Hope you enjoy our first Tweetorial...please let us know what you think and particularly interested to know what we should cover in coming months! #EHJCaseReports #CardioTwitter

🫀🫘2026 ESC「心血管疾患×慢性腎臓病」ガイドラインも公表。欧州腎臓学会（ERA）と共同作成。 ポイント👇 ✅️合言葉は "STAMP on CKD"（Screen・Triage・Address・Modify・Plan） ✅️CVD患者は全員、eGFR＋尿ACRでCKDスクリーニング（Class I）。年1回以上の再検も ✅️心不全の発症は、その後3か月の腎代替療法リスクを最大45倍に上げる ✅️SGLT2阻害薬はeGFR ≥20で開始、開始後20を切っても透析導入までは継続（IIa） ✅️MRAはLVEF >40%＋CKDでは効果が減弱する、と明記 ✅️ARNIはeGFR低下速度を緩める目的でIIa。eGFR <30でも継続を考慮 ✅️利尿薬反応性の評価がIIa（2時間尿Na <70 mmol/Lなら倍量） ✅️うっ血解除中はCr 50%上昇まで利尿を止めない（Class I） ✅️非代償性HF＋CKDではアセタゾラミド上乗せがIIa、サイアザイドはIIb ✅️透析患者のLVEF ≥35%への一次予防ICDはClass III 詳細はスレッドで🧵 🔗academic.oup.com/eurheartj/a…

Cinco años después, la Sociedad Europea de Cardiología reescribe la insuficiencia cardíaca de arriba abajo. Y esta vez no son retoques. 🔴 Desaparece la insuficiencia cardíaca con FEVI ligeramente reducida. 🫀 La FEVI reducida pasa a abarcar todo lo que esté por debajo del 50%. 📈 Los estadios A, B, C y D entran por fin en la guía europea. 💊 Nace el tratamiento médico fundamental, con cuatro fármacos en la FEVI reducida y dos en la preservada. 🧪 Estreno de un sistema de niveles de evidencia con cuatro escalones: A, B1, B2 y C. 🩸 La ferropenia se redefine por la saturación de transferrina. 🏥 La insuficiencia cardíaca aguda pasa a llamarse descompensada, con tres fases de tratamiento hospitalario. ⚖️ Y una asimetría que dará que hablar: para el mismo paciente con FEVI ≥40%, esta guía recomienda el antagonista mineralocorticoideo con clase I y la guía renal hermana, publicada el mismo día, con clase IIa. 📖 Te lo hemos resumido todo, cambio por cambio y con las clases de recomendación al lado. cardioteca.com/insuficiencia…

My most important tweet this year? Dr Pasquale : your chance of being born outside Africa or Asia is 15% , yet all the representation in trials is from countries outside Africa and Asia, the global pharma and device exclude them from trials! #ESCCongress

Dont understand your NHS pension? Confused about AA tax? Think you might have a problem, now or in the future? Caught by the £100k tax trap or taper? Know you need to do something but don't know what, use our new tool at choose.goldstonepenfintech.c…

A major step forward for women at #ESCCongress 🫀 The new 5th Universal Definition of MI explicitly requires sex-specific 99th-percentile troponin thresholds recognizing that using the same cutoff in women and men can systematically underdiagnose myocardial injury in women It also recognizes SCAD, coronary vasospasm & embolism as causes of primary MI—mechanisms especially important in women. Women’s heart attacks don’t always look like men’s. Our definitions finally reflect that. We wanted to enforce this in the Cheat Pain guidelines but we didn’t have enough data in the US at that time. Glad this has changed! #CardioTwitter #WomensHeartHealth #MyocardialInfarction

A British cardiologist who took £50M from BigPharma & wrote clinical guidelines….😱 The Danish TV documentary originally airing (in 2024)…..”but it hasn’t yet been televised in the English speaking world”. ….where were the UK media??

🚨 The 2026 @escardio #HeartFailure Guidelines are here❗️#ESCcongress @secardiologia 1) HFmrEF is gone. Acute HF is gone. NT-proBNP cut-offs are now age-adjusted. Everything that matters 🧵👇 2/ 🔄 NEW DEFINITION — two phenotypes only ❤️‍🩹 HFrEF → LVEF <50% + symptoms/signs 🫀 HFpEF → LVEF ≥50% + symptoms/signs + objective evidence of structural/functional abnormality ❌ HFmrEF eliminated: same aetiology, same pathophysiology, same treatment response as HFrEF

🫀 ESC HEART FAILURE GUIDELINES 2026 — WHAT HAS CHANGED? The new ESC HF Guidelines bring major changes in classification, treatment, decompensation, devices and precision phenotyping. 🔹 1 | New HF classification ➡️ HFrEF: LVEF <50% ➡️ HFpEF: LVEF ≥50% The previous HFmrEF category is removed. 🔹 2 | “Acute HF” → “Decompensated HF (DHF)” Management focuses on identifying the trigger and rapidly assessing congestion, perfusion, BP, renal function and oxygenation. 🔹 3 | Smarter decongestion IV loop diuretics remain first-line. If response is inadequate, consider sequential nephron blockade with IV acetazolamide or oral hydrochlorothiazide. Early urinary sodium assessment may help guide diuretic escalation. 🔹 4 | Treat before discharge Once stabilized, initiate/optimize foundational therapy—including in-hospital SGLT2 inhibitor initiation. After discharge, aim for rapid optimization, with uptitration generally every 1–2 weeks when tolerated. 🔹 5 | MRA therapy expands MRAs now have a broader role across the EF spectrum, including selected patients with HFpEF. And if EF improves? ➡️ Continue foundational therapy. 🔹 6 | HFpEF becomes increasingly treatable Beyond SGLT2 inhibitors, treatment now includes broader use of MRAs and selected RAAS inhibition, alongside phenotype-driven management of comorbidities. 🔹 7 | CRT: refined selection and timing CRT remains Class I A for symptomatic HFrEF with: ➡️ LVEF ≤35% ➡️ sinus rhythm ➡️ LBBB ➡️ QRS ≥150 ms despite optimal foundational therapy. In this strong electrical phenotype, CRT planning may begin alongside initiation of foundational therapy, with reassessment before implantation. ⚠️ Evidence remains insufficient to recommend conduction-system pacing as an alternative to CRT in HFrEF. 🔹 8 | ICD: more individualized Primary prevention: ➡️ Ischaemic HFrEF, LVEF ≤35% → Class I ➡️ Non-ischaemic HFrEF, LVEF ≤35% → Class IIa Consider competing mortality, comorbidities, frailty, life expectancy and patient preference. 🔹 9 | Obesity becomes a treatment target In selected symptomatic HF with LVEF ≥45% and BMI ≥30 kg/m², semaglutide or tirzepatide should be considered to improve weight, symptoms, exercise capacity and QoL. 🔹 10 | Precision imaging & aetiology The focus moves beyond EF toward identifying why the patient has HF, with greater roles for CMR, CT, nuclear imaging and genetic testing. ATTR-CM therapy also expands to tafamidis, acoramidis and vutrisiran. 🔹 11 | Mitral TEER & haemodynamic monitoring Mitral TEER receives a Class I recommendation in appropriately selected HFrEF with severe secondary MR despite optimized therapy/CRT. Pulmonary artery pressure-guided monitoring is strengthened to Class IIa in selected high-risk patients. 📌 The ESC HF 2026 message: Diagnose earlier → phenotype better → decongest effectively → start treatment early → titrate rapidly → personalize devices and interventions → prevent the next decompensation. 💡 HF management is becoming less about treating an EF number—and more about treating the individual patient’s phenotype, aetiology, haemodynamics and comorbidities. #ESCCongress #HeartFailure #Cardiology #HFrEF #HFpEF #CRT #SGLT2i #CardiacImaging

NEW 2026 #ESCGuidelines for the management of heart failure 👇ow.ly/km3250ZGoe9 #ESCCongress

1/10🚨 NOW LAUNCHED! 🚀 Goldstone PenFinTech 26/27 NHS Pension Tax Modellers Clarity on AA, £100k trap, taper, Scheme Pays + full modelling to retirement! For consultants, GPs, SAS, residents & all NHS staff (1995/2008/2015 schemes) Only way to buy: 👉 register.goldstonepenfintech…

The BMA remains concerned and calls on the Israeli government to immediately release all arbitrarily detained Palestinian healthcare workers, including Dr Hussam Abu Safiya. With @AmnestyUK we have written to the foreign secretary demanding action to ensure that the Israeli government adheres to international law and medical neutrality. bma.org.uk/what-we-do/workin…

Genetic testing has become an integral part of the diagnostic workup of patients with dilated cardiomyopathy. New clinical consensus paper provides insights on how to implement it in the clinical practice. doi.org/10.1093/eurheartj/eh… #heartfailure #cardiomyopathy #genetics #cardiotwitter, @ESC_Journals, @escardio

Two Trials Comparing Conduction System Pacing and Biventricular Pacing jamanetwork.com/journals/jam…

💬 Editorial: HeartSync-LBBP found #CSP superior to #BiVP for heart failure outcomes, whereas PhysioSync-HF found CSP inferior, emphasizing the importance of patient selection and operator proficiency. ja.ma/47FIJET

#WednesdayRead Emerging topics in ischaemic heart disease: angina with non-obstructive coronary, aspirin-free antiplatelet treatment, and imaging-guided percutaneous interventions ow.ly/CHKj50Yc8MZ #EHJ

Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements: a prespecified analysis of the SELECT trial The cardioprotective effects of semaglutide were independent of baseline adiposity and weight loss and had only a small association with waist circumference, suggesting some mechanisms for benefit beyond adiposity reduction. #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @TheLancet @TheLancetEndo @CMichaelGibson @SubodhVermaMD @hvanspall @ShelleyZieroth @mmamas1973 @AnastasiaSMihai @Hragy @biljana_parapid thelancet.com/journals/lance…

Impact of Simultaneous Initiation of Finerenone and Empagliflozin on Urinary Albumin-to-Creatinine Ratio in Asia Pre-Specified Analysis of CONFIDENCE Simultaneous initiation of finerenone and empagliflozin was effective and well tolerated among CONFIDENCE study participants from Asia, consistent with the overall population #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @mvaduganathan @JavedButler1 @goKDIGO @ShelleyZieroth @hvanspall @hfcollaboratory @biljana_parapid @safchat @AndrewJSauer @ankeetbhatt @almucastro01 journals.lww.com/cjasn/fullt…

The ‘10 commandments’ for the 2025 focused update of the 2019 ESC/EAS guidelines for the management of dyslipidaemias The 2025 Focused Update1 refines the 2019 Guidelines for the management of dyslipidaemia with new evidence published after 2019. #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @ESC_Journals @escardio @ehj_ed @mmamas1973 @CMichaelGibson @Hragy @hvanspall @AnastasiaSMihai academic.oup.com/eurheartj/a…

Combo diuretics in AHF = faster decongestion, no prognostic gain. Start SGLT2i in-hospital → ↓ mortality & ↓ HF events. 🚑💊📉. Treat congestion fast, but don’t miss disease-modifying therapy. ow.ly/fGhb50Yen6T #EJHF @EJHFEiC @AmrAbdin10 @GiuseppeGalati_ @HanCardiomd