Cardiology fellow with a passion for HF 🫀 | CV Fellow @DukeCardFellows | #GradyMade @EmoryMedicine | Emory School of Medicine ‘22 | University of Chicago ‘15
Atlanta, GA
Joined October 2022
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Yesterday, I presented my Senior Grand Rounds on the impact of race/ethnicity in HFrEF presentation, management, and candidacy for advanced HF therapies. Here are some key takeaways:
Choosing among invasive and non-invasive monitors 🫀 Dr. Alexander Hajduczok (@AHajduczok): the opportunity is the C to D transition. Invasive PA monitoring has the strongest data, wearables may add scale, and we need more data on who gets what 🧵 #ChiHemos2026 @ChiHForum
Many more options, especially for patients who need creative solutions: thoracic impedance, acoustic cardiography, scale-based impedance, IVC diameter, CardioTag (sternal wearable), Acorai, VitalPatch, Nanowear SimpleSense vest. Ankle edema monitor on the horizon.
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Next: devices that treat, not just monitor (Barostim, CCM), inside integrated care models that combine data, algorithms & action. But we need more data in the coming years on how these work and when to use them in the right patient. #ChiHemos2026
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Session V: Hemodynamic Implementation 🫀 Dr. Scott Lundgren (@swlundgren) on putting remote PA pressure data into clinical workflow. No trials to lean on, so it’s best practice: right patients, a dedicated team, standardized review 🧵 #ChiHemos2026 @ChiHForum @Cardionerds
Persistently elevated PA pressures should prompt discussion: are we on optimal medical therapy, is something else going on (severe valvular disease?), should we consider Barostim or other advanced therapies?
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Some of this may soon be moot: Abbott has FDA approval for its Dynamic Treatment Plan platform (CardioGuide app), Edwards is evaluating patient self-management in PROACTIVE-HF-2, and NORM-HF uses algorithm-based self-management as its primary model. #ChiHemos2026
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Debate: What is the real pressure? 🫀 Dr. Adriano Tonelli: esophageal manometry is needed. Dr. Yogesh Reddy (@yreddyhf): all you need is a Swan. The crux: does obesity falsely raise PAWP, or is it real HFpEF? 🧵 #ChiHemos2026 @ChiHForum @Cardionerds
If obesity falsely raised PAWP, why don’t all patients with obesity have a high wedge? Patients with PAH & obesity can have a normal PAWP. And obese HFpEF has more HF hospitalizations at the same NT-proBNP, a non-hemodynamic anchor.
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Obese HFpEF also responds to HFpEF therapy: dapagliflozin lowered PCWP by 3.5 mmHg at rest and 6.1 mmHg with exercise at 24 weeks. Pes correction has no independent validation, so unless treating differently makes patients better, is it worth it? #ChiHemos2026
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