Joe Cuthbert
@jjcuthbert.bsky.social
Senior Lecturer in Cardiology at HYMS. Heart failure researcher. Doubt is not a pleasant condition, but certainty is absurd.
Great paper, great thread, we don’t understand HFPEF at all
Very interesting physiological study of the hemodynamic effect of nitroprusside infusion in HFpEF vs HFrEF. I think this is equally relevant both for the interaction with EF seen with most heart failure therapies, as in the disparate effects seen with IABP in cardiogenic shock 🧵 #cardiosky #emimcc
Effects of Vasodilation in Heart Failure With Preserved or Reduced Ejection Fraction: Implications of Distinct Pathophysiologies on Response to Therapy
The purpose of this study was to compare hemodynamic responses to vasodilator therapy in patients with heart failure (HF) and preserved ejection fract…
www.sciencedirect.com
July 17, 2025 at 4:59 AM
Great paper, great thread, we don’t understand HFPEF at all
Thank goodness - question is; does this apply to beer and chocolate intake too?
Concentrating your physical activity as a "weekend warrior" has similar benefit to exercise spread across the week www.ahajournals.org/doi/10.1161/... #cardiosky
Dual Cohort Insights Into Accelerometer‐Derived Weekend Warrior Physical Activity and Its Impact on Mortality | Journal of the American Heart Association
www.ahajournals.org
June 4, 2025 at 4:00 PM
Thank goodness - question is; does this apply to beer and chocolate intake too?
Couldn’t be more correct!
The job of a doctor is not, necessarily, to be kind or popular or fluffy or liked.
It is to do and to say the right thing for your patients.
However difficult it may be to do so.
However tough you may find it.
Many institutions pretend otherwise, including the GMC.
Here's why they're wrong 🧵
It is to do and to say the right thing for your patients.
However difficult it may be to do so.
However tough you may find it.
Many institutions pretend otherwise, including the GMC.
Here's why they're wrong 🧵
May 18, 2025 at 5:02 PM
Couldn’t be more correct!
I can never resist
This is the Hand Wash Car Wash on Anlaby Road. I've posted it because virtually everytime I go by, I see someone giving the inflatable a high five. I've seen it happen about 10 times.
#hull #yorkshire #travel #photography #sky #carwash #photographersunited #photographersofbluesky #spring
#hull #yorkshire #travel #photography #sky #carwash #photographersunited #photographersofbluesky #spring
May 10, 2025 at 6:20 PM
I can never resist
Redefining conditions that make no sense? (How can something that is sinus be an arrhythmia?) excellent! Next, let’s do away with HF with a preserved ejection fraction.
New online! Redefining respiratory sinus arrhythmia as respiratory heart rate variability: an international Expert Recommendation for terminological clarity #CardioSky
Redefining respiratory sinus arrhythmia as respiratory heart rate variability: an international Expert Recommendation for terminological clarity
Nature Reviews Cardiology, Published online: 06 May 2025; doi:10.1038/s41569-025-01160-zThe physiological phenomenon whereby heart rate varies in phase with breathing in vertebrates has been known as ‘respiratory sinus arrhythmia’. In this Expert Recommendation, the authors argue that this terminology is potentially misleading and propose replacing it with the term ‘respiratory heart rate variability’, which avoids pathological connotations.
bit.ly
May 7, 2025 at 9:35 AM
Redefining conditions that make no sense? (How can something that is sinus be an arrhythmia?) excellent! Next, let’s do away with HF with a preserved ejection fraction.
Yes! Stealing this one
All definitions of p-values are wrong but some are useful
May 4, 2025 at 6:20 PM
Yes! Stealing this one
Reposted by Joe Cuthbert
Lower extremity lymphatic flow is associated with diuretic response in acute heart failure
In 65 AHF patients, lymphatic flow (via ICG lymphangiography) predicted diuretic response.
#AHF #CardioSky #Lymphatics #AHF @shelleyzieroth.bsky.social @escardio.bsky.social @drrajivsankar.bsky.social
In 65 AHF patients, lymphatic flow (via ICG lymphangiography) predicted diuretic response.
#AHF #CardioSky #Lymphatics #AHF @shelleyzieroth.bsky.social @escardio.bsky.social @drrajivsankar.bsky.social
April 9, 2025 at 11:59 PM
Lower extremity lymphatic flow is associated with diuretic response in acute heart failure
In 65 AHF patients, lymphatic flow (via ICG lymphangiography) predicted diuretic response.
#AHF #CardioSky #Lymphatics #AHF @shelleyzieroth.bsky.social @escardio.bsky.social @drrajivsankar.bsky.social
In 65 AHF patients, lymphatic flow (via ICG lymphangiography) predicted diuretic response.
#AHF #CardioSky #Lymphatics #AHF @shelleyzieroth.bsky.social @escardio.bsky.social @drrajivsankar.bsky.social
So true - why does “this sort of thing” keep being done??
This study has been shared widely. This is no more a causal study than those using self reported consumption, just a more reliable marker. Still just as confounded as other observational studies. There is no reason to think here is any health benefit from wine consumption.
Light and moderate consumption of wine is associated with a 38-50% lower risk of cardiovascular complications, as determined by urinary tartaric acid levels--yet another paper from the PREDIMED project: academic.oup.com/eurheartj/ar...
April 6, 2025 at 6:29 PM
So true - why does “this sort of thing” keep being done??
Fluid restriction associated with trend to worse QoL and greater thirst in stable outpatients with HF. No difference in safety.
www.nature.com/articles/s41...
www.nature.com/articles/s41...
Liberal fluid intake versus fluid restriction in chronic heart failure: a randomized clinical trial - Nature Medicine
While fluid restriction is typically recommended for patients with chronic heart failure, this randomized clinical trial showed no difference in health status, as assessed by patient-reported outcomes...
www.nature.com
March 31, 2025 at 5:37 AM
Fluid restriction associated with trend to worse QoL and greater thirst in stable outpatients with HF. No difference in safety.
www.nature.com/articles/s41...
www.nature.com/articles/s41...
A trial in which the rate of side effects (uro-genital infection) was nearly 2x greater than the rate of the primary driver of the outcome benefit (worsening HF +\- hospitalisation)
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
Dapagliflozin in Patients Undergoing Transcatheter Aortic-Valve Implantation | NEJM
Sodium–glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of heart-failure
admission among high-risk patients. However, most patients with valvular heart disease,
including those undergoing...
www.nejm.org
March 30, 2025 at 11:33 AM
A trial in which the rate of side effects (uro-genital infection) was nearly 2x greater than the rate of the primary driver of the outcome benefit (worsening HF +\- hospitalisation)
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
Whatever you think of Mandrola’s approach…he could not be more correct about critical appraisal of trials in the first 5 mins of this week’s episode.
podcasts.apple.com/gb/podcast/t...
podcasts.apple.com/gb/podcast/t...
Mar 14 2025 This Week in Cardiology
Podcast Episode · This Week in Cardiology · 14/03/2025 · 28m
podcasts.apple.com
March 15, 2025 at 10:03 PM
Whatever you think of Mandrola’s approach…he could not be more correct about critical appraisal of trials in the first 5 mins of this week’s episode.
podcasts.apple.com/gb/podcast/t...
podcasts.apple.com/gb/podcast/t...
I maintain that I only have time to eat chocolate and drink beer; not eat chocolate, drink beer, and exercise.
Healthy habits may slip in a committed relationship, a study suggests, but the effect is much less apparent for women ⬇️
Married men more likely to be obese than singles
www.thetimes.com
March 13, 2025 at 9:32 AM
I maintain that I only have time to eat chocolate and drink beer; not eat chocolate, drink beer, and exercise.
Amazing story in which the Guardian use the first year medical student definition of heart failure….”weakened the heart so that it cannot effectively pump blood through the body effectively”…bless them.
www.theguardian.com/australia-ne...
www.theguardian.com/australia-ne...
Australian man survives 100 days with artificial heart in world-first success
Sydney surgeons ‘enormously proud’ after patient in his 40s receives the Australian-designed implant designed as a bridge before donor heart
www.theguardian.com
March 12, 2025 at 5:55 AM
Amazing story in which the Guardian use the first year medical student definition of heart failure….”weakened the heart so that it cannot effectively pump blood through the body effectively”…bless them.
www.theguardian.com/australia-ne...
www.theguardian.com/australia-ne...
Hopeless technique
The King visited the Royal College of Nursing and practiced resuscitating a dummy with the guidance of the nursing cadets 👑👩⚕️
March 11, 2025 at 5:11 PM
Hopeless technique
Reposted by Joe Cuthbert
An IPD analysis of STICHES and REVIVED-BCIS2.
Higher risk in the OMT arm in the older CABG trial STITCHES than the more recent PCI trial REVIVED.
#cardiosky academic.oup.com/eurheartj/ad...
Higher risk in the OMT arm in the older CABG trial STITCHES than the more recent PCI trial REVIVED.
#cardiosky academic.oup.com/eurheartj/ad...
Medical therapy and outcomes in REVIVED-BCIS2 and STICHES: an individual patient data analysis
AbstractBackground and Aims. In the Surgical Treatment for Ischaemic Heart Failure Trial Extension Study (STICHES), coronary artery bypass grafting (CABG)
academic.oup.com
March 11, 2025 at 12:17 PM
An IPD analysis of STICHES and REVIVED-BCIS2.
Higher risk in the OMT arm in the older CABG trial STITCHES than the more recent PCI trial REVIVED.
#cardiosky academic.oup.com/eurheartj/ad...
Higher risk in the OMT arm in the older CABG trial STITCHES than the more recent PCI trial REVIVED.
#cardiosky academic.oup.com/eurheartj/ad...
Argh!!!!!!
I’ve missed the clashes of US vs UK medicine that used to happen on twitter. Someone sent me this one today and oh boy does it demonstrate one of the many reasons I’m glad I won’t need to rely on American healthcare when sick. A “wild” cardiac arrest being posted online
March 5, 2025 at 3:37 PM
Argh!!!!!!
Presence of congestion is central to a diagnosis of HF. There are multiple imaging techniques to identify congestion - are any of them better than a stethoscope and clinical acumen?
pubmed.ncbi.nlm.nih.gov/39998772/
pubmed.ncbi.nlm.nih.gov/39998772/
Imaging of Congestion in Cardio-renal Syndrome - PubMed
As an extension of an echocardiographic examination, ultrasound can be used to identify intravascular (inferior vena cava diameter dilation, internal jugular vein distension or discontinuous venous re...
pubmed.ncbi.nlm.nih.gov
February 28, 2025 at 10:37 PM
Presence of congestion is central to a diagnosis of HF. There are multiple imaging techniques to identify congestion - are any of them better than a stethoscope and clinical acumen?
pubmed.ncbi.nlm.nih.gov/39998772/
pubmed.ncbi.nlm.nih.gov/39998772/
Reposted by Joe Cuthbert
Delighted to be joint first author on this work published in
@ESC_Journals EHJ academic.oup.com/eurheartj/ad...
@ESC_Journals EHJ academic.oup.com/eurheartj/ad...
February 27, 2025 at 11:56 AM
Delighted to be joint first author on this work published in
@ESC_Journals EHJ academic.oup.com/eurheartj/ad...
@ESC_Journals EHJ academic.oup.com/eurheartj/ad...
Absolutely! Such a wonderful thing
Parkrun should be prescribed on the NHS, charity behind it says
Parkrun should be prescribed on the NHS, charity behind it says
Doctors should prescribe Parkrun on the NHS, the charity behind the scheme says.
news.sky.com
February 25, 2025 at 12:07 PM
Absolutely! Such a wonderful thing
One to pass on to the med students - this is excellent
I wrote a short interactive article👆
It uses simulations to demonstrate how different cardiac arrhythmias can develop.
Try it out! (It has defibrillators ⚡️)
jenevoldsen.com/posts/excitable-cells
#medsky #cardiosky #cccsky #emimcc
It uses simulations to demonstrate how different cardiac arrhythmias can develop.
Try it out! (It has defibrillators ⚡️)
jenevoldsen.com/posts/excitable-cells
#medsky #cardiosky #cccsky #emimcc
February 21, 2025 at 6:19 AM
One to pass on to the med students - this is excellent
Reposted by Joe Cuthbert
Here's an interesting study of atrial pacing in patients with HFpEF, showing how increasing heart rate may decrease LAP until it increases again at higher heart rates. A reason not to give these patients beta blockers without a good indication I think #cardiosky academic.oup.com/eurheartj/ar...
Accelerated atrial pacing reduces left-heart filling pressure: a combined clinical-computational study
AbstractBackground and Aims. Accelerated atrial pacing offers potential benefits for patients with heart failure with preserved ejection fraction (HFpEF) a
academic.oup.com
February 9, 2025 at 8:53 PM
Here's an interesting study of atrial pacing in patients with HFpEF, showing how increasing heart rate may decrease LAP until it increases again at higher heart rates. A reason not to give these patients beta blockers without a good indication I think #cardiosky academic.oup.com/eurheartj/ar...
Reposted by Joe Cuthbert
The beautifully refurbished Montague Burton Building on the corner of Whitefriargate. See #alt-text #alttext for full description.
#hull #yorkshire #travel #architecture #artdeco #photography
#hull #yorkshire #travel #architecture #artdeco #photography
January 28, 2025 at 7:53 PM
The beautifully refurbished Montague Burton Building on the corner of Whitefriargate. See #alt-text #alttext for full description.
#hull #yorkshire #travel #architecture #artdeco #photography
#hull #yorkshire #travel #architecture #artdeco #photography
Reposted by Joe Cuthbert
✨WHEEZING✨
January 26, 2025 at 7:16 AM
✨WHEEZING✨
Really pleased to have this published in @jcardfail.bsky.social
Natriuresis guided diuresis: barking up the wrong tree.
Needless to say, we argue that focussing on natriuresis rather than urine volume may be misguided.
onlinejcf.com/article/S107...
Natriuresis guided diuresis: barking up the wrong tree.
Needless to say, we argue that focussing on natriuresis rather than urine volume may be misguided.
onlinejcf.com/article/S107...
DEFINE_ME
onlinejcf.com
December 5, 2024 at 8:19 AM
Really pleased to have this published in @jcardfail.bsky.social
Natriuresis guided diuresis: barking up the wrong tree.
Needless to say, we argue that focussing on natriuresis rather than urine volume may be misguided.
onlinejcf.com/article/S107...
Natriuresis guided diuresis: barking up the wrong tree.
Needless to say, we argue that focussing on natriuresis rather than urine volume may be misguided.
onlinejcf.com/article/S107...
This is, surprisingly, the only study I am aware of that compares oral and SC loop diuretic. Tiny difference in diuretic efficacy 7ml/mg driven only by a difference in those with diuretic resistance. Statistically significant yes, but clinically meaningful?
onlinelibrary.wiley.com/doi/full/10....
onlinelibrary.wiley.com/doi/full/10....
Diuretic efficiency of a single dose of subcutaneous versus oral furosemide after heart failure hospitalization across diuretic resistance strata: A pilot randomized controlled trial
Aims
Diuretic resistance (DR) in heart failure (HF) is associated with worse outcomes. Furoscix®, a self-administered subcutaneous (sc) furosemide injection administered via on-body infusor, is appr.....
onlinelibrary.wiley.com
December 5, 2024 at 6:53 AM
This is, surprisingly, the only study I am aware of that compares oral and SC loop diuretic. Tiny difference in diuretic efficacy 7ml/mg driven only by a difference in those with diuretic resistance. Statistically significant yes, but clinically meaningful?
onlinelibrary.wiley.com/doi/full/10....
onlinelibrary.wiley.com/doi/full/10....