Mamdouh Souleymane

Cardiology Fellow at Marshall University

[Mamdouh Souleymane @mmdhsoule]

@EliDavisMD Congrats

[Mamdouh Souleymane @mmdhsoule]

@NikitaJhawarMD @prabhjotkgrewal @NahyrLugo @MGharacholou @CooperCVFellows Congrats 🎉

[Mamdouh Souleymane @mmdhsoule]

@osobi_ Congratulations

[Mamdouh Souleymane @mmdhsoule]

@azinvkp @ESC_Journals @sina_kazemian Great work

[Mamdouh Souleymane @mmdhsoule]

@DrSidniMD Well done 👍🏾

[Mamdouh Souleymane @mmdhsoule]

@jiaqi_liMD @HanZhuMD @Ron_Witteles @StanfordMedRes Great work

[Mamdouh Souleymane @mmdhsoule]

@SaharSamimii @ACCinTouch Solid work

[Mamdouh Souleymane @mmdhsoule]

Honored to meet Dr. Najm @Dr_HaniNajm at #ACC26. Congratulations on his new role as Vice President of the American College of Cardiology

[Mamdouh Souleymane @mmdhsoule]

Great experience at #ACC26 presenting my research on TAVR and IVUS. Always inspiring to be surrounded by innovation and leaders shaping the future of cardiology @ACCinTouch

[Mamdouh Souleymane @mmdhsoule]

Back at #CRT2026 for the second time quickly becoming one of my favorite cardiology meetings. Great science, great people, and inspiring discussions in structural and interventional cardiology. #CRT2026 @CRT_meeting

[Dr. Filippo Cademartiri @FCademartiri]

🫀🧠 HFpEF is not just “diastolic dysfunction”: the microcirculation is the missing link

This 2025 JACC: Advances state-of-the-art review reframes heart failure with preserved ejection fraction (HFpEF)through a crucial, often underrecognized lens: coronary microvascular dysfunction (CMD) .

📊 How common is CMD in HFpEF? Very.
Up to 75% of HFpEF patients—even without obstructive coronary disease—have CMD. And this is not an innocent bystander:
CMD is independently associated with higher HF hospitalizations
Increased mortality and MACE
Worse quality of life

Yet, CMD is rarely sought and even more rarely diagnosed in routine HFpEF care.

🧠 Why CMD matters pathophysiologically
CMD disrupts the heart at multiple levels:
🔻 Reduced coronary flow reserve (CFR) → subendocardial ischemia
🔥 Microinfarctions & fibrosis → stiff myocardium
⚙️ Impaired cardiac–coronary coupling → blunted flow during stress
🧬 Inflammation & endothelial dysfunction → vicious cycle of ischemia and diastolic failure

HFpEF and CMD reinforce each other in a bidirectional loop, rather than a simple cause–effect relationship.

👩‍⚕️ A sex-specific disease
Women are disproportionately affected:
Higher CMD prevalence
Smaller coronary vessels, higher resting flow
Postmenopausal estrogen loss → inflammation, fibrosis, reduced CFR

This helps explain why HFpEF is more common and more complex in women.

🧪 Diagnosis: we’re under-testing
CMD can be assessed by:
PET or CMR perfusion
Invasive coronary functional testing (CFR, IMR, acetylcholine)

But there is no standardized diagnostic pathway in HFpEF—yet.

💊 Therapy: signals, not solutions
Some treatments show promise (SGLT2i, statins, RAAS modulation, lifestyle, GLP-1/GIP agonists), but no therapy specifically targets CMD in HFpEF so far.

🔮 Bottom line
HFpEF is not only a myocardial disease—it’s a microvascular disease.
If we keep ignoring CMD, we will keep failing HFpEF patients.

👉 Understanding and treating HFpEF may finally require looking beyond the ventricle—into the microcirculation.

[Dr. Deepak L. Bhatt @DLBHATTMD]

Out today! The 13th Edition of Braunwald's Heart Disease. Cover art by @CMichaelGibson and cover image from @RonBlankstein. #cardiology #cardiovascular #cardiotwitter #cardioX @ClinicalKey @ElsevierConnect

[NEJM @NEJM]

Presented at #AHA25:

In patients with atrial fibrillation and a drug-eluting stent placed at least 1 year earlier, monotherapy with a non–vitamin K antagonist oral anticoagulant was noninferior to combination therapy with clopidogrel for net adverse clinical events. Full ADAPT AF-DES trial results: https://t.co/7FQatfAPcl

@AHAScience

[Edgardo Alania @Ed_Alania]

🧵 1/🚨 New era in cardiac amyloidosis!

ATTR-CM is not just about slowing progression anymore — it’s about reversing the disease.

From tafamidis to CRISPR gene editing 🧬💥

Let’s dive into the 2025 European Heart Journal review by Fontana et al.
👇 #CardioTwitter #Amyloidosis

[Philippe Rola @ThinkingCC]

Essentially Magder’s curve of the RV here (blue line), but flip the axes

[CardiovascularCorner @TrackYourHeart]

Understanding Cardiorenal Syndrome : A🧵

1️⃣ What is Cardiorenal Syndrome (CRS)?
CRS refers to a complex disorder where dysfunction in the heart or kidneys triggers dysfunction in the other organ.
It’s a bidirectional relationship Heart affects kidneys, and kidneys affect heart

[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

[European Society of Cardiology Journals @ESC_Journals]

Transthyretin amyloid cardiomyopathy: from cause to novel treatments. Read this State-of-the-Art review just published in #EHJ 👉 https://t.co/xs8gK2WEW0

@RoccoMontone @ehj_ed #amyloidosis

[ACCP Cardiology PRN @accpcardprn]

Meet Dr. Kaitlin Mooney, current PGY2 Cardiology Resident at Atrium Health Wake Forest Baptist Medical Center.
Next #TeachingTuesday Dr. Mooney discusses cardiac amyloidosis!

It's #Amyloidosis Week! We will have a PGY2 CE Spotlight and Teaching Tuesday on cardiac amyloidosis!!

[Sarah Moharem Elgamal, MBBCh, MSc, PhD👩🏻‍⚕️🫀 @Sarah_Moharem]

2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease

Key Change:
🔹In patients with low-flow, low-gradient (LFLG) AS with reduced EF, the 2025 guidelines now place CT aortic valve calcium scoring (AVCS) on equal footing with dobutamine stress echocardiography (DSE) for confirming severity.
🔹AVCS thresholds remain the same: >1200 AU in women and >2000 AU in men.
🔹If CT calcium score is above these cutoffs → this is sufficient for diagnosis of true severe AS, without needing DSE.
🔹DSE is no longer mandatory — it’s optional and equivalent to CT in decision-making.

If one test is not conclusive, complement diagnostics with the other test.