Joseph Elias, MD

Cardiology Fellow @HMHcardiofellow| Former Chief Resident @DOMSinaiNYC MSMW| @AUB_Lebanon M.D Alumnus| RT or Like ≠ Reindorsement. 🇱🇧

[Nadeen N. Faza, M.D. @NadeenFaza]

🔑Key Takeaways on MVP, MR, MAD & Arrhythmic Risk 🫀 #ASEchoJC

✅ MVP affects ~2.5% of the population and is the leading cause of primary MR.

✅ Diagnosis requires ≥2 mm leaflet displacement in the PLAX/long-axis view.

✅ Barlow’s disease ≠ FED:
• Barlow = redundant bileaflet prolapse
• FED = isolated segment prolapse with chordal rupture

✅ MR assessment is tricky—eccentric, multiple, commissural, and late-systolic jets can underestimate severity.

✅ Not all MAD is created equal:
True MAD persists in systole and diastole; pseudo-MAD does not.

✅ MAD and prolapse volume add to LV volume overload beyond MR alone.

⚠️ Arrhythmic MVP can occur even without severe MR.

🚩 Echo markers of increased VA/SCD risk:
• Bileaflet prolapse
• MAD >8.5 mm
• Pickelhaube sign
• Curling
• Mechanical dispersion
• Double-peak strain pattern

🎯 CMR is critical for risk stratification—fibrosis by LGE or elevated ECV identifies patients at higher arrhythmic risk.

See you next #ASEchoJC!

@PWesslyMD @HeartToProve @LucySafi @CASivaram1 @iamritu @purviparwani @ASE360 @JournalASEcho

[WilliamZoghbi @WilliamZoghbi]

Hot off the press! My Editorial in JACC on Atrial functional MR. Among 72 definitions of AfMR (!!) in the literature, Koschatko et al demonstrated that the one provided by JACC CV Imaging Expert Panel in 2022 was the most powerful in predicting outcome. https://t.co/9lOYA0x3Ak

[Sachin Goel @SachinGoelMD]

Improving the Diagnosis of HFpEF: A Comparison of the H2FPEF Score and the 2025 ASE Diastolic Function Guideline Recommendations Using Invasive Hemodynamics as the Gold Standard | JACC: Cardiovascular Imaging https://t.co/jYtRzpVuie

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

@NadeenFaza @SNagueh @dysanborn @BonitaEcho @PWesslyMD @iamritu @SIwa23288585 RECOMMENDED READ ON THIS SUBJECT

"Improving the Diagnosis of HFpEF: A Comparison of the H2FPEF Score and the 2025 ASE Diastolic Function Guideline Recommendations Using Invasive Hemodynamics as the Gold Standard" #ASEchoJC
https://t.co/IarT8vbnbr @SFNagueh

[Haisum Maqsood @haisummaqsood]

New Circulation study on LVFP assessment @snagueh

https://t.co/pznpUiEbK0

This new algorithm improves feasibility and accuracy of LV filling pressure estimation and enhances HF identification when combined with natriuretic peptides.

#Cardiology #HeartFailure #Echo

[Haisum Maqsood @haisummaqsood]

HFpEF diagnosis made smarter @snagueh

https://t.co/a1KnR09Gkp

H₂FPEF <30% → rules out
H₂FPEF >30% → echo (ASE 2025 diastology guidelines) adds significant diagnostic value

Great step toward more precise, stepwise HFpEF evaluation.

#HFpEF #Cardiology #Echocardiography #ASE

[Edgar Argulian @argulian]

A patient with known aortic regurgitation presents with shortness of breath. CW Doppler is obtained across the aortic valve in 5-ch view. What are the findings and hemodynamic implications?

[WilliamZoghbi @WilliamZoghbi]

Privileged to work with this amazing ❤️team @HMethodistCV @ACCinTouch @ASE360 @SCMR @Heart_SCCT @escardio @SCAI

[Houston Methodist Cardiovascular Fellowships @HMHCardioFellow]

Strong hearts, stronger team 💪❤️ Picture Day 2025 at HMH Cardiovascular Disease Fellowship! #HeartOfMedicine #HMHCardioFellows

[Edgar Argulian @argulian]

Is M mode still relevant? A patient with history of open heart surgery. M mode obtained in the parasternal short axis view. What is the finding?

[WilliamZoghbi @WilliamZoghbi]

Proud of and thankful to our amazing team and Institution @HMethodistCV for the national recognition of our stellar service to patients. 👍
@ACCinTouch @ASE360 @Heart_SCCT @SCMR @MyASNC @NYTHealth @escardio

[American Society of Echocardiography @ASE360]

🫀NEW GUIDELINE🫀
Read our newest #ASEGuideline, "Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography and for Heart Failure With Preserved Ejection Fraction Diagnosis!" https://t.co/bKTTQachMJ

[Mohammed Chamsi Pasha, FACC, FASE @ChamsiPash]

Congratulations to authors @SNagueh @JaeKOh2 @AllanLKleinMD1 @BonitaEcho @KSharmaMD on leading a great effort providing a practical algorithmic approach to diastology and filling pressures!

[Victoria Delgado @VDelgadoGarcia]

📢New Algorithm for Estimating LV Filling Pressure by Echo:
🔴increase in the number of patients in whom LV filling
pressure can be estimated
🟢only 2 cases of indeterminate LV filling pressure and the majority had a definitive LV filling pattern
https://t.co/4yL751yFFo

[Joseph Elias, MD @JjeJoseph]

@DrMarwanRefaat @HMHCardioFellow @JuKimMD @NadeenFaza @SLittleMD @WilliamZoghbi Thank you so much, Dr. Refaat!

[Joseph Elias, MD @JjeJoseph]

Celebrating our incredible graduating fellows at @HMHCardioFellow! Grateful and honored to receive the Rising Star Award 🙏Huge thanks to the amazing faculty and co-fellows who welcomed me into the family. Excited for year 2! @JuKimMD @NadeenFaza @SLittleMD @WilliamZoghbi

[Joseph Elias, MD @JjeJoseph]

@ftmaalouf @HMHCardioFellow @JuKimMD @NadeenFaza @SLittleMD @WilliamZoghbi Thank you! 🙌🏽

[Joseph Elias, MD @JjeJoseph]

@tchaaban1 @HMHCardioFellow @JuKimMD @NadeenFaza @SLittleMD @WilliamZoghbi Thank you so much, Dr. Chaaban!

[Joseph Elias, MD @JjeJoseph]

@jadardakani @HMHCardioFellow @JuKimMD @NadeenFaza @SLittleMD @WilliamZoghbi Thank you!

[Joseph Elias, MD @JjeJoseph]

@jad_zeitoun Thanks Jad!

[Joseph Elias, MD @JjeJoseph]

@mdbrunocosta @HMHCardioFellow @JuKimMD @NadeenFaza @SLittleMD @WilliamZoghbi Thank you my friend! See you soon