Great paper, great thread, we don’t understand HFPEF at all

Thank goodness - question is; does this apply to beer and chocolate intake too?

Couldn’t be more correct!

I can never resist

Redefining conditions that make no sense? (How can something that is sinus be an arrhythmia?) excellent! Next, let’s do away with HF with a preserved ejection fraction.

Yes! Stealing this one

Lower extremity lymphatic flow is associated with diuretic response in acute heart failure In 65 AHF patients, lymphatic flow (via ICG lymphangiography) predicted diuretic response. #AHF #CardioSky #Lymphatics #AHF @shelleyzieroth.bsky.social @escardio.bsky.social @drrajivsankar.bsky.social

So true - why does “this sort of thing” keep being done??

Fluid restriction associated with trend to worse QoL and greater thirst in stable outpatients with HF. No difference in safety. www.nature.com/articles/s41...

A trial in which the rate of side effects (uro-genital infection) was nearly 2x greater than the rate of the primary driver of the outcome benefit (worsening HF +\- hospitalisation) www.nejm.org/doi/full/10....

Whatever you think of Mandrola’s approach…he could not be more correct about critical appraisal of trials in the first 5 mins of this week’s episode. podcasts.apple.com/gb/podcast/t...

I maintain that I only have time to eat chocolate and drink beer; not eat chocolate, drink beer, and exercise.

Amazing story in which the Guardian use the first year medical student definition of heart failure….”weakened the heart so that it cannot effectively pump blood through the body effectively”…bless them. www.theguardian.com/australia-ne...

Hopeless technique

An IPD analysis of STICHES and REVIVED-BCIS2. Higher risk in the OMT arm in the older CABG trial STITCHES than the more recent PCI trial REVIVED. #cardiosky academic.oup.com/eurheartj/ad...

Argh!!!!!!

Presence of congestion is central to a diagnosis of HF. There are multiple imaging techniques to identify congestion - are any of them better than a stethoscope and clinical acumen? pubmed.ncbi.nlm.nih.gov/39998772/

Delighted to be joint first author on this work published in @ESC_Journals EHJ academic.oup.com/eurheartj/ad...

Absolutely! Such a wonderful thing

One to pass on to the med students - this is excellent

Here's an interesting study of atrial pacing in patients with HFpEF, showing how increasing heart rate may decrease LAP until it increases again at higher heart rates. A reason not to give these patients beta blockers without a good indication I think #cardiosky academic.oup.com/eurheartj/ar...

The beautifully refurbished Montague Burton Building on the corner of Whitefriargate. See #alt-text #alttext for full description. #hull #yorkshire #travel #architecture #artdeco #photography

✨WHEEZING✨

Really pleased to have this published in @jcardfail.bsky.social Natriuresis guided diuresis: barking up the wrong tree. Needless to say, we argue that focussing on natriuresis rather than urine volume may be misguided. onlinejcf.com/article/S107...

This is, surprisingly, the only study I am aware of that compares oral and SC loop diuretic. Tiny difference in diuretic efficacy 7ml/mg driven only by a difference in those with diuretic resistance. Statistically significant yes, but clinically meaningful? onlinelibrary.wiley.com/doi/full/10....

#Diuretic efficiency of a single dose of SC Vs oral #furosemide after heart failure hospitalization across diuretic resistance strata: A pilot RCT onlinelibrary.wiley.com/doi/full/10.... @shelleyzieroth.bsky.social @novitham.bsky.social @anastasiasmihaili.bsky.social @noshreza.bsky.social

Palliative Care (PC) is integral to HF care, but there is little information on how it can be incorporated into comprehensive HF care. Check out the @HFSA Consensus Statement on PC in HF for a practical guide for clinicians caring for these complex patients. 🔗 bit.ly/4fJNz6e

Difficult to translate completely to UK setting due to cost of medications in US but nicely shows that, whatever reason patients aren’t adherent to treatment, it’s not because they have forgotten!

Some excellent threads on Xitter atm re frailty and HF meds. Hawks vs Doves but in a respectful and evidence-related discussion. FWIW - the geriatricians are right, and the cardiologists are wrong (aren’t they always?!) x.com/lucypgeridoc...

Its back! Ten current papers for the curious cardiologist, including BP targets in T2DM, spiro post MI, left atrial appendage occlusion, coronary sinus reducer for angina, device detected AF & tirzepatide in HFpEF #CardioSky 1/11

I often worry that geriatricians do chronic, stable HF better than the HF cardiologists. I wholeheartedly agree with everything in here. Guidelines allow for no nuance and there is a lot! www.bmj.com/content/387/...