Session 4 of @ChiHForum focuses on the good, the bad, and the ugly of LVAD hemodynamics, with sessions focused on pre-LVAD assessment, hemodynamics with LVAD complications, and the prediction of cardiac recovery. #ChiHemos2025@CardioNerds
Session 1: Beyond Baseline Hemodynamics at @ChiHForum off to a strong start! 🦾 Check out a few highlights from the session here: #ChiHemos2025@CardioNerds
Anthony P. Carnicelli, MD, provides a good framework for evaluation and management of PAH in the ICU!
1) Airway mgmt- just the right PEEP
2) MCS - VA ECMO >>> RV-only support.
3) Serial HDs are helpful to guide tx @RyanTedfordMD
4) New meds - role unclear - TBD
#ChiHemos2025
Engaging analysis of measuring RV reserve with @cla_baratto!
📌 Invasive PV loops are best, but challenging
📌 Echo via TAPSE/PASP --> simple, precise, but open to criticism
📌 Dynamic assessment with exercise
🗝️ For evaluation: "Something is better than nothing"
#ChiHemos2025
@Jonathan_PaulMD provides a fantastic talk on HD changes seen in acute PE.
🗝️ Intermediate risk patients are sicker than you may think.
🗝️ Metrics for risk: PESI, RV/LV ratio, TTE. All imperfect.
🗝️ Hemodynamics can help stratify risk!
#ChiHemos2025
Dr. Marc R. Pritzker, MD walks us through changing perspectives in our treatment targets for PAH.
📌Trials focus on vasodilators with modest effect
📌PVR not well associated with outcomes--> but compliance does!
#ChiHemos2025
@JTThibs provides wonderful context for how to predict RV failure after LVAD so that we may avoid it.
📌 Various scores: (RVSWI, CVP/PCWP/PAPi)
📌 Integrating these scores is helps only modestly (max c-statistic around 0.75 with STOP-RVF) pubmed.ncbi.nlm.nih.gov/3829…#ChiHemos2025
Current testing with vasodilators or response to LV unloading (with Impella), with subsequent improvement in PAPi, can predict good RV outcomes.
🗝️ RV failure after LVAD remains difficult to predict, and it requires ongoing investigation.
#ChiHemos2025
Session 2 starting out with the most firey 🔥 debate of the year: supine versus upright exercise testing! @ChiHForum#ChiHemos2025@CardioNerds Check it out~ 👇