DR OMID

chirurgien Thoracique et cardiovasculaire

[American College of Cardiology @ACCinTouch]

🫀 Did you know #cvHCM affects at least 1 in 500 adults? Help patients better understand HCM with free, evidence-based resources from #CardioSmart, including discussion guides, infographics and patient handouts.

Download today ➡️ https://t.co/gBrlp5NyyI #CardioX

[European Society of Cardiology Journals @ESC_Journals]

New in #EJPC: This study assessed stopping antihypertensive therapy (AHT) in pts without self-reported CV risk factors (other than hypertension) or target organ damage, on monotherapy or low-dose dual AHT.
➡️ About one-third of individuals on monotherapy or low-dose dual AHT maintained controlled BP after one year 📕 Read more: https://t.co/JTsrFeOxhn

@EJPCEiC @AboyansV @SilCastelletti @PTBuketAkinci @PeroneFrancesco @SMosteoru @TimKambic

[OklahomaACC @acc_oklahoma]

📈 In severe degenerative #vhdMR patients undergoing surgery, integrated atrial + ventricular #echofirst strain improved risk stratification beyond guideline LV criteria—with the greatest value seen in asymptomatic patients. https://t.co/IvZcEAwqCR #JACCIMG

[JAMA Cardiology @JAMACardio]

Meta-analysis indicates #Prasugrel provides optimal balance of efficacy and safety for patients after #PCI, with lower major adverse cardiovascular events and stent thrombosis compared with ticagrelor and clopidogrel. https://t.co/JuQRonICDX

[Heart_BMJ @Heart_BMJ]

From ‘high-risk plaque’ to high-value care: measuring vulnerability and managing uncertainty https://t.co/BTN9VsRwaD

[EHJ Editor-in-Chief @ehj_ed]

Can deep learning outperform decades of Cox regression? China-AIHeart, sex-specific transformer models built on 156,790 Chinese adults, outperformed Cox models with identical predictors, plus China-PAR, PREVENT-ASCVD and SCORE2 Asia-Pacific, with strong calibration and robust external validation in two independent cohorts. Read more in #EHJ.
https://t.co/06z1ZwmSmA
#cardiotwitter @ESC_Journals @escardio

[European Society of Cardiology Journals @ESC_Journals]

Prediction of appropriate implantable cardioverter-defibrillator therapy using #MachineLearning and routinely available clinical data https://t.co/UaYPVKMvTf

#EHJDigital #ArtificialIntelligence
@BruiningNico @rafavidalperez @fwasselbergs @rbcasado @EHRAPresident

[EHJ Editor-in-Chief @ehj_ed]

Could a flu shot prevent atrial fibrillation? Influenza vaccination was linked to a 20% lower risk of incident atrial fibrillation plus lower mortality, MI and heart failure. Same soil: inflammation, autonomic drive, thrombosis. Vaccination may keep it quiet. Read more in #EHJ.
https://t.co/sEvX7dsmfX
#cardiotwitter @ESC_Journals @escardio

[European Society of Cardiology Journals @ESC_Journals]

New in #EJPC: ✅ Single-pill combination use results in greater likelihood of achieving target blood pressure control and more rapid, sustained blood pressure reduction without an increase in serious adverse events. 📕 Read more: https://t.co/jGCPVgKjIf

@EJPCEiC @AboyansV @SilCastelletti @PTBuketAkinci @PeroneFrancesco @SMosteoru @TimKambic

[Circulation @CircAHA]

#InDepth on the global, multidisciplinary ARCH-ARC consensus statement to standardize reporting for thoracic aortic repair. https://t.co/7ANY5E8okp

[American Society of Echocardiography @ASE360]

ASE and @accpchest recently partnered on a project to develop two educational webinars to improve the understanding of cardiovascular ultrasound's application in pulmonary hypertension (PH). @chest

You can find them on our Right Heart Resources web page! https://t.co/aHA1IniTS3

[Dr.Marlon Villanueva™ 🩺 𝕏 @MarlonVFZR]

🫀⚙️𝗙𝗶𝘀𝗶𝗼𝗹𝗼𝗴𝗶́𝗮 𝗰𝗮𝗿𝗱𝗶𝗼𝘃𝗮𝘀𝗰𝘂𝗹𝗮𝗿 𝗮𝗽𝗹𝗶𝗰𝗮𝗱𝗮 𝗮𝗹 𝗽𝗮𝗰𝗶𝗲𝗻𝘁𝗲 𝗰𝗿𝗶́𝘁𝗶𝗰𝗼: 𝗲𝗻𝘁𝗲𝗻𝗱𝗲𝗿 𝗹𝗮 𝗵𝗲𝗺𝗼𝗱𝗶𝗻𝗮𝗺𝗶𝗮 𝗲𝘀 𝗰𝗹𝗮𝘃𝗲 𝗽𝗮𝗿𝗮 𝗻𝗼 𝘁𝗿𝗮𝘁𝗮𝗿 “𝗮 𝗰𝗶𝗲𝗴𝗮𝘀”🚨
@CritCareMed
👇🏼👇🏼👇🏼👇🏼
📑🔗🔑🔓
https://t.co/89ht2mBRSA
⬇️⬇️⬇️⬇️
🧵👇

La relación 𝙥𝙧𝙚𝙨𝙞𝙤́𝙣-𝙫𝙤𝙡𝙪𝙢𝙚n y el modelo de 𝙚𝙡𝙖𝙨𝙩𝙖𝙣𝙘𝙞𝙖 𝙫𝙖𝙧𝙞𝙖𝙗𝙡𝙚 𝙚𝙣 𝙚𝙡 𝙩𝙞𝙚𝙢𝙥𝙤: base para interpretar monitorización avanzada y entender el efecto real de los tratamientos en sepsis, shock cardiogénico y soporte mecánico.
#Hemodynamics #CriticalCare

🧠 𝙀𝙡 𝙘𝙤𝙧𝙖𝙯𝙤́𝙣 𝙣𝙤 𝙙𝙚𝙗𝙚 𝙖𝙣𝙖𝙡𝙞𝙯𝙖𝙧𝙨𝙚 𝙨𝙤𝙡𝙤 𝙥𝙤𝙧 𝙥𝙧𝙚𝙨𝙞𝙤́𝙣 𝙤 𝙜𝙖𝙨𝙩𝙤: 𝙝𝙖𝙮 𝙦𝙪𝙚 𝙥𝙚𝙣𝙨𝙖𝙧 𝙚𝙣 𝙖𝙘𝙤𝙥𝙡𝙖𝙢𝙞𝙚𝙣𝙩𝙤 𝙫𝙚𝙣𝙩𝙧𝙞́𝙘𝙪𝙡𝙤-𝙖𝙧𝙩𝙚𝙧𝙞𝙖𝙡
2 conceptos centrales:
📌 𝙀𝙚𝙨 = contractilidad ventricular
📌 𝙀𝙖 = carga arterial efectiva
Y su relación 𝙀𝙖/𝙀𝙚𝙨 determina en gran parte:
🫀 fracción de eyección
🩸 volumen sistólico
📉 presión telesistólica
👉 Cuando 𝙀𝙖/𝙀𝙚𝙨 𝙨𝙪𝙗𝙚, el ventrículo se “desacopla” y el rendimiento cae.
#VentriculoArterialCoupling #Ees #Ea

📈 𝙇𝙖 𝙘𝙪𝙧𝙫𝙖 𝙥𝙧𝙚𝙨𝙞𝙤́𝙣-𝙫𝙤𝙡𝙪𝙢𝙚𝙣 𝙚𝙭𝙥𝙡𝙞𝙘𝙖 𝙢𝙪𝙘𝙝𝙤 𝙢𝙚𝙟𝙤𝙧 𝙡𝙤 𝙦𝙪𝙚 𝙫𝙚𝙢𝙤𝙨 𝙖𝙡 𝙥𝙞𝙚 𝙙𝙚 𝙘𝙖𝙢𝙖
En la 𝘧𝘪𝘨𝘶𝘳𝘢 𝘥𝘦 𝘭𝘢 𝘱𝘢́𝘨𝘪𝘯𝘢 3 del artículo, el loop muestra cómo integrar:
🔹 𝙀𝘿𝙋𝙑𝙍 → rigidez/compliance diastólica
🔹 𝙀𝙎𝙋𝙑𝙍 → contractilidad sistólica
🔹 área del loop → 𝙨𝙩𝙧𝙤𝙠𝙚 𝙬𝙤𝙧𝙠
🔹 área presión-volumen total → relación con 𝙘𝙤𝙣𝙨𝙪𝙢𝙤 𝙢𝙞𝙤𝙘𝙖́𝙧𝙙𝙞𝙘𝙤 𝙙𝙚 𝙊₂
👉 O sea: no solo importa cuánto bombea el corazón, sino 𝙖 𝙦𝙪𝙚́ 𝙘𝙤𝙨𝙩𝙤 𝙢𝙚𝙘𝙖́𝙣𝙞𝙘𝙤 𝙮 𝙚𝙣𝙚𝙧𝙜𝙚́𝙩𝙞𝙘𝙤 𝙡𝙤 𝙝𝙖𝙘𝙚.
#PressureVolumeLoop #CardiacWork #MyocardialOxygenConsumption

🦠 𝙀𝙣 𝙨𝙚𝙥𝙨𝙞𝙨, 𝙚𝙡 𝙢𝙞𝙨𝙢𝙤 𝙖𝙡𝙜𝙤𝙧𝙞𝙩𝙢𝙤 𝙣𝙤 𝙨𝙞𝙧𝙫𝙚 𝙥𝙖𝙧𝙖 𝙩𝙤𝙙𝙤𝙨
La sepsis altera múltiples componentes a la vez:
🩸 tono arterial
🫗 capacitancia venosa
🫀 función sistólica
🫀 función diastólica
Por eso una reanimación rígida puede fallar.
En la 𝘧𝘪𝘨𝘶𝘳𝘢 𝘥𝘦 𝘭𝘢 𝘱𝘢́𝘨𝘪𝘯𝘢 5, la vasoplejia reduce 𝙀𝙖 y 𝙋𝙚𝙨, aumenta la FE de forma “engañosa”, pero cae el 𝙎𝙑 por menor volumen estresado y retorno venoso.
#Sepsis #Vasoplegia #Shock

💉 𝙇𝙤𝙨 𝙫𝙖𝙨𝙤𝙥𝙧𝙚𝙨𝙤𝙧𝙚𝙨 𝙚 𝙞𝙣𝙤𝙩𝙧𝙤́𝙥𝙞𝙘𝙤𝙨 𝙣𝙤 “𝙨𝙪𝙗𝙚𝙣 𝙡𝙖 𝙥𝙧𝙚𝙨𝙞𝙤́𝙣” 𝙩𝙤𝙙𝙤𝙨 𝙞𝙜𝙪𝙖𝙡: 𝙘𝙖𝙢𝙗𝙞𝙖𝙣 𝙡𝙖 𝙛𝙞𝙨𝙞𝙤𝙡𝙤𝙜𝙞́𝙖 𝙙𝙚 𝙛𝙤𝙧𝙢𝙖 𝙙𝙞𝙨𝙩𝙞𝙣𝙩𝙖
🔴 𝙣𝙤𝙧𝙚𝙥𝙞𝙣𝙚𝙛𝙧𝙞𝙣𝙖 → ↑ SVR, ↑ Ea, ↓ capacitancia venosa, ↑ volumen estresado
🟣 𝙫𝙖𝙨𝙤𝙥𝙧𝙚𝙨𝙞𝙣𝙖 → ↑ Ea sin mejorar Ees
🔵 𝙙𝙤𝙗𝙪𝙩𝙖𝙢𝙞𝙣𝙖 → ↑ Ees, ↓ Ea relativo, ↑ SV
🟠 𝙮 → ↓ Ea, ↓ EDP, ↑ SV
👉 La misma PAM puede lograrse con efectos completamente diferentes sobre 𝙥𝙤𝙨𝙘𝙖𝙧𝙜𝙖, 𝙥𝙧𝙚𝙘𝙖𝙧𝙜𝙖, 𝙑𝙎 𝙮 𝙑𝙊₂ 𝙢𝙞𝙤𝙘𝙖́𝙧𝙙𝙞𝙘𝙤.
#Norepinephrine #Dobutamine #Vasopressin #Nitroprusside

🫀 𝙀𝙣 𝙨𝙝𝙤𝙘𝙠 𝙘𝙖𝙧𝙙𝙞𝙤𝙜𝙚́𝙣𝙞𝙘𝙤, 𝙨𝙪𝙗𝙞𝙧 𝙥𝙧𝙚𝙨𝙞𝙤́𝙣 𝙣𝙤 𝙨𝙞𝙚𝙢𝙥𝙧𝙚 𝙨𝙞𝙜𝙣𝙞𝙛𝙞𝙘𝙖 𝙖𝙮𝙪𝙙𝙖𝙧 𝙖𝙡 𝙫𝙚𝙣𝙩𝙧𝙞́𝙘𝙪𝙡𝙤
La 𝘧𝘪𝘨𝘶𝘳𝘢 𝘥𝘦 𝘭𝘢 𝘱𝘢́𝘨𝘪𝘯𝘢 7 compara 2 estrategias:
📍 𝙞𝙣𝙤𝙘𝙤𝙣𝙨𝙩𝙧𝙞𝙘𝙩𝙤𝙧 + 𝙫𝙖𝙨𝙤𝙥𝙧𝙚𝙨𝙤𝙧
vs
📍 𝙞𝙣𝙤𝙙𝙞𝙡𝙖𝙩𝙖𝙙𝙤𝙧 + 𝙫𝙖𝙨𝙤𝙙𝙞𝙡𝙖𝙩𝙖𝙙𝙤𝙧
Y deja una enseñanza potente: una estrategia que eleva mucho la presión puede empeorar 𝙀𝙖/𝙀𝙚𝙨, aumentar 𝙀𝘿𝙋 y subir el costo miocárdico.
👉 A veces una estrategia con más descarga ventricular y mejor VS puede ser fisiológicamente superior aunque la TA no “impresione” tanto.
#CardiogenicShock #Inodilator #Afterload

🚀 𝙀𝙡 𝙨𝙤𝙥𝙤𝙧𝙩𝙚 𝙢𝙚𝙘𝙖́𝙣𝙞𝙘𝙤 𝙩𝙖𝙢𝙗𝙞𝙚́𝙣 𝙙𝙚𝙗𝙚 𝙖𝙣𝙖𝙡𝙞𝙯𝙖𝙧𝙨𝙚 𝙘𝙤𝙣 𝙛𝙞𝙨𝙞𝙤𝙡𝙤𝙜𝙞́𝙖, 𝙣𝙤 𝙨𝙤𝙡𝙤 𝙘𝙤𝙣 𝙛𝙡𝙪𝙟𝙤
La 𝘧𝘪𝘨𝘶𝘳𝘢 𝘥𝘦 𝘭𝘢𝘴 𝘱𝘢́𝘨𝘪𝘯𝘢𝘴 8–9 muestra algo clave:
⚠️ 𝙑𝘼-𝙀𝘾𝙈𝙊 puede aumentar 𝙀𝙖 y no descargar adecuadamente el VI
⚠️ el VI puede seguir con presión y volumen elevados, favoreciendo edema pulmonar y mayor consumo de O₂
✅ agregar descarga con 𝙇𝙑𝘼𝘿/𝙄𝙢𝙥𝙚𝙡𝙡𝙖 o usar estrategias farmacológicas de descarga puede reducir 𝙀𝘿𝙑, 𝙀𝘿𝙋 𝙮 𝙋𝙑𝘼

🔥 Take-home: este review recuerda que la hemodinamia avanzada no debe usarse para perseguir números aislados, sino para identificar el 𝙛𝙚𝙣𝙤𝙩𝙞𝙥𝙤 𝙘𝙖𝙧𝙙𝙞𝙤𝙫𝙖𝙨𝙘𝙪𝙡𝙖𝙧 𝙧𝙚𝙖𝙡 y elegir terapias que mejoren 𝙖𝙘𝙤𝙥𝙡𝙖𝙢𝙞𝙚𝙣𝙩𝙤, 𝙥𝙚𝙧𝙛𝙪𝙨𝙞𝙤́𝙣 𝙮 𝙚𝙛𝙞𝙘𝙞𝙚𝙣𝙘𝙞𝙖 𝙢𝙞𝙤𝙘𝙖́𝙧𝙙𝙞𝙘𝙖.

‼️Si te sirve: ❤️ Me gusta | 🔁 Repost | ➕ Follow para más👇🏼👇🏼👇🏼👇🏼
📚📖#ClubCrit👨🏻‍⚕️👨🏻‍🏫🧠🫶

📚📖 Más en 𝕏 @MarlonVFZR y en el blog 👉 [https://t.co/b0RJ3TaB9I]

#ClubCrit #ShockCardiogénico #Sepsis #ECMO #Impella #Hemodynamics #CriticalCare #POCUS #FOAMed #FOAMcc #CriticalCare #CriticalCare #CuidadoCrítico #MedTwitter #CritCare #icu #intensivecare #diagnosis #management #UCI #MedicinaBasadaEnEvidencia #MedEd #MedX #IntensiveCare #MedIntensiva #MedXCommunity #MedED #ICUmanagement #MustRead #LecturaRecomendada

[EHJ Editor-in-Chief @ehj_ed]

New Editorial paper discusses the last insights about finerenone in cardiovascular–kidney–metabolic syndrome.
https://t.co/9tNWHN8hVF
#finerenone #HF #CKD #cardiotwitter @ESC_Journals @escardio

[European Society of Cardiology Journals @ESC_Journals]

Infective endocarditis of pulmonary valve and Coronary pseudoaneurysm of LAD: a rare coincidence https://t.co/9eLnvSrJht

#EHJCaseReports @Phiso_de @TJ_Yeo @aayshacader @girishviswa @SukritiBanthiya @O_Azizy_MD @saramoscatelli7 @EHJCREiC #CardioX

[Heart_BMJ @Heart_BMJ]

Premature ventricular complexes and risk of atrial fibrillation and stroke in patients without structural heart disease

Please enjoy reading the paper and listening to an in-depth interview between @jhfrudd and first author Dr Robin Bouleau

Publication - https://t.co/dzeEnfL4Yf

Podcast - https://t.co/AC13sex7xP - Apple Podcasts, but the interview is available on all the other podcast platforms

[European Society of Cardiology Journals @ESC_Journals]

Loeffler endocarditis revealed chronic eosinophilic leukaemia 🧬 Rare case of hypereosinophilic syndrome with FIP1L1-PDGFRA rearrangement, intracardiac thrombi and embolic strokes, with remission after chemo + anticoagulation https://t.co/hXCkUxpdaO

#EHJCaseReports @Phiso_de @TJ_Yeo @aayshacader @BoldiKovacsMD @SukritiBanthiya @ANazmiCalik @O_Azizy_MD @saramoscatelli7 @EHJCREiC #CardioX #EPeeps

[EHJ Editor-in-Chief @ehj_ed]

Elevated C-reactive protein in the general population is linked to higher cardiovascular risk, reinforcing the role of inflammation in heart disease. Read more in #EHJ.
https://t.co/IOEg0NfBz4
#CRP #inflammation #cardiotwitter @ESC_Journals @escardio

[European Society of Cardiology Journals @ESC_Journals]

Acetazolamide as a cost-effective treatment in decompensated #HF 👉 https://t.co/9GJUEZAVPT

#EHJQCCO #CVD @cpgale3 @diogoasantosfer @m_piepoli

[EHJ Editor-in-Chief @ehj_ed]

Plaque erosion now drives one-third of all acute coronary syndrome cases. Thanks to OCT, we can see the biology in real time and rethink treatment beyond plaque rupture. The era of personalized acute coronary sybdrome care is here. Read more in #EHJ.
https://t.co/GoPwouSu71
#Erosion #Plaque #ACS #OCT #cardiotwitter @ESC_Journals @escardio

[European Society of Cardiology Journals @ESC_Journals]

New in #EJPC: In the Copenhagen General Population Study with 110 291 individuals, diabetes and ⬆️plasma glucose are associated with risk of aortic and mitral valve calcification and aortic valve stenosis
✅The risk of aortic valve stenosis was partly explained by elevated plasma triglycerides, hypertension, and BMI

https://t.co/hflw7CFxUk

@EJPCEiC @AboyansV @SilCastelletti @PTBuketAkinci @PeroneFrancesco @justvick