Harvard The Mass General Brigham Heart Failure & Shock Course 2024
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Videos+PDFs
Harvard The Mass General Brigham Heart Failure & Shock Course 2024 This Comprehensive Mass General Brigham Heart Failure & Shock symposium will provide practical insights for all clinicians who manage patients with heart failure (HF) and cardiogenic shock. This offering is a 2-part course, of which participants can choose to partake in one or both parts. The first half of the course will be an in-depth review of cardiogenic shock while the second half of the course focuses on HF guideline directed medical therapy (GDMT) and beyond – the latest HF innovations with an emphasis on device- and technology-based therapies.
Massachusetts General Hospital Faculty and guest speakers who are leaders in the field will address state-of-the-art issues including: up-to-date knowledge of cardiogenic shock pathophysiology, shock phenotypes and trajectories; best practices in shock diagnosis and management; the roles of temporary mechanical circulatory support in shock treatment; emerging heart failure therapies; nuts and bolts of day to day HF management by our APPs on how to administer outpatient diuretics, manage IV iron; establish best practices for lifestyle changes; the use of exercise-hemodynamic assessments to characterize heart failure phenotypes; and contemporary heart failure and shock clinical trials that will determine the future of patient care.
In addition, the symposium will debate best practices for cardiovascular team-based care in the management of advanced coronary artery disease and percutaneous valve interventions. Particular attention will be paid to arrhythmia management in HF with an emphasis on ablation in atrial fibrillation for HF with preserved and reduced ejection fraction, how to treat ventricular tachycardia, cardiac resynchronization therapy alternatives, and options for non-cardiac resynchronization therapy candidates.
The assessment of right heart failure from the characterization of disease progression to management approaches, including the selection of candidates for temporary mechanical support will be discussed. The 2024 updates on left ventricular assist devices (LVAD) and state of cardiac transplantation will be provided. The need for improving the disparities in HF treatment and management will be underscored. The symposium will illustrate the Mass General Hospital Heart Failure Division’s comprehensive approach to the management of heart failure and cardiogenic shock for all cardiovascular clinicians.
Who Should Attend
- Nurses
- Primary Care Physicians
- Physician Assistants
- Specialty Physicians
- Pharmacists
- Nurse Practitioners
Learning Objectives
Upon completion of this activity, participants will be able to:
- Explain the pathophysiology of HF and describe the diagnostic evaluation of a patient presenting with HF.
- Describe current evidence-based medical and device therapeutics for HF.
- Identify HF with preserved and reduced ejection fraction phenotypes with use of CPET.
- Recognize the importance of co-managing HF patients with APPs and partner hospitals for advanced HF as well as need for lifestyle management, timely palliative care consultation, and ongoing need for equity.
- Understand the importance of early diagnosis of cardiogenic shock and timely institution of appropriate therapies.
- Describe the indications and managements of temporary mechanical circulatory support.
- Summarize the design of a system of shock care.
- Educate the trajectories of shock, and how to predict which patients will improve vs. worsen.
- Describe race and sex disparities in outcomes and treatments for patients with cardiogenic shock, and approaches to improve equity.
2024 Agenda
All agenda sessions are in Eastern Time.
Thursday, September 12, 2024
Introduction and Welcome
Part I: The 20,000-foot view – Big Ideas in Cardiogenic Shock
Jerome Crowley, MD, MPH; Van-Khue Ton, MD, PhD
Keynote Lecture: The Name of the Game: Cardiogenic Shock – Where We’ve Been, and Where We’re Going
David Morrow, MD, MPH
Q&A
The “Golden Day” of Shock Diagnosis
Van-Khue Ton, MD, PhD
Q&A
Mastermind – Should Shock Care be Centralized or Localized?
Sohah Igbal, MD; Gerin Stevens, MD, PhD
Q&A
…Ready For It? Prime Time for door-to-PAC Time?
Manreet Kanwar, MD
Q&A
Break
Look What You Made Me Do – Pre-Emptive vs. Selective LV Unloading in VA-ECMO
David D. Berg, MD, MPH
Q&A
2 Demo Stations: Indications, Configuration, Troubleshooting for ECMO & IABP
Jonathan Ludmir, MD; Jerome Crowley, MD, MPH
Lunch Break
Welcome Back
Part 2: Special Topics in Cardiogenic Shock
Jerome Crowley, MD, MPH; Van-Khue Ton, MD, PhD
I Knew You Were Trouble – Cardiogenic Shock Treatment in Adult Congenital Heart Disease
Jordan Bloom, MD, MPH; Ada Stefanescu, MD
Q&A
Disparities in Shock Care- Scope of the Problem and Potential Solutions
Saraschandra Vallabhajosyula, MD, MSc, FACP, FCCP, FCCM, FACC, FAHA, FSCAI
Q&A
Knowing Me Knowing You – Is There ARDS in Cardiogenic Shock?
Jonah Rubin, MD
Q&A
Break
Debate: Destination Unknown- Temporary MCS Bridge to Durable LVAD or Transplant?
Erin Coglianese, MD; Eriberto Michel, MD
Q&A
Mamma Mia: Cardio-Obstetric Shock – Management Dilemma
Guilherme Marmontel Nasi, MD; Jerome Crowley, MD, MPH; David D’Alessandro, MD; Erin Coglianese, MD; Gregory Lewis, MD
Q&A
Review of Tomorrow’s Agenda
Van-Khue Ton, MD, PhD; Jerome Crowley, MD, MPH
Friday, September 13, 2024
Welcome
Part 3: Rapid Fire Rounds: Trial Round-up, Cases and Simulations
Van-Khue Ton, MD, PhD; Jerome Crowley, MD, MPH
Round-up of Impactful Shock Trials in 2023-2024
Jonathan Ludmir, MD; Jerome Crowley, MD, MPH
Q&A
Take A Chance On Me – Challenging Shock Cases
Jonathan Ludmir, MD; Jerome Crowley, MD, MPH; Eriberto Michel, MD; Gregory Lewis, MD; Antonia Kreso, MD; Seyed Alireza Rabi, MD, PhD; Elaine Fletcher; Amanda Dantas Ferreira Fernandes; Lynze Franko
Break
Big World, Small Town: Creating MCS/ECMO Programs in Community Hospitals
Gaston Cudemus, MD
Q&A
Introduction of the Heart Failure Course
Van-Khue Ton, MD PhD
Demo Stations: ECMO Cannulation and Troubleshooting
1. Axillary Impella Placement, Troubleshooting
2. Right-sided Devices: Protek Duo, Impella RP
3. Durable LVAD: Surgical Considerations
Eriberto Michel, MD; Seyed Alireza Rabi, MD, PhD; Antonia Kreso, MD
Lunch Break
Part II – Heart Failure – Welcome
Gregory Lewis, MD; Lana Tsao, MD; Erin Coglianese, MD
“Welcome to our World”: Overview of HF Pathophysiology and Epidemiology: HFpEF and HFrEF
Gregory Lewis, MD
“Doctor, Doctor”: What to Do When You Suspect HF – Diagnostic Evaluation of HF 2024
Daniel Zlotoff, MD, PhD
“Freeze Frame” Role of Echocardiography in Diagnosis and Management of HF in 2024
Judy Hung, MD
Q&A
Break
Keynote Address: GDMT and Beyond
James Fang, MD
“Sugar, Sugar” Diabetic Cardiomyopathy and How Should We Repurpose Diabetic Drugs to Treat HF
James Januzzi, MD
“Smarter than You?” What Role Will AI Play in HF?
Jagmeet Singh, MD, PhD
Q&A
Break
“Back to Reality”: Streamlining GDMT PA Acquisition; How to Start a GLP1 agonist; When and How to give IV Iron; Outpatient Diuretics PO vs SC/IV
Moderator: Charounipha Soydara, NP
Panel Discussants: Lori Arrighi, RN; Kristian Bakken, NP; Julia Allen, NP; Theresa Fullerton, FNP; Erin Keenan, RN
HF Care Optimization – How to cope with HF: Managing Stress and Anxiety
How to Manage Caregiver Burnout
When is it Time to Call Palliative Care?
“Let’s get Physical”: Safe and Effective Physical Activity Augmentation
See the Fruits of our Success: Meet a LVAD patient
Christine McCarthy, NP; Johnna Marcus; Sarah Wright, PT, DPT, CCS; Kate Milley, NP; Patient Guest
“Hit me with your best shot”- Debate 1: Mital regurgitation.
Pro: Catheter based structural interventions should promptly follow GDMT optimization.
Con: Clip with caution
Debate 2: Coronary artery disease and HF
Pro: Comprehensive PCI-based revascularization should be prioritized in the treatment of HF
Con: Revascularization has a limited role in the treatment of HF.
William Carlson, MD, PhD; Rahul Sakhuja, MD, MPP, MSC; Ioannis Mastoris, MD; Darshan Doshi, MD; Christopher Newton Cheh, MD, MPH
Panel Q&A: Beyond 4-Pillars
Attendees are Welcome to Bring Questions and Ask About Patient Scenarios
Gui Marmontel, MD;l Gregory D. Lewis, MD; Van-Khue Ton, MD, PhD
Wrap up and Review of Tomorrow’s Agenda
Lana Tsao, MD; Erin Coglianese, MD; Gregory Lewis, MD
Meet the Professors – Cocktail Hour
Saturday, September 14, 2024
Welcome
Gregory D. Lewis, MD; Lana Tsao, MD; Erin Coglianese, MD
“Be Stiff:” Does HFpEF Phenotyping Make a Difference? When and Should We Do a CPET?
Gregory D. Lewis, MD
“Relax:” Expanding Treatment Options for Hypertrophic Cardiomyopathy
Albree Tower-Rader, MD
“Harden my Heart:” Is it HFpEF? Infiltrative Cardiomyopathies
Andrew Schwartzman, MD
“Make it Better:” Optimizing HFpEF Care: How Do We Think About Managing the Patient?
Esther Shao, MD, PhD
Q&A
Break
“You Spin Me Right Around:” The Right Ventricle Has Not Been Forgotten
Lana Tsao, MD
“Unbreak My Heart:” Optimization of the Right Ventricle in Right Heart Failure
Bin Quan Yang, MD
“Take My Breath Away:” The Roles of Pulmonary Hypertension in HF: Focus on the Right Heart
Alexandra Wong, MD
“Rescue Me:” Medications or Temporary Mechanical Support in Right Heart Failure
Jerome Crowley, MD
Q&A
Break
“Electric Avenue” Update on CRT: CRT Alternatives – HIS Bundle Pacing, LBB Pacing, Leadless LV Pacing
Chee Ng, MD
“Rhythm is Gonna Get You” Atrial Fibrillation: To Ablate or Not?
Moussa Mansour, MD
“Electrical Storm” PVCs and VT: Update in Management
William Hucker, MD, PhD
Debate: Narrow QRS – Cardiac Contractility Modulation or BAROSTIM?
Lana Tsao, MD; Theofanie Mela, MD
Q&A
Lunch Break
Keynote Introduction
Erin Coglianese, MD; Lana Tsao, MD; Gregory Lewis, MD
Keynote Speaker: When Drugs and CRT are Not Enough but Not a Transplant Candidate
Joann Lindenfeld, MD
Trying to Make it a “Wonderful World”: Improving Disparities in HF and Cardiac Transplant
Kemar Brown, MD
Q&A
Break
“Hole Hearted” Interatrial Shunts: Past, Present and Future
Ignacio Inglessis-Azuaje, MD
“Nervous:” Update in the Use of Autonomic Neuromodulation to Manage HF
Jagmeet Singh, MD, PhD
“Chrome Plated Heart:” Current State of LV Restoration Devices in the Management of LV Dilation and MR
Ignacio Inglessis-Azuaje, MD
“Bridge Over Troubled Waters:” Tricuspid Regurgitation, When and How to Intervene?
Evin Yucel, MD
Q&A
Break
“Complex Problems – Part 1”: Evaluation and Management of Advanced HF Patients Beyond the Quaternary Care Center – Unique Perspectives from Nontransplant Centers
Dmitri Belov, MD; Christopher Link, MD; Tapan Mehta, MD
“Tin Man:” MCS 2024
Erin Coglianese, MD
“Complex Problems, Part 2”: Post-Transplant Care at a Non-Transplant Center
Meaghan Doucette, NP; Megan Kramer, NP; Rebecca McClelland, PA-C
“My Heart Will Go On:” Heart Transplant 2024
Eriberto Michel, MD
Q&A
“So Long, Farewell:” Wrap-up
Erin Coglianese, MD; Gregory Lewis, MD; Lana Tsao, MD
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