Harriette Van Spall MD MPH 🇨🇦
@hvanspall.bsky.social
Cardiologist, Clinical Trialist McMasterU. Heart failure, Cardiometabolic Disease, Implementation Science. Editor Circulation.
evidence.nejm.org/doi/full/10....
Worsening #HF requiring oral #diuretic intensification is clinically relevant, associated w ⬆️ ☠️
Here we review #RCT data, propose a standard definition for ODI, argue for its inclusion in primary outcome of HF RCTs, & show how this will ⬆️ trial efficiency
Worsening #HF requiring oral #diuretic intensification is clinically relevant, associated w ⬆️ ☠️
Here we review #RCT data, propose a standard definition for ODI, argue for its inclusion in primary outcome of HF RCTs, & show how this will ⬆️ trial efficiency
Oral Diuretic Intensification as a Worsening Heart Failure Event in the Primary Outcome of Clinical Trials
Although evidence-based therapies for patients with heart failure (HF) have decreased
all-cause mortality, the residual risk of other clinically relevant outcomes — such
as worsening HF — remains h...
evidence.nejm.org
January 25, 2026 at 10:40 AM
evidence.nejm.org/doi/full/10....
Worsening #HF requiring oral #diuretic intensification is clinically relevant, associated w ⬆️ ☠️
Here we review #RCT data, propose a standard definition for ODI, argue for its inclusion in primary outcome of HF RCTs, & show how this will ⬆️ trial efficiency
Worsening #HF requiring oral #diuretic intensification is clinically relevant, associated w ⬆️ ☠️
Here we review #RCT data, propose a standard definition for ODI, argue for its inclusion in primary outcome of HF RCTs, & show how this will ⬆️ trial efficiency
Among patients with acute #HF in the #CLOROTIC #RCT
💠 #Diuretic resistance -> worse outcomes
💠 #Hydrochlorthiazide effect on weight loss was consistent across categories of diuretic resistance
Trial led by JC Trullàs, subanalysis by A Pandey
onlinelibrary.wiley.com/doi/10.1002/...
💠 #Diuretic resistance -> worse outcomes
💠 #Hydrochlorthiazide effect on weight loss was consistent across categories of diuretic resistance
Trial led by JC Trullàs, subanalysis by A Pandey
onlinelibrary.wiley.com/doi/10.1002/...
January 22, 2026 at 11:48 AM
Among patients with acute #HF in the #CLOROTIC #RCT
💠 #Diuretic resistance -> worse outcomes
💠 #Hydrochlorthiazide effect on weight loss was consistent across categories of diuretic resistance
Trial led by JC Trullàs, subanalysis by A Pandey
onlinelibrary.wiley.com/doi/10.1002/...
💠 #Diuretic resistance -> worse outcomes
💠 #Hydrochlorthiazide effect on weight loss was consistent across categories of diuretic resistance
Trial led by JC Trullàs, subanalysis by A Pandey
onlinelibrary.wiley.com/doi/10.1002/...
2026 #HeartDisease & #Stroke #Statistics: Report of US & Global Data From American Heart Association is here‼️
Did you know that the leading causes of #heartfailure are preventable?
CAD (20%)
HTN (20%)
tobacco (14%)
obesity (12%)
diabetes (12%)
www.ahajournals.org/doi/10.1161/...
Did you know that the leading causes of #heartfailure are preventable?
CAD (20%)
HTN (20%)
tobacco (14%)
obesity (12%)
diabetes (12%)
www.ahajournals.org/doi/10.1161/...
January 22, 2026 at 11:45 AM
2026 #HeartDisease & #Stroke #Statistics: Report of US & Global Data From American Heart Association is here‼️
Did you know that the leading causes of #heartfailure are preventable?
CAD (20%)
HTN (20%)
tobacco (14%)
obesity (12%)
diabetes (12%)
www.ahajournals.org/doi/10.1161/...
Did you know that the leading causes of #heartfailure are preventable?
CAD (20%)
HTN (20%)
tobacco (14%)
obesity (12%)
diabetes (12%)
www.ahajournals.org/doi/10.1161/...
Reposted by Harriette Van Spall MD MPH 🇨🇦
Worsening heart failure is commonly managed w/oral diuretic intensification (ODI). In a new NEJM Evidence article, learn how the inclusion of ODI into trial endpoints could yield consistent treatment effect estimates & improve statistical efficiency. eviden.cc/48zIwEp
@hvanspall.bsky.social
@hvanspall.bsky.social
December 31, 2025 at 8:02 PM
Worsening heart failure is commonly managed w/oral diuretic intensification (ODI). In a new NEJM Evidence article, learn how the inclusion of ODI into trial endpoints could yield consistent treatment effect estimates & improve statistical efficiency. eviden.cc/48zIwEp
@hvanspall.bsky.social
@hvanspall.bsky.social
#Medtronic press release on our pivotal #ELEVATE-HFpEF RCT which will test the efficacy & safety of a personalized elevated #pacing rate (based on LVEF & height) in #HFpEF
75 countries
2 patients enrolled already (AUS & US)
Methods to be presented at #HFSA25
news.medtronic.com/2025-09-15-M...
75 countries
2 patients enrolled already (AUS & US)
Methods to be presented at #HFSA25
news.medtronic.com/2025-09-15-M...
September 17, 2025 at 9:25 PM
#Medtronic press release on our pivotal #ELEVATE-HFpEF RCT which will test the efficacy & safety of a personalized elevated #pacing rate (based on LVEF & height) in #HFpEF
75 countries
2 patients enrolled already (AUS & US)
Methods to be presented at #HFSA25
news.medtronic.com/2025-09-15-M...
75 countries
2 patients enrolled already (AUS & US)
Methods to be presented at #HFSA25
news.medtronic.com/2025-09-15-M...
FDA announces approval for #semaglutide 2.4 mg sc weekly for #MASLD based on results of the #ESSENCE #RCT.
Did you know that #CVD is the leading cause of death in patients with #MASLD?
Common mechanisms & now, common treatments for #CKLM diseases
www.novonordisk.com/news-and-med...
Did you know that #CVD is the leading cause of death in patients with #MASLD?
Common mechanisms & now, common treatments for #CKLM diseases
www.novonordisk.com/news-and-med...
August 16, 2025 at 2:36 PM
FDA announces approval for #semaglutide 2.4 mg sc weekly for #MASLD based on results of the #ESSENCE #RCT.
Did you know that #CVD is the leading cause of death in patients with #MASLD?
Common mechanisms & now, common treatments for #CKLM diseases
www.novonordisk.com/news-and-med...
Did you know that #CVD is the leading cause of death in patients with #MASLD?
Common mechanisms & now, common treatments for #CKLM diseases
www.novonordisk.com/news-and-med...
Reposted by Harriette Van Spall MD MPH 🇨🇦
📣 How is the American Heart Association fighting for medical research & patient care on Capitol Hill? @ahascience.bsky.social #CardioSky #AHA
Join Heart Powered: The AHA is Advocating for You
🗓️ June 26 | 🕒 3 PM ET
🎙️ Dr. Bradley Marino & Emily Hubelowski
🔗 Register: heart.zoom.us/webinar/regi...
Join Heart Powered: The AHA is Advocating for You
🗓️ June 26 | 🕒 3 PM ET
🎙️ Dr. Bradley Marino & Emily Hubelowski
🔗 Register: heart.zoom.us/webinar/regi...
June 20, 2025 at 4:08 PM
📣 How is the American Heart Association fighting for medical research & patient care on Capitol Hill? @ahascience.bsky.social #CardioSky #AHA
Join Heart Powered: The AHA is Advocating for You
🗓️ June 26 | 🕒 3 PM ET
🎙️ Dr. Bradley Marino & Emily Hubelowski
🔗 Register: heart.zoom.us/webinar/regi...
Join Heart Powered: The AHA is Advocating for You
🗓️ June 26 | 🕒 3 PM ET
🎙️ Dr. Bradley Marino & Emily Hubelowski
🔗 Register: heart.zoom.us/webinar/regi...
I love my outdoor #office, where work and play are fully intertwined!
What does your #Saturday morning look like?
#HappySeason #HomeSweetHome #JoyInWork
What does your #Saturday morning look like?
#HappySeason #HomeSweetHome #JoyInWork
June 14, 2025 at 12:01 PM
I love my outdoor #office, where work and play are fully intertwined!
What does your #Saturday morning look like?
#HappySeason #HomeSweetHome #JoyInWork
What does your #Saturday morning look like?
#HappySeason #HomeSweetHome #JoyInWork
It’s impossible to uncouple #health from #economic policy
Healthiest countries have fair economic policies that allow upward mobility & access to healthier lifestyles
Focusing on individual interventions alone: inadequate www.thelancet.com/journals/lan...
Healthiest countries have fair economic policies that allow upward mobility & access to healthier lifestyles
Focusing on individual interventions alone: inadequate www.thelancet.com/journals/lan...
Childhood obesity: prioritising a healthy start
Recent data from National Health Service (NHS) weight clinics in England show that
a disproportionate number of referrals originate from the most deprived areas, with
some children having BMIs over 40...
www.thelancet.com
June 9, 2025 at 12:34 PM
It’s impossible to uncouple #health from #economic policy
Healthiest countries have fair economic policies that allow upward mobility & access to healthier lifestyles
Focusing on individual interventions alone: inadequate www.thelancet.com/journals/lan...
Healthiest countries have fair economic policies that allow upward mobility & access to healthier lifestyles
Focusing on individual interventions alone: inadequate www.thelancet.com/journals/lan...
Phase 3 Trial of #Semaglutide in #Metabolic Dysfunction–Associated #Steatohepatitis
In patients with #MASH and moderate or advanced #liver #fibrosis, once-weekly semaglutide at a dose of 2.4 mg improved liver steatohepatitis & fibrosis at 72 weeks
t.co/vfcgItgXpb
In patients with #MASH and moderate or advanced #liver #fibrosis, once-weekly semaglutide at a dose of 2.4 mg improved liver steatohepatitis & fibrosis at 72 weeks
t.co/vfcgItgXpb
https://www.nejm.org/doi/full/10.1056/NEJMoa2413258
t.co
June 9, 2025 at 11:00 AM
Phase 3 Trial of #Semaglutide in #Metabolic Dysfunction–Associated #Steatohepatitis
In patients with #MASH and moderate or advanced #liver #fibrosis, once-weekly semaglutide at a dose of 2.4 mg improved liver steatohepatitis & fibrosis at 72 weeks
t.co/vfcgItgXpb
In patients with #MASH and moderate or advanced #liver #fibrosis, once-weekly semaglutide at a dose of 2.4 mg improved liver steatohepatitis & fibrosis at 72 weeks
t.co/vfcgItgXpb
Regional disparities in participant #enrolment in RCTs are related to regional #disparities in site recruitment relative to 🌎disease distribution
We propose estimating site representation index during trial planning to ensure globally (or nationally) representative #RCT popn
doi.org/10.1002/ejhf...
We propose estimating site representation index during trial planning to ensure globally (or nationally) representative #RCT popn
doi.org/10.1002/ejhf...
June 8, 2025 at 1:10 PM
Regional disparities in participant #enrolment in RCTs are related to regional #disparities in site recruitment relative to 🌎disease distribution
We propose estimating site representation index during trial planning to ensure globally (or nationally) representative #RCT popn
doi.org/10.1002/ejhf...
We propose estimating site representation index during trial planning to ensure globally (or nationally) representative #RCT popn
doi.org/10.1002/ejhf...
#NUDGECKD #ERA25 LBT #KristofferSkaar & #TorBiering
SimPub #Circulation
Pragmatic 2x2 factorial #implementation RCT
Randomization at cluster + individual level
E-letters re #GDMT to 1540 GPs & 22617 patients w #CKD did not ⬆️ uptake of #RASi or #SGLT2i
www.ahajournals.org/doi/10.1161/...
SimPub #Circulation
Pragmatic 2x2 factorial #implementation RCT
Randomization at cluster + individual level
E-letters re #GDMT to 1540 GPs & 22617 patients w #CKD did not ⬆️ uptake of #RASi or #SGLT2i
www.ahajournals.org/doi/10.1161/...
June 8, 2025 at 12:58 PM
#NUDGECKD #ERA25 LBT #KristofferSkaar & #TorBiering
SimPub #Circulation
Pragmatic 2x2 factorial #implementation RCT
Randomization at cluster + individual level
E-letters re #GDMT to 1540 GPs & 22617 patients w #CKD did not ⬆️ uptake of #RASi or #SGLT2i
www.ahajournals.org/doi/10.1161/...
SimPub #Circulation
Pragmatic 2x2 factorial #implementation RCT
Randomization at cluster + individual level
E-letters re #GDMT to 1540 GPs & 22617 patients w #CKD did not ⬆️ uptake of #RASi or #SGLT2i
www.ahajournals.org/doi/10.1161/...
June 8, 2025 at 12:46 PM
Reposted by Harriette Van Spall MD MPH 🇨🇦
Huge Danish trial of nudges
Patient level (N 22,000)
+ practice level (1500 practice cluster with N 28,000 pts)
To increase RASination & Flozination
www.ahajournals.org/doi/abs/10.1... in @ahajournals.bsky.social at #ERA25
Absolutely null effect - is the baseline too high to improve upon?
Patient level (N 22,000)
+ practice level (1500 practice cluster with N 28,000 pts)
To increase RASination & Flozination
www.ahajournals.org/doi/abs/10.1... in @ahajournals.bsky.social at #ERA25
Absolutely null effect - is the baseline too high to improve upon?
June 7, 2025 at 12:44 PM
Huge Danish trial of nudges
Patient level (N 22,000)
+ practice level (1500 practice cluster with N 28,000 pts)
To increase RASination & Flozination
www.ahajournals.org/doi/abs/10.1... in @ahajournals.bsky.social at #ERA25
Absolutely null effect - is the baseline too high to improve upon?
Patient level (N 22,000)
+ practice level (1500 practice cluster with N 28,000 pts)
To increase RASination & Flozination
www.ahajournals.org/doi/abs/10.1... in @ahajournals.bsky.social at #ERA25
Absolutely null effect - is the baseline too high to improve upon?
Reposted by Harriette Van Spall MD MPH 🇨🇦
Pill splitting guide for patients who take a lot of pills...
Which ones are safe to divide?
myheartsisters.org/2016/12/04/p...
Which ones are safe to divide?
myheartsisters.org/2016/12/04/p...
Pill splitting: which ones are safe to divide?
Don’t split your pills with a knife. Always use a pill-splitter. Don’t split them in advance – and other very sound tips for people like me who have been (until now!) using a kitchen kn…
myheartsisters.org
June 6, 2025 at 5:30 PM
Pill splitting guide for patients who take a lot of pills...
Which ones are safe to divide?
myheartsisters.org/2016/12/04/p...
Which ones are safe to divide?
myheartsisters.org/2016/12/04/p...
June 7, 2025 at 10:49 AM
Reposted by Harriette Van Spall MD MPH 🇨🇦
Missed the deadline? Plot twist: You didn't!
Deadlines extended! 🗓️
#AHA25 & #ReSS25 abstracts now due 6/9 at 10am ET.
Award applications due 6/9 at 7pm ET.
Submit here:
🔹 AHA: bit.ly/2025Extension
🔹 ReSS: bit.ly/ReSSExtension
@ahascience.bsky.social #CardioSky
Deadlines extended! 🗓️
#AHA25 & #ReSS25 abstracts now due 6/9 at 10am ET.
Award applications due 6/9 at 7pm ET.
Submit here:
🔹 AHA: bit.ly/2025Extension
🔹 ReSS: bit.ly/ReSSExtension
@ahascience.bsky.social #CardioSky
Scientific Sessions
Join us for FOUR days of programming, November 7–10, 2025, for AHA's Scientific Sessions (#AHA25) at the Ernest N. Morial Convention Center in New Orleans, Louisiana. It's AHA's biggest cardiova...
bit.ly
June 6, 2025 at 8:13 PM
Missed the deadline? Plot twist: You didn't!
Deadlines extended! 🗓️
#AHA25 & #ReSS25 abstracts now due 6/9 at 10am ET.
Award applications due 6/9 at 7pm ET.
Submit here:
🔹 AHA: bit.ly/2025Extension
🔹 ReSS: bit.ly/ReSSExtension
@ahascience.bsky.social #CardioSky
Deadlines extended! 🗓️
#AHA25 & #ReSS25 abstracts now due 6/9 at 10am ET.
Award applications due 6/9 at 7pm ET.
Submit here:
🔹 AHA: bit.ly/2025Extension
🔹 ReSS: bit.ly/ReSSExtension
@ahascience.bsky.social #CardioSky
Reposted by Harriette Van Spall MD MPH 🇨🇦
🚨 Missed early registration? No problem.
You can still sign up for RISE @ ESC Congress 2025, the essential event for women in cardiology.
📍 Madrid | 🗓️ Aug 28
🎯 Leadership on the Global Stage
Register now 👉 rise.womenasone.org
#LetsRISE2025 #ESCCongress #WCCardio #CardioSky #WIC
You can still sign up for RISE @ ESC Congress 2025, the essential event for women in cardiology.
📍 Madrid | 🗓️ Aug 28
🎯 Leadership on the Global Stage
Register now 👉 rise.womenasone.org
#LetsRISE2025 #ESCCongress #WCCardio #CardioSky #WIC
June 3, 2025 at 1:30 PM
🚨 Missed early registration? No problem.
You can still sign up for RISE @ ESC Congress 2025, the essential event for women in cardiology.
📍 Madrid | 🗓️ Aug 28
🎯 Leadership on the Global Stage
Register now 👉 rise.womenasone.org
#LetsRISE2025 #ESCCongress #WCCardio #CardioSky #WIC
You can still sign up for RISE @ ESC Congress 2025, the essential event for women in cardiology.
📍 Madrid | 🗓️ Aug 28
🎯 Leadership on the Global Stage
Register now 👉 rise.womenasone.org
#LetsRISE2025 #ESCCongress #WCCardio #CardioSky #WIC
Ship of #tolerance, created by 2000 school children in our town and displayed in #OakvilleGalleries #GairlochGardens
Such a collaborative, moving art display, with ideas communicated in a way that only kids can do.
Such a collaborative, moving art display, with ideas communicated in a way that only kids can do.
June 1, 2025 at 8:17 PM
Ship of #tolerance, created by 2000 school children in our town and displayed in #OakvilleGalleries #GairlochGardens
Such a collaborative, moving art display, with ideas communicated in a way that only kids can do.
Such a collaborative, moving art display, with ideas communicated in a way that only kids can do.
Reposted by Harriette Van Spall MD MPH 🇨🇦
“The true north is indeed, strong and free”
A balanced and appropriate speech from the throne on this historical day. Climate change and biodiversity were woven into this speech alongside, not mentioning by name he who shall not be named.
m.youtube.com/watch?v=FCzk...
A balanced and appropriate speech from the throne on this historical day. Climate change and biodiversity were woven into this speech alongside, not mentioning by name he who shall not be named.
m.youtube.com/watch?v=FCzk...
LIVE: King Charles presents the speech from the throne in Ottawa | CTV News Special Coverage
YouTube video by CTV News
m.youtube.com
May 27, 2025 at 4:08 PM
“The true north is indeed, strong and free”
A balanced and appropriate speech from the throne on this historical day. Climate change and biodiversity were woven into this speech alongside, not mentioning by name he who shall not be named.
m.youtube.com/watch?v=FCzk...
A balanced and appropriate speech from the throne on this historical day. Climate change and biodiversity were woven into this speech alongside, not mentioning by name he who shall not be named.
m.youtube.com/watch?v=FCzk...
Reposted by Harriette Van Spall MD MPH 🇨🇦
Interplay of CKD & Effects of #Tirzepatide in Patients With #HFpEF & Obesity: SUMMIT Trial
#CardioSky #NephroSky #JACC
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @dlbhattmd.bsky.social @hmkyale.bsky.social @chriskramermd.bsky.social @psatishmd.bsky.social @drmonalidesai.bsky.social
#CardioSky #NephroSky #JACC
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @dlbhattmd.bsky.social @hmkyale.bsky.social @chriskramermd.bsky.social @psatishmd.bsky.social @drmonalidesai.bsky.social
Interplay of Chronic Kidney Disease and the Effects of Tirzepatide in Patients With Heart Failure, Preserved Ejection Fraction, and Obesity: The SUMMIT Trial
www.jacc.org
May 15, 2025 at 12:54 AM
Interplay of CKD & Effects of #Tirzepatide in Patients With #HFpEF & Obesity: SUMMIT Trial
#CardioSky #NephroSky #JACC
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @dlbhattmd.bsky.social @hmkyale.bsky.social @chriskramermd.bsky.social @psatishmd.bsky.social @drmonalidesai.bsky.social
#CardioSky #NephroSky #JACC
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @dlbhattmd.bsky.social @hmkyale.bsky.social @chriskramermd.bsky.social @psatishmd.bsky.social @drmonalidesai.bsky.social
May 11, 2025 at 10:35 AM
Reposted by Harriette Van Spall MD MPH 🇨🇦
Is #Aficamten Plus #Disopyramide More Effective Than Aficamten Alone in obstructive HCM?
#CardioSky #JACCHF
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @jimjanuzzi.bsky.social @robmentz.bsky.social @hvanspall.bsky.social @vietheartpa.bsky.social @load-dependent.bsky.social
#CardioSky #JACCHF
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @jimjanuzzi.bsky.social @robmentz.bsky.social @hvanspall.bsky.social @vietheartpa.bsky.social @load-dependent.bsky.social
May 9, 2025 at 3:30 AM
Is #Aficamten Plus #Disopyramide More Effective Than Aficamten Alone in obstructive HCM?
#CardioSky #JACCHF
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @jimjanuzzi.bsky.social @robmentz.bsky.social @hvanspall.bsky.social @vietheartpa.bsky.social @load-dependent.bsky.social
#CardioSky #JACCHF
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @jimjanuzzi.bsky.social @robmentz.bsky.social @hvanspall.bsky.social @vietheartpa.bsky.social @load-dependent.bsky.social
While #health systems across🌎 are designed around #acute illnesses, 86% of yrs lived w disability & 71% yrs of life lost are from #chronic diseases
Burden of chronic dz ⬆️ in higher income countries & w age
How to move needle? See our analysis @Nature.bsky.social
rdcu.be/ek1MH
Burden of chronic dz ⬆️ in higher income countries & w age
How to move needle? See our analysis @Nature.bsky.social
rdcu.be/ek1MH
May 9, 2025 at 12:08 AM
While #health systems across🌎 are designed around #acute illnesses, 86% of yrs lived w disability & 71% yrs of life lost are from #chronic diseases
Burden of chronic dz ⬆️ in higher income countries & w age
How to move needle? See our analysis @Nature.bsky.social
rdcu.be/ek1MH
Burden of chronic dz ⬆️ in higher income countries & w age
How to move needle? See our analysis @Nature.bsky.social
rdcu.be/ek1MH
Reposted by Harriette Van Spall MD MPH 🇨🇦
📢 #CardioSky #MedSky #NephSky join us👇for our @ahascience.bsky.social #HTNImpact webinar!
🌟Faculty @jordybc.bsky.social
@daichishimbo.bsky.social + more provide insights on #BP
Timely @amjhypertension.bsky.social State of Art Review
#AI to improve #BP Control
academic.oup.com/ajh/article-ab…
🌟Faculty @jordybc.bsky.social
@daichishimbo.bsky.social + more provide insights on #BP
Timely @amjhypertension.bsky.social State of Art Review
#AI to improve #BP Control
academic.oup.com/ajh/article-ab…
May 5, 2025 at 5:33 AM
📢 #CardioSky #MedSky #NephSky join us👇for our @ahascience.bsky.social #HTNImpact webinar!
🌟Faculty @jordybc.bsky.social
@daichishimbo.bsky.social + more provide insights on #BP
Timely @amjhypertension.bsky.social State of Art Review
#AI to improve #BP Control
academic.oup.com/ajh/article-ab…
🌟Faculty @jordybc.bsky.social
@daichishimbo.bsky.social + more provide insights on #BP
Timely @amjhypertension.bsky.social State of Art Review
#AI to improve #BP Control
academic.oup.com/ajh/article-ab…