Fri.Mar 21, 2025

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Physiology Friday #262: Everything You Need to Know about Zone 2 Training

Physiologically Speaking

Greetings! Welcome to the Physiology Friday newsletter. Details about the sponsors of this newsletter including FSTFUEL electrolytes, Examine.com , and my book “VO2 Max Essentials ” can be found at the end of the post. You can find more products I’m affiliated with on my website. Physiologically Speaking is a reader-supported publication.

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Amvuttra Arrives for ATTR-CM with a High Asking Price

CardiacWire

Its not surprising that Alnylams Amvuttra (vutrisiran) received FDA approval for ATTR-CM last week, but what shocked many was Alnylams choice to price the drug at nearly half a million dollars per year in a segment where its incumbent competitors cost half as much. Amvuttra is now the third FDA-approved therapy for ATTR-CM, following Pfizers Vyndaqel and BridgeBios Attruby/Beyonttra.

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Cholesterol-elevating substances found in coffee from machines at work

Medical Xpress - Cardiology

The coffee from most of the coffee machines in workplaces contains relatively high levels of cholesterol-elevating substances. There is a big difference in comparison to coffee made in regular paper filter coffee makers, which filter out most of these substances.

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Think Twice Before Quitting Oral Anticoagulants After Afib Ablation?

Med Page Today

(MedPage Today) -- For people with atrial fibrillation (Afib or AF), stopping oral anticoagulation (OAC) after a "successful" catheter ablation left them exposed to increased risk, according to a Japanese hospital's dataset. At Nagoya University.

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Bridging Innovation & Patient Care: The Growing Role of AI

Speaker: Simran Kaur, Co-founder & CEO at Tattva Health Inc.

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

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Comparison of Centers for Disease Control and Prevention and Hospital‐Based Stroke Mortality Data in Kentucky: The Paul Coverdell National Acute Stroke Program

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print.

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When Lesions Go Deep: Hidradenitis Suppurativa and Cardiovascular Risk

American College of Cardiology

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting approximately 0.3-1.2% of the population, though underdiagnosis is common due to challenges in recognition and reporting.

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Vutrisiran Snags FDA Approval for TTR Amyloidosis Cardiomyopathy

Med Page Today

(MedPage Today) -- Gene-silencing therapy vutrisiran (Amvuttra) graduated to a broad indication in treatment of transthyretin amyloidosis cardiomyopathy, as Alnylam Pharmaceuticals announced expanded FDA approval. Vutrisiran, a transthyretin-directed.

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Eplerenone, diabetes, and chronic kidney disease in patients hospitalized for acute heart failure: findings from the EARLIER trial

Cardiovascular Diabetology

Mineralocorticoid receptor antagonists (MRAs) are often underutilized in patients with heart failure (HF), particularly those with diabetes and/or chronic kidney disease (CKD). However, the impact of concurren.

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HCPLive Five – Allergy Updates at AAAAI 2025

HCPLive

Counting down the most impactful news at major medical meetings, its the HCPLive Five! This episode focuses on 5 key allergy updates from the 2025 American Academy of Allergy, Asthma, and Immunology (AAAAI) annual meeting.

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ACC CardiaCast: Decision Makers: Crafting Personalized AFib Care with a Team Approach

American College of Cardiology

In this podcast hosts highlight the 2023 Guideline updates and the importance of a patient centered cardiac care team approach to AFib diagnosis, management, and treatment.

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Study Highlights Atopic Dermatitis Practices in Different Regions of the World

HCPLive

These data highlight differences and similarities among dermatologists globally in their decisions related to the treatment of mild-to-moderate atopic dermatitis.

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Exploring the impact of metabolic comorbidities on epicardial adipose tissue in heart failure with preserved ejection fraction

Cardiovascular Diabetology

Heart failure (HF) with preserved ejection fraction (HFpEF) is increasingly prevalent worldwide due to aging and comorbidities. Epicardial adipose tissue (EAT), favored by diabetes and obesity, was shown to co.

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A new guiding strategy for treating the free margin of the leaflet in an aortic root remodelling procedure

Journal of Cardiothoracic Surgery

In valve-sparing aortic root replacement procedure, leaflet prolapse can be corrected by shortening the length of the free margin. But precisely determining the extent of the reduction remains a problem. This.

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Impact of glycemic control metrics on short- and long-term mortality in transcatheter aortic valve replacement patients: a retrospective cohort study from the MIMIC-IV database

Cardiovascular Diabetology

Glycemic control is critical for managing transcatheter aortic valve replacement (TAVR) patients, especially those in intensive care units (ICUs).

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Asthma Bronchodilator Tests May be More Reliable in the Morning

HCPLive

A new cross-sectional study found that the odds of having bronchodilator responsiveness declined by 8% per hour during the working day.

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Remote Ischemic Preconditioning Lowers AKI Incidence After CAG or PCI

American College of Cardiology

Among at-risk patients undergoing elective coronary angiography (CAG) or PCI, delayed remote ischemic preconditioning (RIPC) reduces the incidence of contrast-associated acute kidney injury (CA-AKI) compared with sham preconditioning.

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ACC 2025 Clinical Trials to Watch with Deepak Bhatt, MD, MPH, MBA

HCPLive

Bhatt previews 3 late-breaking clinical trials being presented at this year's American College of Cardiology Annual Scientific Sessions.

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The Definition of Failure

The New England Journal of Medicine

When his mother is diagnosed with what medicine calls heart failure, an epidemiologist identifies harmful flaws in both the term and communication with patients and families.

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PCV13 Pneumonia Vaccine Shows Longer Durability Over PPV23 in People With COPD

HCPLive

By year 5, COPD exacerbations occurred in 81.3% of the PPV23 group and 23.6% of the PCV13 group.

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The Quantitative Flow Ratio Uncertainty‐Zone: Finding Certainty Within Uncertainty

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print.

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Maria's Patient Journey: Impact of Support Systems

HCPLive

A panelist discusses how finding an effective treatment for their condition has dramatically improved their mental health and quality of life by restoring their confidence and reducing anxiety about their appearance, allowing them to participate more fully in social activities and giving them a renewed sense of hope and normalcy.

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Social Vulnerability and Long‐Term Cardiovascular Outcomes After COVID‐19 Hospitalization: An Analysis of the American Heart Association COVID‐19 Registry Linked With Medicare Claims Data

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundPatients hospitalized with COVID19 from socioeconomically vulnerable communities are at risk for inhospital cardiovascular events. However, the association of socioeconomic vulnerability and outcomes after hospitalization is uncertain.Methods and ResultsAmerican Heart Association COVID19 Cardiovascular Disease Registry hospitalizations between March 1, 2020, and June 30, 2022, linked with Medicare feeforservice claims, were ana

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Brea's Patient Journey: Diagnosis and Impact on Quality of Life

HCPLive

A panelist discusses how Brea's patient journey involved a gradual recognition of unusual hair loss patterns, followed by an emotional diagnostic process for alopecia areata, which significantly impacted her quality of life through decreased self-confidence, social withdrawal, and psychological distress before finding effective treatment options.

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Genomic Exploration of Essential Hypertension in African‐Brazilian Quilombo Populations: A Comprehensive Approach With Pedigree Analysis and Family‐Based Association Studies

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundEssential hypertension (EH) is a global health issue. Despite extensive research, much of EH heritability remains unexplained. We investigated the genetic basis of EH in Africanderived individuals from partially isolated quilombo populations in Vale do Ribeira (So Paulo, Brazil).Methods and ResultsSamples from 431 individuals (167 affected, 261 unaffected, 3 unknown) were genotyped using a 650 000 singlenucleotide polymorphism

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The Role of the JAK/STAT Signaling Pathway in Atopic Dermatitis

HCPLive

Experts discuss the JAK/STAT signaling pathways critical role in immune response, highlighting the involvement of JAK enzymes in atopic dermatitis (AD) pathogenesis and how JAK inhibitors effectively reduce itch and inflammation, improving symptoms and skin clearance in AD.

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Resource Efficient Screening for Primary Prevention of Coronary Heart Disease: A Proof‐of‐Concept Test in the MESA Cohort

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundThe best use of cardiac imaging to guide preventive coronary heart disease (CHD) treatment is debated. Current guidelines recommend the pooled cohort equation, followed by computed tomography for coronary artery calcification (CAC) assessment. We evaluated if this approach could be simplified using a selfreport risk algorithm instead of the pooled cohort equation.MethodsA gradient boosting machine model was trained on selfrepor

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JAK1 Selective Inhibition and the Impact of Selectivity on Efficacy and Safety

HCPLive

Experts discuss the significance of using selective JAK1 inhibitors for atopic dermatitis (AD), noting their targeted action compared with nonselective JAK inhibitors, and how JAK1 selectivity enhances both the efficacy and safety of these agents in treating AD.

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Timing and Adherence Matter for Sodium–Glucose Cotransporter‐2 Inhibitors in Heart Failure

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundIt is imperative to maintain the use of sodiumglucose cotransporter2 inhibitors (SGLT2is) in patients with diabetes both after the index diagnosis of heart failure (HF) and even prior to the index diagnosis of HF. We aimed to investigate whether timing of SGLT2 is before the index diagnosis of HF, and second, adherence to SGLT2is in the form of the proportion of days covered metric matter in patients with HF and diabetes.Method

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Reviving the Swan: Presenting the Chicago Hemodynamic Forum

Circulation: Heart Failure

Circulation: Heart Failure, Ahead of Print.

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Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundCarotid intimamedia thickness (CIMT) and carotid distensibility are markers of arterial change; however, little is known of the association with incident heart failure (HF). We aimed to assess this.MethodsThis was a longitudinal analysis of data from the British Regional Heart Study, a prospective cohort study.

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Inflammatory Myofibroblastic Tumor Mimicking Pulmonary Artery Sarcoma and Causing Pulmonary Artery Obstruction: A Rare Case Report

Circulation: Cardiovascular Imaging

Circulation: Cardiovascular Imaging, Ahead of Print.

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Polygenic Risk and Cardiovascular Event Risk in Patients With Atrial Fibrillation With Low to Intermediate Stroke Risk

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundThe clinical utility of the polygenic risk score in predicting cardiovascular events in patients with atrial fibrillation (AF) has not yet been established. This study aimed to determine whether the polygenic risk score for AF might be useful in the risk stratification of AFrelated cardiovascular events.Methods and ResultsThis study included 9597 oral anticoagulationnaive patients with AF with a CHA2DS2VA (congestive heart fail

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3D Echocardiographic and CMR Imaging for the Assessment of Right Ventricular Function and Tricuspid Regurgitation Severity

Circulation: Cardiovascular Imaging

Circulation: Cardiovascular Imaging, Ahead of Print. BACKGROUND:Tricuspid regurgitation (TR) is associated with increased mortality and is often underdiagnosed due to limitations in imaging modalities. While routine 2-dimensional echocardiography (2DE) demonstrates frequent disagreement with cardiac magnetic resonance imaging (CMR) in classifying TR severity, the incremental value of 3-dimensional echocardiography (3DE) remains unknown also due to the lack of a generalizable grading scheme acros

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Rationale and Design of the CREATE Trial: A Multicenter, Randomized Comparison of Continuation or Cessation of Single Antithrombotic Therapy at 1 Year After Transcatheter Aortic Valve Replacement

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundCurrent guidelines and expert consensus recommend lifelong single antiplatelet therapy for patients undergoing transcatheter aortic valve replacement who have no indication for anticoagulation or dual antiplatelet therapy. However, there is no direct evidence from randomized controlled trials supporting this practice.

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Severe Mitral Regurgitation in Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis

Circulation: Cardiovascular Imaging

Circulation: Cardiovascular Imaging, Ahead of Print. BACKGROUND:Patients with paradoxical low-flow, low-gradient severe aortic stenosis exhibit low transvalvular flow rate (Q), while maintaining preserved left ventricular ejection fraction. Severe mitral regurgitation (MR) also causes a low-flow state, adding complexity to diagnosis and management. This study aimed to examine the impact of severe MR on outcomes in paradoxical low-flow, low-gradient severe aortic stenosis.METHODS:Data from an ins

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Cerebral Embolic Protection Devices in Transcatheter Aortic Valve Implantation: Meta‐Analysis With Trial Sequential Analysis

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundWe aimed to reevaluate randomized controlled trial data on outcomes of cerebral embolic protection device use during transcatheter aortic valve implantation. A conventional metaanalysis followed by trial sequential analysis was conducted to evaluate the strength of the current evidence.Methods and ResultsDatabases were searched for randomized controlled trials.