Clinical Medicine Insights. Cardiology最新文献

{"title":"Is Noncardiac Chest Pain Truly Noncardiac?","authors":"Hiroki Teragawa,&nbsp;Chikage Oshita,&nbsp;Yuichi Orita","doi":"10.1177/1179546820918903","DOIUrl":"https://doi.org/10.1177/1179546820918903","url":null,"abstract":"<p><p>Many causes of noncardiac chest pain (NCCP) have been studied and gastroesophageal reflux disease is considered to be the major cause. However, studies have reported that treatment with a proton pump inhibitor does not effectively provide relief for NCCP-related symptoms, and these symptoms frequently recur. These findings suggest that patients with cardiac disease may be excluded completely from the NCCP group. Several examinations can be conducted to verify the presence of cardiac disease. Such examinations include the assessment of biochemical markers, rest and exercise electrocardiogram, echocardiography, cardiac computed tomography, stress myocardial perfusion imaging, cardiac magnetic resonance imaging, and coronary angiography (CAG). However, the presence of functional coronary artery diseases (CADs), such as vasospastic angina and/or microvascular angina, cannot be detected using these modalities. These functional CADs can be diagnosed by CAG with spasm-provocation testing and/or physiological coronary measurement. Thus, when a patient who is suspected of having NCCP takes a proton pump inhibitor and does not respond well, further examination-including assessment for possible functional CADs-may be needed.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820918903"},"PeriodicalIF":3.0,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820918903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38098600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Myocardial Deformations in Hemodialysis Children by Speckle Tracking Echocardiography.","authors":"Manal F Elshamaa,&nbsp;Fatma A Mostafa,&nbsp;Inas Aes Sad,&nbsp;Ahmed M Badr,&nbsp;Yomna Aem Abd Elrahim","doi":"10.1177/1179546820930015","DOIUrl":"https://doi.org/10.1177/1179546820930015","url":null,"abstract":"<p><strong>Background: </strong>Cardiac systolic dysfunction was potentially found in adult patients with end-stage renal disease (ESRD) who have preserved left ventricular ejection fraction (EF%). In children with ESRD, little data are available on early changes in myocardial function. This study aimed to detect the early changes in myocardial mechanics in pediatric patients with ESRD using speckle tracking echocardiography (STE).</p><p><strong>Methods: </strong>Thirty ESRD children receiving hemodialysis (HD) and30 age-matched controls were prospectively studied. Patients underwent echocardiographic studies before and after HD. Left ventricular longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) myocardial deformation parameters (strain, strain rate) were evaluated by STE.</p><p><strong>Results: </strong>The LS was significantly reduced in pre-HD and post-HD patients compared with controls (<i>P</i> = .000). Controls showed the highest global longitudinal strain. The RS measurements did not differ significantly among the studied groups except for the inferior segment that is significantly reduced after HD compared with controls (<i>P</i> < .05). The CS was significantly reduced in pre-HD and post-HD patients compared with controls at the lateral and posterior segments (<i>P</i> = .035 and <i>P</i> = .013, respectively).</p><p><strong>Conclusion: </strong>Speckle-tracking echocardiography might detect early changes in myocardial mechanics in children with ESRD with preserved EF%.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820930015"},"PeriodicalIF":3.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820930015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38060133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Smartphone-Based Secondary Preventive Strategies in Coronary Artery Disease.","authors":"Alexandra C Murphy, Georgina Meehan, Anoop N Koshy, Phelia Kunniardy, Omar Farouque, Matias B Yudi","doi":"10.1177/1179546820927402","DOIUrl":"10.1177/1179546820927402","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation programs provide a comprehensive framework for the institution of secondary preventive measures. Smartphone technology can provide a platform for the delivery of such programs and is a promising alternative to hospital-based services. However, there is limited evidence to date supporting this approach. Accordingly, we performed a systematic review and meta-analysis examining smartphone-based secondary prevention programs to traditional cardiac rehabilitation in patients with established coronary artery disease to ascertain the feasibility and effectiveness of these interventions.</p><p><strong>Methods: </strong>A systematic search of PubMed, MEDLINE, EMBASE, and the Cochrane Library was conducted. A meta-analysis was performed using a random-effects model with the outcomes of interest being 6-minute walk test (6MWT) distance, systolic blood pressure, low-density lipoprotein (LDL) cholesterol, and body mass index (BMI).</p><p><strong>Results: </strong>A total of 8 studies with 1120 patients across 5 countries were included in the quantitative analysis. Follow-up ranged from 6 weeks to 12 months. Five studies examined all patients post acute coronary syndrome, 2 studies examined only patients undergoing percutaneous coronary intervention, and 1 study examined all patients with a diagnosis of coronary artery disease, independent of intervention. Exercise capacity, as measured by the 6MWT, was significantly greater in the smartphone group (20.10 meters, 95% confidence interval [CI] 7.44-33.97; <i>P</i> < .001; <i>I</i> ² = 45.58). There was no significant difference in BMI reduction, systolic blood pressure, or LDL cholesterol levels between groups (<i>P</i> value for all > .05).</p><p><strong>Conclusion: </strong>Publicly available smartphone-based cardiac rehabilitation programs are a convenient and easily disseminated intervention which show merit in exercise promotion in patients with established coronary artery disease. Further research is required to establish the clinical significance of recent findings favoring their use.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820927402"},"PeriodicalIF":3.0,"publicationDate":"2020-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/44/10.1177_1179546820927402.PMC7278307.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38060132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics, Management Strategies, and In-Hospital Outcomes of Acute Coronary Syndrome in a Low Socioeconomic Status Cohort: An Observational Study From Urban India.","authors":"Navdeep Singh Sidhu,&nbsp;Sunil Kumar Kondethimmannahally Rangaiah,&nbsp;Dwarikaprasad Ramesh,&nbsp;Kumaraswamy Veerappa,&nbsp;Cholenahally Nanjappa Manjunath","doi":"10.1177/1179546820918897","DOIUrl":"https://doi.org/10.1177/1179546820918897","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease is the leading cause of mortality in India. There is scarcity of data on demographic profile and outcomes of acute coronary syndrome (ACS) in low socioeconomic status (SES) population of India.</p><p><strong>Objectives: </strong>This study was undertaken to determine the clinical presentation, management strategies, and in-hospital outcomes of ACS in low SES population.</p><p><strong>Methods: </strong>We conducted 1-year prospective observational cohort study of ACS patients admitted at Employees State Insurance Corporation unit of our tertiary care cardiac center. Clinical parameters, management strategies, and in-hospital outcomes of 621 patients enrolled during the study period from February 2015 to January 2016 were studied.</p><p><strong>Results: </strong>Mean age of patients was 56.06 ± 11.29 years. Majority (62%) of the patients had ST elevation myocardial infarction (STEMI), whereas Non-ST elevation acute coronary syndrome (NSTE-ACS) was seen in 38% of the patients. Median time from symptom onset to hospital admission was 285 min with wide range from 105 to 1765 min. Coronary angiography was performed in 81% of patient population. Single-vessel disease (SVD) was the most common pattern (seen in 43.3%) of coronary artery involvement with left anterior descending coronary artery (LAD) being the most frequently involved vessel (62.8%). Pharmaco-invasive approach was the preferred strategy. Overall percutaneous coronary intervention (PCI) rates were 59.1% (62.1% in STEMI and 54.2% in NSTE-ACS). Overall in-hospital mortality was 3.2%, being significantly higher in STEMI (4.2%) as compared with NSTE-ACS (1.7%).</p><p><strong>Conclusions: </strong>With implementation of evidence-based pharmacotherapy and interventions, outcomes comparable with developed countries can be achieved even in low SES populations of developing world.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820918897"},"PeriodicalIF":3.0,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820918897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37949482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"l-arginine Supplementation Increased Only Endothelium-Dependent Relaxation in Sprague-Dawley Rats Fed a High-Salt Diet by Enhancing Abdominal Aorta Endothelial Nitric Oxide Synthase Gene Expression.","authors":"Abdullahi Adejare,&nbsp;Ahmed Oloyo,&nbsp;Chikodi Anigbogu,&nbsp;Smith Jaja","doi":"10.1177/1179546820902843","DOIUrl":"https://doi.org/10.1177/1179546820902843","url":null,"abstract":"<p><strong>Background: </strong>Abnormal vascular reactivity and reduced expression of endothelial nitric oxide synthase (<i>eNOS</i>) gene are hallmark of salt-induced hypertension in rats. Although l-arginine is an established vasodilator, the mechanism by which it modulates vascular reactivity in salt-induced hypertension is not clearly understood.</p><p><strong>Objectives: </strong>This study was designed to investigate the mechanism by which oral l-arginine supplementation modulates vascular reactivity and <i>eNOS</i> gene expression in Sprague-Dawley rats fed a high-salt diet.</p><p><strong>Methods: </strong>Forty-eight weaned male Sprague-Dawley rats of weight range 90 to 110 g were randomly divided into 6 groups of 8 rats per group. Group I was fed normal rat chow <i>ad libitum</i> and served as the Normal Diet group. Group II was fed a diet that contained 8% NaCl. Groups III and IV took normal and high-salt diet, respectively, and then received oral l-arginine supplementation (100 mg/kg/day), while groups V and VI took normal and high-salt diet, respectively, and then were co-administered with both l-arginine and l-nitro-arginine methyl ester (L-NAME; 100 mg/kg/day and 40 mg/kg/day, respectively) orally. At the end of 12-week experimental period, the animals were sacrificed to assess vascular reactivity and gene expression level.</p><p><strong>Results: </strong>Our results show that high-salt diet significantly reduced (<i>P</i> < .05) endothelium-dependent relaxation response to acetylcholine and qualitatively reduced <i>eNOS</i> gene expression in the abdominal aorta of the rats. However, l-arginine supplementation improved the impaired endothelium-dependent relaxation and nitric oxide level while ameliorating the reduced <i>eNOS</i> gene expressions.</p><p><strong>Conclusion: </strong>This study suggests that oral supplementation of l-arginine enhances endothelial-dependent relaxation in rats fed a high-salt diet by ameliorating <i>eNOS</i> gene expression in the abdominal aorta of the rats.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820902843"},"PeriodicalIF":3.0,"publicationDate":"2020-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820902843","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37648337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Outcomes of Percutaneous Coronary Intervention in Patients with End-Stage Liver Disease.","authors":"Daniel Y Lu,&nbsp;Matthew D Saybolt,&nbsp;Daniel H Kiss,&nbsp;William H Matthai,&nbsp;Kimberly A Forde,&nbsp;Jay Giri,&nbsp;Robert L Wilensky","doi":"10.1177/1179546820901491","DOIUrl":"https://doi.org/10.1177/1179546820901491","url":null,"abstract":"<p><strong>Background: </strong>Patients with cirrhosis and coronary artery disease (CAD) are at high risk for morbidity during surgical revascularization so they are often referred for complex percutaneous coronary intervention (PCI). Percutaneous coronary intervention in the cirrhotic population also has inherent risks; however, quantifiable data on long-term outcomes are lacking.</p><p><strong>Methods: </strong>Patients with angiographically significant CAD and cirrhosis were identified from the catheterization lab databases of the University of Pennsylvania Health System between 2007 and 2015. Outcomes were obtained from the medical record and telephonic contact with patients/families.</p><p><strong>Results: </strong>Percutaneous coronary intervention was successfully performed in 42 patients (51 PCIs). Twenty-nine patients with significant CAD were managed medically (36 angiograms). The primary outcome (a composite of mortality, subsequent revascularization, and myocardial infarction) was not significantly different between the 2 groups during a follow-up period at 1 year (PCI: 50%, Control: 40%, <i>P</i> = .383). In the PCI group, a composite adverse outcome rate that included acute kidney injury (AKI), severe bleed, and peri-procedural stroke was elevated (40%), with severe bleeding occurring after 23% of PCI events and post-procedural AKI occurring after 26% of events. The medical management group had significantly fewer total matched adverse outcomes (17% vs 40% in the PCI group, <i>P</i> = .03), with severe bleeding occurring after 11% of events and AKI occurring after 6% of events. Increased risk of adverse events following PCI was associated with severity of liver disease by Child-Pugh class.</p><p><strong>Conclusions: </strong>Percutaneous coronary intervention in patients with cirrhosis is associated with an elevated risk of adverse events, including severe bleeding and AKI.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820901491"},"PeriodicalIF":3.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820901491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37618513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone ECG Monitoring System Helps Lower Emergency Room and Clinic Visits in Post-Atrial Fibrillation Ablation Patients.","authors":"Mossab Aljuaid,&nbsp;Qussay Marashly,&nbsp;Jad AlDanaf,&nbsp;Ibrahim Tawhari,&nbsp;Michel Barakat,&nbsp;Rody Barakat,&nbsp;Brittany Zobell,&nbsp;William Cho,&nbsp;Mihail G Chelu,&nbsp;Nassir F Marrouche","doi":"10.1177/1179546820901508","DOIUrl":"https://doi.org/10.1177/1179546820901508","url":null,"abstract":"Aim: To evaluate the effectiveness of using a smartphone-based electrocardiography (ECG) monitoring device (ECG Check) on the frequency of clinic or emergency room visits in patients who underwent ablation of atrial fibrillation (AF). Methods: Two groups of patients were identified and compared: The conventional monitoring group (CM group) included patients who were prescribed conventional event monitoring or Holter monitoring systems. The ECG Check group (EC group) included patients who were prescribed the ECG Check device for continuous monitoring in addition to conventional event monitoring. The primary outcome was the number of patient visits to clinic or emergency room. The feasibility, accuracy, and detection rate of mobile ECG Check were also evaluated. Results: Ninety patients were studied (mean age: 66.2 ± 11 years, 64 males, mean CHA2DS2-VASc score: 2.6 ± 2). In the EC group, forty-five patients sent an average of 52.8 ± 6 ECG records for either routine monitoring or symptoms of potential AF during the follow-up period. The rhythm strips identified sinus rhythm (84.7%), sinus tachycardia (8.4%), AF (4.2%), and atrial flutter (0.9%). Forty-two EC transmissions (1.8%) were uninterpretable. Six patients (13%) in the EC group were seen in the clinic or emergency room over a 100-day study period versus 16 (33%) in the standard care arm (P value < 0.001). Conclusions: Use of smartphone-based ECG monitoring led to a significant reduction in AF-related visits to clinic or emergency department in the postablation period.","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820901508"},"PeriodicalIF":3.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820901508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37601211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thanks to Reviewers","authors":"","doi":"10.1177/1179546820906691","DOIUrl":"https://doi.org/10.1177/1179546820906691","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"28 5-6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820906691","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72452494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Main Coronary Artery Thrombus Diagnosed and Managed With Coronary Computed Tomography Angiography and Fractional Flow Reserve Derived From Computed Tomography.","authors":"Shone O Almeida,&nbsp;Nasih M Ahmed,&nbsp;Ronald P Karlsberg","doi":"10.1177/1179546819894592","DOIUrl":"https://doi.org/10.1177/1179546819894592","url":null,"abstract":"<p><p>Left main coronary artery thrombus (LMCA-T) is a rare disease state and diagnosed with invasive coronary angiography (ICA). We present a case of LMCA-T diagnosed with coronary computed tomography angiography (CTA) and treated without ICA in a patient who presented to a hospital in the middle of war zone in Erbil, Iraqi Kurdistan. Coronary CTA performed 1 month later demonstrated resolution of the thrombus. Fractional flow reserve computed from computed tomography (FFR-CT; HeartFlow, Redwood City, CA) performed retrospectively confirmed that the clot was not hemodynamically significant at the time of diagnosis. This case demonstrates the diagnostic capabilities of coronary CTA and FFR-CT when ICA is not readily available.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"13 ","pages":"1179546819894592"},"PeriodicalIF":3.0,"publicationDate":"2019-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546819894592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37470762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Accuracy of Combined Electrocardiogram Criteria to Diagnose Right Atrial Enlargement in Adults With Uncorrected Secundum Atrial Septal Defect","authors":"Purwati Pole Rio, H. Hariawan, D. Anggrahini, A. B. Hartopo, L. K. Dinarti","doi":"10.1177/1179546819869948","DOIUrl":"https://doi.org/10.1177/1179546819869948","url":null,"abstract":"Background: Right atrium (RA) enlargement in uncorrected atrial septal defect (ASD) is due to chronic volume overload. Several electrocardiogram (ECG) criteria had been proposed for screening RA enlargement. This study aimed to compare the accuracy of ECG criteria in detecting RA enlargement in adults with uncorrected ASD. Methods: This was a cross-sectional study involving 120 adults with uncorrected secundum ASD. The subjects underwent ECG examination, transthoracic echocardiography, and right heart catheterization. An RA enlargement was determined with RA volume index by transthoracic echocardiography. Various ECG and combined ECG criteria were evaluated. Statistical analysis was performed to analyze the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV). Results: An RA enlargement was detected in 64.2% subjects. The P wave height > 2.5 mm in lead II criterion had the best specificity (100%) and PPV (100%), but low sensitivity (19%) and accuracy (48%). The combined 2 ECG criteria (QRS axis > 90°, R/S ratio > 1 in V1) had 82% sensitivity, 56% specificity, 73% accuracy, 77% PPV, and 63% NPV. The combined 3 ECG criteria (QRS axis > 90°, R/S ratio > 1 in V1, and P wave height > 1.5 mm in V2) had 35% sensitivity, 86% specificity, 53% accuracy, 82% PPV, and 43% NPV. Conclusions: The combined 2 ECG criteria (QRS axis > 90° and R/S ratio > 1 in V1) had increased sensitivity, better accuracy, and more balance of PPV and NPV as compared with P wave > 2.5 mm in II criterion and combined 3 ECG criteria to diagnose RA enlargement in adults with uncorrected ASD.","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"13 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78497525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}