Colin Blumenthal, MD MS

0q@⁰0 147894563214789456333 33217/89,Family of Henrietta Lacks settles with biotech company accused of exploiting her cells nbcnews.com/news/nbcblk/fa… via @nbcnews

@RyanTedfordMD @CardioNerdsJC These pieces of data were also conflicting to me. When I saw the average resting HR I speculated that this could might have a lot of diastolic dysfunction and therefore would not be good candidates for pacing. The average proBNP seems to argue against this though. #CardsJC

@CardioNerdsJC One really possibility is that pacing just doesn't help! Others: Did patients have HFpEF (or at least significant HFpEF) - proBNP was not significantly elevated on average; resting HR was already fairly high (~80 bpm); no data on AV delay; dyschrony from RA pacing? #CardsJC

RAPID-HF results showed: ⬆️ increase in exercise HR ↔️ no change in VO2AT, VO2, or QoL ➡️What might explain this discrepancy? 🤔 #CardsJC

@EJSMD @CardioNerdsJC Seriously! When i first saw this trial come out that was what I was most impressed with. 4 patients a year on average! #CardsJC

@CardioNerdsJC This trial took 8 yrs to enroll 32 patients. It's impressive they hung in there and completed the trial even when negative. The findings are impactful. For expensive, invasive therapies, it's critical to get this information. Otherwise the train keeps rolling 🚂 #cardsjc

💡This was a negative trial, where the null hypothesis was not rejected. ➡️What is the impact of publication bias and how does the publication of negative trials contribute to science? 🤔 #CardsJC

@KTamirisaMD @CardioNerdsJC @CardioNerds Yeah I think this pairs directly with what @EJSMD was saying. How do you know that the patient is symptomatic because of their chronotropic incompetence to allow you to select the correct subset of HFpEF patients? #CardsJC

@CardioNerdsJC @CardioNerds A bit late due to work @CardioNerdsJC #CardsJC Definition of chronotropic incompetence is tough without patient/lifestyle etc data. Especially in HFpEF patients - symptoms due to filling issues/abnormal diastology/meds or HR? How do you differentiate?

Let’s get started with RAPID-HF! Chronotropic incompetence is common in pts w/ HFpEF & a potential driver of exercise intolerance. Rate-adaptive pacing is a IIa, expert consensus recommendation for symptom management. #CardsJC

@RyanTedfordMD @CardioNerdsJC I also thought this was interesting, especially when they are doing VO2 stress tests on these patients. Seems like it would be very easy to accidentally see if a patient was paced

@CardioNerdsJC Patients serving as their own control with paired data is a definite strength and improves power. Downside - perhaps opportunities for accident unblinding if not done carefully #CardsJC

RAPID-HF was a single center, double-blinded, crossover RCT with 4 weeks of atrial adaptive pacing, a 4-week washout, and 4 weeks w/o pacing (& vice versa). ➡️What benefits do incorporating a washout & crossover bring to the study validity & bias? Any downsides? 🤔 #CardsJC

@Dr_Mike_Fradley @Dr_DanMD @CardioNerds @GiselleSA_MDPhD @KahtanAlfadhl Thank you! Can't wait for everyone to hear this one. Just packed with pearls!

@Dr_DanMD @CardioNerds @GiselleSA_MDPhD @KahtanAlfadhl @CBlumenthal2 Thank you so much for the opportunity to speak with you about something I’m so passionate about!

🎙️🎧 @CardioNerds #CardioOncology recording in progress! Exciting stuff! 😍 Arrhythmias and Autonomic Disorders in Cardio-oncology 🚀 Featuring the awesome lineup of @GiselleSA_MDPhD, @KahtanAlfadhl, @CBlumenthal2, and faculty expert @Dr_Mike_Fradley! 🌟 cardionerds.com/cardiooncology/

Rooting for everyone participating in the fellowship match today and so excited to welcome our next class of 10 general #cardiology fellows to the @PennCardiology @PennCVFellows @PennCVWomen @PenncvARMI family! 🍾🥳🎉 #MatchDay @FSilvestryMD @hmartinjulien @MonSangh

Seems like it would be both environmentally friendly and economically adventitious to just turn off all these lights...

On my drive in to work this morning in the darkness, every closed business (is it really that much advertising??), empty mall parking lot, sports stadium, office building, public administration building, research building etc is fully lit with lights on inside.

Why do we spend so much energy lighting major portions of cities at night? Given the concerns about strain on the energy grid, rising energy costs, not to mention the environmental impacts of light pollution and energy production, do we need to waste electricity on a mass scale?

Such an amazing opportunity for anyone interested in medical education and use of social media! Just an amazing group of people I can't say enough good things about!

🚨ATTN CardioNerds! Applications are open for the CardioNerds Academy! If you are a current trainee interested in the intersection of medical education & #SoMe, we encourage you to apply! 📜Applications are due November 15th! 🔗forms.gle/7yTUzTybFdrZ1x…

@DavidLBrownMD @gcfmd @RichardAFerraro @AndrewJSauer @JACCJournals @AHajduczok @noshreza @SABOURETCardio Absolutely. It's more that it makes me question the methods of the entire study. There are obviously significant differences in quality of evidence and trials for each med combination, but the way it is being presented makes them appear equal and directly comparable.

@gcfmd @CBlumenthal2 @RichardAFerraro @AndrewJSauer @JACCJournals @AHajduczok @noshreza @SABOURETCardio Agreed which casts doubt on the other treatment results.

Excellent and hopefully well seen piece in @JACCJournals #JACCHeartFailure on GDMT in HFrEF Thoughts on the differences between groups? Getting on even three agents looks pretty good! #FunctionNotFailure jacc.org/doi/abs/10.101…

@DavidLBrownMD @RichardAFerraro @AndrewJSauer @JACCJournals @AHajduczok @noshreza @SABOURETCardio @gcfmd I might be wrong though but aren't the confidence intervals not directly comparable here because these combinations weren't all tested against each other?

@CBlumenthal2 @RichardAFerraro @AndrewJSauer @JACCJournals @AHajduczok @noshreza @SABOURETCardio @gcfmd And who knew BB, ACEi, digoxin, hydralazine and isosorbide was so effective?

@DavidLBrownMD @RichardAFerraro @AndrewJSauer @JACCJournals @AHajduczok @noshreza @SABOURETCardio @gcfmd Seriously though. Almost half of the regimens have overlapping confidence intervals. I feel what this really shows is ARNI + BB are important and provides the backbone.

@RichardAFerraro @AndrewJSauer @JACCJournals @AHajduczok @noshreza @SABOURETCardio @gcfmd A great reminder that differences between groups is defined by the confidence intervals, not the point estimates.

Get ready for an epic #tweetorial on how to use the @SCAI Shock Stages at the bedside ⚡️🫀 @CardioNerds #CardioTwitter #Cardiology #MedEd #MedTwitter

Quick thoughts on this new proposal from @TheNRMP: Should we replace the SOAP with a two-round match system including Match Days in February *and* March? Who wins - and who loses - if we move to a two-round Match system? (a 🧵)

Join @CadioNerds at #ASPC2022 to learn the latest in Cardiovascular Prevention. @DrAlaaDiab @DeveshRaiMD @KahtanAlfadhl will be the @CardioNerds Conference Scholars bringing you key takeaways...follow them now! @DrMarthaGulati @dramitkhera

CardioNerds behind the scenes discussing #CardsJC VITAL-AF! We hope you all had as much fun as we did! @AmitGoyalMD @DeveshRaiMD @CBlumenthal2 @PatrickZakka @KahtanAlfadhl @DrAlaaDiab @BreannaHansen_ @catweneboah @OranefoJustice

@MoussaMansour10 @RMesubi Brings up the ?, how long does the stroke risk last after an episode of AF? We know risk seems to be highest 1-5d after episode, but for "pill in the pocket" AC how long do you take the AC for? 1 week? 1 month? How long of an episode do you need to have? Tough questions #CardsJC

@RMesubi One more thing. Continuous anticoagulation may not be needed in some patents with non-frequent AF. Intensive home screening (consumer device) + PRN DOAC may be the practice of the future in patients with less frequent PAF #CardsJC

Based on the data in this paper, there is not enough evidence for routine screening, especially with the Kardia device at a clinic visit to a primary care visit. #CardsJC