Dr RR Baliga's "Got Knowledge Doc" Podkast

🚨 AI vs Sudden Cardiac Death in HCM 🫀🤖

Exciting new study published in Nature Cardiovascular Research showcases MAARS, a multimodal AI model that dramatically improves risk prediction for sudden arrhythmic death in hypertrophic cardiomyopathy patients.

📊 MAARS outperformed current guidelines with AUROC of 0.89 (internal) and 0.81 (external)

🧠 Integrated data: LGE-CMR 🧲, EHR 📋, and echo/CMR reports 💻

⚖️ Demonstrated fairness across age and sex subgroups

🔍 Transparent predictions via Shapley values and attention heatmaps

A leap toward personalized, preventative cardiology 💡🩺

#AI #Cardiology #HypertrophicCardiomyopathy #SuddenCardiacDeath #MachineLearning #PrecisionMedicine #Digit...

“Vax to the Future: Cancer Immunity Revolution 🧬💉”

Cancer vaccines are no longer a promise — they’re a precision revolution. From HBV and HPV to cutting-edge mRNA-based neoantigen vaccines, we explore how tumor sequencing + AI + immune checkpoint inhibitors are reshaping oncology.

📈 Real data from trials in melanoma, ccRCC, and pancreatic cancer

⚔️ PD-1 inhibitors meet targeted T cells

🌍 A safer, scalable future for cancer care

🎧 Tune in to Got Knowledge Doc as we decode this game-changing viewpoint from JCI — “Vaccines in Cancer Treatment and Prevention: The Time is Now.”

🚨 New Findings on Aspartame & Heart Health! 🍬🫀

A groundbreaking study in Cell Metabolism reveals how aspartame, a common artificial sweetener, may worsen atherosclerosis via an insulin-triggered inflammatory pathway involving the CX3CL1-CX3CR1 axis.

🧪 Key insights from mice and monkeys:

– Aspartame spikes insulin via vagus nerve stimulation

– Elevated insulin boosts CX3CL1 expression in endothelial cells

– CX3CL1 recruits inflammatory monocytes ➡️ plaque growth & instability

🧬 Blocking CX3CR1 in monocytes stopped plaque progression entirely.

⚠️ Implications for diabetics, sweetener users, and those at risk of cardiovascular disease...

Saint Augustine of Hippo (354–430 CE), a prominent theologian, philosopher, and bishop in Roman North Africa, profoundly influenced Western Christianity and philosophy.

Known for works like Confessions, The City of God, and On Christian Doctrine, he developed doctrines on original sin, grace, just war, and ecclesiology.

His thoughts shaped medieval theology, inspired Protestant Reformers, and continue to impact Christian teachings.

🚨 Just out in JAMA!

💡 PanEcho, a multitask AI model trained on over 1.2 million echo videos, can automate complete echocardiographic interpretation — from LVEF to valvular disease — with diagnostic AUCs up to 1.00 and MAE as low as 4.2%.

🌍 Validated across international cohorts, including point-of-care settings, this tool could redefine access, accuracy, and efficiency in cardiac imaging.

🫀🤖 A major leap toward AI-assisted cardiovascular diagnostics.

🔗 Read the study

#AIinMedicine #Cardiology #EchoRevolution #PanEcho #DigitalHealth #JAMA #MachineLearning #CardioAI #MedicalImaging #DeepLearning

🚨 New insights from cancer neuroscience! 🧠🧬

A groundbreaking Nature study reveals that cancer cells can steal mitochondria from nearby neurons via tunneling nanotubes — supercharging their metabolism, stemness, and metastatic potential 🌪️💥

Using a clever tool called MitoTRACER, researchers traced this “mitochondrial hijack” across cancers (breast, prostate, melanoma) and showed that recipient cells were more likely to seed distant metastases — especially in the brain 🧳🧠

🧪 Targeting this nerve–tumor energy axis may open new doors to stop metastasis in its tracks 🛑🛤️

#CancerResearch #Neuroscience #Metastasis #Mitochondria #Innovation #NaturePaper #Oncology #TumorMicroenvironment #Stemness #CellBiology #MedicalBreakthrough

🧠💓 Cognitive decline and cardiovascular disease often go hand in hand — but they don’t have to spiral together.

In our latest breakdown, we explore how cardiologists can detect, manage, and even improve cognitive impairment through smart risk factor control, lifestyle changes, and a multidisciplinary approach. From MoCA to memantine, TAVR to team-based care — it’s time to connect the mind and the heart.

📊 Evidence-based strategies

🩺 Practical tools for clinicians

💡 Insights from JACC’s state-of-the-art review

👉 Let’s build heart-smart, brain-friendly care — together. #Cardiology #CognitiveHealth #Geriatrics #HeartB

🧠💉 Can vaccines protect the mind? New research suggests that AS01-adjuvanted vaccines like Shingrix and Arexvy may reduce the risk of dementia—possibly by stimulating immune pathways like IFN-γ and TLR4, not just by preventing infection.

📊 In a large US-based EHR study, those who received the RSV or shingles vaccine had a significantly lower 18-month dementia risk than flu-vaccinated peers.

🔬 The common thread? The AS01 adjuvant.

🛡️ Could this be a new frontier in neuroprotection? Let’s discuss. #Vaccines #Dementia #RSV #AS01 #Neuroimmunology #PublicHealth #Alzheimers #PrecisionMedicine

New Insights from the DanGer Shock Trial! 🫀💡

Can early left ventricular unloading with a microaxial flow pump (mAFP) save lives in STEMI-related cardiogenic shock?

This compelling substudy shows that mAFP not only boosts cardiac output and power, but also reduces pulmonary pressures—all while using less pharmacologic support. 📉💊

🧪 Native CO improved steadily over 48 hours, hinting at myocardial recovery.

📊 PAC data gives us a front-row seat to the physiology behind the survival curves.

🔬 The editorial dives deeper: timing, technique, and future questions.

👉 Time to rethink shock care? D...

🚨 New Breakthrough in Type 2 Diabetes Care! 💊🧬

The ACHIEVE-1 trial shows that Orforglipron, a once-daily oral, nonpeptide GLP-1 receptor agonist, delivers significant reductions in HbA1c and body weight—without injections and with minimal restrictions! 🌍📉

👨‍⚕️ 559 patients across 5 countries

⏱️ 40 weeks, 3 dosing arms (3, 12, 36 mg)

📊 HbA1c ↓ by up to 1.48%, weight ↓ up to 7.6%

✅ No severe hypoglycemia

📌 Mild GI side effects during dose titration

This is a potential gamechanger for early T2DM care—simple, effective, and patient-friendly. 🚀

#Type2Diabetes #GLP1 #Orforglipron #Endocrinology #ClinicalTrials #PrecisionMedicine #Innovation #NEJM #ACHIEVE1 #Or

🚨 Frailty matters — even in the cath lab! 🧓🫀

A new NCDR registry analysis of 1.3M+ older adults shows a clear gradient: as frailty increases, so do complications, mortality, and procedural risks during PCI. Severely frail patients faced a striking 20.3% in-hospital mortality and >50% mortality with cardiogenic shock.

🧠 It’s time to treat frailty as a vital sign — embedded in our workflow, guiding shared decisions, and shaping post-PCI care.

📊 Let’s bring team-based, geriatric-informed strategies to the forefront of interventional cardiology.

#Cardiology #Frailty #PCI #PrecisionMedicine #AgingWell #GeriatricCardiology #NCDR...

🚨 Major breakthrough in obesity pharmacotherapy!

The REDEFINE-1 & REDEFINE-2 trials show that once-weekly CagriSema (Cagrilintide + Semaglutide) delivers up to 20% weight loss in people with obesity—and significant glycemic improvements in those with type 2 diabetes. 💉📉

🌍 Global, double-blind RCTs

⚖️ >90% lost ≥5% body weight

🩺 SBP ↓, QoL ↑, prediabetes reversed in 88%

⚠️ GI side effects common but mostly mild

💡 CagriSema is redefining the weight loss frontier—with dual satiety and metabolic action.

#Obesity #GLP1 #Cagrilintide #Semaglutide #CagriSema #WeightLoss #RCT #MetabolicHealth #Prediabetes #NovoNordisk #Endocrinology #InternalMedicine #PrecisionMedicine #Pharma #ClinicalTrials #ObesityMedicine #Amylin #GLP1Agonist #T2D #LifestyleMedicine

🔥 New Study Alert! 🩺

Wildfire smoke isn’t just a respiratory threat — it’s taking a toll on the heart, especially in older adults.

📊 A nationwide Medicare cohort (~22M) shows that long-term exposure to wildfire-specific PM2.5 is linked to significantly higher heart failure risk — more so than urban pollution.

📍 Vulnerable groups — women, Medicaid-eligible individuals, and low-income communities — face the highest burden.

🌫️ Tiny particles. Massive impact.

📚 Read the study: Hao et al, JACC July 2025

#Cardiology #AirPollution #WildfireSmoke #HeartFailure #EnvironmentalJustice #PM25 #PublicHealth #Epidemiology

🧠💊 Appetite Meets Its Match: The Amylin Advantage”

In this episode of Got Knowledge Doc, we explore how amylin, the lesser-known hormone co-secreted with insulin, is making a comeback — this time as part of a dual receptor strategy with GLP-1.

💡 Learn how amylin:

🧠 Activates brainstem satiety centers

⏳ Delays gastric emptying

📉 Suppresses glucagon

🔁 Synergizes with GLP-1 & leptin

We break down the science behind amycretin, the first oral dual GLP-1/amylin agonist, and what it could mean for the future of obesity and met

🧠💉 When should you start anticoagulation after an ischaemic stroke in atrial fibrillation? The CATALYST meta-analysis may have the answer!

📊 5,441 patients from 4 RCTs

⏱️ Early DOAC (≤4 days) reduced recurrent stroke risk at 30 days

⚖️ No increased bleeding, even in moderate stroke severity

🚫 But patients with PH2 or very severe strokes were excluded

Individual Participant Data Meta-Analysis allowed detailed subgroup analysis and minimized bias

💡 Clinical Takeaway: In most mild-to-moderate strokes, don’t delay—start DOACs early!

📄 #Stroke #AtrialFibrillation #CATALYST #DOAC #Neurology #Cardiology #MetaAnalysis #IPDMA #ClinicalTrials #PrecisionMedicine #StrokePrevention

🚨 Breakthrough in Type 1 Diabetes! 🧬💉

A new study in NEJM shows that zimislecel, a fully differentiated stem cell–derived islet therapy, restored insulin production and led to insulin independence in 83% of participants! ✅

📉 HbA1c dropped, 📈 time-in-range soared to 93%, and ⚖️ glucose variability was dramatically reduced.

This marks a major step toward curing—not just managing—Type 1 diabetes.

🔬 Precision science. 💪 Real-world impact. 🌍 Hope for millions.

#Type1Diabetes #StemCellTherapy #IsletTransplant #Zimislecel #NEJM #Innovation #RegenerativeMedicine #Vertex #Endocrinology #DiabetesCure

🧘‍♂️ How Well Can You Sit and Rise from the Floor? 🪑⬆️

That simple motion might say more about your longevity than you think.

A 12-year study of 4,282 adults found that lower Sit–Rise Test (SRT) scores predicted 3.8x higher natural death and 6x higher cardiovascular death rates. 😱

✅ No equipment

✅ Under 2 minutes

✅ Predicts survival

Why aren’t we using this more in routine clinical exams? 🩺

💡 If you score a 10, your 10-year survival is 97%.

Score 0–4? It drops to 73%.

🔍 Let’s rethink non-aerobic fitnes...

Aristotle (384–322 BC), a Greek philosopher and polymath, founded the Peripatetic school and Lyceum in Athens.

His extensive works spanned diverse fields, including logic, ethics, politics, biology, and metaphysics, profoundly influencing Western thought, science, and philosophy.

⚡Gatekeepers of Strength: Allopurinol, Calcium & the RyR Revolution”!

Did you know that an old gout drug might hold the key to reversing age-related muscle weakness and heart failure? Using cryo-EM, researchers found that allopurinol and xanthine derivatives directly activate ryanodine receptors—calcium channels essential for muscle contraction.

💡 This could change how we think about cardiac therapeutics and sarcopenia. Tune in for the full story—explained for med students, researchers, and curious minds alike.

🎧 Listen. Learn. Share. Let’s unlock the power within. 💪🧠 #PrecisionMedicine #Cardiology #MuscleScience #Allopurinol #RyR #MedicalEducation #GotKnow

🧠🔥 Neuroinflammation: The Common Flame in MS, Stroke, Alzheimer’s & Parkinson’s

Why do microglia flip from guardians to arsonists?

How does immune cell infiltration differ between MS and AD?

And which CNS-penetrant therapies show the most promise in dousing the inflammatory fire?

In our latest Got Knowledge Doc podcast, we decode the science behind neuroinflammation, explore treatment frontiers like BTK inhibitors and TREM2 agonists, and highlight key clinical insights for neurologists and internists.

🎧 Listen now to “Brains on Fire: Can CNS Drugs Cool the Heat?”

🔬💓 New Insights on HFimpEF 💓🔬

Heart Failure with Improved Ejection Fraction (HFimpEF) is no longer just a transition phase—it’s a distinct, dynamic phenotype with its own risks and management needs.

From biomarkers and imaging to the latest trials like PROSPER-HF and FINEARTS-HF, we’re entering an era of more personalized care for these patients.

📈 Better EF ≠ Complete Recovery.

💊 Continued GDMT, careful ICD decisions, and ongoing surveillance are key.

Let’s discuss: Are we ready to rethink “recovery” in heart failure?

#Cardiology #HFimpEF #HeartFailure...

🧠 Is your brain orchestrating how fast you age?

New insights suggest that aging isn’t just about wear and tear—it may be centrally coordinated by the brain through molecules like GDF15, responding to stress, senescence, and energy demands.

💬 Fascinating findings from Nature (June 2025) show how psychological stress accelerates aging at a cellular level—and how lifestyle interventions like exercise may help reverse it.

👇 How are you integrating brain–body science into your approach to aging and wellness?

#AgingScience #BrainHealth #Longevity #PrecisionMedicine #GDF15 #Epigenetics #Nature2025 #StressBiology #Healt...

“Obesity Rx 💊❤️🔥: Hormones, Hearts, and Hope”

The 2025 ACC guidance reframes obesity as a chronic disease—with precision therapies like GLP-1/GIP agonists now essential in cardiology.

We explore NuSH therapies (semaglutide, tirzepatide), the latest trial data, clinical thresholds for risk reduction, and practical steps for de-stigmatizing care.

👉 Tune in if you’re ready to treat obesity like the cardiovascular disease it truly is.

#Cardiology #ObesityMedicine #GLP1 #Tirzepatide #NuSH #MASLD #ACC2025 #MedicalWeightLoss #HFpEF #PrecisionMedicine #GotKnowledgeDoc

🔬 New meta-analysis alert! 🧪 Researchers compared rapamycin and metformin to dietary restriction across 167 studies in 8 vertebrate species.

📈 Key finding: Rapamycin mirrors dietary restriction’s longevity benefits—but metformin falls short.

⚠️ High heterogeneity and species bias remind us: translation to human health still needs careful navigation.

🧠 Full of insights for aging science, pharmacology, and precision medicine!

#LongevityScience #Rapamycin #AgingResearch #MetaAnalysis #LifespanExtension #PrecisionMedicine 👩‍🔬📊🧬

🫀 The Heart Ages—But Can We Intervene?

New insights from Nature Reviews Cardiology highlight how endothelial dysfunction, inflammageing, CHIP, and senescence-associated secretory phenotypes (SASP) drive cardiovascular ageing. Promising interventions—from gerotherapeutic diets and exercise to NAD+ boosters, senolytics, and ACBP neutralization—may help delay decline and promote resilience.

💡 Can we target the biology of ageing to extend cardiovascular healthspan, not just lifespan?

👇 Join the conversation: Which intervention holds the most promise—and what are the biggest challenges in translating this to clinical practice?

#Cardiology #Longevity...

We unpack the UN Scientific Advisory Board Brief on Aging—from telomeres and epigenetic clocks 🧫 to senolytics 💊 and AI-driven geroscience 🤖.

Why does aging matter to every clinician?

Because aging is the common soil of all chronic disease. 🌱

🔗 Listen now and join the longevity conversation!

#Aging #UNBrief #Geroscience #Epigenetics #Healthspan #GotKnowledgeDoc

🚨 Game-changing breakthroughs in chimaera research! 🧬💓

From beating human hearts grown in pig embryos to human organoids integrating into mouse intestines and brains via amniotic injection—two bold advances are reshaping the future of organ transplantation and regenerative medicine.

But with scientific promise comes ethical complexity. How far should we go in creating human–animal hybrids? What safeguards are needed?

👇 Join the conversation:

Are we building miracles—or crossing lines?

#StemCells #RegenerativeMedicine #Bioethics #ChimaeraResearch #Transplantation #FutureOfMedicine

🌞 New Guidelines on Vitamin D Supplementation! 💊🧪

JAMA’s latest synopsis recommends empirical vitamin D dosing—without routine testing—for children, the elderly, pregnant women, and those with prediabetes. The evidence? Conditional, with wide confidence intervals—but the low cost and minimal harm may tip the scales.

Let’s discuss: Is this the dawn of “test less, dose more” in preventive medicine? #VitaminD #PublicHealth #Endocrinology #JAMA #ClinicalGuidelines #PreventiveCare

🚨 One in five people carry a hidden cardiovascular risk—do you?

The Brussels Declaration on Lipoprotein(a) calls for global, once-in-a-lifetime Lp(a) testing to prevent premature heart disease and stroke. With strong scientific backing and health equity at its core, this is a pivotal step toward personalized cardiovascular prevention.

🧬 Let’s test early. Act early. Save lives. #LipoproteinA #BrusselsDeclaration #CVDprevention #PrecisionMedicine #HeartHealth

From baby blood to breakthrough cures — we explore how unlocking fetal hemoglobin through gene editing (exa-cel/Casgevy) is transforming treatment for sickle cell disease and β-thalassemia. 🧬✂️

Featuring the science of BCL11A, CRISPR therapies, and what the future holds for global access 🌍💉

🎧 Tune in: “Switching Gears: From Fetal Hemoglobin to Gene Therapy”

#GeneTherapy #CRISPR #HbF #BCL11A #Casgevy #SickleCell #Thalassemia #Innovation #PrecisionMedicine

Treat it Early. Treat it Right. Treat it Once.

New Lancet comment calls for a paradigm shift in heart valve disease care—advocating early referral, multidisciplinary heart networks, and lifetime management strategies that prioritize durability over delay.

Surgery isn’t the villain—delay is.

#Cardiology #HeartValveDisease #PrecisionMedicine #SurgicalInnovation #Lancet2025 #LifetimeCare #MultidisciplinaryCare

Vasubandhu was a 4th–5th century Indian Buddhist monk, philosopher, and co-founder of the Yogācāra school of Mahayana Buddhism.

Renowned for his works on Abhidharma, he developed key philosophical concepts such as “consciousness-only” (vijñaptimātra) and authored texts on Buddhist metaphysics, logic, and meditation.

His influential treatises, including Abhidharmakośa and Thirty Verses, significantly shaped Buddhist thought in India, Tibet, and East Asia.

🧠💥 New spin on stroke care!

The Milli-Spinner thrombectomy device shrinks clots by up to 95% using shear + compression — no rupture, no fragments.

🚑 Achieves revascularization in 90%+ cases, even when aspiration fails.

#Stroke #Innovation #NeuroTech 🔄🩸🔬

📖 https://doi.org/10.1038/s41586-025-09049-0

🔥 Immunosenescence + Inflammaging = Aging’s hidden engines.

🧬 New studies link immune decline to frailty, dementia, and disease.

🥗💉 Sleep, diet, vaccines, and GLP-1s may slow the clock.

#Healthspan > #Lifespan 💡👴🛡️

Derived from Dr. Eric Topol’s Ground Truths on Substack.

Heart attacks & strokes are down, but guess what’s rising?

⚡ Atrial fibrillation, 🫀 valve disease, & 🩸 VTE are taking the lead!

It’s time to rethink prevention: from plaque to pulse to prognosis.

🧠💊📊 #CardioTwitter #HeartHealth #TheLancet

https://doi.org/10.1016/S0140-6736(25)00990-0

🧠🍬 New study in Nature reveals: High-fructose exposure in early life impairs brain development by suppressing microglial phagocytosis via GLUT5 ➡️ HK2-driven metabolic rewiring.

Result? 🐭 develop anxiety-like behavior.

Cut the sweet talk. Think before you drink. #NeuroScience #FructoseFacts #MentalHealth 🧪🍼

🚨 New 2025 ACC Statement!

Obesity worsens heart failure—but weight loss changes the game.

🏃‍♂️ Lifestyle helps.

💊 Semaglutide & tirzepatide show promise in HFpEF.

🔬 Rethink BMI.

⚖️ Precision + empathy = better outcomes.

👇 Dive into key takeaways.

#CardioTwitter #Obesity #HeartFailure

👵🍽️ Malnutrition in aging isn’t just about food — it’s frailty, forgetfulness, and function.

The DoMAP model 🧠🔺 reveals how low intake, high needs, and poor absorption collide with social, physical & mental challenges.

Let’s fix the hidden hunger. 🥣❤️ #Geriatrics #Malnutrition #HealthyAging

🚨 New BMJ meta-analysis!

After PCI & stopping DAPT, P2Y12 inhibitor monotherapy 💊 reduces MACCE 🧠❤️ (HR 0.77) vs aspirin — without more major bleeding 💉

🫀 MI & stroke ↓

📊 16,117 pts, 5 trials

🧠 Smarter post-PCI strategy?

#CardioTwitter #BMJ #PCI #P2Y12 #Aspirin 🚫

🧬 New study in Aging Cell finds immune resilience—anchored by TCF7 expression—confers a 🚀 15.5-year survival advantage!

💥 SAS-1 high / MAS-1 low = 🔑 to longevity

👵 Midlife is the window.

🧠 Age is biology, but resilience is destiny.

#Longevity #Aging #Immunology #TCF7