Excellent meeting indeed! ❤️And don’t forget to do exercise echo in HCM - 1 in 3 may have Mavacamten indication! #EchoCPET #HCM

Not sure, HFpEF disease not driven by afterload (see Borlaug paper from Circ Heart Fail above)… Despite better blood pressure control, HFpEF tends to progress… EchoCPET helps to phenotype patients, I try targeting specific HFpEF risk factors first before adressing moderate AS!

… and of course I do a lot of #echoCPET in #HFpEF, symptomatic moderate valve lesions and asymptomatic severe valve lesions, but this is with initial diagnosis!

Today we have performed our first cases of #echoCPET in dyspnea patients. @auroraluque91 @dani11gf @peteiro @FH_Verbrugge @alberenguel

Teaming up again with the great @VerwerftJan to share our experience with #echoCPET in #HFpEF. This hot-of-the-press paper @ESC_Journals demonstrates myriad of opportunities for diagnosis & treatment, far beyond #SGLT2i only. Tweetorial below!

Count me in! Close to establishing our breathlessness clinic here in Australia with iCPET and echoCPET and very keen to combine it with pragmatic research and trials.

I don’t routinely reschedule them for CPET after optimisation, but subjectively most patients feel better. Also, the fact that #echoCPET allows you to give very detailed information on mechanisms of dyspnea is a great help for many people to understand and tackle their disease…

Current @ESC_Journals paper goes one step further: "In patients with confirmed HFpEF or probability >90% according to well-validated HFpEF scores (both are complimentary in our view), why #echoCPET within a dedicated #dyspnoea clinic? What is the impact of findings?"

Teaming up again with the great @VerwerftJan to share our experience with #echoCPET in #HFpEF. This hot-of-the-press paper @ESC_Journals demonstrates myriad of opportunities for diagnosis & treatment, far beyond #SGLT2i only. Tweetorial below! @SarahStroobant2 @HerbotsLieven

How was #HFpEF defined (and differentiated from controls) if only non-invasive echoCPET was performed? It is virtually impossible to exclude HFPEF without iCPET, you can only confirm…

A helpful one is the CO/VO2 ratio, this one is most exact on #iCPET, yet I find it very helpful on #echoCPET as well, values 7-9 on #echoCPET are compatible with deconditioned muscles, anything >9 should trigger a work-up for an intrinsic muscle/mitochondrial problem…

3. I would say our diagnostic yield with echoCPET is around 85%, in 15% we remain unsure, than we need iCPET!

Hopefully will publish blueprints of our setup soon. But basically, 3-step approach: 1. Screen for evident reasons (structural heart disease, lung disease) & examine pre-test HFpEF probability with both scores 2. Anyone without clear reason or any score >0: echoCPET