Cardiologist at Washington University in St. Louis. #CardioOnc, evidence-based medicine, prevention, patient advocacy. Army veteran (#RLTW). Opinions my own.

St Louis, MO
Joined April 2013
Joshua Mitchell retweeted
GCOS 2026 — Amyloidosis Session Update: Advancing ATTR Treatment The session highlighted how modern therapies are reshaping outcomes in ATTR cardiac amyloidosis. The discussion returned to the core biology: transthyretin becomes harmful when it destabilizes and misfolds, forming fibrils that damage organs. Current treatments work by either reducing TTR production or stabilizing the protein to prevent misfolding. Across trials, all approved therapies show meaningful reductions in mortality, cardiovascular events, and functional decline. Early separation of outcome curves — sometimes within weeks — reinforces a key message: start treatment as early as possible. Delays reduce the potential benefit. Speakers also addressed the comparison between silencers and stabilizers. While biochemical responses may differ, real world outcomes remain nuanced, and combination therapy is not routinely recommended. Emerging agents show promise in selected groups but require further study. A practical takeaway emphasized coordinated care: navigating approvals quickly, monitoring clinical response, and using TTR levels to confirm biological effect. The overarching message was clear — early recognition and early therapy change the trajectory of disease. OncoDaily continues coverage from Williamsburg, bringing forward the insights shaping the future of amyloidosis care. @ICOSociety @Ron_Witteles @joshmitchellmd
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See you tonight!
🚨 ATTR-CA care is evolving. Are you ready? Join @PeerView + @joshmitchellmd & @jvaishnavmd at #HFSA2026 for an #ATTRCA symposium on 10.09! 🧠 Test clinical thinking 💬 Apply the latest data 👥 Tackle real-world cases ⚡ Put evidence into practice 🔗 bit.ly/ATTR-26-T
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Joshua Mitchell retweeted
Join Joshua Mitchell, MD, MSCI (@joshmitchellmd) and Joban Vaishnav, MD (@jvaishnavmd) on 10/9 at 7:30 PM MST during #HFSA for an #ATTRCA #MedEd event: bit.ly/ATTR-26-T #cardiology
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Joshua Mitchell retweeted
#ATTRCA is underdiagnosed & undertreated — but that's changing. Join Drs. Vaishnav (@jvaishnavmd) & Mitchell (@joshmitchellmd) Friday, 10/9 at #HFSA2026: bit.ly/ATTR-26-T #MedicalEducation
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Honored to be guest Editor-in-Chief of the #JACCCaseReports @JACCJournals special issue on #amyloidosis. Great collection of unique cases we can all learn from. See my editor's corner on important lessons and where we go from here: jacc.org/doi/10.1016/j.jacca… Full journal issue here by section: jacc.org/toc/case-reports/31… Only made possible with tremendous help from the JACC:CR team led by @GilbertTangMD and @MinnowWalsh and the amazing guest associate editors: Jose Alvarez-Cardona, @Richardkcheng2 , @MargotDavisMD @rodney_falk @MGKhouri_md @nishantshahmd @SinghVasvi @LilySternMD. @WashUCardiology
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Joshua Mitchell retweeted
Welcome to our SEPTEMBER 23 special sponsored issue of #JACCCaseReports @JACCJournals on cardiac #amyloidosis! jacc.org/journal/case-report…. Full PDF here: jacc.org/doi/10.1016/S2666-0… Thank you @JoshMitchellMD for being our guest Editor-in-Chief! Cardiac Amyloidosis: A Field Transformed and the Work That Remains jacc.org/doi/10.1016/j.jacca… @minnowalsh @hmkyale Imaging and Diagnostic Challenges and Pitfalls ATTR-CM in Patients With Clinically Significant Plasma Cell Dyscrasias: A Case Series Highlighting Diagnostic Challenges jacc.org/doi/10.1016/j.jacca… Donut Morphology of Cardiac Amyloidosis: A Glazed Over Diagnosis jacc.org/doi/10.1016/j.jacca… Systemic Oxalosis Mimicking Transthyretin Amyloid Cardiomyopathy: A Cause of False Positive Tc-99m PYP Scintigraphy jacc.org/doi/10.1016/j.jacca… Perugini Grade 3 Uptake Does Not Exclude AL Cardiac Amyloidosis: When Noninvasive Diagnosis Fails jacc.org/doi/10.1016/j.jacca… 3 Discordant Extracardiac Amyloid Proteins Highlighting Bystander Deposition in a Case of Light-Chain Amyloid Cardiomyopathy jacc.org/doi/10.1016/j.jacca… Successful Heart Transplantation in a Patient With Triple Infiltrative Cardiomyopathy: Sarcoidosis, AL and TTR Amyloidosis jacc.org/doi/10.1016/j.jacca… Abnormal Cardiac PET Imaging in ATTR Amyloidosis jacc.org/doi/10.1016/j.jacca… Early Recognition and Atypical Presenatations Epicardial Amyloidoma Mimicking Secondary Cardiac Lymphoma: A Sneeze Away From the Diagnosis jacc.org/doi/10.1016/j.jacca… Smartwatch-Detected Sinus Tachycardia Unmasking AL Cardiac Amyloidosis in a Young Adult jacc.org/doi/10.1016/j.jacca… Transthyretin Cardiac Amyloidosis in a Safety-Net Hospital: A Case Series of 10 Afro-Caribbean Patients jacc.org/doi/10.1016/j.jacca… Sustained Ventricular Tachycardia as the First Presentation of Hereditary Transthyretin Amyloidosis With the Glu109Gln Mutation jacc.org/doi/10.1016/j.jacca… Light Chain Cardiac Amyloidosis With Skeletal Muscle Weakness jacc.org/doi/10.1016/j.jacca… Amyloid Light Chain Amyloidosis Involving the Heart and Temporal Arteries, Mimicking Giant Cell Arteritis jacc.org/doi/10.1016/j.jacca… Obstructive Intramural Coronary Amyloidosis: Uncommon or Under-Recognized Cause of Microvascular Angina? jacc.org/doi/10.1016/j.jacca… p.(V142I)-Associated Variant Transthyretin Amyloid Cardiomyopathy Complicating Complex Congenital Heart Disease: A Lethal Combination jacc.org/doi/10.1016/j.jacca… Hypertrophic Cardiomyopathy Overlap Hereditary Transthyretin Cardiac Amyloidosis With Severe Left Ventricular Outflow Tract Obstruction Mimicking Hypertrophic Obstructive Cardiomyopathy jacc.org/doi/10.1016/j.jacca… Multimodality Imaging Reveals Rare Hereditary Transthyretin Amyloidosis Mimicking Hypertrophic Cardiomyopathy jacc.org/doi/10.1016/j.jacca… Unmasking AL Cardiac Amyloidosis During Familial Cardiomyopathy Screening jacc.org/doi/10.1016/j.jacca… Coexistence of Hypertrophic Cardiomyopathy and Hereditary Transthyretin Amyloid Cardiomyopathy jacc.org/doi/10.1016/j.jacca… Management and Hemodynamics Abnormal Cardiovascular Responses During Orthostatic Hypotension in Cardiac Amyloidosis Revealed by Semi-Sitting/Standing Stress Echocardiography jacc.org/doi/10.1016/j.jacca… Neurohormonal Therapy in Patients With Transthyretin Cardiac Amyloidosis: Is It an Option? jacc.org/doi/10.1016/j.jacca… Early Recovery of Cardiac Function After Hematologic Response in Systemic AL Amyloidosis jacc.org/doi/10.1016/j.jacca… When Hematologic Response Does Not Translate to Cardiac Recovery in AL Amyloidosis jacc.org/doi/10.1016/j.jacca… Rare Amyloid Types and Genetic ATTR Variant’s Page Apolipoprotein A-IV Cardiac Amyloidosis: Beyond ATTR and AL jacc.org/doi/10.1016/j.jacca… Apolipoprotein A-IV Cardiac Amyloidosis Presenting as Massive Ventricular Wall Thickening Mimicking Hypertrophic Cardiomyopathy jacc.org/doi/10.1016/j.jacca… Apolipoprotein A-IV Cardiac Amyloidosis as a Diagnostic Pitfall: Beyond the Noninvasive Algorithm jacc.org/doi/10.1016/j.jacca… Transthyretin Amyloidosis Due to a Rare TTR Val142del Deletion With Relatively Early Clinical Manifestations jacc.org/doi/10.1016/j.jacca… TTR Variant p.Ala65Val Causing Early-Onset Hereditary Transthyretin Amyloidosis With Mixed Cardiac and Neuropathic Phenotype jacc.org/doi/10.1016/j.jacca… Rare Hereditary Cardiac Amyloidosis Treated With SGLT2 Inhibitor: Beyond ATTR/AL jacc.org/doi/10.1016/j.jacca… Hereditary Transthyretin Amyloidosis in Brazilian Amazon Caused by a Globally Rare Variant Predominant in Asia jacc.org/doi/10.1016/j.jacca… @NAkhterMD @aroniskn @CraigBasman @JACabreraCardio @MiChen__ @aabha_divya @MarcEngels7 @sarano_maurice @Miho_Fukui_ @CardioOncCO @MMarinCuartas @Nishaki1 @ChrissyMD2000 @ACHDocTMoe @PanjrathG @jsaef1 @Kentso987 @TagliariPaula @m_taramasso @SyedZaidMD
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Joshua Mitchell retweeted
Join us Friday, 10/9, at 7:30 PM MST for our #ATTRCA live in-person & virtual symposium with Drs. Mitchell (@joshmitchellmd) & Vaishnav (@jvaishnavmd) at #HFSA2026: bit.ly/ATTR-26-T #CardiacAmyloidosis #MedEd
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Honored to be able to partner with @American_Heart to discuss workable strategies to improve #amyloid recognition. Will discuss early recognition, barriers, and optimal system based practices. Register at lnkd.in/gTdr88UB. @ICOSociety @WashUCardiology @PennMedicine
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Joshua Mitchell retweeted
Immune Checkpoint Inhibitor–Associated Cardiovascular Toxic Effects by Drs. @mayocvonc, @joshmitchellmd et al. An International Cardio-Oncology Society Position Statement: jamanetwork.com/journals/jam…
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I am always in awe of the team we have on the @ICOSociety Scientific and Research Committee. Such a fantastic group of international collaborators. Really enjoyed working on this position statement with them. Great content in the manuscript and supplement! #cardiooncology jamanetwork.com/journals/jam…
📰 HOT OFF THE PRESSES 📰 Immune Checkpoint Inhibitor (#ICIs) treatments are known to potentially cause harm to the heart, particularly through conditions like #myocarditis. Today in @JAMAOnc, we stressed the importance of interdisciplinary collaboration as the best way to mitigate effects and protect the #hearts of #cancer patients. Read the positioning statement: jamanetwork.com/journals/jam…
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Joshua Mitchell retweeted
Check out our publication in #CardioOncology. Atrial fibrillation/flutter in stem cell transplant patients. Prevalence, association with outcomes, and impact on healthcare resource-utilization/readmissions. @joshmitchellmd @Teebi_MD rdcu.be/euXbx
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3 years ago my good friend @MorenoMDPhD approached me about this crazy idea to fill a much needed gap in heart failure education (1/3).
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Congrats to @RajaZaghlol for leading our contemporary review of CV complications from radiation therapy including historic trends and current recs. Always great to work with @carmenbergom @DrLPedersen and @yoo_sgkyle! #cardioonc @WashUCardiology authors.elsevier.com/a/1jze-…
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Congrats to @gwalls89 for an excellent manuscript detailing the practice patterns and general uptake of guidelines in #radonc internationally. Interesting insights! #cardioonc @icosociety @gerryhanna doi.org/10.1016/j.clon.2024.…
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Awesome work by @RajaZaghlol exploring the CV effects of CAR-T in the Medicare population. Well-deserved! Special thanks to @kejoynt, @dgermain21 and Elena Deych, among others as well! Looking forward to the manuscript! @WashUCardiology #cardioonc
Proud to be selected as a YIA finalist in the #GCOS2024 presenting our work investigating MACE in older adults receiving CART therapy. Special thanks to @joshmitchellmd for exceptional mentoring. @ICOSociety
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