Jeapvz

Internal medicine, cardiology. Complex adaptive systems, system dynamics, thermodynamic and ecological economics

[Rudy Havenstein, Senior Markets Commentator. @RudyHavenstein]

*ORANGE JUICE TO REPLACE DIESEL FUEL IN PPI BASKET - BLS.

[Hedgeye @Hedgeye]

Workers now capture the smallest share of business income on record

[🔴LexTweetr🔴🌎 @LexTweetr]

@JensenHuang knew that the 'AI' shops in the US are getting killed between their insane cult propaganda and the open source models.
That's why @nvidia bought @huggingface to save its own GPU monopoly.
It's all crashing down now.
'AI' is a psyop scam. They not making God in a GPU.

[Thorsten Froehlich @FroehlichThors1]

The USA "solved" its unemployment problem.

The white rabbit🐰

The US pulled off the greatest magic trick in economics: it made unemployment look fantastic by making the workers disappear.

For decades the economy needed ca. 150k jobs a month just to stand still. Then immigration face-planted - net migration crashed from ca. 2.2M (2024) to maybe half a million, possibly negative for the first time since the '70s. ICE removals more than tripled. Boomers kept retiring.

The labor force stopped growing. The foreign-born workforce alone shrank by ca. 1.8M in a year.

So now the economy only needs ca. 30k jobs a month to hold 4.1% unemployment - that's great, right?

Here's the kicker: a real worker shortage means fat raises and bidding wars. Instead - real wages just went negative . Pay is losing to inflation again.

You can't have a "worker shortage" AND a hiring freeze... unless supply and demand are both quietly collapsing. They are.

4.1% unemployment isn't a strong economy. It's a shrinking one in a strong economy's clothes.

[Jeapvz @jeapvz]

@FroehlichThors1 Que preciosidsad de post y de información. Gracias

[CardiovascularCorner @TrackYourHeart]

Aortic stenosis: don’t grade severity from AVA alone.

Echo assessment of AS should be integrative.

For severe AS, the classic concordant parameters are:

🔵 Vmax ≥4.0 m/s
⚪ Mean gradient ≥40 mmHg
🔴 AVA ≤1.0 cm²
⚫ Indexed AVA ≤0.6 cm²/m² can support severe AS, particularly in patients with small body size.

( But what if the numbers disagree)
That is where the real echocardiographic reasoning begins.

1️⃣ First, check for measurement error, especially LVOT diameter, LVOT VTI and Doppler alignment.
2️⃣ Then assess flow status:
Low flow: SVi ≤35 mL/m²

A patient with AVA ≤1.0 cm² and mean gradient <40 mmHg may have low-flow, low-gradient AS, with interpretation depending on LVEF and the clinical context.

In selected discordant cases, CT assessment of aortic valve calcification can provide important additional evidence of stenosis severity. The 2025 ESC/EACTS guidelines emphasize multimodality assessment when severity remains uncertain.

#Echocardiography #Cardiology #AorticStenosis #ASE

[Mashford Mahute @MashfordMahute]

Saw this from Benjamin Niedermann, on LinkedIn, and could not stop thinking about it.

The interactive visualization here: https://t.co/PWa5Z8qR7B

[Cody Fenwick @codytfenwick]

My favorite AI joke:

Current models are getting close to PhD-level intelligence. After that, they're expected to achieve the intelligence of someone who decided not to do a PhD.

[Eric Basmajian @EPBResearch]

Total debt-to-GDP has remained unchanged for the past 10+ years.

~360% across all sectors.

What's changed is the blend: more government debt, less private debt.

The net result is a less boom-bust economy but a slower and more assured erosion in the standard of living.

[RogueMacro @RogueMacro_]

@rdomenechv @TheEconomist It's not AI, it AI capex that is creating jobs.

[Gregg Fonarow MD @gcfmd]

First-in-class, novel-mechanism agents tested in Phase 3 CV outcomes trials have &lt;20% success rate

It is very challenging to incrementally/meaningfully improve CV outcomes

Yet, tragic when there are proven therapies, but not implemented, and preventable events allowed to occur

[Thorsten Froehlich @FroehlichThors1]

🔥GERMAN REAL ESTATE

I have been pounding the table for a while now - and where there is smoke, there is typically also fire.

See for yourself below, funds’ suspensions and liquidations (for the first time in 10Y, residential is also affected).

More suspensions inbound and lower prices.

[Eric Topol @EricTopol]

This is a big bust, folks
The first large scale (N&gt;8000 participants) for lowering Lp(a) did not meet its primary endpoint for reducing adverse cardiovascular outcomes (vs placebo) https://t.co/dNV6RHXtJb

[Emmanuel Daniel @eodanielmd]

🫀 Arrhythmic Mitral Valve Prolapse

‼️ MVP subset where SCD risk is INDEPENDENT of MR severity—even mild MR can kill.
🔑 Watch for:
• Bileaflet prolapse + MAD
• Young women, EKG- inferior TWI, PVCs/NSVT
• "Pickelhaube sign" (&gt;16 cm/s)
• CMR fibrosis: basal inferolat wall

[Dr Mahmoud Hashem @Drmahmoudhashe1]

🫀 دراسة جديدة:
هل عملية الرجفان الأذيني (Ablation) بتحسن جودة حياة المريض فعلاً؟
دراسة PVI-SHAM-AF قدمت في مؤتمر جمعية القلب الأوروبية (ESC)، وعملت حاجة نادرة في عالم القلب: قارنت عملية الـ catheter ablation الحقيقية بـ عملية شكلية (Sham) — يعني المريض بيدخل العملية بس من غير أي تدخل فعلي، ومحدش (لا المريض ولا الفريق المُقيّم) عارف هو كان في أي جروب.
العدد: 262 مريض بيعانوا من الرجفان الأذيني
بعد 6 شهور:
✅ نسبة المرضى اللي اختفى عندهم الرجفان: 73% مع العملية الحقيقية، مقابل 52% مع العملية الشكلية
❌ لكن جودة الحياة (حسب استبيان مخصص) تحسنت بنفس القدر تقريبًا في المجموعتين — يعني مفيش فرق حقيقي بين العملية الحقيقية والشكلية من ناحية "الإحساس بالتحسن"
يعني ايه ده؟
العملية فعلاً بتنجح في تقليل نوبات الرجفان (من الناحية الطبية/التخطيطية)، لكن إحساس المريض بالتحسن في حياته اليومية مش بالضرورة مرتبط بنجاح العملية بالمقياس ده — وده ممكن يكون بسبب قوة تأثير "الاعتقاد بالعلاج" (placebo effect) القوي جدًا في حالات زي دي.
الرسالة المهمة:
قبل ما الطبيب ينصح مريضه بعملية ablation، لازم يوضح له إن الهدف الأساسي منها هو تقليل نوبات الرجفان الأذيني ومخاطره، مش بالضرورة إحساس فوري بتحسن جودة الحياة.
#ESCCongress #Cardiology #AFib

[Gregg W. Stone MD @GreggWStone]

Presented today and published in NEJM, our PADN-HF-PH trial in which 264 pts with left-heart failure (HFrEF or HFpEF) and pulmonary hypertension (mPAP &gt;20 mmHg and PCWP &gt;15 mmHg) were randomized at 25 centers to pulmonary artery denervation (PADN) + GDMT vs GDMT alone.

[Prof Chris P Gale @cpgale3]

WOW!

Sham #AFib ablation RCT…. neutral

[Nate Hagens @NJHagens]

The economic superorganism doesn’t care about narratives or policy- it merely seeks and eats power…

[NEJM @NEJM]

Presented at #ESCCongress:

In patients with severe tricuspid regurgitation and heart failure, transcatheter tricuspid-valve repair plus medical therapy was superior to medical therapy alone in reducing hospitalizations for heart failure and deaths. Full TRIC-I-HF trial results: https://t.co/zJpLtFsASP

@escardio