Didn’t I tell you all that I am the luckiest:) @DrMarthaGulati was humble enough to take a selfie with me at #ACC22, @ACCinTouch It was an honor to meet you in person.

The hardest part of cardiology 🫀fellowship?? Holding the pager at night.

I built the Cardiology Night Float Application 💻

7 PM: STEMI, shock, VT storm, a crashing Impella, and more. You can call your attending

Work them up and Survive till 7 AM 🕖

cardsnightfloat.netlify.app

Extremely proud of the @HMHCardioFellow Jeopardy team 👏 ! They represented us with excellence, passion, and an impressive depth of cardiology knowledge. A true privilege to be part of their journey & witness their talent and dedication! 🫀 #TCACC26

294 patients undergoing M-TEER (2014–2023):
⏱️ Median time from severe MR diagnosis to structural heart evaluation:
👩Women: 39 days 👨Men: 45 days (P=0.27)
Sex was not associated with referral delay after multivariable adjustment.
📉Referral intervals also shortened over time.

🔍 But here's an important question:
❓What about patients with severe MR who NEVER make it to the structural heart team?
Our study included patients who ultimately underwent M-TEER.
Understanding what happens BEFORE referral is an important next step. 🫀

🙏 So grateful to my mentors, Drs. @NadeenFaza and @DrMarthaGulati , for their guidance and support throughout this project, and to our wonderful co-authors!

🫀Excited to share our work, now published in @Jscai!
❓Do women and men with severe MR experience different delays in reaching the structural heart team?
➡️We looked at referral timing among patients undergoing M-TEER @DeBakeyCVedu 🧵
sciencedirect.com/science/articl…

🫀Grateful to see our work on women’s representation in the leadership of interventional structural heart disease trials now published in @JACCJournals, alongside a very thoughtful accompanying editorial by @Drroxmehran, @ditchhaporia and Dr. Puja B. Parikh.

Among 88 high-impact SHD trials, women held just 7% of trial committee positions, with no meaningful improvement over 15 years.

Read more about trends in women’s representation in SHD trial leadership, factors that may contribute to these patterns, and potential opportunities for future improvement here: 🔗jacc.org/doi/10.1016/j.…

Very thankful to my amazing coauthors @KharsaChloe, @mderdem3, @NadeenFaza, and @MayraGuerreroMD, who helped shape this work.

#CardioTwitter #CardioX #StructuralHeart #ACCWIC @ACCinTouch

🚨 10 striking conclusions from ESC 2026

1. HFmrEF is essentially gone.
ESC now defines HFrEF as LVEF <50% and HFpEF as ≥50%.

2. MRAs have broken the EF barrier.
Mineralocorticoid receptor antagonists now have a Class I recommendation in chronic HF irrespective of LVEF. Semaglutide/tirzepatide receive Class IIa recommendations for HFpEF with obesity.

3. SINGLE-AF: anticoagulation may start earlier than we thought.
In AF patients at intermediate stroke risk, DOAC therapy reduced adverse clinical outcomes by 69% versus no anticoagulation.

4. Severe TR is no longer just “give diuretics and watch.”
TRIC-I-HF: transcatheter tricuspid repair reduced HF hospitalisation and all-cause mortality compared with medical therapy alone.

5. Unexplained syncope deserves early prolonged ECG monitoring.
ASPIRED: immediate 14-day monitoring did not prevent recurrent syncope, but substantially improved arrhythmia diagnosis/treatment and was associated with lower mortality.

6. Intermediate–high-risk PE may be entering the catheter era.
PRAGUE-26: catheter-directed thrombolysis improved short-term clinical outcomes versus anticoagulation alone, without an obvious major bleeding penalty.

7. Cardiac arrest + no STEMI ≠ automatic immediate cath lab.
DISCO: immediate angiography after OHCA without ST elevation did not improve 30-day survival.

8. Being ≥70 is not a reason to abandon primary-prevention statins.
STAREE: atorvastatin reduced major cardiovascular events by about 30% in older adults without known CVD, although disability-free survival was unchanged.

9. AF ablation has a surprisingly large placebo component for symptoms.
PVI-SHAM-AF: ablation reduced AF recurrence, yet improvement in AF-related quality of life was not significantly greater than sham treatment.

10. Even the definition of MI has changed.
The 5th Universal Definition of MI replaces the traditional numbered framework with primary MI, secondary MI and procedure-related MI, while incorporating sex-specific troponin thresholds and greater use of imaging.

🔥 The one-line ESC 2026 message:

Treat HF across the EF spectrum, anticoagulate selected AF patients earlier, intervene on TR, monitor syncope sooner—and stop rushing every post-arrest patient without STEMI to the cath lab.

Honored to present our late‑breaking CoreValve/Evolut TAVR durability data @crfheart #NYValves2026: &lt;3% reintervention, &lt;6% bioprosthetic valve failure at 8 yrs, SVD main failure mechanism. Proud of our fellows’ contributions and grateful for the chance to share and learn.

Wrapping up the final morning of #NYValves2026 on a high note! ☀️

⚡ Late-Breakers delivering fresh, practice-changing data
🧠Complications from the Masters: real-world lessons from the experts
💡Innovation sessions spotlighting what’s next
🤝Connections and conversations orward

#CardioX #CardioTwitter #CardioEd #CardioResearch @Kalazizimd @bapat_savrtavr @BurkhoffMD @djc795 @npfam1 @igeorge1975 @jgranadacrf @AdamGreenbaumMD @hahn_rt @EdwinHoMD @TsuyoshiKaneko1 @SusheelKodaliMD @azeemlatib @MartyBLeon @TheDoctorMack @MVMadhavanMD @jamiemccabeMD @modine_thomas @tnazifMD @PopmaJeffrey @laurenranard @MarwanSaadMD @psorajja @GilbertTangMD @drnvanmieghem @vonBardelebenRS @PradeepYadavMD @mirvatalasnag @triciarawh @TCTConference @TCTMD @sbhci @Dr_ibrahimHarbi @CathWhisperer @caldera_99 @aelsab @mderdem3 @CAESmedmd @NadeenFaza @RaghavG_MD @evandrofilhobr @GiorgioMedranda @purviparwani @SaadUrRahman55 @LucySafi @ShariqShamimMD @Sticchi_Alex @ladyheart_md

🧵 Day 3 at #NYValves2026 wrapped up with a packed room for the Late-Breaking Science session featuring the PROGRESS Trial. 👏 @crfheart @TCTMD @TCTConference

I’ll share some of the key concepts discussed today in this thread. Stay tuned for the complete trial results, which will be presented at #TCT2026.

💡 One interesting takeaway:

Compared with prior TAVR trials, PROGRESS enrolled patients who were:

✔️ Older
✔️ Highly symptomatic
✔️ Rich in heart failure risk markers

This trial targets a group frequently encountered in everyday clinical practice—but one for whom we currently evidence.

📌 Bottom line

PROGRESS is asking;

Can carefully selected patients with moderate AS and high-risk features benefit from earlier TAVR rather than waiting for severe AS?