Eddiana Colon

Cardiac Imaging Fellow | Tech Enthusiast | Gods Daughter #Echofirst #WhyCMR #YesCCT

[Society for Cardiovascular Magnetic Resonance @SCMRorg]

🫀 Join the next SCMR webinar!
Learn about flow mapping, acquisition setup, and CMR applications for aortic and mitral intervention planning through expert-led presentations and case-based discussions.

Register: https://t.co/GhcvNKohsE

[Ron Blankstein @RonBlankstein]

Imaging guided treatment of subclinical atherosclerosis—We’ve come a long way! - Journal of Clinical Lipidology
@EugeniaGianos @ACCinTouch @nationallipid https://t.co/h6aDFypjGT

[Hani Mahmoud-Elsayed @DrHaniMahmoud]

Demonstrating _using my hand gestures_ the difference between normal, billowing, prolapse and flail mitral valve anatomy.

[Dr. FEVI🫀🩺 @javier20ch]

Hipertensión Pulmonar asociada a cardiopatía izquierda. 🫀💥🫁
🔷️La HP asociada a cardiopatía izquierda representa entre el 65-80% de todos los casos de HP, convirtiéndose en la forma más frecuente de la enfermedad. Su presencia incrementa significativamente la mortalidad, las hospitalizaciones y el riesgo de disfunción ventricular derecha, pero continúa siendo una entidad infradiagnosticada. 🚨🧐🔎
🔷️Definición hemodinámica: PAP media >20 mmHg y, para clasificarla como HP por cardiopatía izquierda, debe coexistir una PAWP >15 mmHg. La RVP adquiere un papel central: ≤2 UW define la HP poscapilar aislada, mientras que >2 UW identifica la forma combinada precapilar y poscapilar (asociada con aproximadamente 2.5 veces mayor mortalidad, mayor remodelado vascular y peor función del ventrículo derecho).
🔷️Los fármacos aprobados para HAP NO deben utilizarse rutinariamente en la HP por cardiopatía izquierda. Los antagonistas de endotelina, inhibidores de PDE-5, estimuladores de guanilato ciclasa y prostaciclinas NO han demostrado beneficio clínico consistente e incluso pueden incrementar la congestión pulmonar, la retención de líquidos y las hospitalizaciones por insuficiencia cardiaca. 🚫🥲
✔️El manejo continúa basándose en optimizar la enfermedad cardíaca subyacente mediante terapia dirigida por guías para insuficiencia cardiaca o corrección de valvulopatías, además del control adecuado del estado de volumen.

📚🆓️⤵️ State-Of-The-Art Review2026 @JACCJournals 💯
https://t.co/QZnvGgApSq
https://t.co/rudKWIqVqQ

[Ahmed Ata @Ahmedata7777]

Annulus Paradoxus

🩺 What is Annulus Paradoxus?

Annulus paradoxus is the paradoxical finding where the E/e′ ratio is normal or low despite elevated left ventricular filling pressures, because the mitral annular e′ velocity is preserved or increased.

Thread 👇

[Oliverio @LuisOliverio]

Consenso de la ESC (European Society of Cardiology) 2026, sobre Obstrucción Microvascular Coronaria (o fenómeno de no-reflujo). Lo más sintetizado que puedo:

🟢Fenómeno No-reflow coronario: perfusión tisular miocárdica inadecuada a pesar de la recanalización exitosa de la arteria coronaria epicárdica sin obstrucción mecánica. Frecuente y lo pensamos poco (hasta 60% post infarto con elevación del ST tienen perfusión subóptima). Es un problema microvascular que clínicamente puede evolucionar a falla cardíaca.

🟢 El predictor más importante para no-reflow: tiempo en isquemia (puerta-balón). Ser mujer también es un factor.

🟢 Es un marcador pronóstico importante. Un IMR (index of microvascular resistance) >40 casi triplica el hazard de muerte cardiaca. La hemorragia intramiocárdica triplica muerte.

🟢 Casi ninguna terapia farmacológica cambia el desenlace. Adenosina, nitroprusiato y calcioantagonistas mejoran marcadores angiográficos, no mortalidad. Aspiración de trombo rutinaria no se recomienda (riesgo de EVC).

🟢 Así que el enfoque es: diagnóstico temprano, reducir tiempo en isquemia, Estatina de alta dosis temprana, P2Y₁₂ potente, control de presión, glucemia y factores de riesgo.

Es un tema muy interesante. Pueden ver el artículo completo en el canal (https://t.co/3O93s10lns).

[Shehab Anwer, MD @ShehabAnwer]

Most symptomatic HCM patients don't show their obstruction lying on the examination table🫀

A new EHJIMP review by Keen & Desai from Cleveland Clinic is a masterclass in why your imaging protocol, beyond just your imaging modality, determines whether you catch it.

The stress test choice matters more than most workups reflect:

* Upright treadmill can unmasks obstruction in >90% of patients at peak exercise.

* Semi-supine bicycle → only ~40%

* Bicycle allows continuous imaging through exertion, capturing the timing of obstruction onset and dynamic MR. Treadmill mostly captures recovery. It's a genuine trade-off, not a clear winner — the choice should be individualized.

* CMR remains uniquely good at catching what echo misses: small apical aneurysms (prognostically significant — arrhythmia and thrombus risk) and fibrosis burden via late gadolinium enhancement. But even LGE quantification isn't standardized — the two dominant methods (n-SD thresholding vs. full-width-half-maximum) can disagree enough to change how a patient gets risk-stratified.

Also worth flagging: AI-derived, demographic-adjusted LVH thresholds are showing that fixed wall-thickness cutoffs may under-diagnose HCM in women and smaller patients — a bias baked into decades of "normal" reference values.

Zooming out, the review isn't arguing for one best modality. It frames HCM imaging as a workflow problem: echo as the foundation, CMR for phenotyping and fibrosis, CT and PET deployed selectively when there's real diagnostic uncertainty — not sequentially by default.

Full open-access review at the #EHJIMP on /10.1093/ehjimp/qyag099

Genuinely curious where others land on this — treadmill or semi-supine bicycle your default for suspected latent LVOT obstruction, and has that choice ever changed your management?

[NEJM Clinician @NEJMClinician]

𝐆𝐮𝐢𝐝𝐞𝐥𝐢𝐧𝐞 𝐖𝐚𝐭𝐜𝐡: A new AHA/ACC guideline on pulmonary embolism (PE) offers a system for classifying PE and provides management recommendations for each category. Behnood Bikdeli, MD, MS (@bbikdeli) shares the key recommendations: https://t.co/6QNInnQDoe

[Ahmed Bennis MD 🫀 @drbennisahmed]

Management of Heart Failure With Preserved Ejection Fraction: 2026 ACC Expert Consensus Decision Pathway: A Report ACC Solution Set Committee

HFpEF is no longer viewed as a single cardiac condition, but rather as a complex
multisystem syndrome

https://t.co/ZGqNU6vBUQ

[EHJ-IMP Editor-in-Chief @EHJIMPEiC]

🫀⚡ Not all CRT candidates benefit… but maybe we’re looking at the wrong signal.
A new “how-to” paper shows how visual echocardiography can identify the real substrate for CRT response 👇
✨ Key concept:
👉 It’s not just electrical delay (QRS)…
👉 It’s mechanical dyssynchrony that matters
🔥 What to look for on echo:
⚡ Septal Flash (SF) → early septal contraction + rebound
🔄 Apical Rocking (ApRock) → biphasic apex motion
➡️ Together = SFoAR = mechanical dyssynchrony
📊 As shown in the 4-step workflow (Figure, page 3):
1️⃣ High-quality multi-view acquisition
2️⃣ Detect septal flash
3️⃣ Detect apical rocking
4️⃣ Integrate → diagnose dyssynchrony
💡 Why it matters:
❗ 20–45% of CRT patients are non-responders
🎯 Presence of SF/ApRock = higher likelihood of response
🧠 Visual assessment = simple, reproducible, bedside tool
🚨 Clinical message:
👉 Electrical ≠ mechanical
👉 Echo can refine patient selection beyond guidelines
🎯 Big take-home:
From “wide QRS = CRT”
➡️ to
“mechanical dyssynchrony = CRT responder”
📄 Read the full paper:
👉
🔗 DOI: 10.1093/ehjimp/qyaf158
#Cardiology #Echocardiography #CRT #HeartFailure #CardioTwitter #Imaging #Dyssynchrony #PrecisionMedicine #MedEd 🩺📊

[Dr. FEVI🫀🩺 @javier20ch]

🟥Insuficiencia Aórtica, update 2026. 🫀💥
🩻El Eco♡ sigue siendo el estándar de oro, utilizando un enfoque multiparamétrico. Ningún parámetro aislado debe definir la gravedad. La RM cardíaca es el método de referencia para cuantificar volúmenes y fracción regurgitante cuando el ecocardiograma es inconcluso.
📊 Criterios ecocardiográficos de IAo grave:
✔️Vena contracta >6 mm.
✔️Volumen regurgitante ≥60 mL.
✔️Fracción regurgitante ≥50%.
✔️EROA ≥0.30 cm².
✔️Reversión holodiastólica del flujo en la aorta descendente.
⚠️La dilatación progresiva del VI y la 📉FEVI preceden al deterioro clínico. El strain (GLS) emerge como un marcador temprano de disfunción ventricular y podría ayudar a identificar pacientes candidatos a cirugía antes de cumplir los criterios clásicos.
🔪 El reemplazo valvular aórtico qx (SAVR) es el tratamiento de elección en la IAo severa sintomática o cuando existe disfunción/dilatación ventricular.
🧐🔎 En pacientes asintomáticos, la cirugía está indicada cuando: FEVI <50%, LVESD >50 mm o >25 mm/m². La evidencia reciente sugiere que una FEVI <60%, un volumen telesistólico indexado ≥45 mL/m² y un GLS alterado podrían identificar pacientes de mayor riesgo que se beneficiarían de una intervención más temprana. 🤔

📄🆓️⤵️
DOI:10.4103/ACCJ.ACCJ_4_26
https://t.co/XmKwHPYNzU

[Carlos El-Tallawi, MD, FACC, FASE @HeartToProve]

@SIwa23288585 @PWesslyMD #ASEchoJC I prefer a "Pringles" shaped annulus

[Society for Cardiovascular Magnetic Resonance @SCMRorg]

🚨 Don’t Miss the June JCMR Journal Club Webinar 🚨

🗓 June 10, 2026
⏰ 11 AM ET

👥 Dr. Simon Littlewood &amp; Prof. René M. Botnar
🎙 Moderator: Dr. Ruud B. van Heeswijk

👉 Register:
https://t.co/KBhPxmMft1

[American Society of Echocardiography @ASE360]

UPCOMING WEBINAR: Join us on July 14 from 6-7 PM ET for the #ASEWebinar, "Guidelines in Practice Webinar Series: Identification and Mitigation of Cardiac Ultrasound Artifacts!" 🫀

Sign up: https://t.co/2NuEf3JoYK

[American Society of Echocardiography @ASE360]

🫀NEW GUIDELINE🫀
Read our new #ASEGuideline, "Guidelines for the Intraprocedural Imaging for Mitral Valve Transcatheter Edge-to-Edge Repair!" https://t.co/mPEUDziCfD

[Novi Yanti Sari @slumberbell]

Just published in JACC @JACCJournals!🫀

Acute HF care is evolving:
📍Rapid diagnosis
📍Early decongestion
📍Timely GDMT initiation
📍Structured follow-up
📍Focus on long-term outcomes, not just symptom relief

Grateful to have contributed to this international collaboration & learned so much from the exceptional experts involved in this work. Congratulations to @Jolie_Bruno_ and @AlexMebazaa for the leadership & to all co-authors on this important publication🫀

Read the full paper🔗: https://t.co/408QmNOznr

#HeartFailure #AcuteHeartFailure #JACC @jozinetm @BiykemB @GianluSava @pmyhre

[European Society of Cardiology Journals @ESC_Journals]

Beware of rare delayed LV rupture post M-TEER esp in elderly with limited space near commisure lesions https://t.co/VeYKgHwzXh

#EHJCaseReports @Phiso_de @TJ_Yeo @aayshacader @girishviswa @SukritiBanthiya @O_Azizy_MD @saramoscatelli7 @EHJCREiC #CardioX

[EACVI President @EACVIPresident]

Delighted to see the launch of this course focused on the evolving role of AI in cardiovascular imaging.

An excellent opportunity to explore how artificial intelligence and multimodality imaging — including cardiac CT and stress cardiac MRI — are advancing cardiovascular risk assessment and supporting more personalised patient care.

A valuable learning experience for cardiologists, radiologists, researchers, and healthcare professionals interested in the future of digital health and precision cardiology.

Exciting to see continued innovation at the intersection of medicine, imaging, and AI.

🔗 https://t.co/x6AYKYjqyq

#AI #EACVI #CVImaging #Cardiology #MedicalEducation #CardiacCT #CMR #DigitalHealth #PrecisionMedicine #HealthcareInnovation

@PezelT @Cosyns @NAjmoneMarsan @rmanka_ @DrMarkWestwood1 @AndreBaggi @dr_maghraby @rafavidalperez @YBououdina @MSBBrandao @ydaryani @Elizabeth_antos @pfelissamburu @CharlesFauvel @alexsfelixecho @galzeranod @andgiannopmd @hrt01a @WilliamKokFaiK1 @M_Marwan_ @drahmedmohsen85 @aniela_petrescu @benayozbay @slumberbell @senguptasp @ElizabetaK10533 @samsrivastava77 @MihaiTrofenciuc @C_VanDeHeyning @drozgeozden @Giulia_Vinco @VazyurVasquez @Sarah_Moharem @denisamuraru @VictoriaDe32503

[SEIC - Sociedad Española de Imagen Cardíaca @ImagenCardiaca]

4D-Flow CRM: revisión de la experiencia de 8 años
👓 https://t.co/Sm4IEgJrkz ◀️
Si tuviéramos que convertirlo en una regla de laboratorio: 4D-Flow no es para “ver flujo”, es para responder preguntas que no se dejan responder con un plano
✅ En "García Fernández te pone al día"

[American Society of Echocardiography @ASE360]

🫀NEW GUIDELINE🫀
Read our newest #ASEGuideline, "Recommendations for the Identification and Mitigation of Cardiac Ultrasound Artifacts!" https://t.co/wST56DL1ZH