Pablo Perez Lopez

#EHJCVI🫀How do sex and valve morphology shape AS severity? In fibrotic vs calcific remodeling, calcification shows the strongest association with severity, while fibrosis may represent a distinct phenotype more prominent in women with BAV 🔍 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀Too old or too sick for TAVI? When should we consider futility in advanced AS? This editorial explores whether advanced cardiac damage helps identify patients unlikely to benefit from TAVI and where the line should be drawn 🔍 Read more 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 💡 Cardiac invasive lung cancer is extremely rare. #whyCCT is key for identifying tumour-related coronary involvement and differentiating it from CAD. Diagnosis was confirmed via thoracic biopsy, and best supportive care was provided 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🔍 What is the diagnosis?

A) Invasive Osteosarcoma
B) Invasive lung carcinoma
C) Primary cardiac lymphoma
D) Primary cardiac sarcoma

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#EHJCVI🫀When the coronaries are not moving as usual?!: Coronary angiogram in a 69 yo w with anterior AMI and COPD revealed severe stenosis of the LAD & diagonals with loss of motion related to the cardiac cycle. CXR showed a silhouette sign, and CCTA showed this 👀 #whyCCT.

#EHJCVI 💡SOLUTION: Cardiac neuroendocrine tumours are exceedingly rare. Multiparametric CMR #whyCMR is key to tumour characterization and preoperative assessment. Complete surgical resection remains the only definitive treatment 👉 ⏩Read more: academic.oup.com/ehj...

#EHJCVI 🔍 What is the diagnosis?
A) Cardiac hemangioma
B) Cardiac rhabdomyoma
C) Cardiac neuroendocrine tumor
D) Cardiac Sarcoma
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#EHJCVI🫀A rare cardiac case to look out for 👀: A 66-year-old woman with exertional chest & back pain, T-wave inversions in V1–V6, aVL 📉, normal coronaries, and a LV lateral wall mass on #EchoFirst and #whyCCT 👉 #WhyCMR and histology reveal these findings 🧲🔬 #MedSky

#EHJCVI🫀What’s the impact of age on aortic valve calcium progression? In a MESA substudy, AVC progression tracked with baseline AVC burden, with no age-related differences after adjustment. Higher AVC predicted greater risk of moderate–severe AS 🔍 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🧲 What’s the utility of CMR quantification of tricuspid regurgitation? CMR-derived regurgitant fraction reflects right-sided HF, liver involvement, and adverse RV remodeling, aligning with prognostic markers (TAPSE/PASP, TRISCORE) 📉🔍 👉 doi.org/10.1093/ehjc... #MedSky

🫀#EHJCVI When the LV grows an extra chamber. During routine cardio-oncology imaging, a 70-year-old woman was found to have a contracting 4-cm LV diverticulum, creating a rare double-chambered LV, easily mistaken for an aneurysm, yet entirely benign 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀 Image Focus | Liver herniation to the pericardium 🤯👀 This case beautifully illustrates the importance of multimodality #CVImaging, particularly in rare, bizarre cases! #echofirst #CCT
⏩ Read more: doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀 Who said LV filling pressures can’t be assessed by #whyCMR? 🤔 In this analysis of >450 patients with non-ischemic 🫀 disease, PCWP estimated by #whyCMR was a strong independent prognostic factor, enhancing risk stratification‼️⏩Read more: doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀 An unusual cough in the pediatric setting... A 12-yr-old male presented with persistent cough. 👦 #echofirst and #CCT found a large LAA aneurysm, compressing the LV. After surgery, complete resolution of respiratory symptoms was achieved 🔍 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 📢 New #EACVI Consensus Statement🚨 Role of multimodality imaging in the management of #HCM in 2025🫀In-depth, state-of-the-art document focusing on the role and advances of #CVImaging techniques in #HCM💡#echofirst #WhyCMR #CVNuclear #CCTV ⏩ doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀 Referral for intervention in aortic regurgitation, a classical clinical conundrum‼️ Current criteria may overlook early myocardial damage💡Time to integrate #whyCMR fibrosis metrics to personalize timing of valve intervention❓⏩Read more: doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀 Prognosis in #Fabry disease - is there more to it than just the X count 🧬? Does LVH fully capture cardiac involvement in females with FD👩? 'Milder does not mean benign'⚠️The reaffirmed importance of sex-specific thresholds in FD ⏩ doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀 How to choose between 2nd line therapies for HOCM ? 🤔 Mavacamten, but not disopyramide, ⬇️ LV mechanical dispersion and GWW, while ⬆️ GWE in a cohort of 120 #HCM pts ⚡Those under #CMI also showed fewer arrhythmic events. Read more: doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀 RV shape matters shape matters 📐New 3D echo–derived RV shape metrics reveal how geometry reflects haemodynamics and predicts outcomes beyond size and EF. Read more 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀Left atrial enlargement isn’t always pathology, context matters. The LA:LV ratio (LAESV/LVEDV) helps separate adaptive from maladaptive remodelling: ≥0.75 suggests disproportionate LA remodelling (notably in AF/HFpEF). Read more 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🫀Quantitative stress CMR can go beyond visual assessment, improving non-invasive decision-making. Fully automated MBF mapping helps distinguish CTO from severe stenosis and uncovers the true ischaemic burden in multivessel disease 👉doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🔍 Integrating CT, CMR, and PET-CT is critical for correctly distinguishing structural vs non-structural prosthetic valve dysfunction, detecting thrombosis or endocarditis, and guiding reintervention before clinical deterioration. Read more 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🧲 Is CMR redefining timing in chronic aortic regurgitation? A meta-analysis (~2,000 pts) shows CMR-derived AR fraction >33% is linked to ~4× higher risk, even in asymptomatic patients. CMR sharpens risk stratification beyond echo 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🧲 Can imaging keep up with modern therapy in cardiac amyloidosis? CMR (ECV, T1 mapping) and SPECT detect treatment response earlier than echo or clinical markers, often months before functional change. Multimodality imaging is becoming central 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI 🎆✨ Wishing our cardiovascular imaging community a very Happy New Year 2026! 🫀🚀 Thank you for an inspiring year of science, collaboration, and innovation. Here’s to new discoveries, impact, and excellence ahead in 2026 🥂📈

#EHJCVI Number 1️⃣ 🏆👉 What’s the incremental value of CMR for risk stratification in non-dilated LV cardiomyopathy? 🫀🧲 Midwall LGE is a strong independent predictor of MAACE ⚠️ with an HR of 6.7 (1.33–33.67). More 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI Number 2️⃣ 👉 What are the recommendations for multimodality imaging of the LA and LAA? 🫀📘 This new consensus highlights techniques 🔍, integration into prognostic evaluation 📊, and periprocedural imaging to optimize outcomes ⚙️ More 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI Number 3️⃣ 👉 What are the outcomes of non-ischaemic ring-like LGE on CMR? 🫀🧲 Although uncommon and non-specific across morpho-functional phenotypes, it is associated with genetic aetiologies 🧬 and a high burden of adverse outcomes ⚠️ 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI Number 4️⃣ 👉 What’s the prognostic value of the left AV coupling index in heart failure? 🫀📊 In patients with HF and LVEF <50%, LACI is independently associated with adverse events after adjustment for multiple factors (HR 1.77) ⚠️ More 👉 doi.org/10.1093/ehjc... #MedSky

#EHJCVI Number 5️⃣ 👉 What’s the effect of high-intensity statins on PCAT attenuation? 💊 They reduce PCAT attenuation in both statin-continued and statin-initiated patients 📉, in relation to LDL changes, after correction for CV risk factors 🫀 More 👉 doi.org/10.1093/ehjc... #MedSky