Trance In the Woods 30.05.26

The Trance Empire

Play Episode Listen Later Jun 10, 2026 59:53


Rodman live from Trance In the Woods, Not So Secret Stage, 30.05.26.    Choose your player

Le magazine de la rédaction
Vivre avec un trouble dissociatif de l'identité 1/5 : TDI : cohabiter avec des dizaines d'identités à l'intérieur de sa tête

Le magazine de la rédaction

Play Episode Listen Later Jun 1, 2026 6:18


durée : 00:06:18 - Grand Reportage - par : Aurélie Kieffer - À 28 ans, Zelliana est titulaire d'un master en neurobiologie. Mais parfois, elle parle comme une enfant de 8 ans et dit se prénommer Irish. Son cerveau abrite ainsi plus de dix personnalités. Psychiatre, Pr Hingray rappelle que le trouble dissociatif de l'identité reste, à tort, très controversé. - réalisation : Tara Schlegel, Annie Brault, Caroline Bennetot, Éric Chaverou Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Balade accompagnée - FB La Rochelle
Samuel Vincent, gérant de Belle Factory, à la tête de plusieurs festivals charentais

Balade accompagnée - FB La Rochelle

Play Episode Listen Later May 29, 2026 2:26


durée : 00:02:26 - Samuel Vincent, organisateur de festivals avec Belle Factory, témoigne de sa passion pour la scène et de son attachement à la production d'événements. Il chapeaute notamment le festival Cognac Blues Passions, qui aura lieu du 1er au 4 juillet à Cognac. Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Le p'tit cours de breton France Bleu Breizh Izel
Le p'tit cours de breton: tête de Merlu

Le p'tit cours de breton France Bleu Breizh Izel

Play Episode Listen Later May 27, 2026 2:14


durée : 00:02:14 Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Paul's Security Weekly
Listening, Drupal, TTE, KEV, Mythos, Megalodon, Badanov, MFA, Pope Leo, Aaran Leyland - SWN #584

Paul's Security Weekly

Play Episode Listen Later May 26, 2026 30:59


They're Listening, Drupal, TTE, KEV, Mythos, Megalodon, Boris and Natasha, MFA, Pope Leo, Aaran Leyland, and More on the Security Weekly News. Visit https://www.securityweekly.com/swn for all the latest episodes! Show Notes: https://securityweekly.com/swn-584

Paul's Security Weekly TV
Listening, Drupal, TTE, KEV, Mythos, Megalodon, Badanov, MFA, Pope Leo, Aaran Leyland - SWN #584

Paul's Security Weekly TV

Play Episode Listen Later May 26, 2026 30:59


They're Listening, Drupal, TTE, KEV, Mythos, Megalodon, Boris and Natasha, MFA, Pope Leo, Aaran Leyland, and More on the Security Weekly News. Show Notes: https://securityweekly.com/swn-584

Hack Naked News (Audio)
Listening, Drupal, TTE, KEV, Mythos, Megalodon, Badanov, MFA, Pope Leo, Aaran Leyland - SWN #584

Hack Naked News (Audio)

Play Episode Listen Later May 26, 2026 30:59


They're Listening, Drupal, TTE, KEV, Mythos, Megalodon, Boris and Natasha, MFA, Pope Leo, Aaran Leyland, and More on the Security Weekly News. Visit https://www.securityweekly.com/swn for all the latest episodes! Show Notes: https://securityweekly.com/swn-584

Hack Naked News (Video)
Listening, Drupal, TTE, KEV, Mythos, Megalodon, Badanov, MFA, Pope Leo, Aaran Leyland - SWN #584

Hack Naked News (Video)

Play Episode Listen Later May 26, 2026 30:59


They're Listening, Drupal, TTE, KEV, Mythos, Megalodon, Boris and Natasha, MFA, Pope Leo, Aaran Leyland, and More on the Security Weekly News. Show Notes: https://securityweekly.com/swn-584

100% PSG
100% PSG le Mag (Ep. 75) – PSG-Arsenal : dans la tête d'Arteta

100% PSG

Play Episode Listen Later May 26, 2026 21:24


durée : 00:21:24 - A trois jours de la finale de Ligue des champions entre le PSG et Arsenal, on répond à une question proprement existentielle : le football pratiqué par les Gunners est-il vraiment si moche ? - réalisation : Pia Clemens Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Culture en direct
Dans la tête d'un enfant qui parle seul, avec Gérard Lefort

Culture en direct

Play Episode Listen Later May 4, 2026 58:25


durée : 00:58:25 - Le Book Club - par : Marie Richeux - Camille vit dans les Ardennes, il dialogue avec son double intérieur et arpente une région chargée d'histoire. L'enfant promène son regard poétique sur le monde qui l'entoure dans un roman aux allures de conte à la fois sombre et lumineux. - réalisation : Vivien Demeyère - invités : Gérard Lefort Journaliste, critique de cinéma et écrivain

The Trance Empire
Transaphonic Guestmix

The Trance Empire

Play Episode Listen Later Apr 16, 2026 60:00


We welcome our Artist of the Year 2025 - Transaphonic to The Trance Empire guestmix.    Choose your player

Les pieds sur terre
La tête dans les nuages

Les pieds sur terre

Play Episode Listen Later Apr 4, 2026 27:59


durée : 00:27:59 - Les Pieds sur terre - par : Sonia Kronlund - Allongé dans l'herbe, au milieu de la ville, ou au bord de la mer, le nez en l'air pointé vers le ciel, qui n'a pas un jour regardé défiler les nuages ? A quoi font penser ces cheveux d'ange, ces gros nuages lourds, ou ces petits floconneux ? De 5 à 88 ans, les réponses fusent sous le ciel… - réalisation : Sandrine Chapron, Élise Andrieu, Charlotte Bienaimé, Amaury Chardeau, Leila Djitli, Rémi Dybowski Douat, Morgane Du Liège, Bahar Makooi, Pauline Maucort, Olivier Minot, Nicolas Ruffault, Delphine Saltel, Jérôme Sandlarz, Farida Taher, Léa Veinstein, Julie Beressi, Alexandra Malka, Annabelle Brouard, Emmanuel Geoffroy Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

dans dans les radio france les pieds nuages tte andrieu veinstein charlotte bienaim julie beressi alexandra malka olivier minot pauline maucort leila djitli
The Tilehurst End - A Reading FC Podcast
The Tilehurst End Podcast Episode 457: Anniversaries For Days

The Tilehurst End - A Reading FC Podcast

Play Episode Listen Later Apr 2, 2026 63:59


It's 20 years since the 106 season and 15 years since Wimb started The Tilehurst End! Ben and Ross bring on the founder for a breakdown of the Wigan Athletic game and a walk down TTE memory lane. With the 106 season celebration coming up, Ross quizzes his (said with love) older compatriots on their memories from the campaign, and the lineup from the promotion-winning game in Leicester City. Thanks as always to our friends at ZCZ Films for sponsoring the pod Thank you to The Amazons for providing the theme song Thank you to Siren Brewing - Get 10% off your next Siren order. Use code TILEHURST10 at the checkout on a minimum spend of £30.  Follow The Tilehurst End on Twitter @thetilehurstend  Follow Ross on Bluesky @webberross.bsky.social Follow Ben on Twitter @mrblthomas

Les enjeux internationaux
Elections au Danemark : l'épreuve des urnes pour celle qui a tenu tête à Trump

Les enjeux internationaux

Play Episode Listen Later Mar 25, 2026 12:35


durée : 00:12:35 - Les Enjeux internationaux - par : Guillaume Erner - Au Danemark, Mette Frederiksen s'affirme à l'international face aux crises, mais sa popularité étrangère suffit-elle à séduire les électeurs danois, divisés et attentifs aux clivages nationaux et aux coalitions ? - réalisation : Félicie Faugère - invités : Christelle Meilland Chercheuse à l'Institut de recherches économiques et sociales (IRES)

Le zoom de la rédaction
Municipales 2026 : à Roubaix, le candidat LFI en tête, David Guiraud, repart en campagne pour arracher la victoire

Le zoom de la rédaction

Play Episode Listen Later Mar 17, 2026 3:58


durée : 00:03:58 - Le Grand reportage de France Inter - David Guiraud est arrivé largement en tête du premier tour des élections municipales à Roubaix, dimanche 15 mars, avec 46,64% des voix, loin devant son adversaire de la droite, Alexandre Garcin, et ses 20,09%. Il repart désormais en campagne pour essayer de consolider son avance. - réalisation : Matthieu Bonhoure Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

Soft Power
Dans la tête de la BPI, grand argentier de l'innovation française

Soft Power

Play Episode Listen Later Mar 8, 2026 108:21


durée : 01:48:21 - Soft Power - par : Frédéric Martel - Fondée en 2012, la Banque Publique d'Investissement (BPI) est devenue l'un des rouages clé de l'innovation française. Quatorze ans après ses débuts, le travail de l'organisme est autant salué par les uns que ciblé par les autres. Soft Power reçoit son directeur, Nicolas Dufourcq. - réalisation : Peire Legras, Alexandra Malka - invités : Nicolas Dufourcq Directeur général de Bpifrance; Pierre-Olivier Costa Président du Mucem.; Charlotte Casiraghi Ecrivaine, présidente et co-fondatrice des Rencontres Philosophiques de Monaco

The Trance Empire
THE TRANCE EMPIRE 412 with Rodman

The Trance Empire

Play Episode Listen Later Mar 7, 2026 119:40


Two hours of the best Trance music, this is episode 412 of The Trance Empire, with your host, Rodman.     Choose your player

The Trance Empire
THE TRANCE EMPIRE 411 with Rodman

The Trance Empire

Play Episode Listen Later Mar 1, 2026 119:59


Two hours of the best Trance music, this is episode 411 of The Trance Empire, with your host, Rodman.     Choose your player

The Trance Empire
THE TRANCE EMPIRE 407 with Rodman

The Trance Empire

Play Episode Listen Later Feb 2, 2026 123:17


Two hours of the best Trance music, this is episode 407 of The Trance Empire, with your host, Rodman.     Choose your player

The Smattering
190. January 2026 Mailbag

The Smattering

Play Episode Listen Later Jan 28, 2026 48:53


We open the mailbag to answer your questions on whether Life Insurance Retirement Plans (LIRPs) are a scam, if spending millions on a Super Bowl commercial is ever a good idea (looking at you, CrowdStrike), and if equal-weight S&P 500 ETFs are the best way to hedge against a tech crash. Plus, we debate the future of the energy sector, discuss the power of "stock cannibals" like Adobe and PayPal, and reveal the two stocks we think could generate life-changing returns over the next 15 years.01:44 Housekeeping and Listener Support02:53 Diving into Listener Questions03:04 Explaining Life Insurance Retirement Plans09:03 Super Bowl Commercials: Worth the Investment?16:47 Exploring ETF Diversification23:10 Introduction and Wayne's Email23:17 Colin's Energy Market Inquiry24:04 Oil and Gas Market Dynamics27:38 Investment Strategies in Energy Sector29:48 Wayne's Question on ADRs32:17 John's Query on Stock Buybacks37:41 Ramey's AI and Investment Question43:27 Future Investment Picks47:23 Spam Comment of the MonthCompanies mentioned: ADBE, AZO, CRWD, GDDY, KNSL, KR, ORLY, PSX, PYPL, RKLB, TBBB, TTE, TXNFind where to listen & subscribe,  portfolio contests, and contact information at https://investingunscripted.com*****************************************To get 15% off any paid plan at fiscal.ai, visit https://fiscal.ai/unscriptedListen to the Chit Chat Stocks Podcast for discussions on stocks, financial markets, super investors, and more. Follow the show on Spotify, Apple Podcasts, or YouTube*****************************************Join our PatreonSubscribe to our portfolio on Savvy Trader

The Trance Empire
THE TRANCE EMPIRE 406 with Rodman - 138 & 140 bpm Special

The Trance Empire

Play Episode Listen Later Jan 24, 2026 120:40


Two hours of the best in Trance music, this is a 138 & 140 bpm special episode 406 of The Trance Empire, with your host, Rodman.     Choose your player

The Trance Empire
THE TRANCE EMPIRE 405 with Rodman

The Trance Empire

Play Episode Listen Later Jan 17, 2026 120:49


Two hours of the best in Trance music, this is episode 405 of The Trance Empire, with your host, Rodman.     Choose your player

Les matins
Iran : le régime vise délibérément les manifestant.e.s aux yeux et à la tête, portraits de victimes

Les matins

Play Episode Listen Later Jan 14, 2026 5:16


durée : 00:05:16 - La Revue de presse internationale - par : Catherine Duthu - Dans un Iran privé d'Internet, impossible de connaître le bilan précis de la répression menée par le régime contre les manifestations qui durent depuis deux semaines mais des médias parlent de 3 000 voire 12 000 morts. Portraits de victimes de cette répression, tuées par balles ou bientôt exécutées.

The Trance Empire
THE TRANCE EMPIRE 404 with Rodman

The Trance Empire

Play Episode Listen Later Jan 11, 2026 120:29


Two hours of the best in Trance music, this is episode 404 of The Trance Empire, with your host, Rodman.     Choose your player

The Trance Empire
THE TRANCE EMPIRE 403 with Rodman

The Trance Empire

Play Episode Listen Later Jan 3, 2026 121:15


Two hours of the best in Trance music, this is episode 403 of The Trance Empire, with your host, Rodman.     Choose your player

The Tilehurst End - A Reading FC Podcast
The Tilehurst End Podcast Episode 443: The 'Week From Hell'

The Tilehurst End - A Reading FC Podcast

Play Episode Listen Later Dec 17, 2025 71:04


Oh dear: the Leam Richardson bump comes crashing down as Reading lose two games with a whimper in the space of four days. TTE writer Bobbins joins Ross to discuss the fallout from the two games and helps dissect a mailbag full of frustrated Royals. Plus, the pair discuss Lewis Wing's recent impact on the team, the seeming lack of leaders and the silent style of Joel Pereira, and the recruitment mistakes that need correcting in the next transfer windows. Thanks as always to our friends at ZCZ Films for sponsoring the pod! Thank you to The Amazons for providing the theme song!  Follow The Tilehurst End on Twitter @thetilehurstend Follow Ross on Bluesky @webberross.bsky.social Follow Bobbins on Twitter @ohbobbins

The Trance Empire
THE TRANCE EMPIRE 400 with Rodman & Jasmine Lorna - Live from Sheffield

The Trance Empire

Play Episode Listen Later Dec 13, 2025 152:01


Celebrating 400 episodes of The Trance Empire, this is a live recording of Rodman solo and Rodman b2b with Jasmine Lorna from TTE 400 Live in Sheffield taken on Saturday, December 6th @ Plot 22.     PART 1 - RODMAN SOLO     Rene Ablaze - Tokyo [FSOE]  Lange feat. Skye - Drifting Away (U-Mount Bootleg) [White Label]  C-Systems, Aina - In The Cold [In Trance We Trust]  K.O.V.I. Project - Searching [Alter Ego]  Robin McIlmoyle, G. Summers & Ren Faye - Paradise Here [Think Trance]  Transaphonic & Ren Faye - Nothing On Your Love [ZYX Trance]  Dogzilla - Without You (Rodman's Blinding Lights Remix) [White Label]  Rodman - Storm [SPACE 4]  Rodman - Aurora [Ascent]  Para X - Elarion [ZYX Trance]  Paul Miller, Sneijder - En Route [Who's Afraid Of 138?!]  Chris Hunt - Unifier [We Love Trance]  RAM & Arctic Moon & Stine Grove - A Billion Stars Above (Darren Porter Remix) [Nocturnal Knights]  C-Quence, Fictivision, Ferry Tayle & Tonks - Symbols (Mirage Remix) [In Trance We Trust]  Drival, Christina Novelli - Save My Life (Steve Allen Remix) [AVA White]  Phil Stringer feat. Carolann Curran - My Love [Reason II Rise Uplift]  Ferry Corsten, Gouryella & Saskia Lie Atjam - Marama (Moon & Stars) [Flashover]     *****     PART 2 - RODMAN b2b JASMINE LORNA     Ralphie B, Frank Waanders & Collide1 - No Tomorrow [Find Your Harmony]  Billy Gillies - Expand [Afterdark]  John O'Callaghan - Riverside (Paul Denton Remix) [Subculture]  Ferry Corsten, Ben Hemsley & Rose Gray - Tidal [Armada Music]  Matt Robertson - Sunstruck [VANDIT]  CRW - I Feel Love (Omar Sherif Remix) [Grotesque]  Rodman - Runway [State Control]  Trance Wax - Ascend (Sneijder Remix) [Armada Music]  Asteroid - Kanjō [FSOE]  Enigma State - State Of Mind (Bryan Kearney Rework) [Kearnage]  David Forbes, Susie Ledge - Lose Ma Head [Who's Afraid Of 138?!]  The Rocketman - Strange World [Armada Music]  Giuseppe Ottaviani - Linking People [VANDIT]     Everything TTE 

The Tilehurst End - A Reading FC Podcast
The Tilehurst End Podcast Episode 442: That's Numberwang

The Tilehurst End - A Reading FC Podcast

Play Episode Listen Later Dec 2, 2025 68:20


TTE editor Simeon Pickup is on the pod to discuss Reading's first league win in Blackpool for two decades. Ross runs through the things that can still improve after an impressive 3-0 win, and Ben comes around on Daniel Kyerewaa, lauding his breakout performance in Royal colours. The TTE team also discuss Kelvin Ehibhatiomhan's evolving role at the club and how it may look after Jack Marriott returns to fitness.  Thanks as always to our friends at ZCZ Films for sponsoring the pod! Thank you to The Amazons for providing the theme song!  Follow The Tilehurst End on Twitter @thetilehurstend  Follow Ross on Bluesky @webberross.bsky.social Follow Ben on Twitter @mrblthomas Follow Sim on Twitter @simfrombucks

Dividend Talk
EP #268 | PayPal's First Dividend! | Schneider Data-Center Surge, UNH & Shell Earnings + Listener Qs

Dividend Talk

Play Episode Listen Later Nov 1, 2025 74:05


In this week's episode of Dividend Talk, we're back with a jam-packed Dividend Announcements & Earnings deep dive.We kick things off with PayPal initiating its first-ever dividend (welcome to the club, Monkey!), Hershey holding flat to stay off the aristocrat chopping block, and a wild stat on revenue-per-employee (OnlyFans crushes tech giants at $37.6M per head). Then it's over to dividend hikes from Iberdrola (+8.2%), Rockwell Automation, AbbVie, and ExxonMobil, before diving into earnings: Nestlé's volume rebound in China, Schneider Electric riding data-center tailwinds, Altria's cash-rich but growth-poor reality, UnitedHealth's margin squeeze, T. Rowe Price outflows, and Shell's $10B FCF buyback machine.In the Q&A, we tackle benchmarking vs. S&P 500, dollar-cost-averaging into falling knives, estate tax broker moves, covered-call ETFs, Finnish gems, Evolution's permanent pivot, and stock-specific takes on Novo Nordisk, APD, Qualcomm, and more.SEE YOU ON THE INSIDE!!Tickers discussed: PYPL, HSY, GOOGL, MSFT, EBAY, AMZN, IBM, MCD, IEP, IBDR.MC, MUM.DE, SIE.DE, APD, LIN, NOVO-B.CO, EVO.ST, QCOM, ARE, ADC, MO, BATS.L, PM, UNH, TROW, SHEL, XOM, TTE, ITW, ABT, ADP, SCHN.PA, ROC.AX, NOVN.SW, NESN.SW, MCD, APH, DHR, TXN, VFC, RELAS, VWS.CO, WSO, GRG.LJoin us:[Facebook] – Https://www.facebook.com/groups/dividendtalk[Twitter] – @DividendTalk_ , @European_DG[Discord] – https://discord.gg/nJyt9KWAB5[Premium Services] – https://dividendtalk.eu/download-your-free-samples/[Malmo Meetup] – https://t.co/STgV1nMWKj

Cardionerds
424. Treatment of Transthyretin Amyloid Cardiomyopathy (ATTR-CM) with Dr. Justin Grodin

Cardionerds

Play Episode Listen Later Aug 19, 2025 44:38


CardioNerds (Drs. Rick Ferraro and Georgia Vasilakis Tsatiris) discuss ATTR cardiac amyloidosis with expert Dr. Justin Grodin. This episode is a must-listen for all who want to know how to diagnose and treat ATTR with current available therapies, as well as management of concomitant diseases through a multidisciplinary approach. We take a deep dive into the importance of genetic testing, not only for patients and families, but also for gene-specific therapies on the horizon. Dr. Grodin draws us a roadmap, guiding us through new experimental therapies that may reverse the amyloidosis disease process once and for all.  Audio editing by CardioNerds academy intern, Christiana Dangas. This episode was developed in collaboration with the American Society of Preventive Cardiology and supported by an educational grant from BridgeBio.  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 Cardiac Amyloid PageCardioNerds Episode Page Pearls: You must THINK about your patient having amyloid to recognize the pattern and make the diagnosis. Start with a routine ECG and TTE, and look for a disproportionately large heart muscle with relatively low voltages on the ECG.  Before you diagnose ATTR amyloidosis, AL amyloidosis must be ruled out (or ruled in) with serum light chains, serum/urine immunofixation, and/or tissue biopsy.  Genetic testing is standard of care for all patients and families with ATTR amyloidosis, and the future is promising for gene-specific treatments. Current FDA-approved treatments for TTR amyloidosis are TTR stabilizers and TTR silencers, but TTR fibril-depleting agents are on their way.  Early diagnosis of ATTR affords patients maximal benefit from current amyloidosis therapies.   TTR amyloidosis patients require a multidisciplinary approach for success, given the high number of concomitant diseases with cardiomyopathy.  Notes: Notes: Notes drafted by Dr. Georgia Vasilakis Tsatiris.  What makes you most suspicious of a diagnosis of cardiac amyloidosis from the typical heart failure patient?  You must have a strong index of suspicion, meaning you THINK that the patient could have cardiac amyloidosis, to consider it diagnostically. Some characteristics or “red flags” to not miss:   Disproportionately thick heart muscle with a relatively low voltages on EKG   Bilateral carpal tunnel syndrome – estimated that 1 in 10 people >65 years old will have amyloidosis   Previously tolerated antihypertensive medications  Atraumatic biceps tendon rupture   Bilateral carpal tunnel syndrome  Spinal stenosis   Concomitant with other diseases: HFpEF, low-flow low-gradient aortic stenosis  How would you work up a patient for cardiac amyloidosis?   Start with a routine ECG (looking for disproportionally low voltage) and routine TTE (looking for thick heart muscle)  CBC, serum chemistries, hepatic function panel, NT proBNP, and troponin levels  NOTE: It is critical to differentiate between amyloid light chain (AL amyloidosis) and transthyretin ATTR amyloidosis, as both make up 95-99% of amyloidosis cases.   Obtain serum free light chains, serum & urine electrophoresis, and serum & urine immunofixation to rule out AL amyloidosis. (See table below)  AL Amyloidosis ATTR Amyloidosis  → Positive serum free light chains and immunofixation (Abnormal M protein) → Tissue biopsy (endomyocardial, fat pad) to confirm diagnosis → Negative serum free light chains and immunofixation (ruled out AL amyloidosis) → Cardiac scintigraphy (Technetium pyrophosphate with SPECT imaging)  What treatment options do we have to offer now for ATTR CM, and how has this compared to prior years?   Before 2019, treatment options were limited outside of cardiac tr...

Cardionerds
423. Case Report: The Malignant Murmur – More Than Meets the Echo in Nonbacterial Thrombotic Endocarditis – Baylor College of Medicine

Cardionerds

Play Episode Listen Later Aug 3, 2025 16:03


CardioNerds (Dr. Rick Ferraro and Dr. Dan Ambinder) join Dr. Sahar Samimi and Dr. Lorraine Mascarenhas from Baylor College of Medicine, Houston, Texas, at the Houston Rodeo for some tasty Texas BBQ and a tour of the lively rodeo grounds to discuss an interesting case full of clinical pearls involving a patient with nonbacterial thrombotic endocarditis (NBTE). Expert commentary is provided by Dr. Basant Arya. Episode audio was edited by CardioNerds Intern Dr. Bhavya Shah. (Photo by Xu Jianmei/Xinhua via Getty Images)Xinhua News Agency via Getty Images We discuss a case of a 38-year-old woman with advanced endometrial cancer who presents with acute abdominal pain, found to have splenic and renal infarcts, severe aortic regurgitation, and persistently negative blood cultures, ultimately diagnosed with nonbacterial thrombotic endocarditis (NBTE). We review the definition and pathophysiology of NBTE in the context of malignancy and hypercoagulability, discuss initial evaluation and echocardiographic findings, and highlight important management considerations. Emphasis is placed on the complexities of anticoagulation choice, the role of valvular surveillance, and the need for coordinated, multidisciplinary care.   US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls- Nonbacterial Thrombotic Endocarditis Eliminate the Usual Suspects. NBTE is a diagnosis of exclusion! Always rule out infective endocarditis (IE) first with serial blood cultures and serologic tests.  More than Meets the Echo. Distinguishing NBTE from culture-negative endocarditis can be tricky. Look beyond the echo—focus on clinical context (underlying malignancy, autoimmune issues) and lab findings to clinch the diagnosis.  TEE for the Win... Mostly. While TEE is more sensitive than TTE, NBTE vegetations can be sneaky and may embolize quickly. Don't hesitate to use advanced imaging (i.e., cardiac MRI, CTA) or repeat imaging if you still suspect NBTE.  Choose your champion. In cancer-associated NBTE, guideline recommendations for anticoagulation choice are lacking. Consider DOACs and LMWH as agents of choice, but ultimately use shared decision-making to guide management.  No obvious trigger? Go hunting for hidden malignancies or autoimmune disorders. A thorough workup is essential to uncover the driving force behind NBTE.  Check out this state-of-the-art review for a comprehensive, one-stop summary of NBTE: European Heart Journal, 46(3), 236–245. Please note that the figures and tables referenced in the following notes are adapted from this review.  notes- Nonbacterial Thrombotic Endocarditis Notes were drafted by Dr. Sahar Samimi.  What is nonbacterial thrombotic endocarditis (NBTE)?   NBTE, previously known as marantic endocarditis, is a rare condition in which sterile vegetations form on heart valves.1  It occurs most commonly in association with malignancies and autoimmune conditions (i.e, antiphospholipid antibody syndrome or systemic lupus erythematosus).1 In addition, NBTE has been reported in association with COVID-19 infection, burns, sepsis, and indwelling catheters.2  Precise mechanisms remain unclear, but an interplay of endothelial injury, hypercoagulability, hypoxia, and immune complex deposition contributes to the formation of these sterile vegetations. 1  How do we diagnose NBTE?  Physicians should have a high level of suspicion for NBTE in at-risk patients (e.g., with active malignancy) who present with recent or recurrent embolic events (i.e., stroke, splenic, renal, or mesenteric infarct, and acute coronary syndrome).1