Conscious lump of atoms posting edutaining tweets | AUBMC cardiology | Houston Methodist Multimodality CV Imaging | Echo CMR | Valvular heart disease — MVP
Joined April 2017
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534 Photos and videos
Severe TR with IVC/HV systolic flow reversal
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Carlos El-Tallawi, MD, FACC, FASE retweeted
Jun 3
🔍 What exactly is prolapse volume?
Prolapse volume is the "hidden" volume trapped between the prolapsing mitral leaflets and the annulus at end-systole.
This volume:
➡️ Is not forward stroke volume
➡️ Is not transvalvular MR
➡️ Returns to the LV during diastole
🫀 Total LV volume load = MR volume prolapse volume
💎 A paradigm-shifting concept introduced by @HeartToProve @DipanJShah @WilliamZoghbi and colleagues that may help explain disproportionate LV enlargement and remodeling in Barlow MVP.
#ASEchoJC #EchoFirst #MVP @ASE360 #CardioX #MVP @JournalASEcho
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Carlos El-Tallawi, MD, FACC, FASE retweeted
Jun 3
💎 Why does the LV sometimes appear "too enlarged" for the degree of MR in MVP?
🫀 Because MR is not the entire volume load.
In the landmark work by @HeartToProve and colleagues, adding prolapse volume to MR volume strengthened the relationship between volume load and LV enlargement.
🎯 Total volume load = MR volume prolapse volume
A powerful concept that may explain disproportionate LV remodeling in Barlow MVP.
#ASEchoJC #EchoFirst #MVP @ASE360 @JournalASEcho #CardioX
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Carlos El-Tallawi, MD, FACC, FASE retweeted
Jun 3
Such an elegant observation, @HeartToProve 👏
💎 The bifid-E wave may be a novel Doppler marker of advanced MVP.
Associated with:
➡️ Bileaflet MVP (33% vs 6% in single leaflet prolapse)
➡️ Larger prolapse volume
➡️ Disproportionate LV enlargement despite mild MR
➡️ LV replacement fibrosis
🔑 On multivariable analysis, the bifid-E wave was the only echocardiographic parameter independently associated with MVP-related fibrosis.
🔍 Sometimes the most important clues are hiding in plain sight on the mitral inflow Doppler.
#ASEchoJC #EchoFirst @ASE360 @JournalASEcho #MVP #CardioX
Our group also identified a novel Doppler sign —Bifid-E wave— that could represent an additional echocardiographic marker of advanced MVP and myocardial fibrosis. Keep an eye out for this next time you're reading a Barlow Echo. #ASEchoJC
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Carlos El-Tallawi, MD, FACC, FASE retweeted
Jun 3
Such an important point, @HeartToProve 💎
As highlighted in your editorial 👇, not all flails are created equal.
🎯 A flail leaflet should raise suspicion for severe MR—but it is not synonymous with severe MR. An integrated assessment remains essential.
#ASEchoJC #EchoFirst @ASE360 @JournalASEcho #MVP #WhyCMR
Very important -- flail =/= severe MR! In our data a flail leaflet had 81% specificity for severe MR as defined on CMR >60 mL/50% #ASEchoJC
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Carlos El-Tallawi, MD, FACC, FASE retweeted
Jun 3
✨ Huge thank you to everyone who joined tonight's #ASEchoJC!
What an incredible discussion on MVP, MR, MAD, ventricular arrhythmias, and the evolving concept of arrhythmic MVP. 🫀⚡️
Grateful to our outstanding guest authors Dr. Jeffrey Silbiger @LucySafi, @priyaPanday27, and for sharing their expertise and insights, and to my wonderful co-moderators @NadeenFaza and @HeartToProve. A special thank you to our #EchoFirst enthusiasts and engaged audience for contributing to such a lively, thoughtful, and high-yield discussion.
Proud to be part of this amazing global #EchoFirst community! 💙🌍 @ASE360 @JournalASEcho
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🩺 Mastering the Evaluation of Mitral Regurgitation using Echo and CMR🫀
Presented by Drs. Nadeen Faza @NadeenFaza and Carlos El-Tallawi @HeartToProve
📺 Full presentation: youtube.com/watch?v=oSE0FRwr…
OUTLINE AND SECTION LINKS BELOW:
🎥Part 1: Echocardiography Evaluation
• Intro to MR Imaging: youtube.com/watch?v=oSE0FRwr…
• Color Doppler Limits: youtube.com/watch?v=oSE0FRwr…
• Evaluating Severity: youtube.com/watch?v=oSE0FRwr…
• Guideline Criteria: youtube.com/watch?v=oSE0FRwr…
• 10 Commandments for Echo: youtube.com/watch?v=oSE0FRwr…
🧲 Part 2: Cardiac MRI Evaluation
• Intro to MRI MR Assessment: youtube.com/watch?v=oSE0FRwr…
• Lesion Mechanism & Etiology: youtube.com/watch?v=oSE0FRwr…
• Ventricular Remodeling: youtube.com/watch?v=oSE0FRwr…
• Echo vs. MRI Accuracy: youtube.com/watch?v=oSE0FRwr…
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Carlos El-Tallawi, MD, FACC, FASE retweeted
Hot off the press! My Editorial in JACC on Atrial functional MR. Among 72 definitions of AfMR (!!) in the literature, Koschatko et al demonstrated that the one provided by JACC CV Imaging Expert Panel in 2022 was the most powerful in predicting outcome. pubmed.ncbi.nlm.nih.gov/4194…
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Mechanism of diastolic mitral regurgitation in complete heart block
pmc.ncbi.nlm.nih.gov/article…
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DeBakey Cardiovascular Education Channel
Free resource for all: 🫀📚🎓
youtube.com/channel/UCb8PGmJ…
Highest-quality cardiovascular education on @YouTube
Evidence-based content across the full spectrum of cardiovascular medicine.
Tailored for practicing clinicians and trainees alike.
We did it - 133K subscribers and we just hit 3000 videos -- thanks to all who contributed and thanks to our world class DeBakey Education team. @DeBakeyCVedu
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Carlos El-Tallawi, MD, FACC, FASE retweeted
16 Oct 2021
2.2 Liters
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Anatomical basis of electrical alternans in cardiac tamponade
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Coronary-cameral fistula — complication of septal myectomy
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Pulmonary vein Doppler tracks LA–LV hemodynamics beat-to-beat:
•S wave → LA relaxation annular descent (systolic suction)
•D wave → LV filling (mirrors mitral E)
•Ar wave → atrial contraction (retrograde)
Blunted S, dominant D, ↑Ar? → elevated LA pressure & reduced compliance.
Simple waveform. High-yield physiology. 🫀
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Intracardiac lipoma
(dark delineating rim around the mass is a signal cancellation artifact at the interface of fat and water residing protons)
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Sometimes Dobutamine stress echo is not needed in low-flow low-gradient AS
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