Hannah Asghar MD,FACC

Cardiologist

[Scott Isaacs @scottisaacsmd]

Breaking: FDA approves tirzepatide to reduce cardiovascular risk in adults with type 2 diabetes at high CV risk, based on results from SURPASS-CVOT. A major milestone for tirzepatide, adding cardiovascular risk reduction to its growing clinical profile.
https://t.co/KEoxeAIDb8

[Dr. Gilbert Tang @GilbertTangMD]

Welcome to our APRIL 22 issue of #JACCCaseReports @JACCJournals.
https://t.co/HEW4oV37b4

Full PDF here:
https://t.co/Ix03k2mUCX

@minnowwalsh
@hmkyale
@Justine_Turco

Coronary, Peripheral and Structural Interventions
Percutaneous Mechanical Aspiration Revealing Lambl’s Excrescences Initially Suspected as Papillary Fibroelastomas
https://t.co/gADdOroFer
Glucocorticoid Therapy for Recurrent In-Stent Restenosis: A Prospective Explorative Case Series
https://t.co/wV2zfANPQi

Immediate Reversal of Hypoxemia With PFO Closure in Carcinoid Heart Disease and Platypnea-Orthodeoxia Syndrome
https://t.co/rpYLhoBKn7
Balloon Rupture-Facilitated Grenadoplasty in Complex Left Anterior Descending Chronic Total Occlusion
https://t.co/9I8bvNeoNj

Hydralazine-Associated Pericardial Effusion Causing Cardiac Tamponade Without Hypotension
https://t.co/4MMSHMmwIy
Using Optical Coherence Tomography to Distinguish Healed Spontaneous Coronary Dissection, Woven Coronary, and Recanalized Thrombus
https://t.co/gk9OOP0PFf

Aortoplasty and Stent Implantation for the Dacron–Jotec Junction Stenosis: First-in-Human Case Report
https://t.co/Lco8Tn91Q5
Persistent Shock After Successful PCI Due to CPR-Related Internal Mammary Artery Hemorrhage
https://t.co/yx3xUH0YU4

Spontaneous Coronary Artery Dissection or Coronary Atherosclerosis: Diagnostic Challenges in an Unclear Case
https://t.co/y3K0MbdrOc
Clinical Evaluation of Completely Biological Engineered Vessel for Coronary Artery Bypass
https://t.co/O2veOlxk1N

Congenital Heart Disease
Integrated Psychological Care of an Adult With Congenital Heart Disease
https://t.co/HBhAtBcjAs

Psychological Care is Mission Critical in ACHD
https://t.co/yc204Xs7RA
Percutaneous Occlusion of Anomalous Circumflex From Pulmonary Artery Treating Coronary Steal and Left Ventricular Dysfunction
https://t.co/DxfSI24E0j

Transcatheter Pulmonary Artery Intervention in Tetralogy of Fallot With Pulmonary Atresia During Pregnancy
https://t.co/0vor4qx1Vw
Complex Management of Adults With Congenital Heart Disease During Pregnancy
https://t.co/ejCGg09n2J

Percutaneous Patent Foramen Ovale Closure and Aneurysm Elimination by Direct Suture
https://t.co/8I33nTzn3s
Platypnea-Orthodeoxia Syndrome Provoked by Small Bowel Obstruction
https://t.co/6x5BkZ2Q7L

Concomitant Discovery and Treatment of Acquired and Congenital Cardiac Disease
https://t.co/EQPsQSTtOn
Isolated Transcatheter Tricuspid Valve Edge-to-Edge Repair in Repaired Tetralogy of Fallot
https://t.co/RptJvNhF0E

Do Not Let Them Fall-ot: Emerging Role of Transcatheter Therapies in Adult Congenital Heart Diseases
https://t.co/sUibTqdCAu
Rhythm Disorders and Electrophysiology
Critical Isthmus Identification in Macro–Re-Entrant Atrial Tachycardia With Epicardial Conduction by Peak Frequency Mapping
https://t.co/nHgxonyHSD

The Narrow QRS Deception: Alternating Bundle Branch Block Uncovered on Ambulatory Monitoring After TAVR
https://t.co/GhpB2ypt9h
Conduction Disturbances After TAVR: To Pace or Not to Pace?
https://t.co/0Z7kbwAFdQ

Giant Interventricular Septal Lipoma: From Silent Mass to Sudden Cardiac Arrest
https://t.co/5VgRElEhby
Electrocardiographic Artifact Caused by Deep Brain Stimulation Mimicking Atrial Flutter in Patient With Contralateral Pacemaker
https://t.co/ZOzWRHNEhK

Right Atrial and SVC Cardiac Sarcoidosis: Not All Atrial Masses Are Tumors
https://t.co/B2FEi1rG01
Using a Cast Iron Skillet to Resolve Percutaneous Ventricular Assist Device and Implantable Cardioverter-Defibrillator Electromagnetic Interference
https://t.co/CS96fGCujB

Heart Failure and Cardiomyopathies
Dysphagia Megalatriensis From Massive Left Atrial Enlargement
https://t.co/oFJABxiOwg

Chagas Heart Disease: Social Determinants and Delayed Diagnosis
https://t.co/LtrvbyrQsT
Diagnosis and Outcome of a Fulminant Case of Dengue Myocarditis
https://t.co/LkVoG7IKfs

Imaging
Recurrent Culture-Negative Prosthetic Valve Endocarditis Diagnosed by Multimodality Imaging
https://t.co/lhhz9zlbM2

Dual Intracardiac Thromboses Associated With Dilated Coronary Sinus and Persistent Left Superior Vena Cava
https://t.co/SdcdFWE1HZ
Multimodality Imaging of a Right Atrial Myxoma Mimicking Pancreatitis
https://t.co/rVVYnmb3M0

Cardio-Oncology
Teclistamab Treatment Followed by Heart Transplantation for Advanced Immunoglobulin Light Chain Amyloid Cardiomyopathy
https://t.co/bgDKPKQ3qX

Changing the Treatment Landscape in Amyloid Light Chain Cardiomyopathy: Implications for Heart Transplantation
https://t.co/fqI9fA9OhZ
Myxoid Pleomorphic Liposarcoma Imitating Recurrent Traumatic Hemopericardium
https://t.co/9d1VuagLiB

Valvular Heart Disease
Is Aortic Regurgitation Associated With Long-Term Ergotamine Use?
https://t.co/SJvc52vqD5
The Spectrum of Iatrogenic Valvular Heart Disease
https://t.co/uxKGuAfAdp

Multimodality Imaging-Guided Valve-Sparing Resection of an Atypical LVOT Blood Cyst in an Adult
https://t.co/OMNUj26Cb2
Vascular Medicine

Extreme Late Presentation of Marfan Aortopathy: Clinical, Surgical, and Decision-Making Challenges
https://t.co/4B2rji1dP7
Rupture of a Nonaneurysmal Left Sinus of Valsalva Into the Pericardium
https://t.co/gqloDEvvhP

Genetics, Omics and Tissue Regeneration
KLHL24-Associated Hypertrophic Cardiomyopathy: When Genotype Outpaces Phenotype
https://t.co/Nt5Wvzhrvc

Heart Failure and Cardiomyopathies
Biallelic KLHL24 Loss-of-Function Variants: Emerging Evidence for Early-Onset Arrhythmias and Hypertrophic Cardiomyopathy
https://t.co/ZTamKt53pY

Ischemic Heart Disease
Invasive Confirmation of Microvascular Recovery Parallel to Left Ventricular Functional Restoration
https://t.co/Cmvb22Nho6

Surgery
Thoracoabdominal Aortic Aneurysm Treated With a Novel Off-the-Shelf Device: A First-in-Human Experience
https://t.co/f6b3Xt34HP

@aroniskn
@CraigBasman
@JACabreraCardio
@MiChen__
@aabha_divya
@sarano_maurice
@Miho_Fukui_
@ErikaHuttce
@Nishaki1
@MMarinCuartas
@ChrissyMD2000
@ACHDocTMoe
@PanjrathG
@jsaef1
@Kentso987
@TagliariPaula
@m_taramasso
@SyedZaidMD

[Hannah Asghar MD,FACC @HannahAsghar]

So glad to be part of SPECIAL CARDIO-OBSTETRICS issue of #JACCCaseReports
@JACCJournals @NICVD
@AKUGlobal

[Dr. Gilbert Tang @GilbertTangMD]

Welcome to our APRIL 1 SPECIAL CARDIO OBSTETRICS issue of #JACCCaseReports @JACCJournals.
https://t.co/HEW4oV37b4

Full PDF here:
https://t.co/d2J1v7P0yH

Thank you @MinnowWalsh for leading this special issue!
@hmkyale
@Justine_Turco

JACC: Case Reports and Cardio-Obstetric Essentials
https://t.co/Noe2j9AuMK

Imaging:
Navigating the Aortopathy Dilemma in Pregnancy: Case Series Insights From a Cardiac Surgical Center
https://t.co/ejJTM77Dcn

Heart Failure and Cardiomyopathies:
Temporary Left Ventricular Assist Device for Peripartum Cardiogenic Shock as a Bridge to Cesarean Delivery
https://t.co/kP8djeIoKK

Group 5 Pulmonary Hypertension Resulting From Thyrotoxicosis During Pregnancy
https://t.co/XjKCBlE0Mw

Chemotherapy-Induced Cardiomyopathy in Pregnancy: A Multidisciplinary Approach
https://t.co/3Ps5Qvijm6

Calcific Constrictive Tuberculous Pericarditis in Pregnancy: A Shared Decision-Making Approach
https://t.co/s5Y5W9doah

Rhythm Disorders and Electrophysiology:
Asymptomatic Complete Heart Block in Pregnancy
https://t.co/MvlX7nwiWs

Fascicular Ventricular Tachycardia in Pregnancy
https://t.co/HQDPcxaxiz

Vascular Medicine:
Fibrosing Mediastinitis in Pregnancy: A Rare Case with Antepartum Hemoptysis and Airway Obstruction
https://t.co/jHaUG2Aows

Pregnancy-Associated Spontaneous Coronary Artery Dissection in a 32-Year-Old Woman With Postpartum Hemorrhage
https://t.co/ZV05sDCHpD

Cardiometabolic:
Gestational Hypertriglyceridemia Management and the Utility of Multidisciplinary Care
https://t.co/1rv2CuJl8O

Congenital Heart Disease:
Patent Foramen Ovale–Induced Hypoxemia Unmasked During Pregnancy
https://t.co/e7xBj526Ko

Imaging:
A Cardio-Obstetric Breakthrough Beyond Routine Pregnancy Care: Unmasking Hodgkin’s Lymphoma
https://t.co/ZCKkVSpm70

Ischemic Heart Disease:
Silent Myocardial Infarction in Pregnancy Uncovered During Routine Antenatal Echocardiographic Screening
https://t.co/idgdo1OJ9k

Outcomes and Quality:
Cardiac Tamponade Revealing a New Diagnosis of Malignancy: When Intervention Is the Answer
https://t.co/HMvBqYUJey

Valvular Heart Disease:
Managing Pregnancy in the Presence of Rheumatic Heart Disease and Antiphospholipid Syndrome
https://t.co/YLxIVdNskz

Percutaneous Mechanical Aspiration Thrombectomy-Assisted Management of Right-Sided Infective Endocarditis During Pregnancy
https://t.co/A3hyiGcIxt

Health Promotion and Preventive Cardiology:
Creating a Cardio-Obstetrics Elective as a Fellow In Training
https://t.co/FuI6uGTzBv

Outcomes and Quality:
Early Outcomes of an Extended Postpartum Hypertension Program: Care Beyond Delivery
https://t.co/RF6QgU6A9O

Valvular Heart Disease:
Transcaval SESAME, LAMPOON, and Valve-in-MAC: First Experience With SESAME Outside the United States
https://t.co/UBxALVAkOr

The Next Era of Transcatheter Electrosurgery for Structural Heart Interventions
https://t.co/KPrXyMGz7C

A Very Late Mitral Valve Hypoattenuated Leaflet Thickening With Significant Warfarin Response
https://t.co/03lTctlVRP

Obstructive Hypoattenuated Leaflet Thickening in a Complex Valve-in-Valve TAVR Successfully Treated With Thrombolysis
https://t.co/zMKEn4X527

Thrombolysis for Obstructive HALT in Complex Valve-in-Valve TAVR
https://t.co/ll5O3yVmT9

Severe Aortic and Mitral Regurgitation After Blunt Chest Trauma
https://t.co/li54g1fifE

When Trauma Obscures the Heart: Diagnostic Blind Spots After Blunt Chest Injury
https://t.co/Z8tnhGLt4w

Coronary, Peripheral and Structural Interventions:
Transapical Edge-to-Edge Repair for Systolic Anterior Motion in Obstructive Hypertrophic Cardiomyopathy
https://t.co/qNi0gveZwf

Management of Coronary Artery Perforations: A Stepwise, Case-Based Review From a High-Volume Center
https://t.co/PzYv2Pn7QS

Post-Myocardial Infarction Ventricular Septal Defect Percutaneous Closure
https://t.co/YMDfVMfAa9

Atypical Presentation of Mycotic Coronary Artery Aneurysm
https://t.co/G00RnehzRl

Laser-Assisted OPN Technique for Recalcitrant Multilayer In-Stent Restenosis: A Systematic Approach
https://t.co/s21ddvvbWH

Percutaneous Rescue With Sequential Second-Device Usage for Left Atrial Appendage Perforation During Amulet Implantation
https://t.co/HqWFNGDnhv

Imaging:
High-Output Heart Failure Associated With Arteriovenous Fistula
https://t.co/dfh3hbN2Dh

Heart Failure and Cardiomyopathies:
Hemodialysis Access–Related High-Output Heart Failure: From Mechanisms to Multidisciplinary Management
https://t.co/T7USgOPA8s

Imaging:
“Flying Saucer”–Like Morphology in Infective Endocarditis Arising on a Stenotic Mitral Valve
https://t.co/NDAI43bPUt

Purulent Pericarditis Complicated With Cardiac Tamponade, Multiorgan Failure, and Constrictive Pericarditis
https://t.co/zMCORH8Rcw

Primary Cardiac Lymphoma Presenting With Chest Pain
https://t.co/t7otEAziRJ

Rhythm Disorders and Electrophysiology:
Combined Lead Extraction and Leadless VDD Pacemaker Implantation in d-TGA Patient After Senning Procedure
https://t.co/wrwZpJUrrq

Leadless Pacing and the Emerging Era of Combined Procedures in Adult Congenital Heart Disease
https://t.co/S3z7hVn1Do

Propafenone Overdose Presenting With Brugada Phenocopy, QRS Widening, and Ventricular Fibrillation
https://t.co/6BFgsBsEWO

15-Year ECG Evolution of Interatrial Block and Effects of Atrial Septal Pacing
https://t.co/xVP4HPoOa3

@aronisMD
@JACabreraCardio
@MiChen__
@aabha_divya
@sarano_maurice
@Miho_Fukui_
@ErikaHuttce
@Nishaki1
@ChrissyMD2000
@ACHDocTMoe
@M_Pompeu_Sa_MD
@jsaef1
@JTSaxon
@AndreaScotti21
@Kentso987
@TagliariPaula
@m_taramasso
@SyedZaidMD

[Helen Bevan @HelenBevan]

Are we realising the potential of our networks to make change happen?

Most innovation emerges from collaborative projects where teams openly “borrow” & adapt each other’s (often small but powerful) ideas. Many networks & communities of practice could achieve so much more by experimenting together around collective priorities to generate & share new solutions.

This is beyond spreading known “best” or “good” practices. It is about innovating to design new solutions collectively.

So I appreciated this piece from Ed Morrison of @Strategic_Doing about three different kinds of networks:
- Advocacy networks are communities that seek to mobilise people, creating pressure to shift policies, priorities or messages in a particular direction. Their aim is to connect & influence rather than to change how they themselves work.
- Learning networks are communities of practice. They share knowledge, compare practice & build shared capability. Learning networks often excel at spread & improvement of existing practice, but only sometimes move into structured innovation work.
- Innovating (or transforming) networks are communities that combine their assets - ideas, relationships, data, capabilities - to create new value that none could produce alone. They manage collaboration as a process of experimentation: agreeing a shared outcome, running multiple connected tests of change, learning by doing & amplifying what works across the network.

https://t.co/70NcTsBLjl

Every learning network has the potential to become an innovating/transforming network. Some actions to enable this:
1. Build a foundation of strong, trusting relationships within the network, understanding each member’s starting point & motivation for change
2. Focus on helping each other to succeed; listen to each others’ stories & plans, co-coach, give advice to each other & build shared inquiry
3. Move from “sharing” or “raising awareness” to some concrete outcomes the network want to change together through collective experimentation
4. Agree some simple norms for the network so that members help each other to make progress, make it safe to try things, fail fast & share incomplete work
5. Encourage multiple, parallel tests of change around similar outcome so projects can “steal with pride” from one another & quickly refine promising ideas
6. Put simple routines in place for noticing patterns (what is shifting where & why), capturing these insights & amplifying them across the network
7. Add additional success metrics including innovations tested, adapted & adopted in multiple places

Graphic by Ed Morrison.
Content with added inspiration from @juneholley.

[Cardio-Obstetrics @CardioOb]

#CardioObstetrics

[Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 @DrMarthaGulati]

Today the Black Box was removed from ALL Menopausal Hormone Therapy (MHT). For transvaginal, I think this is reasonable, but what do we actually know about contemporary doses of transdermal & oral #MHT? I also think the statements being made are doing a huge disservice to women. This is NOT a win for women. A win would be funding a trial that studies women on contemporary doses of transdermal & oral MHT.

The statement by Makary that "With the exception of vaccines or antibiotics, there's no medication that can improve the health of women on a population level more than hormone replacement therapy," is not based on fact. We just don’t know and certainly any statement on cardiac safety remains unknown for contemporary doses of transdermal and oral MHT

I want to care for women using evidence based treatments. We have seen by many examples of what can happen when we don’t study women. Let’s not do this again.

#womenshealth #HormoneTherapy #hearthealth #savingwomenshearts #menopause

[Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 @DrMarthaGulati]

The amazing @CBallantyneMD summarizing the first #LBCT & the importance of #CVprev

We must prioritize CV prevention. I would argue Prevention is sexy and the best area of cardiology. Everything else pales in comparison. Join us!
#AHA25

[Ron Blankstein @RonBlankstein]

Big message from #AHA25 #VESALIUS: We do not want to wait until pts have MI or CVA to start aggressive LDL-C lowering! Pts w/ CAD, including by coronary imaging #CAC #CCTA and prior PCI & high risk DM had:
25%⬇️ in CV CHD death/MI/CVA
36%⬇️ in MI
w/ addition of PCSK9i 🧵

[Hannah Asghar MD,FACC @HannahAsghar]

@sebas_arruarana [email protected]

[Harlan Krumholz @hmkyale]

After decades of disappointment in HFpEF, a new idea is shaking things up.
Could heart failure with preserved EF actually be an adipose-driven disease?
JACC’s latest issue explores “The Adipokine Hypothesis.” @JACCJournals
🔗 https://t.co/uy3fbcwzk6

[European Society of Cardiology Journals @ESC_Journals]

GLP-1RA ⬇️ HF🏥 & CV ☠️ across CKM conditions. In HFrEF, data suggest ↓CV ☠️ but a numeric ↑HF🏥. Outcome trials in HFrEF are needed.
https://t.co/L76C0oZP34

#EJHF @EJHFEiC @AmrAbdin10 @GiuseppeGalati_ @HanCardiomd

[Muthu Vaduganathan @mvaduganathan]

🔥 New in @NatureMedicine

How do you communicate lifetime benefits expected with HFpEF therapies?

New data from 3 RCTs (#DELIVER #FINEARTS #PARAGON) estimate up to *5 years* of event-free survival w combination Rx

#GDMT for HFpEF has finally arrived!

🔗https://t.co/ozSx3UwkLN

[Michael Albert, MD @MichaelAlbertMD]

🚨 Primary Prevention Milestone in Heart Disease
- - -
Amgen just announced topline results from VESALIUS-CV (12,000 patients, 4.5 years follow-up):
➡️ Adding Repatha (evolocumab) to statins or other LDL-lowering therapy significantly reduced major CV events in adults without prior heart attack or stroke.

➡️ First PCSK9 inhibitor to show outcomes benefit in primary prevention, not just secondary.

➡️ No new safety signals reported.

Why it matters:
🔹Every 40 seconds, a heart attack or stroke occurs in the U.S.—and 75% are first-time events.
🔹Prior PCSK9 trials (FOURIER, ODYSSEY) proved benefit after ASCVD events.
🔹VESALIUS-CV could shift the treatment paradigm to earlier use for high-risk adults who remain above LDL-C targets (<70 mg/dL) despite statin ± ezetimibe.

👀 What to watch for at #AHA25 (Nov 8):
🔹Absolute risk reduction & NNT
🔹Subgroup effects (diabetes, baseline LDL-C, Lp(a))
🔹Cost-effectiveness & payer adoption

💡 Bottom line: If confirmed at AHA, this trial could expand PCSK9 use from “after the first event” ➡️ “preventing the first one” in carefully selected high-risk adults.
🔗https://t.co/geoqeMIlRx

[Amelia Carro — Instituto Corvilud @icorvilud]

CARDIOVASCULAR DISEASE: WORLD'S Nº1 KILLER
✍️626 mill people with CVD
✍️19.2 mill deaths 2023
✍️80% of CVD burden is preventable
✍️CVD⬆️fastest in low- /middle-income countries
🚨Health systems must act now
🚨Risk-factor⬇️&amp; equitable access to care can reverse the trend
#CARDIOX

[Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 @DrMarthaGulati]

Our @iCardioAlliance Global Implementation Guidelines for the Management of #Obesity 2025 now in Global Cardiology

Lead by Dr. Anker with global experts to create international guidelines on obesity management

@fjpinto1960 @ShelleyZieroth @DBelardoMD @SubodhVermaMD @ShahzebKhanMD

📎https://t.co/e21bZqF8yC

[Abdulla A. Damluji, MD, PhD @DrDamluji]

Inflammation and Cardiovascular Disease: 2025 ACC Scientific Statement: A Report of the American College of Cardiology: @JACCJournals and @ACCinTouch

🥸 Inflammation and aging are interlinked: #inflammaging

😱 Great science statement here

👇👇👇

[Scott Isaacs @scottisaacsmd]

Semaglutide and tirzepatide both cut risk of hospitalization for heart failure or death by over 40% in patients with cardiometabolic #HFpEF.
https://t.co/Dc388bFirG

[Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 @DrMarthaGulati]

#Cardioobstetrics
#Statin use in pregnancy

[Dr Rob 🫀🩺 🇦🇺 @drhungo]

👶💊 Statins in pregnancy

🇳🇴 805k pregnancies (2005–2018)

📊 No ↑ risk of any, major, or minor congenital malformations with 1st-trimester statin use

✅ Statins unlikely to be major teratogens

🫀 For women at high CV risk (ie HoFH), benefits likely outweigh potential risks

#cardiotwitter #MedTwitter #MedEd #FOAMed @escardio @

🔗 https://t.co/1vGTp435xh


[Dr Anastasia Mihailidou FAHA FCSANZ FESC @AnastasiaSMihai]

Cardiac rehabilitation: the gateway for secondary prevention

https://t.co/z3gfZaizEw

You would agree @JRedHeart @SolveChd @thecsanz