Ahmad Masri
@MasriAhmadMD
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Following
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@OHSUCardio | #HCM #Amyloid #Fabry #LVH #Cardiomyopathies #Cardiogenetics #Echofirst #WhyCMR #CVNuc #RCTs | Views are mine & not medical advice
Portland, OR
Joined April 2014
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Pinned Tweet
Thread/
There are many new exciting trials in transthyretin
#amyloidosis
– as we continue to enroll patients in the CARDIO-TTRansform trial, I thought I would highlight some of these trials in ATTR-CM
#cardiotwitter
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What is happening here
#echofirst
? a new
#CircImage
in
@CircImaging
37 year old with palpitations and syncope
#CardioTwitter
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Thread/
This was a great day for
#HCM
patients. The results of EXPLORER-HCM were presented
#ESC2020
and published ( ). This timeline shows some of the major clinical events in
#HCM
@MyoKardia
#cardiotwitter
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Excellent example of mitral annular disjunction and its associations. I recall seeing 3 survivors of
#SCD
with
#whycmr
reports conclusion as no abnormal findings (yes, association =/- causation, over a span of 2 years).
#cardiotwitter
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We are recruiting! If you are a
#cardiologist
or
#ACCFIT
who likes
#HCM
and/or
#amyloidosis
,enjoys research (RCTs/translational/basic), wants to join an exceptional group, & likes to have fun
#PNW
, please DM me (or refer my way, e mail: masria @ ohsu .edu)
#cardiotwitter
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Hospital fee $143k
Physician fee $600
Some econ want to solve healthcare crisis by going after the $600. Excellent
Health care would cost less if we had more public accountability for things like THIS: Stanford's $143,000 BREAST BIOPSY!?! Doctors should be leaders in addressing this problem affecting OUR patients & med societies should speak up rather than be silent.
@ZDoggMD
@SAGES_Updates
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That hypertension is not always "essential". Middle aged man, treated for hypertension. Murmur on exam.
#whyCMR
#ACCFIT
#CardioTwitter
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A 3.5 x 2.2 cm veg on the TV. What is the largest you have seen? Share a clip.
This was persistent MRSA
#Echofirst
#cardiotwitter
#CardioEd
#meded
#foamed
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I didnt know these things still exist. Have you seen one before? Answer below
#whyCMR
#cardiotwitter
#MedEd
@purviparwani
@onco_cardiology
@venkmurthy
@PushpaShivaram
@vass_vassiliou
@cshenoy3
@rajdoc2005
@MarkELindsay
@FredWuMD
@afshinfarzan
@AChoiHeart
@LopezOpitz
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What happened between EKG 1 and 2 from the same individual with
#HCM
? No coronary artery disease. No intracranial catastrophe or severe hypertensive episode
Answer below
#CardioTwitter
#MedTwitter
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This is a difficult time for all especially those under strict lockdown. But it is a great time to remember that you still have a home, heat, electricity, food, water, TV, internet, and health.
#COVID19
#itwillpass
#stayhome
6
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The REDWOOD
#HCM
Cohorts 1 and 2 data are now published in
@JACCJournals
Congrats to all especially patients who participated during the height of the COVID-19 pandemic.
Follow this thread for a quick overview
#CardioTwitter
7
48
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Do you know what Ortner syndrome is?
A 42 yo presented with a hoarse voice for a month. Work up led to a finding of a saccular aortic arch aneurysm. A case in
@CircImaging
#CircImage
#CardioTwitter
#MedTwitter
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Any document published by a society is a guideline written by individuals. Ultimately the decision of what to do lies within the person in charge.
Reducing the whole practice of medicine to a mandated set of tables/algorithms is frequently problematic.
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What a story. A needle of unknown origin.
#cardiotwitter
#FOAMed
#meded
#echofirst
#yescct
In
@ESC_Journals
Videos unedited from the original source-only combined.
10
46
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Sharing a case I presented at
#ACC19
to highlight the nuances and complexities in patients with
#amyloidosis
- and a reminder that endomyocardial biopsy is your friend - likely underutilized. Pause the video to read the slides
#accimaging
#cardiotwitter
#whycmr
#echofirst
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A thread.
So the
@US_FDA
@SGottliebFDA
issued a warning re: Fluoroquinolones (FLQ) and aortic dissection (AD) or aneurysm (AA). Do FLQs cause AD/AA? Not really. Is there an association? Maybe. Let’s go throw the evidence and you can decide for yourself.
#CardioTwitter
#MedEd
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#whycmr
is essential in defining apical
#HCM
phenotype. Here is one with an apical aneurysm and thrombus.
#cardiotwitter
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An honor to be recognized by
@HFSA
and
@hfcollaboratory
-thank you for your leadership in this space
This award goes to PIs but it represents the sum of hard work by many individuals and the time and effort of our patients who participate
#CardioTwitter
🙌🥳Celebrating the remarkable achievements of Dr. Tariq Haddad &
@MasriAhmadMD
for winning the TOP PI titles in 2023 for their incredible work in clinical trials!🎉
Check out the more research awards at the HFC website
@OHSUNews
@OHSUCardio
#HF
#cardio
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A health 30 year old woman presented with sudden chest pain 2 days post 2nd
#COVID19
mRNA vaccine shot. Here is the
#EKG
- follow along
A new
#CircImage
in
@CircImaging
#CardioTwitter
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Complete plaque regression over a 3 year period in
@ESC_Journals
Impressed?
I am, also with the amount of repeat work up which helped write this nice story.
They dont report on diet/lifestyle changes
#cardiotwitter
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35
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Cortriatriatium on
#echofirst
in an elderly man with dyspnea. Gradients Pk/Mn 10/3, peak v 1.6 m/sec.
#ACCFIT
#MedEd
#cardiotwitter
@purviparwani
@onco_cardiology
@rajdoc2005
@PushpaShivaram
@DavidWienerMD
@ASE360
@wikimagen
@almasthela
@mariovar55
@msenussiMD
@ChamsiPash
17
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SAVR in asymptomatic "very" severe AS
It only took 50 years to do this study
Congrats to the authors
And waiting on EARLY TAVR
#AHA19
#cardiotwitter
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An
#echofirst
case of "status bubbliticus".
50 yo female with history of compensated cirrhosis (unknown etiology) presents with chest & epigastric pain. No EKG changes and troponin negative. Echo obtained shown here.
#ACCimaging
#ACCFIT
#MedEd
#FOAMed
#cardiotwitter
#CardioEd
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Despite growing up in the West Bank & knowing what darkness and bombardment mean, I can't begin to imagine the horrors that children and families in Gaza are living now.
Collective punishment and genocide will not work. Every tragedy is a serious chance for peace
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Different patients. All sick. All were on hydroxychloroquine.
Simply one need to study this - severity of illness vs drugs.
*shared with permission from another MD.
#covid19
#cardiotwitter
#FOAmed
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#HCM
is in the spotlight today with 2 papers from RCTs in
@JACCJournals
which I had the pleasure to write an editorial for
First-
@AnneDybro
and colleague did what has not been done b4, an RCT of metoprolol in 29 pts w/ obstructive HCM
#CardioTwitter
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I abandoned this paper but now I am submitting to NEJM
"Cardiac Outcomes in the Vascular Inpatient Department in 2019 (COVID-19)"
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Today we presented the full results of
#REDWOOD
#HCM
#Cohort4
#HFA2023
@escardio
, this is a p2 trial of
#aficamten
in
#nHCM
Here are the results, and based on them our patients will get to consider participation in a phase III trial later this year -stay tuned
#CardioTwitter
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Coinciding with the
@US_FDA
approval of
#mavacamten
, in
@JAHA_AHA
is 2 viewpoints and brief responses on the use of
#myosin
#inhibitors
and where they fit in the care of patients with
#oHCM
myself &
@IacopoOlivotto
start here
#CardioTwitter
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These are just incredible stories from
#HappyImmigrantDocs
I'll play...
Narrowly escaped being a statistic 4 times (one was an air to ground missile while walking to school).
Volunteered in hospitals since age 12.
Moved here age 23.
8 years later -- academic cardiologist
Born to a refugee father in Jordan🇯🇴.
Diagnosed with stage IV cancer age 6.
Left with mother to Germany🇩🇪 for 2 yrs of (intensive) treatment.
Parents spent most of their life savings on my med school🇮🇪.
Now Interventional Cardiology Fellow
@BrighamWomens
.
#HappyImmigrantDocs
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3K
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Excellent CPR but those ribs are gone
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This is an example of the effect of
#aficamten
on top of maximally tolerated BB in obstructive
#HCM
, and where disopyramide didn't improve symptoms.
Baseline: BB
Video 1 (Week 2): BB+aficamten 5 mg
Video 2 (Week 24): aficamten 15 mg, no BB
#cardiotwitter
#echofirst
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Asymptomatic 50 year old. What do you think of this
#echofirst
?
#WhyCMR
later today
#Cardiotwitter
@purviparwani
@onco_cardiology
@venkmurthy
@PushpaShivaram
@Mehtap58194722
@rajdoc2005
@wikimagen
@almasthela
@DavidWienerMD
@iamritu
@NadeenFaza
@cshenoy3
@dr_adeebq
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So proud of our
#HCM
team and our patients. We just evaluated our 50th patient for aficamten, a cardiac myosin inhibitor. & we had a cake with asymmetrical septal hypertrophy, a myectomy and a sarcomere unit - made by the brilliant MLL ( )
#CardioTwitter
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Outcomes of patients with AS with and without ATTR
#amyloidosis
work led by
@HRRosenblum
showing that in 205 patients referred for
#TAVR
, 13% had
#ATTR
. Over 2 years,
#ATTR
was associated with
#HF
admissions but not
#Mortality
#Cardiotwitter
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5 new
#amyloidosis
patients today in clinic. Every single one with a unique story, phenotype & presentation which were largely non overlapping. Range of delayed diagnosis of 1-7 years. All with significant disease burden. Tons of work to do in disease recognition
#CardioTwitter
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45 yo female presenting with chest pain of 1 day duration. Troponin I 73. EKG here, cath below.
#ACCFIT
#MedEd
#Cardiotwitter
#CardioEd
#Radialfirst
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Excellent study - time to stop using the term ARVD --> ACM with or without LV/RV involvement
#cardiotwitter
#whycmr
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He sealed the deal to never be invited again
Strong work
#covid19
How to ensure you don't get follow-up questions on Fox, apparently.
2K
21K
99K
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Shared with permission
Many years of delayed diagnosis despite many signs/findings
T60A
Keep
#amyloidosis
on your mind
Comparison to a "normal" specimen
#cardiotwitter
#CVnuc
#whycmr
#echofirst
5
17
81
Apico-septal bands and abnormal papillary muscles play an important role in
#HCM
This is a case where the apico-septal band was prominent inserting directly on the septum. Check out
#whycmr
and the path in the video
#cardiotwitter
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Amazing effort by patients, coordinators, PIs, sponsor et al.
282 patients with obstructive
#HCM
#aficamten
vs
#placebo
Topline results tomorrow
#CardioTwitter
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19
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An exciting
#ACC22
for
#HCM
and
#Amyloidosis
is in 2 weeks. Here is a quick run through what to look for (trials):
First - VALOR-HCM trial: mavacamten as an alternative to septal reduction therapy (patient referred to SRT, placebo controlled trial, 16 weeks)
#CardioTwitter
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A milestone in
#HCM
care
@OHSUCardio
. 180 weeks of ongoing cardiac myosin inhibition with
#mavacamten
.
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This is an example of why we should explain all LVH.
Here, 60 yo man, 30+ years of uncontrolled HTN (6 meds), uncontrolled DM, obesity, CKD. Recurrent HF hospitalizations. LVH is longstanding and presumed to the above. Reasonable
#echofirst
#CardioTwitter
#medtwitter
Most important - explain all LVH & not just blame HTN without due diligence. Use NTproBNP in stable outpatient settings. If available, teach sonographers to do strain in all LVH or keep an eye on the lateral LV S' wave in LVH (<6 cm/s).
#cardioTwitter
#echofirst
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These are the primary results from the APOLLO-B
@ISA_Amyloidosis
#ISA_2022
presented by
@MathewMaurer
#Cardiotwitter
2
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Thread/
59 yo male on 2 anti-hypertensives, CKD (stage IIIa), presents with worsening dyspnea. BNP 800, troponin I negative.
EKG
#CardioTwitter
#MedEd
#WhyCMR
#EchoFirst
#ACCFIT
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We presented the results of
#PIONEER
#HCM
#OLE
at
#ACC23
This is the longest follow up of mavacamten to date - a 5 year study, average follow up at the time of this data cut was 200 weeks.
#CardioTwitter
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18
71
Social media vs reality:
Twitter: I think I am the only one left unvacvinated on this earth
Reality: most HCWs are still not
4
6
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What is the biggest LVEDD you have ever seen? This is 9.4 cm.
A quick video in the comments.
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Using 15 mm cut off for hypertrophy in
#HCM
@JccmoonMoon
howing the issues and complexities with using non indexed measures
Check out this calculator for personalized limits of hypertrophy
#CardioTwitter
5
32
73
A group of us (
@FudimMarat
@noshreza
@JainySavlaMD
@yaqoub_lina
and
@YChowdhuryMD
) have worked with
#AHA
@AHAScience
@eantman
& Judy Bezanson to develop clinical slides from the recent
#HCM
#guidelines
Check them out
#Cardiotwitter
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Thread. Our systematic review and MA on LifeVest (WCD) published in
@JACCJournals
(EP) - This was a clinical question that I had as a first year fellow. We prescribed a lot of WCDs at the time.
#ACCFIT
#EPeeps
#CardioTwitter
#MedEd
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It is official. Based on the results of the REDWOOD-HCM Cohort 4 ( ), we are progressing with the phase III ACACIA-HCM, aficamten vs placebo in non-obstructive
#HCM
#CardioTwitter
Today we presented the full results of
#REDWOOD
#HCM
#Cohort4
#HFA2023
@escardio
, this is a p2 trial of
#aficamten
in
#nHCM
Here are the results, and based on them our patients will get to consider participation in a phase III trial later this year -stay tuned
#CardioTwitter
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Heading to
#ACC23
It is a busy meeting for
#HCM
LIVE-HCM, REDWOOD-HCM Cohort 4, FOREST-HCM, PIONEER-OLE, MAVA-LTE CMR, post hoc analyses from EXPLORER and VALOR
Stay tuned
#CardioTwitter
0
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70
@FilipeAMoura
Happened recently:
Reviewer 1: poor study design analysis not helpful etc. Not a single constructive comment
Reviewer 2: excellent much needed study here are some comments to improve it
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1
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Thread/ exciting times for
#HCM
patients and physicians. We randomized the first patient
@OHSUCardio
in the world in the phase II HCM-
#REDWOOD
trial investigating a new small molecule cardiac myosin inhibitor CK-274 $CYTK. What to learn more? follow along
#cardiotwitter
3
15
67
A thread. Follow along. Infective Endocarditis (IE) in
#TAVR
.
92 yo, s/p self-expandable valve 4 years ago, presents with fevers. No clear focus.
#EchoFirst
TTE was obtained.
#CardioTwitter
#MedEd
3
37
69
A quick comparison between
#MITRA
-FR &
#COAPT
Awaiting COAPT presentation at
#TCT2018
@onco_cardiology
@DocStrom
@iamritu
@ekgpdx
@MusaSharkawi
@PittCardiology
@SVRaoMD
@JamesDThomasMD1
@tiffchenMD
@ATYounesMD
@bcostelloMD
@BPierce_MD
@malamo512
@DrFaherMA
@mhammadah
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60 yo female, no other history. mPAP 28 mmhg(RHC).
@onco_cardiology
@PittCardiology
@AmrFBarakat
@MusaSharkawi
@abaky_MD
@JoaoLCavalcante
@NadeenFaza
@purviparwani
@ash71us
@cshenoy3
@tiffchenMD
@DavidWienerMD
@msenussiMD
@echotainment
@ChamsiPash
@AkhilNarangMD
@JamesDThomasMD1
15
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@drnjy
@EPeeps_Bot
@msenussiMD
@ChamsiPash
@AmrFBarakat
@malamo512
@EmilyGuhl
@RamiKafa
@BPierce_MD
@bcostelloMD
@mhammadah
@MusaSharkawi
Bingo. It is interesting that its vascular not inhalation but because of the mercury properties they follow this distribution
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On behalf of my co-investigators & the study team, we presented results from
#REDWOOD
#HCM
Cohort 4
#ACC23
This is the first evaluation of aficamten in nonobstructive HCM
Excellent results of this phase 2 trial --> plan to progress to pIII
Tweetorial coming soon
#CardioTwitter
Check out this interview with
@MasriAhmadMD
at
#ACC2023
where he provides further insight into the results of the REDWOOD-HCM cohort 4, which included 41 patients with non-obstructive hypertrophic cardiomyopathy.
#Cardiology
#HCM
0
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39 year old woman, no PMHx. Presents with chest pain, sudden onset. EKG here. Had also sustained polymorphic VT. Troponin I peaked at 16. LHC in comments. what do you think
#CardioTwitter
?
#ACCFIT
#MedEd
15
30
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19 year old presenting with syncope in
@CircImaging
#Epeeps
#cardiotwitter
#EKG
: NSR, RAD, iRBBB, and TWI in precordial leads
6
13
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Unparalleled resilience. They see the beauty in life when others fail.
Idlib - Syria by AFP
3
8
63
In patients with ATTR
#amyloidosis
, be mindful of the type of bone tracer used. This is a case in
@ESC_Journals
where the patient was thought to have a negative bone scan because Tc-99m MDP was used inappropriately.
#Cardiotwitter
5
16
63
Patient: "I'm short of breath",found to have no pulse.Syncopized briefly after. Was being paced transcut when the EKG was obtained with failure to capture at the time. CHB. Got a pacemaker, did well. There is a reason this is not common.
#cardiotwitter
#MedEd
#EPeeps
#CardioEd
9
26
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The
@ESC_Journals
guidelines on cardiomyopathies include LVOTO management. Massive effort congrats to all
This is what we do in daily practice, but only 1 thing on this list underwent 2 multicenter phase III RCTs and it got a class IIa recommendation, why? 1/3
#CardioTwitter
1
12
64
SGLT inhibition with sotagliflozin making its way into
#HCM
with a potential phase III trial by
@LexPharma
#CardioTwitter
1
21
64
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11
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Another day in the beautiful
#PNW
Mt Rainier
Comet Falls
Naranda Falls
High Rock Lookout
Silver Falls
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History of prior valve sparing aortic root replacement. A funny looking AI jet on
#echofirst
with moderate severity. Might cause MV issues down the road. Normal aortic flow pattern. PHT 380.
#ACCFIT
#FOAMed
#CardioTwitter
#MedEd
#CardioEd
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