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Harriette Van Spall MD MPH 🇨🇦

@hvanspall.bsky.social
716 followers 136 following 125 posts

Cardiologist, Clinical Trialist McMasterU. Heart failure, Cardiometabolic Disease, Implementation Science. Editor Circulation.

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Reposted by Harriette Van Spall MD MPH 🇨🇦
Donovan Blake @donovanwrites.bsky.social · 17/02/2026
Important work.. recognizing oral diuretic intensification as a meaningful worsening HF event could really improve how trials capture real-world risk and patient outcomes.
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 25/01/2026
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
evidence.nejm.org
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...
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 22/01/2026
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/...
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 22/01/2026
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/...
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Reposted by Harriette Van Spall MD MPH 🇨🇦
NEJM.org @nejm.org · 31/12/2025
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
Figure 2. Oral Diuretic Intensification as a Worsening Heart Failure Event in the Primary Outcome of Clinical Trials.
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 17/09/2025
#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...
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 16/08/2025
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...
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 14/06/2025
I love my outdoor #office, where work and play are fully intertwined! What does your #Saturday morning look like? #HappySeason #HomeSweetHome #JoyInWork
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 09/06/2025
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...
thelancet.com
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...
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 09/06/2025
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
t.co
https://www.nejm.org/doi/full/10.1056/NEJMoa2413258
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 08/06/2025
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...
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 08/06/2025
#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/...
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 08/06/2025
The #sun rose and put on a show just for me! #LifeOnTheLake #Sunrise #LakeMuskoka
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 07/06/2025
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?
Figure 2Figure 5
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Carolyn Thomas 🇨🇦 @heart-sisters.bsky.social · 06/06/2025
Pill splitting guide for patients who take a lot of pills... Which ones are safe to divide? myheartsisters.org/2016/12/04/p...
myheartsisters.org
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…
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 07/06/2025
#Happy season is here! #LifeOnTheLake #LakeMuskoka #Sunsets
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Women As One @womenasone.bsky.social · 03/06/2025
🚨 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
A woman sat at a table whilst having a conversation during RISE @ ESC Congress 2024. Overlain is Information about RISE @ ESC Congress 2025.
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 01/06/2025
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.
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Citizens’ Climate Lobby Canada @citizenslobbyca.bsky.social · 27/05/2025
“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...
m.youtube.com
LIVE: King Charles presents the speech from the throne in Ottawa | CTV News Special Coverage
YouTube video by CTV News
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Parham Eshtehardi MD @cardioobdoc.bsky.social · 15/05/2025
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
jacc.org
Interplay of Chronic Kidney Disease and the Effects of Tirzepatide in Patients With Heart Failure, Preserved Ejection Fraction, and Obesity: The SUMMIT Trial
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 11/05/2025
The sweetest word in the world, the one I’m most grateful to hear each day, is #mum. #MothersDay2025
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Parham Eshtehardi MD @cardioobdoc.bsky.social · 09/05/2025
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
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 09/05/2025
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
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Dr Anastasia S Mihailidou PhD FAHA FCSANZ FESC @anastasiasmihaili.bsky.social · 05/05/2025
📢 #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…
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 29/04/2025
Today, we voted to protect our #sovereignty, freedom, environment, economy, people, We voted for knowledge, alliances, respect, strength, unity We voted to care about those with less so that every kid has a chance to build #CanadaStrong #ViveLeCanada #April2025
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 28/04/2025
Canadians go to #polls today Counting on us to elect a strategic, steady leader who will protect #Canada’s - sovereignty - environment - economy - education - healthcare - global alliances Counting on us to reject politics of anger, fear, division #TrueNorth #CanadaStrong
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 24/04/2025
Happy #AdministrativeProfessionalsDay, dear Robin Thank you making magic happen in my professional life & in our program every day Thank you for being a caring friend in the truest sense of the word Thank you for being incredibly kind to our patients I’m so #grateful for you
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 23/04/2025
#ClimateChange threatens health and livelihood, commonly displacing people. Children are among the most vulnerable. www.unicef.org/stories/3-wa...
unicef.org
3 ways climate change threatens children's lives
Climate change poses significant risks to children’s health and well-being
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 21/04/2025
I voted on #EasterSunday for - A builder of #bridges, not walls - A strong #economy - Strategic international #partnerships - Environmental #sustainability - Data-informed #policy - #Education & #healthcare for all - #Respect for all Did you #vote?🇨🇦 #CanadaStrong #CanadaElection2025
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Brendon Neuen @brendonneuen.bsky.social · 21/04/2025
New in CJASN: Our meta-analysis of 66 CKD trials shows both acute & chronic GFR slope independently predict clinical outcomes Findings support 3-year total slope as the optimal surrogate endpoint for CKD trials @asnpublications.bsky.social: doi.org/10.2215/CJN....
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 20/04/2025
#Light over darkness #Hope over despair #Faith over fear #HappyEaster #Easter2025
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 19/04/2025
“Let everything you do be done with love.” - 1 Corinthians Happy Easter from my home to yours! #Easter2025
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Max Kozlov @maxkozlov.bsky.social · 18/04/2025
Per source, NIH has been instructed to hold off from issuing ALL awards to Harvard, Cornell, Columbia, Brown, and Northwestern (including med schools) Agency staff have also been instructed to not speak about this funding freeze to grantees and applicants
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 18/04/2025
Was honoured to talk to Dr Joseph Hill, EIC of Circulation @ahajournals.bsky.social about his career path, our era of medical disinformation, & power of effective scientific #communication. Brilliant, accomplished, honest, humble, he’s among the best of the best! #Publishing tinyurl.com/2sdsuk7h
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 17/04/2025
The #TarteAuChocolat was delicious, but the note was even sweeter! I never take our privilege for granted. #Cardiology #Medicine #Chocolate
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 16/04/2025
New 2025 #CONSORT guidelines for #RCT #reporting standards The 30 checklist items ensure transparent reporting, but adherence is suboptimal & only required by some journals (onlinelibrary.wiley.com/doi/10.1002/ej…) Essential for trialists + editorial/review teams!www.bmj.com/content/389/...23
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 14/04/2025
“The administration’s prescription goes beyond the power of the federal government. It violates #FirstAmendment rights and exceeds the statutory limits of the government’s #authority under Title VI.” www.harvard.edu/president/ne...
harvard.edu
The Promise of American Higher Education
No government—regardless of which party is in power—should dictate what private universities can teach, whom they can admit and hire, and which areas of study and inquiry they can pursue
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 13/04/2025
Is there a better time of day? (Featuring my favourite cup from grad school days) #5AM #SundayMorning
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 13/04/2025
#Nudges are behavioral interventions that influence decisions without restricting choices or giving incentives This 2x2 factorial #RCT will evaluate effect of 🇩🇰 nationwide electronic letter nudges delivered to people with #CKD, their GPs, or both on #GDMT www.sciencedirect.com/science/arti...
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 12/04/2025
Canadian #researchers w US federal funding must now confirm that research does not 📌include climate / environmental justice component 📌contain diversity, equity & inclusion elements 📌ascribe to “gender ideology” Some knees bend to money Others wont www.globenewswire.com/news-release...
globenewswire.com
Trump administration threatening Canadian researchers
OTTAWA, Ontario, March 18, 2025 (GLOBE NEWSWIRE) -- The Canadian Association of University Teachers (CAUT) is warning that the Trump administration is...
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Reposted by Harriette Van Spall MD MPH 🇨🇦
JACC Journals @jaccjournals.bsky.social · 11/04/2025
📢 Call for Papers: #JACCAdvances seeks submissions for a focus issue on Implementation Science & CV Learning Health Systems. Submissions may include pragmatic trials, digital infrastructure, & more. 📅 Deadline: April 15 🔗 bit.ly/43QfNcu
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 10/04/2025
Is anyone aware of any #RCT that demonstrated the efficacy of any intervention in any CVD on the primary #endpoint of “days alive and out of the hospital”? If so, please share. (And what #breakfast are you having to fuel the clinical workday?) #DAOH #TrialDesign
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Reposted by Harriette Van Spall MD MPH 🇨🇦
Henry Han @hancardiomd.bsky.social · 10/04/2025
This State-of-the-Art Review addresses the current understanding on the pathophysiological link between #CVD and #CKD, clinical implications and challenges academic.oup.com/eurheartj/ad... #CardioSky @escardio.bsky.social @cardioobdoc.bsky.social @hvanspall.bsky.social @novitham.bsky.social
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 10/04/2025
📌E.g. of #Coanda effect: jet passing through an orifice that abuts a curved surface will deviate from ipath & adhere to surface 📌Due to entrainment of fluid from downstream chamber into jet, creating low P area around jet margin (towards which jet moves) #EchoFirst #MR #Flail
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 09/04/2025
When you take a break from hospital clinical services to meet @vkittipibul who is visiting @PHRIresearch as part of @DCRIFellows exchange program..
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 09/04/2025
Wonder what makes #healthcare systems successful? Read this #GlobalRounds 📑 on #Denmark led by Tor Biering-Sorensen in #Circulation @AHAjournals.bsky.social Economically just society Universal healthcare Strong primary care for every person Enviable clinical & research infrastructure #Cardiosky
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 08/04/2025
Troubling evidence that inadequate exploration of reversible #suffering – lack of access to medical services, poverty, loneliness, and feelings of being a burden – have driven some Canadians to choose #MAiD, now provided with same-day service. macdonaldlaurier.ca/rushing-to-d...
macdonaldlaurier.ca
Rushing to death in Canada’s MAiD regime: Ramona Coelho for Inside Policy | Macdonald-Laurier Institute
New reports from Ontario’s MAiD Death Review Committee (MDRC) raise questions about whether proper assessments, thorough exploration of suffering, and informed consent were consistently practised by M...
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Harriette Van Spall MD MPH 🇨🇦 @hvanspall.bsky.social · 07/04/2025
A 💫 finding of run-in phase of #ADVANCE-HTN Ph2b #RCT: 64% ppl with “uncontrolled” #hypertension got BP control in 3 wks through standard genericTx #Aldosterone synthase blocker #lorundrostat 50 mg ⬇️BP at 8wks (w ⬆️K). 100mg: no evidence of added benefit #ACC25 www.radcliffecvrm.com/video-index/...
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