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so its a real privilege to me for me to introduce welcome my friend and colleague dr. Ahmad Hussain whos been a great addition to our heart failure group he completed his internship and residency at Emory followed by his cardiology training at Mayo they did his advanced heart failure training University of Washington in Seattle and just been doing a superb job so research focus and heart failure would preserve the earth which he promises not to be disappointing following heart failure with reduced ejection fraction and and really hes positioned nicely to give us a primer if you will on detecting and treating heart fair wood preservative come on morning and welcome again to the heart failure summit um so Im gonna take the next 20 to 25 minutes hopefully a little over because its a broad topic I get 1/3 of the time you know you know its anyway so I want to start off Im going to start off with a case presentation that delineates this problem and then well move on from there this