Zyne Tan

"Current and emerging treatment options for transthyretin amyloid cardiomyopathy" Enjoy the paper and listen to an in-depth discussion about what the future holds for amyloidosis therapies, between @jhfrudd and Senior author, Dr Marianna Fontana Publication - bit.ly/4cap4i7 Podcast - apple.co/4tc6mNW (also available on all other major podcast platforms)

🚀 Excited to share our study presented as a LBCT at #EuroPCR and simultaneously published in @CircIntv! 🫀 “Impact of Intravascular Imaging on Clinical Outcomes in Focal versus Diffuse Coronary Artery Disease” 🔍 Key findings: • Intravascular imaging-guided PCI reduced 1-year target vessel failure • Benefit was observed across the spectrum of CAD • Particularly pronounced benefit in focal disease 📊 In 811 patients (840 vessels) undergoing physiology-guided PCI, intravascular imaging improved clinical outcomes compared with angiography guidance alone. 💡 These findings support the complementary role of physiology + imaging to optimize PCI outcomes. 🔗 [ahajrnls.org/3Ps2jPh] 🙏 Special thanks to @ColletCarlos, @bernardBruyne, @KoshiroSakai_MD, and @DMunhoz for their invaluable guidance and support. 👏 Grateful to all collaborators and investigators involved in the PPG global study. #CardiologyX #Physiology #PPG #IVI #PCI #EuroPCR

#CoronaryPhysiology #Plaque #OCT #IVI PECTUS-obs study NEGATIVE FFR …but high-risk PLAQUES 👎 NOT good. 👋 @RickVolleberg @ElvinKedhi @NielsRoyen 👇 eurointervention.pcronline.com/article/long-t…

Multicenter study (220 vessels) in complex #cvCAD lesions: ➡️IVUS-derived UFR showed stronger correlation w/ FFR (r=0.79 vs 0.68) & higher diagnostic accuracy (AUC 0.91 vs 0.86) vs QFR🎯 🔗 jacc.org/doi/10.1016/j.… #JACCAsia #ACCIntl #IVUS

🫀 Atrial Fibrillation needs two things to start and survive 📖 Everything about AF → afguidelines.com ⚡ A trigger — abnormal electrical impulse firing in the heart 📍 85% of triggers originate from the pulmonary vein ostia 🔁 A substrate — remodeled heart tissue that keeps it going ❤️ Most common substrate: posterior wall (60%) & pulmonary vein ostia (50%) 📊 The infographic below shows the exact percentage occurrence of each trigger and substrate location in the heart #cardiology #medicaleducation #paramedic #MedstudentTwitter #CardioTwitter #FOAMed #MedEd #CardioEd #AFib #EPeeps

IVUS derived UFR !!! Whoa!!!! Unbelievably good science in #EuroPCR smaller rooms from young investigators world wide presenting their work.. @PCRonline

@assiri99 @CathGuy @Almohammadi_M Anticoagulant

65M inferior STEMI on 1st EMS EKG but on arrival to ED room CP resolved and STE subsided almost completely. This is the angio!What do you do ? #SACISVoices #InterventionalCardiology #CathLab #VascularClosure #FemoralAccess #OneTeamOneVision @CathGuy @assiri99 @Almohammadi_M @bandar2011_ @alotaibi @chadialraies @YassineMedicine @Zill_cardio @ibalsaadi @alasmary31 @Nasser_Ghattar @Hragy @Dralkutshan @Dr_ShazaAlalawi @O_Azizy_MD @Sultanotb @alialmasood @Dr_aldiri1 @DrAlsubei @SACIS_SoMe @SACIS_KSA

Conduction System Pacing for Cardiac Resynchronization Therapy – A Systematic Review | EP Europace | Oxford Academic academic.oup.com/europace/advan…

🧠🫀 We still treat carotid disease like it’s 1995.
Measure the stenosis. Decide. Move on. This wonderful and insightful paper is a quiet but very uncomfortable reminder that this model is… outdated. In patients with: 👉 “moderate” (40–60%) carotid stenosis 👉 no neurological symptoms more than half already have: 👉 intraplaque haemorrhage 👉 lipid-rich necrotic core 👉 ulceration And here’s the key point: 👉 These biological features—not the degree of narrowing—are associated with silent brain infarcts. When both are included: 👉 stenosis loses significance 👉 plaque biology doesn’t Let’s translate this properly. We are still asking: ❌ “How tight is the carotid?” When we should be asking: 👉 “How dangerous is the plaque?” The paradox is almost comical In coronary disease, we’ve finally accepted that: 👉 stenosis ≠ disease 👉 ischemia ≠ disease 👉 plaque biology drives events But in carotids? We still behave like: 👉 a 55% stenosis is “moderate” → relax 👉 a 75% stenosis is “severe” → act Meanwhile, reality: 👉 11% already have silent brain infarcts 👉 many more have diffuse small vessel disease All while being labelled: “asymptomatic” My take (slightly uncomfortable) Carotid atherosclerosis is not: ❌ a plumbing problem It is: 👉 a biological, inflammatory, embolic disease And the idea that: 👉 lumen narrowing alone defines risk is increasingly hard to defend. The real issue We don’t lack tools. CT and MRI can already show: 👉 IPH 👉 LRNC 👉 surface disruption We lack: 👉 a paradigm shift Bottom line We’ve already learned this lesson in the coronaries. We just haven’t fully accepted it in the carotids. ⚡ Until we do, we’ll keep: 👉 underestimating “moderate” disease 👉 over-trusting stenosis 👉 and missing the biology that actually causes events #Atherosclerosis #CarotidDisease #StrokePrevention #PlaqueBiology #CCTA #MRI #PrecisionMedicine

New publication on the impact of the SCAI Door to Lactate Clearance (SCAI DLC) initiative on clinical outcomes in #CardiogenicShock ➡️ sciencedirect.com/science/articl… Learn more about the SCAI DLC initiative ➡️ scai.org/media-center/n… #SCAISHOCK @ChiragMcardio @HeenaAsnaniMD @CarlAtallah @IreneVargasMD @aryandevmehta @SrihariNaiduMD @JasonKatzMD @MEspositoMD @davebaran @JDawnAbbott1 @SarasVallabhMD

The #ShortCut IVUS images tell the story, cutting balloons can’t cut it in more challenging calcium. In the #ShortCut IVUS sub-analysis presented at #EuroPCR today, cutting balloons failed to match Shockwave IVL’s effectiveness with increasing calcium burden. #ShockwaveIVL showed statistically significant larger MSAs across nodular and concentric calcium arcs, including complex calcified lesions as defined by the IVUS scoring system (0-1 vs 2-4). #ThereAreNoShortCutsInCalcium US Rx only. Safety Info: shockwavemedical.com/isi/?utm_sourc… Product availability may vary by country.

🧵 Patient with unexplained dyspnea? Figure 7 gives us the most comprehensive stepwise diagnostic algorithm for #HFpEF I’ve seen — from chart review all the way to invasive CPET. A must-know framework 👇

❤️‍🔥 Comprehensive Review on Clinical Utility of Intravascular Lithotripsy for Calcified Left Main Artery Disease #MustRead @SCAI @MyJSCAI #CAC #IVL #LMPCI 🔗 for 🆓️ access 👇 doi.org/10.1016/j.jsca…

📄 Low-burden ATTR cardiac amyloidosis: can CMR detect early disease? 🔗 DOI: doi.org/10.1093/ehjimp… 🫀 Transthyretin cardiac amyloidosis (ATTR-CA) is often diagnosed late—but early detection is critical. This study focuses on a challenging question: 👉 What does early (low-burden) ATTR look like on CMR—and how do we distinguish it from mimickers? ✨ Study at a glance: 🔹 83 patients with confirmed ATTR-CA 🔹 Stratified by ECV (extracellular volume) 👉 Low burden: ECV ≤43% 🔹 Compared with: ✔ hypertensive heart disease (HHD) ✔ mild hypertrophic cardiomyopathy (HCM) ✨ Key findings: 📊 Low-burden ATTR has a distinct phenotype: 🔹 Often subtle or even normal wall thickness 🔹 Mildly reduced EF (~52%) 🔹 Abnormal strain despite preserved function 👉 As shown in Figure 2 (page 5): ➡️ early disease predominantly affects basal segments 📈 Tissue characterization is the key: 🔹 LGE and ECV outperform strain ➡️ LGE AUC: 0.99 ➡️ ECV AUC: 0.97 ❗ Strain-based metrics perform significantly worse ⚠️ Why this matters: 👉 Early ATTR can mimic: HCM hypertensive LVH 👉 Conventional parameters (wall thickness, EF) are insufficient ➡️ Risk of misdiagnosis or delayed diagnosis 🧠 Unique imaging signature: ✔ Basal predominance of infiltration ✔ Progressive base-to-apex gradient ✔ Increased ECV even with mild phenotype 👉 As illustrated in segmental maps (page 6): ➡️ clear spatial pattern of disease progression 📉 Prognostic insight: ✔ Low-burden ATTR = better survival ❗ But still abnormal biomarkers and imaging 👉 Early stage = window for intervention 💡 Clinical take-home message: 👉 Suspect ATTR even in mild LVH or “atypical HCM” ✔ Use CMR tissue characterization (ECV + LGE) ✔ Do not rely on strain alone 🚨 Bottom line: Early ATTR is subtle—but CMR tissue characterization can unmask it and differentiate it from hypertrophic mimickers. #Cardiology #CMR #Amyloidosis #ATTR #CardiacImaging #ECV #LGE #HeartFailure #PrecisionMedicine #EarlyDiagnosis 🫀📊

Anatomical Considerations for Left Bundle Branch Area Pacing heartrhythmjournal.com/article/S1547-…

Excited to share our meta-analysis published in JCF Intersections @JCFINT : Fluid restriction vs liberal fluid intake in HF showed no significant differences in mortality, hospitalization, QoL, congestion, or biomarkers. @SarasVallabhMD @JDawnAbbott1

Key takeaway at #Fellows2026 Patients with chronic LVSD are often already operating at the limits of their compensatory reserve: LV remodeling and ⬆️filling pressures Minimal reserve to tolerate ischemia/hemodynamic shifts Heavy dependence on baseline medical therapy @crfheart

Association between atrial fibrillation duration and epicardial adipose tissue: Insights into the “AF begets EAT” framework heartrhythmjournal.com/article/S1547-…

📈 According to new data, performing coronary CT angiography prior to chronic total occlusion percutaneous coronary intervention procedures resulted in better outcomes. 🫀 Read the article to learn three concrete ways CCTA can help operators ➡️ cardiovascularbusiness.com/topics/clinica… #InterventionalCardiology #PCI #CTO

Both ivabradine and propranolol reduced tachycardia and symptoms of postural orthostatic tachycardia syndrome, compared with placebo, based on findings from a randomized, double-blind crossover trial published in #JACC and #JACCAdvances. Learn more: bit.ly/3P8A3RD #cvEP