This Week in Cardiology

Devices for HF, Twitter for disseminating science, HDL levels, and dubious post-hoc studies are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic

I – Interatrial Shunts for HF

- Interatrial Shunt in HF Hints at Heart Structural, Functional Benefits https://www.medscape.com/viewarticle/974776

- Atrial shunt device for heart failure with preserved and mildly reduced ejection fraction (REDUCE LAP-HF II): a randomised, multicentre, blinded, sham-controlled trial https://doi.org/10.1016/S0140-6736(22)00016-2

- Reducing Lung CongestIon Symptoms in Advanced Heart Failure (RELIEVE-HF) https://clinicaltrials.gov/ct2/show/NCT03499236

II – Twitter for Science Communication

- Twitter Promotion Boosts Visibility, Citation for CV Research https://www.medscape.com/viewarticle/974653

- Twitter promotion is associated with higher citation rates of cardiovascular articles: the ESC Journals Randomized Study https://doi.org/10.1093/eurheartj/ehac150

- A Randomized Trial of Social Media From Circulation https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.013509

III – HDL Level

- Very High HDL-C: Too Much of a Good Thing? https://www.medscape.com/viewarticle/974651

- Association Between High-Density Lipoprotein Cholesterol Levels and Adverse Cardiovascular Outcomes in High-risk Populations https://jamanetwork.com/journals/jamacardiology/article-abstract/2792282

- Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889017/

IV – Dubious Sub-Studies: Omecamtiv Mecarbil

- Myosin Inhibitor May Benefit Data-Deprived Patients With Heart Failure and Low Blood Pressure https://www.medscape.com/viewarticle/974960

- Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2025797

- METEORIC-HF: Omecamtiv Mecarbil Does Not Improve Exercise Capacity in HFrEF Patients https://www.acc.org/Latest-in-Cardiology/Articles/2022/04/02/13/22/Sun-945am-METEORIC-HF-acc-2022

- Effects of Omecamtiv mecarbil in heart failure with reduced ejection fraction according to blood pressure: the GALACTIC-HF trial https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehac293/6590348

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Ischemia vs anatomic testing for CAD, UK-TAVI trial, TAVI for AR? and post-PCI anti-thrombotics are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic

I – Ischemic vs Anatomic Evaluation for CAD

- ISCHEMIA Substudy Data Just Don't Add Up, Cardiac Surgeons Say https://www.medscape.com/viewarticle/974107

- Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.120.049755

- Initial Invasive or Conservative Strategy for Stable Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1915922

- Forget Ischemia: It's All About the Plaque https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.054102

- Optimal Medical Therapy With or Without Percutaneous Coronary Intervention to Reduce Ischemic Burden https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.107.743963

- Baseline stress myocardial perfusion imaging results and outcomes in patients with stable ischemic heart disease randomized to optimal medical therapy with or without percutaneous coronary intervention https://doi.org/10.1016/j.ahj.2012.05.018

- Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease https://www.nejm.org/doi/full/10.1056/nejmoa1415516

- Coronary CT Angiography and 5-Year Risk of Myocardial Infarction https://www.nejm.org/doi/full/10.1056/NEJMoa1805971

- Five Reasons I Don't Believe an Imaging Test Improves Outcomes https://www.medscape.com/viewarticle/901204

II – UK-TAVI Trial

- UK TAVI: Similar Outcomes to Surgery in Real World https://www.medscape.com/viewarticle/927729

- Effect of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement on All-Cause Mortality in Patients With Aortic Stenosis https://jamanetwork.com/journals/jama/fullarticle/2792251

III – TAVI for AI?

- JenaValve Trilogy Takes Another Step Forward in Severe AR https://www.medscape.com/viewarticle/974304

IV – Post PCI DAPT

- One-Month DAPT Enough for Complex PCI if Bleeding Risk High https://www.medscape.com/viewarticle/974224

- Duration of Antiplatelet Therapy After Complex Percutaneous Coronary Intervention In Patients at High Bleeding Risk: a MASTER DAPT trial sub-analysis https://doi.org/10.1093/eurheartj/ehac284

- Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk https://www.nejm.org/doi/full/10.1056/NEJMoa2108749

Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine

The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

Questions or feedback, please contact

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Obstructive hypertrophic cardiomyopathy and mavacamten, SGLT2 inhibitors, the triple whammy, espresso, and clinician burnout are the topics John Mandrola, MD, covers in today's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic

I – Mavacamten

- FDA Clears Mavacamten (Camzyos) for Obstructive Hypertrophic Cardiomyopathy https://www.medscape.com/viewarticle/972945

- Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM): a randomised, double-blind, placebo-controlled, phase 3 trial https://doi.org/10.1016/S0140-6736(20)31792-X

- FDA approves new drug to improve heart function in adults with rare heart condition https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-new-drug-improve-heart-function-adults-rare-heart-condition

II – Dapagliflozin in HFpEF

- Positive Topline Results for Dapagliflozin in HFpEF: DELIVER https://www.medscape.com/viewarticle/973490

- Empagliflozin in Heart Failure with a Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2107038

III – Triple Whammy for AKI

- Mixing BP Meds With NSAID May Be 'Triple Whammy' for Kidneys https://www.medscape.com/viewarticle/973885

IV – Espresso

- Espresso Coffee Associated With Increased Total Cholesterol https://www.medscape.com/viewarticle/973819

- Association between espresso coffee and serum total cholesterol: the Tromsø Study 2015–2016 https://openheart.bmj.com/content/9/1/e001946

- Is everything we eat associated with cancer? A systematic cookbook review https://pubmed.ncbi.nlm.nih.gov/23193004/

- Enough With the Coffee Research and Other Distractions https://www.medscape.com/viewarticle/883709

V – Clinician Burnout

- Administrative Hassle Hacks: Strategies to Curb Physician Stress https://www.medscape.com/viewarticle/973597

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HRS meeting presentations: conduction system pacing, AF in the ED, a possible new treatment for vagal bradycardia, and women in EP are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

To read a partial transcript or to comment, visit:

https://www.medscape.com/twic

I – HRS Comments

II – Conduction System Pacing

Conduction System Disease Recast as Preventive Therapy Target

https://www.medscape.com/viewarticle/973488

• Rescue Left Bundle Branch Area Pacing in Coronary Venous Lead Failure or Non-response to Biventricular Pacing: Results From International LBBAP Collaborative Study Group

https://doi.org/10.1016/j.hrthm.2022.04.024

• Clinical Outcomes Of Conduction System Pacing Compared To Biventricular Pacing In Patients Requiring Cardiac Resynchronization Therapy

https://doi.org/10.1016/j.hrthm.2022.04.023

III – Emergency Triage of AF

Early Arrhythmia-Specialist Consult, Ordered in the ER, a Boon to AF Outcomes: ER2EP Study

https://www.medscape.com/viewarticle/973250

• ClinicalTrials.gov Reference

https://clinicaltrials.gov/ct2/show/NCT04476524

• George Bernard Shaw Reference:

https://jamanetwork.com/journals/jama/fullarticle/2623628

IV – Cardioneural Ablation

Can Ablation Abolish Vasovagal Syncope? Early Series Promising

https://www.medscape.com/viewarticle/973346

V – Women in EP

Why Are Numbers of Women, Minorities So Low in Cardiac EP?

https://www.medscape.com/viewarticle/972968

• Temporal and geographical trends in women operators of electrophysiology procedures in the United States

https://doi.org/10.1016/j.hrthm.2022.02.015

• Quantification of Female and Underrepresented Minority Applicants to Clinical Cardiac Electrophysiology Fellowship

https://www.jacc.org/doi/full/10.1016/j.jacep.2022.04.001

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https://www.medscape.com/author/bob-harrington

Questions or feedback, please contact [email protected]

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Aspirin for primary prevention, time-restricted feeding, renal denervation, and a potential new obesity drug are the topics John Mandrola, MD, covers in this week's podcast.

This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic

I – ASA for Primary Prevention:

- USPSTF Final Recommendation on Aspirin for Primary CV Prevention https://www.medscape.com/viewarticle/972761

- Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement https://jamanetwork.com/journals/jama/fullarticle/2791399

- Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly https://www.nejm.org/doi/10.1056/NEJMoa1805819

- Effect of Aspirin on All-Cause Mortality in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1803955

II – Time Restricted Feeding

- Is There a Benefit to Fasting Plus Calorie Counting? https://www.medscape.com/viewarticle/972579

- Calorie Restriction with or without Time-Restricted Eating in Weight Loss https://www.nejm.org/doi/full/10.1056/NEJMoa2114833

- Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity. The TREAT Randomized Clinical Trial https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771095

III – Renal Denervation

- Renal Denervation BP Benefits Remain at 3 Years: SPYRAL HTN-ON https://www.medscape.com/viewarticle/971883

- Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial https://doi.org/10.1016/S0140-6736(22)00455-X

IV – Tirzepatide for Obesity

- Tirzepatide Excites in Obesity Now Too, Says Lilly https://www.medscape.com/viewarticle/972936

- Lilly's tirzepatide delivered up to 22.5% weight loss in adults with obesity or overweight in SURMOUNT-1 https://www.prnewswire.com/news-releases/lillys-tirzepatide-delivered-up-to-22-5-weight-loss-in-adults-with-obesity-or-overweight-in-surmount-1--301534871.html

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Questions or feedback, please contact [email protected]

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Critiques of last week's comments on VT ablation and a review of EHRA presentations, including new ways to ablate atrial myocardium and pace the ventricle, are discussed by John Mandrola, MD, in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic

I – VT ablation

- VT Ablation After First ICD Shock Boosts Survival: PARTITA https://www.medscape.com/viewarticle/971969

- Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.059598

- Substrate Ablation vs Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia https://www.jacc.org/doi/10.1016/j.jacc.2022.01.050

- Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs https://www.nejm.org/doi/full/10.1056/NEJMoa1513614

II – Pulsed-Field Ablation

- Pulsed Field Ablation Treats AF With Few Complications https://www.medscape.com/viewarticle/972147

- Pulsed Field Ablation for Persistent Atrial Fibrillation (PersAFOne): Hope or Hype? https://www.jacc.org/doi/10.1016/j.jacc.2020.07.032

III – High-Power Short Duration Ablation

- Short, High-Power Ablation on Par With Standard AF Ablation https://www.medscape.com/viewarticle/972087

IV – LBB-Area Pacing

- MELOS: LBB Area Pacing Promising for Bradyarrhythmias, HF https://www.medscape.com/viewarticle/972270

Also of interest...

- Conduction System Pacing Noninferior to Biventricular Pacing for HF With Wide QRS https://www.medscape.com/viewarticle/971740

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Questions or feedback, please contact [email protected]

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

ACC Recap, Part 2: VT ablation, HF care, three-vessel disease, and patiromer are the topics John Mandrola, MD, covers in this week's podcast.

This podcast is intended for healthcare professionals only.

To read a partial transcript or to comment, visit:

https://www.medscape.com/twic

I – VT ablation

VT Ablation After First ICD Shock Boosts Survival: PARTITA

https://www.medscape.com/viewarticle/971969

• Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.059598

• Substrate Ablation vs Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia https://www.jacc.org/doi/10.1016/j.jacc.2022.01.050

• Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs https://www.nejm.org/doi/full/10.1056/NEJMoa1513614

II – HF Care

Alerts Improve Prescribing of HF Quadruple Therapy: PROMPT-HF https://www.medscape.com/viewarticle/972079

• Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice: A Cluster Randomized Trial https://www.jacc.org/doi/10.1016/j.jacc.2022.03.338

• Reassessing Quality Assessment — The Flawed System for Fixing a Flawed System https://www.nejm.org/doi/full/10.1056/NEJMms2200976

III – Three-Vessel Disease

FAME 3 Subanalysis Adds Twist to Negative Primary Results

https://www.medscape.com/viewarticle/971495

• Fractional Flow Reserve–Guided PCI as Compared with Coronary Bypass Surgery https://www.nejm.org/doi/10.1056/NEJMoa2112299

• Quality of Life After Fractional Flow Reserve-Guided PCI Compared with Coronary Bypass Surgery https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.060049

IV – Treating Drug Side Effects with More Drugs

DIAMOND: Adding Patiromer Helps Optimize HF Meds, Foils Hyperkalemia https://www.medscape.com/viewarticle/971616

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https://www.medscape.com/author/bob-harrington

Questions or feedback, please contact

[email protected]

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

ACC Recap: John Mandrola, MD, provides part 1 of an ACC recap in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic

I – HTN in Pregnancy

- Hypertension Control During Pregnancy Validated in Large Trial https://www.medscape.com/viewarticle/971486

- Treatment for Mild Chronic Hypertension during Pregnancy https://www.nejm.org/doi/full/10.1056/NEJMoa2201295

II – Prevention of Bleeding in Non-Cardiac Surgery

- POISE-3 Backs Wider Use of Tranexamic Acid in Noncardiac Surgery https://www.medscape.com/viewarticle/971483

- Tranexamic Acid in Patients Undergoing Noncardiac Surgery https://www.nejm.org/doi/full/10.1056/NEJMoa2201171

III – HCM

- VALOR-HCM: Novel Drug May Delay, Avert Invasive Therapy in OHCM https://www.medscape.com/viewarticle/971484

IV – Left Atrial Appendage Occlusion

- Small Leaks After LAAO Linked to Thromboembolism, Bleeding https://www.medscape.com/viewarticle/971709

V – Low Sodium Diet for HF

- Low-Sodium Diet Did Not Cut Clinical Events in Heart Failure Trial https://www.medscape.com/viewarticle/971482

- Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial https://doi.org/10.1016/S0140-6736(22)00369-5

VI – Flu Vaccine and Heart Failure

- Flu Vaccines Cut Seasonal Death in Patients With Heart Failure https://www.medscape.com/viewarticle/971619

VII – New Anticoagulant?

- Less Bleeding With Factor XI Inhibitor Anticoagulant? PACIFIC-AF https://www.medscape.com/viewarticle/971702

Features:

- Sodium Restriction in Heart Failure: Another Dogma Felled by Randomization https://www.medscape.com/viewarticle/971697

- Percutaneous Left Atrial Appendage Occlusion: ACC Data Challenge Promise vs Reality https://www.medscape.com/viewarticle/971512

- Mavacamten in Hypertrophic Cardiomyopathy: Reasons for Both Optimism and Caution https://www.medscape.com/viewarticle/971485

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The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

Questions or feedback, please contact: [email protected]

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Coronary CTA, semaglutide, coronary artery calcium, exercise, and an ACC and EHRA preview are the topics discussed by John Mandrola, MD, in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic

I – Coronary CTA Feedback

- Coronary Computed Tomography Angiography vs Functional Stress Testing for Patients With Suspected Coronary Artery Disease https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2655243

II – Semaglutide

- FDA Okays Semaglutide Higher Dose, 2 mg/Week, for Type 2 Diabetes https://www.medscape.com/viewarticle/971156

- Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial https://doi.org/10.1016/S2213-8587(21)00174-1

- Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa1607141

- Once-Weekly Semaglutide in Adults with Overweight or Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

III – CAC and SCD

- Calcium Scores Predict Sudden-Death Risk in Preclinical CAD in Large Cohort Study https://www.medscape.com/viewarticle/971056

- Coronary Artery Calcium for Risk Stratification of Sudden Cardiac Death: The Coronary Artery Calcium Consortium https://www.jacc.org/doi/10.1016/j.jcmg.2022.02.011

IV – Exercise and COVID-19

- More Exercise Linked to Lower Chance of Severe COVID-19: Study https://www.medscape.com/viewarticle/949468

- Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes http://dx.doi.org/10.1136/bjsports-2021-105159

V – ACC Preview

- Hybrid ACC.22 Resurrects the Live Scientific Session https://www.medscape.com/viewarticle/971083

- Mandrola Previews the 2022 American College of Cardiology Scientific Sessions https://www.medscape.com/viewarticle/971084

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Questions or feedback, please contact [email protected]

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

AF ablation vs rate control in HF, TAVI vs SAVR, atherosclerosis, and surrogate endpoints in observational studies are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit:

https://www.medscape.com/twic

I – AF ablation vs Rate Control

RAFT-AF, Despite Itself, Hints at Advantage for Ablation Rhythm Control in Heart Failure With AF https://www.medscape.com/viewarticle/951326

• Randomized Ablation-Based Rhythm-Control Versus Rate-Control Trial in Patients with Heart Failure and Atrial Fibrillation: Results from the RAFT-AF trial https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.121.057095

• Catheter Ablation for Atrial Fibrillation with Heart Failure

https://www.nejm.org/doi/full/10.1056/nejmoa1707855

• Lenient versus Strict Rate Control in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/nejmoa1001337

II – TAVI vs SAVR

Surgery Groups Push Back on VARC-3 Valve Trial Definitions https://www.medscape.com/viewarticle/970753

• Joint Surgical Associations (EACTS, LACES, ASCVTS, AATS, and STS) Position Statement Regarding the VARC-3 Definitions for Aortic Valve Clinical Research https://doi.org/10.1093/ejcts/ezac110

III – Atherosclerosis

Medical Management Best for Atherosclerotic Stroke: New AAN Guidance

https://www.medscape.com/viewarticle/970886

• Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis Practice Advisory https://n.neurology.org/content/98/12/486

IV – ECHO parameters with Rhythm Control

Global Gains in Heart Function From Early AF Rhythm Control

https://www.medscape.com/viewarticle/970329

• Restoring Sinus Rhythm Reverses Cardiac Remodeling and Reduces Valvular Regurgitation in Patients With Atrial Fibrillation https://doi.org/10.1016/j.jacc.2021.12.029

• Effects of Atrial Fibrillation and Sinus Rhythm on Cardiac Remodeling and Valvular Regurgitation https://doi.org/10.1016/j.jacc.2021.12.028

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Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine

https://www.medscape.com/features/public/machine

The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD.

https://www.medscape.com/author/bob-harrington

Questions or feedback, please contact

[email protected]

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.