Marwan

Multimodality Imaging Fellow •Lipidology, preventative cardiology and structural heart disease is where it's at 😍
Insta: @marocardium

[Marwan @marocardium]

@IM_Crit_ 🤣

[Marwan @marocardium]

What an amazing year it's been. A lot of learning. Met amazing people, learned from the best experts in the field. Can't wait for the echo year! Definitely the 2 PM cappuccinos kept me going

[Giulia Passaniti @PassanitiGiulia]

It’s been a pleasure working with you and surviving 18.000 CTAs and more than 2000 MRIs 🤣
Wishing you all the best!
@NamanUpadhyayMD

Just remember my most important lesson:
no cappuccino after 11 am… 🤌🏻☕️🙅🏻‍♀️
@marocardium @AzkaNaeemMD @lana_rashdan @OKhaliqueMD @rooshaparikh

[Giuseppe Biondi-Zoccai @gbiondizoccai]

A pre-TAVR CT algorithm stratifies patients into 3 coronary obstruction risk categories, though the decision for coronary protection in clinical practice seems to incorporate additional clinical and procedural variables https://t.co/Hu5o3o5WB6

[Marwan @marocardium]

This is a great and important addition to the heart failure guidance. As cardiac and heart failure patients live longer, they get more sensitive to medications and polypharmacy. Great read!

[Harriette Van Spall, MD MPH 🇨🇦 @hvanspall]

In this scientific statement, we
💢address the multidimensional needs of older adults w/ #HF, paying attention to multimorbidity, frailty, goals of care
💢discuss strategies to ⬆️uptake of #HF drug & device Txs that improve outcomes but are underused in👵🏼
https://t.co/dBd5920YzM

[Dr Alo, DO, FACC @MohammedAlo]

🚨 A Mendelian randomization study of over 1 million people just confirmed what the wellness industry does not want you to hear.

Every 38 mg/dL increase in your lifelong LDL cholesterol costs you 1.2 years of life.

But the data says otherwise when the gurus tell you low LDL is dangerous.

🔬 Here is what makes this study different from everything else the skeptics try to dismiss.

Most observational studies get attacked with one argument: reverse causality. Sick people have low cholesterol because they are already dying. Therefore low LDL looks dangerous. The wellness crowd runs with that talking point endlessly.

Mendelian randomization destroys that argument at the root.

Your genetic variants are assigned at conception. Before any disease. Before any medication. Before any lifestyle choice. This study used those genetic variants as a proxy for lifelong LDL exposure across more than 1 million people. The direction of causation runs one way only. Higher genetically determined LDL shortens lifespan. Period.

💓 The science is not subtle here.

Each 38 mg/dL increase in genetically determined LDL equals 1.2 fewer years of life. That is not a rounding error. That is a real, measurable, biologically determined cost you pay for carrying more LDL through your arteries across a lifetime.

This is cumulative exposure. Your arteries do not forget. Every year of elevated LDL adds to the plaque burden, the inflammatory load, and the vascular damage that eventually produces a heart attack or stroke.

🩺 I am a cardiologist. I treat patients with established cardiovascular disease every day. I watch people arrive in my clinic after decades of untreated high LDL, convinced by wellness content that their numbers were fine. The damage I see on their imaging tells a different story than the influencer they followed.

The question is no longer whether LDL causes harm. The question is how many years you are willing to trade for the comfort of ignoring it.

❌ Low LDL will not kill you.
❌ Statins will not destroy your muscles or your brain.
❌ Cholesterol skepticism is not brave scientific thinking. It is dangerous misinformation with a body count.

❤️ Bottom line:

Low LDL does not shorten your life. Over 1 million people with genetic data prove the opposite.

Higher lifelong LDL exposure directly reduces lifespan by 1.2 years per 38 mg/dL increase. That is causal, not correlational.

Know your LDL. Know your ApoB. Talk to a cardiologist who reads the actual data. Do not manage your cardiovascular risk based on YouTube.

The wellness industry profits when you distrust the evidence. Your arteries pay the price.

Are you going to let a guru with a podcast cost you a year of your life?

#Cardiology #HeartDisease #HeartHealth #CardiovascularHealth #LDLCholesterol #CholesterolMyths #MendelianRandomization #ApoB #PreventiveCardiology #MetabolicHealth

[Marwan @marocardium]

@McCulloughFund @LDLSkeptic The data is clear 🤣🤣🤣 dude please

[Amazing Physics @amazing_physics]

"Not flat, we checked" -- NASA

[Oscar Cingolani, MD @cingolani_oscar]

Times (not that long ago) when Housestaff outnumbered computers..
Fun times!

[EuroIntervention @EuroInterventio]

As TAVI expands to younger and more complex patients, preventing coronary obstruction is becoming increasingly important.
This review summarised evolving leaflet modification strategies — from BASILICA to ShortCut and UNICORN — aimed at improving procedural safety in high-risk TAVI and valve-in-valve interventions. #CardioTwitter #TAVI #BASILICA #StructuralHeart

https://t.co/fj0knFuXns

@sunnygoelmd @GilbertTangMD

[Marwan @marocardium]

@elonmusk @SawyerMerritt @Not_the_Bee Amazing abundance for a handful of people right?

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

🩺 Mastering the Evaluation of Mitral Regurgitation using Echo and CMR🫀

Presented by Drs. Nadeen Faza @NadeenFaza and Carlos El-Tallawi @HeartToProve

📺 Full presentation: https://t.co/jfSAVgNKS5

OUTLINE AND SECTION LINKS BELOW:

🎥Part 1: Echocardiography Evaluation
• Intro to MR Imaging: https://t.co/KRkdtsAUj4
• Color Doppler Limits: https://t.co/w1obO09vX9
• Evaluating Severity: https://t.co/nzbox4vs0k
• Guideline Criteria: https://t.co/Fyb0S84Lbz
• 10 Commandments for Echo: https://t.co/cIgXKhBNyS

🧲 Part 2: Cardiac MRI Evaluation
• Intro to MRI MR Assessment: https://t.co/bD0cwossMv
• Lesion Mechanism & Etiology: https://t.co/WKE49MoC3E
• Ventricular Remodeling: https://t.co/hBanRuXfPs
• Echo vs. MRI Accuracy: https://t.co/3p26Bton4j

[Marwan @marocardium]

@Winn23Q If only the brain were smarter than that

[Marwan @marocardium]

@jurgen_nauditt Lol

[Marwan @marocardium]

@Bencera 100%

[Nisha Patel, MD MS, Dipl of ABOM, CCMS @DrPlantel]

Uncomfortable truths that ruffle people’s feathers:

You can eat fiber rich plant foods and take a statin to lower cholesterol.

You can lift weights, build strength, and take a GLP-1 to improve body composition.

You can meditate and do yoga and still need therapy or medication for your mental health.

Health is not ruined by using tools. These things are not mutually exclusive. That’s kind of the point.

[Marwan @marocardium]

@Mylovanov Sure Macron sure

[Marwan @marocardium]

@mikegalsworthy 😅

[Dr. Filippo Cademartiri @FCademartiri]

🧠 We optimized the stent. We forgot the disease.

Two major NEJM trials just dropped.
Both asked the same question:
👉 Does IVUS-guided PCI improve outcomes vs angiography alone?

The answer?
❌ No.

📊 Trial #1 – Complex High-Risk PCI (IVUS-CHIP)
IVUS: 13.9% events
Angio: 11.1% events
HR 1.25 → trending worse

📊 Trial #2 – Left Main PCI (OPTIMAL)
IVUS: 33.7% events
Angio: 30.9% events
HR 1.11 → no difference

Let’s be honest.
💡 IVUS did exactly what it’s supposed to do:
✔️ Better sizing
✔️ More post-dilation
✔️ More “optimized” stents

And yet…

👉 No clinical benefit.

⚠️ This is the uncomfortable truth:
We’ve been chasing procedural perfection,
thinking it would translate into patient outcomes.

It doesn’t
(and yes I know the comparator is highly skilled PCI operators/centers; but does this appears as inclusion criteria?)

Because events are NOT driven by:
❌ stent expansion
❌ lumen gain
❌ apposition metrics

They are driven by:
🔥 plaque biology
🔥 disease burden
🔥 patient-level risk

Even more interesting:
👉 The “inferior” arm (angiography) was already excellent
👉 Modern PCI is already optimized
👉 There’s very little left to gain mechanically

💥 So what did these trials really show?
Not that IVUS is useless.

But that:
👉 The paradigm is wrong.

🧬 We are:
✔️ optimizing millimeters
✔️ while events come from microns of biology

🚨 The future is NOT:
“optimize the stent more”

It is:
👉 identify disease earlier
👉 quantify plaque, not stenosis
👉 treat-to-plaque, not treat-the-lumen

💬 Final thought:
We spent 20 years perfecting PCI.
And almost none of that effort touched the disease that actually kills patients.

#Cardiology #PCI #IVUS #CardiacImaging #PhotonCountingCT #PreventiveCardiology #TreatToPlaque

[Marwan @marocardium]

@RasmusJarlov Lol sure

[Marwan @marocardium]

@_InfoGram_ Clown recognizes clown