Thread by @rachkataria, 1/ Comprehensive talk by Dr. @JoaoLCavalcante who who patiently walked us through [...]

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Comprehensive talk by Dr. @JoaoLCavalcante who who patiently walked us through #WhyCMR in Mitral Regurgitation.
First: different etiologies of MR where #WhyCMR may be applicable:

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Primary MR

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Arrhythmogenic MVP phenotype (including MAD)

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Secondary MR (work in progress)

1/ Comprehensive talk by Dr. @JoaoLCavalcante who who patiently walked us through #WhyCMR in Mitral Regurgitation. First: different etiologies of MR where #WhyCMR may be applicable:https://abs.twimg.com/emoji/v2/... draggable=

Primary MRhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Arrhythmogenic MVP phenotype (including MAD)https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Secondary MR (work in progress)" title="1/ Comprehensive talk by Dr. @JoaoLCavalcante who who patiently walked us through #WhyCMR in Mitral Regurgitation. First: different etiologies of MR where #WhyCMR may be applicable:https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Primary MRhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Arrhythmogenic MVP phenotype (including MAD)https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Secondary MR (work in progress)">

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Limitations of #echofirst:

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">overestimation of MR by PISA, underestimation of eccentric MR.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">poor reproducibility if MR severity (inter- and intra-observer)

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Alas, there is no accuracy without reproducibility

https://abs.twimg.com/emoji/v2/... draggable="false" alt="👎🏻" title="Thumbs down (heller Hautton)" aria-label="Emoji: Thumbs down (heller Hautton)">

2/Limitations of #echofirst:https://abs.twimg.com/emoji/v2/... draggable=

overestimation of MR by PISA, underestimation of eccentric MR. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">poor reproducibility if MR severity (inter- and intra-observer)https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Alas, there is no accuracy without reproducibility https://abs.twimg.com/emoji/v2/... draggable="false" alt="👎🏻" title="Thumbs down (heller Hautton)" aria-label="Emoji: Thumbs down (heller Hautton)">" title="2/Limitations of #echofirst:https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">overestimation of MR by PISA, underestimation of eccentric MR. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">poor reproducibility if MR severity (inter- and intra-observer)https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Alas, there is no accuracy without reproducibility https://abs.twimg.com/emoji/v2/... draggable="false" alt="👎🏻" title="Thumbs down (heller Hautton)" aria-label="Emoji: Thumbs down (heller Hautton)">">

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#WhyCMR for Primary MR

https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">CIRC ‘17

https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">CMR severe-TTE moderate MR outcomes similar to CMR severe-TTE-severe MR.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">JACC ‘15

https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="👎🏻" title="Thumbs down (heller Hautton)" aria-label="Emoji: Thumbs down (heller Hautton)">correlation of MR estimates by #WhyCMR & #echofirst in pts referred to MV Sx.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="💪🏻" title="Angespannter Bizeps (heller Hautton)" aria-label="Emoji: Angespannter Bizeps (heller Hautton)"> correlation b/w post-op LV remodeling & baseline MR severity by CMR

3/ #WhyCMR for Primary MRhttps://abs.twimg.com/emoji/v2/... draggable=

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https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">AJC 2020

https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">evidence for strong correlation between predicted and observed change in post-MR “correction” LVEDV based on baseline MR severity by #whyCMR.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Greater superiority of #whyCMR when quantifying post #mitraclip residual MR.

4/https://abs.twimg.com/emoji/v2/... draggable=

AJC 2020https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">evidence for strong correlation between predicted and observed change in post-MR “correction” LVEDV based on baseline MR severity by #whyCMR. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Greater superiority of #whyCMR when quantifying post #mitraclip residual MR." title="4/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">AJC 2020https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">evidence for strong correlation between predicted and observed change in post-MR “correction” LVEDV based on baseline MR severity by #whyCMR. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Greater superiority of #whyCMR when quantifying post #mitraclip residual MR.">

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#WhyCMR for arrhythmogenic MVP phenotype:

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬆️" title="Pfeil nach oben" aria-label="Emoji: Pfeil nach oben">prevalence of MF in MVP vs non MVP & greater w/

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬆️" title="Pfeil nach oben" aria-label="Emoji: Pfeil nach oben">LV remodeling &

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬆️" title="Pfeil nach oben" aria-label="Emoji: Pfeil nach oben">MR severity.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">”interstitial

https://abs.twimg.com/emoji/v2/... draggable="false" alt="❤️" title="Rotes Herz" aria-label="Emoji: Rotes Herz"> disease” described >40 yrs ago in

https://abs.twimg.com/emoji/v2/... draggable="false" alt="💀" title="Schädel" aria-label="Emoji: Schädel">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="❤️" title="Rotes Herz" aria-label="Emoji: Rotes Herz">s w/ chronic vol/pressure overload.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet"> #WhyCMR helps identify structural myocardial changes

5/ #WhyCMR for arrhythmogenic MVP phenotype: https://abs.twimg.com/emoji/v2/... draggable=

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#WhyCMR in FMR:

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">ongoing attempts at quantifying & characterizing significant FMR to help triage patients for appropriate therapies.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">FMR is a dz of the LV.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Need better assessment of LV “health” and #echofirst with abundant limitations in this regard.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Enter #WhyCMR

6/ #WhyCMR in FMR:https://abs.twimg.com/emoji/v2/... draggable=

ongoing attempts at quantifying & characterizing significant FMR to help triage patients for appropriate therapies.https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">FMR is a dz of the LV. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Need better assessment of LV “health” and #echofirst with abundant limitations in this regard. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Enter #WhyCMR" title="6/ #WhyCMR in FMR:https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">ongoing attempts at quantifying & characterizing significant FMR to help triage patients for appropriate therapies.https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">FMR is a dz of the LV. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Need better assessment of LV “health” and #echofirst with abundant limitations in this regard. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Enter #WhyCMR">

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https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">JACC 2019

https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">patients with ICM+ FMR,MIS quantified by LGE.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">on multivariable analysis, interaction of MIS & IMR was a

https://abs.twimg.com/emoji/v2/... draggable="false" alt="💪🏻" title="Angespannter Bizeps (heller Hautton)" aria-label="Emoji: Angespannter Bizeps (heller Hautton)"> predictor of adverse outcomes.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">subgrp analysis: pts w/ subsequent CABG+MVR had better outcomes if significant FMR but

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬇️" title="Pfeil nach unten" aria-label="Emoji: Pfeil nach unten"> MIS at baseline.

7/https://abs.twimg.com/emoji/v2/... draggable=

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https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Catheter Cardiviasc Interv. 2019

https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">MF by #WhyCMR LGE also a/w post #mitraclip adverse outcomes.

8/https://abs.twimg.com/emoji/v2/... draggable=

Catheter Cardiviasc Interv. 2019https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">MF by #WhyCMR LGE also a/w post #mitraclip adverse outcomes." title="8/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Catheter Cardiviasc Interv. 2019https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">MF by #WhyCMR LGE also a/w post #mitraclip adverse outcomes.">

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Well then, let’s bust some common myths about #WhyCMR: See myths below.
1) busted by Dr. @cshenoy3, see below

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬇️" title="Pfeil nach unten" aria-label="Emoji: Pfeil nach unten">
2)same machine used for knees, brain and

https://abs.twimg.com/emoji/v2/... draggable="false" alt="❤️" title="Rotes Herz" aria-label="Emoji: Rotes Herz">. Just need #WhyCMR software and training.
3)CAN be done in pts with PPM, ICDs (it’s 2020!!)
4)Read thread from the top!

9/Well then, let’s bust some common myths about #WhyCMR: See myths below.1) busted by Dr. @cshenoy3, see belowhttps://abs.twimg.com/emoji/v2/... draggable=

2)same machine used for knees, brain and https://abs.twimg.com/emoji/v2/... draggable="false" alt="❤️" title="Rotes Herz" aria-label="Emoji: Rotes Herz">. Just need #WhyCMR software and training. 3)CAN be done in pts with PPM, ICDs (it’s 2020!!)4)Read thread from the top!" title="9/Well then, let’s bust some common myths about #WhyCMR: See myths below.1) busted by Dr. @cshenoy3, see belowhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="⬇️" title="Pfeil nach unten" aria-label="Emoji: Pfeil nach unten">2)same machine used for knees, brain and https://abs.twimg.com/emoji/v2/... draggable="false" alt="❤️" title="Rotes Herz" aria-label="Emoji: Rotes Herz">. Just need #WhyCMR software and training. 3)CAN be done in pts with PPM, ICDs (it’s 2020!!)4)Read thread from the top!" class="img-responsive" style="max-width:100%;"/>

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In conclusion:

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Use #WhyCMR when discordance b/w clinical and echo Doppler findings OR suboptimal echo images OR pts with FMR to establish etiology and assess scar burden.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Growing role for #WhyCMR given reproducibility, prediction of LV remodeling and diagnosing MF.

10/In conclusion: https://abs.twimg.com/emoji/v2/... draggable=

Use #WhyCMR when discordance b/w clinical and echo Doppler findings OR suboptimal echo images OR pts with FMR to establish etiology and assess scar burden. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Growing role for #WhyCMR given reproducibility, prediction of LV remodeling and diagnosing MF." title="10/In conclusion: https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Use #WhyCMR when discordance b/w clinical and echo Doppler findings OR suboptimal echo images OR pts with FMR to establish etiology and assess scar burden. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧲" title="Magnet" aria-label="Emoji: Magnet">Growing role for #WhyCMR given reproducibility, prediction of LV remodeling and diagnosing MF.">

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Thanks very much, Dr. @JoaoLCavalcante for such a detailed talk, from basics to more advanced and for answering my question about 3D ECHO.

Those interested in learning more, check out this upcoming workshop by @MHIF_Heart.

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