Michael Hadley
@hadleymd.bsky.social
System Director, Advanced Cardiac Imaging, Northwell Health
not medical advice; views are my own; retweets are not endorsements
not medical advice; views are my own; retweets are not endorsements
🚨 New AHA statement on NOCA from @CardioMDPhD @lesleejshaw and others.
👉 AI plaque analysis improves risk discrimination and changes downstream management.
🚀 @NorthwellHealth will be studying this as we prepare to roll out Plaque Analysis!
#CardioSky
www.ahajournals.org/doi/10.1161/...
👉 AI plaque analysis improves risk discrimination and changes downstream management.
🚀 @NorthwellHealth will be studying this as we prepare to roll out Plaque Analysis!
#CardioSky
www.ahajournals.org/doi/10.1161/...
November 11, 2025 at 11:00 PM
🚨 New AHA statement on NOCA from @CardioMDPhD @lesleejshaw and others.
👉 AI plaque analysis improves risk discrimination and changes downstream management.
🚀 @NorthwellHealth will be studying this as we prepare to roll out Plaque Analysis!
#CardioSky
www.ahajournals.org/doi/10.1161/...
👉 AI plaque analysis improves risk discrimination and changes downstream management.
🚀 @NorthwellHealth will be studying this as we prepare to roll out Plaque Analysis!
#CardioSky
www.ahajournals.org/doi/10.1161/...
We’re doing CT before most TAVRs, but we’re only cashing in on the “planning” part. This review argues we should be squeezing the rest of the dataset for prognosis and longitudinal care.
www.journalofcardiovascularct.com/article/S193...
What else is sitting on those scans? 👇
www.journalofcardiovascularct.com/article/S193...
What else is sitting on those scans? 👇
October 30, 2025 at 11:33 PM
We’re doing CT before most TAVRs, but we’re only cashing in on the “planning” part. This review argues we should be squeezing the rest of the dataset for prognosis and longitudinal care.
www.journalofcardiovascularct.com/article/S193...
What else is sitting on those scans? 👇
www.journalofcardiovascularct.com/article/S193...
What else is sitting on those scans? 👇
💥 Masterful review of the literature on CT-FFR in @journalCCT
www.journalofcardiovascularct.com/article/S193...
#CCTA + #CTFFR = anatomy + physiology in one stop 🚀
Growing evidence to look at the translesional ΔFFR, not just the distal FFR value 🔺
@PRodriguezMD #cardioSky #CAD #SCCT
www.journalofcardiovascularct.com/article/S193...
#CCTA + #CTFFR = anatomy + physiology in one stop 🚀
Growing evidence to look at the translesional ΔFFR, not just the distal FFR value 🔺
@PRodriguezMD #cardioSky #CAD #SCCT
October 29, 2025 at 11:32 PM
💥 Masterful review of the literature on CT-FFR in @journalCCT
www.journalofcardiovascularct.com/article/S193...
#CCTA + #CTFFR = anatomy + physiology in one stop 🚀
Growing evidence to look at the translesional ΔFFR, not just the distal FFR value 🔺
@PRodriguezMD #cardioSky #CAD #SCCT
www.journalofcardiovascularct.com/article/S193...
#CCTA + #CTFFR = anatomy + physiology in one stop 🚀
Growing evidence to look at the translesional ΔFFR, not just the distal FFR value 🔺
@PRodriguezMD #cardioSky #CAD #SCCT
🤔 Thought-provoking piece in @CircAHA from Kole & Joshi
🫀 A growing group of patients with subclinical atherosclerosis falls in between traditional "primary" and "secondary" prevention. I've heard of "prevention 1.5" or "plaque-informed prevention." How about the following classification system?👇
🫀 A growing group of patients with subclinical atherosclerosis falls in between traditional "primary" and "secondary" prevention. I've heard of "prevention 1.5" or "plaque-informed prevention." How about the following classification system?👇
October 27, 2025 at 10:21 PM
🤔 Thought-provoking piece in @CircAHA from Kole & Joshi
🫀 A growing group of patients with subclinical atherosclerosis falls in between traditional "primary" and "secondary" prevention. I've heard of "prevention 1.5" or "plaque-informed prevention." How about the following classification system?👇
🫀 A growing group of patients with subclinical atherosclerosis falls in between traditional "primary" and "secondary" prevention. I've heard of "prevention 1.5" or "plaque-informed prevention." How about the following classification system?👇
💥 Just out in #JACC CVI: State-of-the-Art on Photon-Counting CT
👇 Why this technology is a game-changer:
☢️ Better for patients: ⬇️ radiation and ⬇️ contrast
😅 Better for readers: spatial rez of 0.1mm + ⬇️ blooming = stents and calcified plaques are clearer than ever before
👇 Why this technology is a game-changer:
☢️ Better for patients: ⬇️ radiation and ⬇️ contrast
😅 Better for readers: spatial rez of 0.1mm + ⬇️ blooming = stents and calcified plaques are clearer than ever before
October 24, 2025 at 10:50 PM
💥 Just out in #JACC CVI: State-of-the-Art on Photon-Counting CT
👇 Why this technology is a game-changer:
☢️ Better for patients: ⬇️ radiation and ⬇️ contrast
😅 Better for readers: spatial rez of 0.1mm + ⬇️ blooming = stents and calcified plaques are clearer than ever before
👇 Why this technology is a game-changer:
☢️ Better for patients: ⬇️ radiation and ⬇️ contrast
😅 Better for readers: spatial rez of 0.1mm + ⬇️ blooming = stents and calcified plaques are clearer than ever before
✨ Beautiful #CMR pictures. Young patient with new chest pain. SSFP, T2W, and LGE.
#NorthwellHealth #cardiosky
#NorthwellHealth #cardiosky
October 21, 2025 at 10:00 PM
✨ Beautiful #CMR pictures. Young patient with new chest pain. SSFP, T2W, and LGE.
#NorthwellHealth #cardiosky
#NorthwellHealth #cardiosky
🪦 Ischemic heart disease remains the #1 cause of death worldwide
💥 That's 8.9M premature deaths or 136M years of life lost in 2023 alone
💊 We need a better strategy to detect and prevent ischemic heart disease
👏 Thanks to GBD for another incredible report: www.thelancet.com/journals/lan...
#CCTA
💥 That's 8.9M premature deaths or 136M years of life lost in 2023 alone
💊 We need a better strategy to detect and prevent ischemic heart disease
👏 Thanks to GBD for another incredible report: www.thelancet.com/journals/lan...
#CCTA
October 14, 2025 at 11:02 PM
🪦 Ischemic heart disease remains the #1 cause of death worldwide
💥 That's 8.9M premature deaths or 136M years of life lost in 2023 alone
💊 We need a better strategy to detect and prevent ischemic heart disease
👏 Thanks to GBD for another incredible report: www.thelancet.com/journals/lan...
#CCTA
💥 That's 8.9M premature deaths or 136M years of life lost in 2023 alone
💊 We need a better strategy to detect and prevent ischemic heart disease
👏 Thanks to GBD for another incredible report: www.thelancet.com/journals/lan...
#CCTA
💥 As coronary CTA volumes increase, we must keep radiation exposures as low as reasonably achievable.
☢️ AHA/ACC/SCCT recommend a goal of median CCTA dose ≤4 mSv, which has been achieved in multicenter trials without compromising quality.
☢️ AHA/ACC/SCCT recommend a goal of median CCTA dose ≤4 mSv, which has been achieved in multicenter trials without compromising quality.
October 14, 2025 at 10:01 PM
💥 As coronary CTA volumes increase, we must keep radiation exposures as low as reasonably achievable.
☢️ AHA/ACC/SCCT recommend a goal of median CCTA dose ≤4 mSv, which has been achieved in multicenter trials without compromising quality.
☢️ AHA/ACC/SCCT recommend a goal of median CCTA dose ≤4 mSv, which has been achieved in multicenter trials without compromising quality.
💥 Photon-counting detector CT offers good diagnostic accuracy for detecting ISR, overcoming artifacts that have plagued prior generations of scanners.
🔬 In a blinded study of 283 stented lesions, PCD-CT, as compared to cath, demonstrated NPV of 96.4% and accuracy of 88.9% for ISR ≥50%.
🔬 In a blinded study of 283 stented lesions, PCD-CT, as compared to cath, demonstrated NPV of 96.4% and accuracy of 88.9% for ISR ≥50%.
October 9, 2025 at 11:33 PM
💥 Photon-counting detector CT offers good diagnostic accuracy for detecting ISR, overcoming artifacts that have plagued prior generations of scanners.
🔬 In a blinded study of 283 stented lesions, PCD-CT, as compared to cath, demonstrated NPV of 96.4% and accuracy of 88.9% for ISR ≥50%.
🔬 In a blinded study of 283 stented lesions, PCD-CT, as compared to cath, demonstrated NPV of 96.4% and accuracy of 88.9% for ISR ≥50%.
🧲 #CMR can identify cardiac allograft vasculopathy effectively and non-invasively.
🔬 In this study of 110 patients s/p heart transplant, quant myocardial perfusion reserve <2.2 had NPV 100% and AUC 0.88 for significant CAV, as compared to cath. doi.org/10.1093/ehjc...
@SCMR @EHJ #CardioSky
🔬 In this study of 110 patients s/p heart transplant, quant myocardial perfusion reserve <2.2 had NPV 100% and AUC 0.88 for significant CAV, as compared to cath. doi.org/10.1093/ehjc...
@SCMR @EHJ #CardioSky
October 8, 2025 at 11:32 PM
🧲 #CMR can identify cardiac allograft vasculopathy effectively and non-invasively.
🔬 In this study of 110 patients s/p heart transplant, quant myocardial perfusion reserve <2.2 had NPV 100% and AUC 0.88 for significant CAV, as compared to cath. doi.org/10.1093/ehjc...
@SCMR @EHJ #CardioSky
🔬 In this study of 110 patients s/p heart transplant, quant myocardial perfusion reserve <2.2 had NPV 100% and AUC 0.88 for significant CAV, as compared to cath. doi.org/10.1093/ehjc...
@SCMR @EHJ #CardioSky
💫 #CMR is useful for predicting SCD in NICM.
📊 DERIVATE 2.0 provides better risk classification, incorporating gender, LVEF, and amount/location of #LGE.
👉 Let's look beyond LVEF alone to determine which NICM patients get ICD.
Full text: doi.org/10.1093/ehjc...
#CMR @SCMR #cardiosky
📊 DERIVATE 2.0 provides better risk classification, incorporating gender, LVEF, and amount/location of #LGE.
👉 Let's look beyond LVEF alone to determine which NICM patients get ICD.
Full text: doi.org/10.1093/ehjc...
#CMR @SCMR #cardiosky
Redefining the risk of major arrhythmic events in non-ischaemic cardiomyopathy: insights from the DERIVATE-NICM study
AbstractAims. Selection of the patients for implantable cardioverter defibrillator primary prevention therapy in non-ischaemic cardiomyopathy (NICM) needs
doi.org
October 7, 2025 at 11:02 PM
💫 #CMR is useful for predicting SCD in NICM.
📊 DERIVATE 2.0 provides better risk classification, incorporating gender, LVEF, and amount/location of #LGE.
👉 Let's look beyond LVEF alone to determine which NICM patients get ICD.
Full text: doi.org/10.1093/ehjc...
#CMR @SCMR #cardiosky
📊 DERIVATE 2.0 provides better risk classification, incorporating gender, LVEF, and amount/location of #LGE.
👉 Let's look beyond LVEF alone to determine which NICM patients get ICD.
Full text: doi.org/10.1093/ehjc...
#CMR @SCMR #cardiosky
🚨 Preventing first heart attacks may need a rethink.
🔬 In this massive study of 4.6 million people with their first heart attack:
--18% had no standard modifiable risk factors
--51% had no warning symptoms beforehand
--63% weren't on preventive meds (only 22% on statin)
🔬 In this massive study of 4.6 million people with their first heart attack:
--18% had no standard modifiable risk factors
--51% had no warning symptoms beforehand
--63% weren't on preventive meds (only 22% on statin)
October 7, 2025 at 10:00 PM
🚨 Preventing first heart attacks may need a rethink.
🔬 In this massive study of 4.6 million people with their first heart attack:
--18% had no standard modifiable risk factors
--51% had no warning symptoms beforehand
--63% weren't on preventive meds (only 22% on statin)
🔬 In this massive study of 4.6 million people with their first heart attack:
--18% had no standard modifiable risk factors
--51% had no warning symptoms beforehand
--63% weren't on preventive meds (only 22% on statin)
💥 The SCOT-HEART 2 trail could transform how we identify those at risk of heart attacks.
🔬 Trial randomizes asymptomatic patients ages 40-70 with ≥1 risk factors to either #CoronaryCTA or standard care, with appropriate therapies, looking for primary outcome of heart attack.
🔬 Trial randomizes asymptomatic patients ages 40-70 with ≥1 risk factors to either #CoronaryCTA or standard care, with appropriate therapies, looking for primary outcome of heart attack.
October 7, 2025 at 12:45 AM
💥 The SCOT-HEART 2 trail could transform how we identify those at risk of heart attacks.
🔬 Trial randomizes asymptomatic patients ages 40-70 with ≥1 risk factors to either #CoronaryCTA or standard care, with appropriate therapies, looking for primary outcome of heart attack.
🔬 Trial randomizes asymptomatic patients ages 40-70 with ≥1 risk factors to either #CoronaryCTA or standard care, with appropriate therapies, looking for primary outcome of heart attack.
Superb article summarizing the knowns and unknowns of broken heart syndrome (Takotsubo syndrome).💔
Yes, emotions can stun the heart. A fascinating tale of mind–heart biology. Full text here: www.nature.com/articles/s41...
@elmir1omerovic #cardiotwitter
Yes, emotions can stun the heart. A fascinating tale of mind–heart biology. Full text here: www.nature.com/articles/s41...
@elmir1omerovic #cardiotwitter
October 6, 2025 at 10:21 PM
Superb article summarizing the knowns and unknowns of broken heart syndrome (Takotsubo syndrome).💔
Yes, emotions can stun the heart. A fascinating tale of mind–heart biology. Full text here: www.nature.com/articles/s41...
@elmir1omerovic #cardiotwitter
Yes, emotions can stun the heart. A fascinating tale of mind–heart biology. Full text here: www.nature.com/articles/s41...
@elmir1omerovic #cardiotwitter
🚨Late-presenting ostial LAD STEMI, imaged 7-days later with #CMR. Here's the #LGE.
❓Would you call thrombus? Microvascular obstruction? Intramyocardial hemorrhage? Or a combination of these?
@NorthwellHealth @LenoxHill #cardiotwitter
❓Would you call thrombus? Microvascular obstruction? Intramyocardial hemorrhage? Or a combination of these?
@NorthwellHealth @LenoxHill #cardiotwitter
October 3, 2025 at 10:50 PM
🚨Late-presenting ostial LAD STEMI, imaged 7-days later with #CMR. Here's the #LGE.
❓Would you call thrombus? Microvascular obstruction? Intramyocardial hemorrhage? Or a combination of these?
@NorthwellHealth @LenoxHill #cardiotwitter
❓Would you call thrombus? Microvascular obstruction? Intramyocardial hemorrhage? Or a combination of these?
@NorthwellHealth @LenoxHill #cardiotwitter
❓As Plaque Analysis roles out nationwide for #CCTA, providers are asking "How will this change clinical management?"
✔️The DECIDE registry provides one framework: Total Plaque Volume determines level of therapy.
🔬More research is needed to show impact on hard outcomes.
#cardiotwitter @NorthwellHealth
✔️The DECIDE registry provides one framework: Total Plaque Volume determines level of therapy.
🔬More research is needed to show impact on hard outcomes.
#cardiotwitter @NorthwellHealth
October 3, 2025 at 12:41 AM
❓As Plaque Analysis roles out nationwide for #CCTA, providers are asking "How will this change clinical management?"
✔️The DECIDE registry provides one framework: Total Plaque Volume determines level of therapy.
🔬More research is needed to show impact on hard outcomes.
#cardiotwitter @NorthwellHealth
✔️The DECIDE registry provides one framework: Total Plaque Volume determines level of therapy.
🔬More research is needed to show impact on hard outcomes.
#cardiotwitter @NorthwellHealth
This #CMR shows anteroapical intramyocardial enhancement.
Taking the image as a whole, what's one potential explanation?
#cardiotwitter #CardiacImaging
Taking the image as a whole, what's one potential explanation?
#cardiotwitter #CardiacImaging
October 2, 2025 at 11:33 PM
This #CMR shows anteroapical intramyocardial enhancement.
Taking the image as a whole, what's one potential explanation?
#cardiotwitter #CardiacImaging
Taking the image as a whole, what's one potential explanation?
#cardiotwitter #CardiacImaging
Important multicenter study in #EHJ
#CMR outperforms societal recs for ICD placement in cardiac sarcoidosis
📈AUC=0.86 for 5-yr risk of fatal/life-threatening arrhythmias
⚡Highest risk = abnl LVEF + LGE that is multifocal, septal, subepicardial, or involves RV freewall
buff.ly/Nc2upbU
#cardiotwitter
#CMR outperforms societal recs for ICD placement in cardiac sarcoidosis
📈AUC=0.86 for 5-yr risk of fatal/life-threatening arrhythmias
⚡Highest risk = abnl LVEF + LGE that is multifocal, septal, subepicardial, or involves RV freewall
buff.ly/Nc2upbU
#cardiotwitter
September 30, 2025 at 11:02 PM
Important multicenter study in #EHJ
#CMR outperforms societal recs for ICD placement in cardiac sarcoidosis
📈AUC=0.86 for 5-yr risk of fatal/life-threatening arrhythmias
⚡Highest risk = abnl LVEF + LGE that is multifocal, septal, subepicardial, or involves RV freewall
buff.ly/Nc2upbU
#cardiotwitter
#CMR outperforms societal recs for ICD placement in cardiac sarcoidosis
📈AUC=0.86 for 5-yr risk of fatal/life-threatening arrhythmias
⚡Highest risk = abnl LVEF + LGE that is multifocal, septal, subepicardial, or involves RV freewall
buff.ly/Nc2upbU
#cardiotwitter
Nice review in #EHJ on LGE and SCD by @DrMarchlinski et al. buff.ly/GeU589P
🫀Good reminder that in CAD: LGE predicts SCD better than LVEF; absence of LGE has a high NPV for SCD
🔭Looking ahead, digital twins made from CMR data undergo virtual inductions to uncover arrhythmia risk
#cardiotwitter
🫀Good reminder that in CAD: LGE predicts SCD better than LVEF; absence of LGE has a high NPV for SCD
🔭Looking ahead, digital twins made from CMR data undergo virtual inductions to uncover arrhythmia risk
#cardiotwitter
September 30, 2025 at 10:01 PM
Nice review in #EHJ on LGE and SCD by @DrMarchlinski et al. buff.ly/GeU589P
🫀Good reminder that in CAD: LGE predicts SCD better than LVEF; absence of LGE has a high NPV for SCD
🔭Looking ahead, digital twins made from CMR data undergo virtual inductions to uncover arrhythmia risk
#cardiotwitter
🫀Good reminder that in CAD: LGE predicts SCD better than LVEF; absence of LGE has a high NPV for SCD
🔭Looking ahead, digital twins made from CMR data undergo virtual inductions to uncover arrhythmia risk
#cardiotwitter