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Chetan Shenoy

@cshenoy.bsky.social
844 followers 446 following 58 posts

Cardiologist and researcher, in cardiovascular magnetic resonance imaging, at the University of Minnesota

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Chetan Shenoy @cshenoy.bsky.social · 05/04/2026
For reference, here's our work on CMR phenotyping: pubmed.ncbi.nlm.nih.gov/40400457/ pubmed.ncbi.nlm.nih.gov/36103165/ pubmed.ncbi.nlm.nih.gov/31954639/ pubmed.ncbi.nlm.nih.gov/31070111/ #WhyCMR #sarcoidosis #cardiacsarcoidosis #CardioSky
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Chetan Shenoy @cshenoy.bsky.social · 05/04/2026
They even extended our findings. CMR phenotyping had much greater interobserver reproducibility than LGE quantification. CMR phenotyping was 5-fold faster than LGE quantification. FDG-PET added no incremental predictive value beyond CMR phenotyping.
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Chetan Shenoy @cshenoy.bsky.social · 05/04/2026
In a prospective cohort of 206 patients (CHASM-CS), they found that ALL ventricular arrhythmia events occurred exclusively in patients with the high-risk (pathology-frequent) LGE phenotype. There were NO events in the low-risk patients.
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Chetan Shenoy @cshenoy.bsky.social · 05/04/2026
In science, successful replication is the ultimate quality check! This is a highlight for our research group—David Birnie's group (one of the biggest names in cardiac sarcoidosis) just independently replicated our CMR phenotyping work! doi.org/10.1093/ehji... #EHJIMP #CardioSky #sarcoidosis
This study confirms, for the first time in a fully prospective cohort, the prognostic importance of CMR phenotyping in cardiac sarcoidosis. The high-risk CMR phenotype had 100% NPV, indicating the absence of VA events among patients without the high-risk phenotype. LGE phenotyping showed much higher interobserver reproducibility than LGE quantification and was five-fold faster.
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Lars Mølgaard Saxhaug @load-dependent.eurosky.social · 01/04/2026
Related: you’ve definitely made me more conscious about not calling something «ischemic cardiomyopathy» just because there is coronary disease as it might just be a bistander.
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Chetan Shenoy @cshenoy.bsky.social · 01/04/2026
The sensitivity of CMR for acute non-Q-wave MIs was 91% in this multicenter study: www.ahajournals.org/doi/10.1161/... So yes, that's one part of it, but only a small part.
Sensitivity and localization accuracy of CMR for acute and chronic MI.
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Parag Bawaskar @paragbawaskar.bsky.social · 01/04/2026
🧵 Are OCT and CMR really "complementary" in MINOCA? Or are they telling us conflicting stories? Reynolds et al (Circulation 2026) combined both modalities in 284 MINOCA patients. The results raise more questions than answers. 📄 www.ahajournals.org/doi/abs/10.1... 1/7
ahajournals.org
American Heart Association Journals
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Parag Bawaskar @paragbawaskar.bsky.social · 11/11/2023
Have you ever wondered whether your patient with CAD and cardiomyopathy truly has ischemic cardiomyopathy, or whether the CAD is a “bystander”? You might be interested in our paper now out in Circulation #simultaneouspublication #AHA23 #cardiosky #Medsky #WhyCMR
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Chetan Shenoy @cshenoy.bsky.social · 06/10/2025
academic.oup.com/eurheartj/ad... #CardioSky #WhyCMR #Medsky
Response to a Letter to the Editor in Response to the Original Article "Prediction of ventricular arrhythmic outcomes in suspected cardiac sarcoidosis: a comparison of cardiovascular magnetic resonance phenotyping vs. societal recommendations for implantable cardioverter-defibrillator placement" published in the European Heart Journal.
Response to a Letter to the Editor in Response to the Original Article "Prediction of ventricular arrhythmic outcomes in suspected cardiac sarcoidosis: a comparison of cardiovascular magnetic resonance phenotyping vs. societal recommendations for implantable cardioverter-defibrillator placement" published in the European Heart Journal.
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Chetan Shenoy @cshenoy.bsky.social · 02/10/2025
Thanks for the shoutout! A minor clarification - the high risk phenotype does not even incorporate an abnormal LVEF!!!!
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Chetan Shenoy @cshenoy.bsky.social · 02/10/2025
#Cardiosky
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Michael Hadley @hadleymd.bsky.social · 01/10/2025
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
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Kardioklick @kardioklick.bsky.social · 19/07/2025
Must-watch lecture on cardiomyopathy and CMR by @cshenoy.bsky.social „more often than what is the EF we should ask the why?“ youtube.com/live/9or85hk...
youtube.com
Identifying the Cause of Cardiomyopathy Using CMR (Chetan Shenoy, MBBS, MS)
YouTube video by Houston Methodist DeBakey CV Education
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Chetan Shenoy @cshenoy.bsky.social · 17/07/2025
Here's our paper in Circulation on the topic - bsky.app/profile/para...
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Chetan Shenoy @cshenoy.bsky.social · 17/07/2025
Here's my talk on how to identify the etiology of cardiomyopathy using CMR - www.youtube.com/watch?v=9or8...
youtube.com
Identifying the Cause of Cardiomyopathy Using CMR (Chetan Shenoy, MBBS, MS)
YouTube video by Houston Methodist DeBakey CV Education
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Chetan Shenoy @cshenoy.bsky.social · 17/07/2025
In my opinion, both trials are fundamentally useless. What is ischemic cardiomyopathy? Both trials defined ischemic cardiomyopathy as LV dysfunction + obstructive CAD. This does not identify the etiology of cardiomyopathy as ischemic, but identifies the presence of CAD. Two different things!!!
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Chetan Shenoy @cshenoy.bsky.social · 13/07/2025
I don't exactly know. But... 1 - There was no real change in ECV in Explorer HCM (PMID 33190524). 2 - An increase in ECV is not necessarily bad. It increases after AVR (PMID 29471937). 3 - The amount of dead myocardium will never decrease. So, a "decrease in LGE" does not mean less badness.
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Chetan Shenoy @cshenoy.bsky.social · 13/07/2025
Interesting. The ECV increased 1.1% (25 min) to 2.2% (5 min), which is difficult to explain. But it explains why LGE was less; it was quantified as the amount of myocardium 6SD brighter than "remote". LGE amount will be less if the remote myocardium is brighter after mavacamten than at baseline.
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Chetan Shenoy @cshenoy.bsky.social · 20/06/2025
#cardiosky #medsky #WhyCMR
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TCTMD @tctmd.bsky.social · 19/06/2025
“CMR phenotyping can be used immediately in clinical practice to identify patients with suspected cardiac sarcoidosis who would benefit from a primary prevention ICD," said Chetan Shenoy, MD. Read more about how this can prevent life-threatening ventricular arrhythmias: www.tctmd.com/news/cmr-may...
tctmd.com
CMR May Improve Assessment of ICD Need in Cardiac Sarcoidosis
The imaging was better than societal recommendations at discriminating long-term risk of ventricular arrhythmias.
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Chetan Shenoy @cshenoy.bsky.social · 11/06/2025
Thank you, @toddneale.bsky.social, for your excellent reporting on our EHJ paper! @tctmd.bsky.social @escardio.bsky.social @paragbawaskar.bsky.social
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Pablo Perez Lopez @pabloplopez.bsky.social · 10/06/2025
#EHJCVI 🫀 What's the value of ventricular strain in systemic sclerosis? 📉 Both LVGLS and RVGLS are linked to death or MACE, unlike LVEF and RVEF 🧠 How does strain compare to traditional prognostic markers? 🔍 Read more 👉 doi.org/10.1093/ehjc... #CardioSky @jgrapsa.bsky.social @escardio.bsky.social
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Chetan Shenoy @cshenoy.bsky.social · 27/05/2025
Prediction of ventricular arrhythmic outcomes in suspected cardiac sarcoidosis: a comparison of cardiovascular magnetic resonance phenotyping vs. societal recommendations for implantable cardioverter-defibrillator placement academic.oup.com/eurheartj/ad... #Cardiosky #WhyCMR #Epeeps #Medsky
In patients with suspected cardiac sarcoidosis, CMR phenotyping showed greater discriminative accuracy than societal recommendations for predicting fatal or life-threatening ventricular arrhythmias, suggesting that it may be more effective at identifying candidates for primary prevention ICDs.
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Kardioklick @kardioklick.bsky.social · 25/05/2025
Cardiac sarcoidosis is a undervalued disease and difficult to diagnose and treat, considering potential life-threatening arrhythmias. Nice to have some more guidance. #cardiosky.
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Chetan Shenoy @cshenoy.bsky.social · 25/05/2025
VT and VF/cardiac arrest - correct. That would be secondary prevention. AV block is a Class IIa indication for an ICD in the guidelines for cardiac sarcoidosis. But who has cardiac sarcoidosis is not always clear. What if patient has extracardiac sarcoidosis and complete AV block but no LGE? 🤔
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Chetan Shenoy @cshenoy.bsky.social · 24/05/2025
academic.oup.com/eurheartj/ad... @escardio.bsky.social #Cardiosky #WhyCMR #Epeeps #Medsky Please DM me if you would like a full-text PDF of the paper!
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Chetan Shenoy @cshenoy.bsky.social · 23/04/2025
pmc.ncbi.nlm.nih.gov/articles/PMC... #HCM #CardioSky #Cardiomyopathy
pmc.ncbi.nlm.nih.gov
Comparisons against baseline within randomised groups are often used and can be highly misleading
In randomised trials, rather than comparing randomised groups directly some researchers carry out a significance test comparing a baseline with a final measurement separately in each group. We give se...
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Chetan Shenoy @cshenoy.bsky.social · 21/03/2025
In patients with suspected cardiac sarcoidosis, cardiac FDG-PET is recommended after a normal CMR if there is a high clinical suspicion. What are the data supporting this recommendation? #CardioSky #MedSky #Sarcoidosis
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Martin Ugander @mugander.bsky.social · 23/03/2025
Query sarcoid, normal #WhyCMR, so then should we do FDG-PET? Not much benefit.
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Chetan Shenoy @cshenoy.bsky.social · 23/03/2025
We discuss this in our editorial: academic.oup.com/ehjcimaging/...
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Chetan Shenoy @cshenoy.bsky.social · 21/03/2025
Read our accompanying editorial for our thoughts on the important paper – academic.oup.com/ehjcimaging/... @paragbawaskar.bsky.social #CardioSky #MedSky #Sarcoidosis
academic.oup.com
Cardiac FDG-PET imaging in patients with suspected cardiac sarcoidosis and no late gadolinium enhancement on cardiovascular magnetic resonance imaging: the emperor has no clothes!
This editorial refers to ‘The Role of FDG PET/CT in Assessing Cardiac Sarcoidosis with No High-Risk Cardiac Features and Normal CMR’, by F. Shuduyeva et al
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Chetan Shenoy @cshenoy.bsky.social · 21/03/2025
Link to the study - academic.oup.com/ehjcimaging/... #CardioSky #MedSky #Sarcoidosis
academic.oup.com
The role of FDG-PET/CT in assessing cardiac sarcoidosis with no high-risk cardiac features and normal CMR
AbstractAims. Diagnosing cardiac sarcoidosis (CS) is challenging due to the variable presentation and the lack of consensus on optimal screening strategies
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Chetan Shenoy @cshenoy.bsky.social · 21/03/2025
A new study in EHJ - Cardiovascular Imaging describes 324 patients with normal CMR and no high-risk features who all also had FDG-PET. 21.3% had FDG uptake. Their annualized event rate was <1%, indicating that FDG-PET has little diagnostic or prognostic utility.
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Chetan Shenoy @cshenoy.bsky.social · 21/03/2025
A wealth of data indicates that patients evaluated for suspected cardiac sarcoidosis have excellent long-term outcomes if their CMR is normal, indirectly indicating that a normal CMR reliably rules out cardiac sarcoidosis.
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Chetan Shenoy @cshenoy.bsky.social · 21/03/2025
None. This recommendation is based on clinical observations that sometimes FDG-PET is positive even when a CMR is normal. Is that good enough?
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Chetan Shenoy @cshenoy.bsky.social · 21/03/2025
In patients with suspected cardiac sarcoidosis, cardiac FDG-PET is recommended after a normal CMR if there is a high clinical suspicion. What are the data supporting this recommendation? #CardioSky #MedSky #Sarcoidosis
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Chetan Shenoy @cshenoy.bsky.social · 23/01/2025
The odds of having both genetic cardiomyopathy (which is not common) and cardiac sarcoidosis (which is very rare) are extremely rare. Even in such cases, it’s simply a coincidence rather than a mechanistic link (based on what we know thus far).
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Chetan Shenoy @cshenoy.bsky.social · 23/01/2025
A patient with cardiac sarcoidosis may meet the ARVC diagnostic criteria, but that does not mean the cardiomyopathy is ARVC.
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Chetan Shenoy @cshenoy.bsky.social · 23/01/2025
A patient can have extracardiac sarcoidosis and a genetic cardiomyopathy. They may meet the cardiac sarcoidosis diagnostic criteria, but that does not mean the cardiomyopathy is cardiac sarcoidosis.
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Chetan Shenoy @cshenoy.bsky.social · 23/01/2025
In patients with extracardiac sarcoidosis, non-caseating granulomas of sarcoidosis can occur in the heart incidentally without causing cardiac sarcoidosis (myocardial damage or its clinical consequences). www.ajconline.org/article/S000...
ajconline.org
Comparison of Necropsy Findings in Patients With Sarcoidosis Dying Suddenly from Cardiac Sarcoidosis Versus Dying Suddenly from Other Causes
The clinical diagnosis of cardiac sarcoidosis can be difficult and is largely dependent on newer imaging modalities. A retrospective search of sudden cardiac deaths was performed from a reference labo...
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Chetan Shenoy @cshenoy.bsky.social · 23/01/2025
Genetic variants without phenotypic manifestations (no penetrance) are common. In a study of 61K clinical individuals, 1 in 435 had a desmosomal loss-of-function variant, but the estimated penetrance was only 6%. www.ahajournals.org/doi/10.1161/...
ahajournals.org
Prevalence and Electronic Health Record-Based Phenotype of Loss-of-Function Genetic Variants in Arrhythmogenic Right Ventricular Cardiomyopathy-Associated Genes | Circulation: Genomic and Precision Me...
Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with variants in desmosome genes. Secondary findings of pathogenic/likely pathogenic variants, primarily loss-of-functi...
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Chetan Shenoy @cshenoy.bsky.social · 23/01/2025
The conclusions assume the patients have both cardiac sarcoidosis and arrhythmogenic cardiomyopathy. But this assumption may not be valid for the following reasons…
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Chetan Shenoy @cshenoy.bsky.social · 23/01/2025
The conclusion - “Clinicians should suspect CS in genotype-positive ACM patients presenting with atrioventricular block and/or septal abnormalities. Early identification of coexisting CS and ACM is crucial for tailoring diagnostic and therapeutic strategies, including advanced imaging and biopsy.”
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Chetan Shenoy @cshenoy.bsky.social · 23/01/2025
This paper reports the coexistence of cardiac sarcoidosis and arrhythmogenic cardiomyopathy in 5 patients. heart.bmj.com/content/earl... #CardioSky #MedSky
heart.bmj.com
Coexistence of cardiac sarcoidosis and arrhythmogenic cardiomyopathy-associated genetic variants: a multicentre case-control study
Background Cardiac sarcoidosis (CS) is a chronic inflammatory disease characterised by non-caseating granulomas, while arrhythmogenic cardiomyopathy (ACM) is a genetic condition mainly affecting desmo...
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Chetan Shenoy @cshenoy.bsky.social · 05/01/2025
Examples of study patients with serial CMR images. 

Patient A had resolution of LV thrombus on the first serial CMR done 64 days after the index CMR, and no recurrence was noted on subsequent serial CMRs done 688 and 1043 days after the index CMR. 
Patient B had no resolution of LV thrombus on serial CMRs done 591, 966, and 3555 days after the index CMR. 

Patient C had resolution of LV thrombus on the first serial CMR done 86 days after the index CMR; however, a new LV thrombus was identified on the second serial CMR done 401 days after the index CMR, which had resolved again by the third serial CMR done 1336 days after the index CMR.
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Chetan Shenoy @cshenoy.bsky.social · 05/01/2025
Short-Axis LGE Images Showing Similar Septal Midmyocardial LGE in Viral Myocarditis and Genetic Cardiomyopathy.

(A) A patient with endomyocardial biopsy-proven parvovirus B19 myocarditis. Reproduced with permission from Greulich et al.

(B) A patient with cardiomyopathy and likely pathogenic variants in the desmin (DES) and transforming growth factor β 3 (TGFB3) genes. 

(C) A patient with cardiomyopathy and a pathogenic variant in the desmoplakin (DSP) gene. 

(D) A patient with cardiomyopathy and a pathogenic variant in the filamin C (FLNC) gene. 

(E) A patient with cardiomyopathy and a pathogenic variant in the lamin A/C (LMNA) gene. 

(F) A patient with cardiomyopathy and a pathogenic variant in the titin (TTN) gene.
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Sarah Hudson @sarahhudsonuk.bsky.social · 21/11/2024
Great thread on LV thrombus and embolism risk - especially if RWMA I discuss lifelong anti coagulation with my pts even if it looks resolved on echo, good to have some data to help back this up 👇
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Chetan Shenoy @cshenoy.bsky.social · 18/11/2024
The "only 2% greater than the general population" does not mean there is no room for improvement. The 10-year mortality after STEMI in that study was 31.7%, of which a third was from cardiovascular deaths.
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Chetan Shenoy @cshenoy.bsky.social · 17/11/2024
Amazing achievement by rising star and post-doc in my lab @paragbawaskar.bsky.social, winner of the prestigious 2024 Melvin Judkins Early Career Investigator Award at #AHA24!! Congratulations!!! @ahascience.bsky.social
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Lars Mølgaard Saxhaug @load-dependent.eurosky.social · 13/11/2024
It’s great that journals are coming over here, but what I have really missed after my departure from Twitter 2 years ago is this, the authors themselves presenting their works and discussing it with peers. #cardiosky #medsky #emimcc
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