JRSM Cardiovascular Disease最新文献

{"title":"Computer assisted Doppler waveform analysis and ultrasound derived turbulence intensity ratios can predict early hyperplasia development in newly created vascular access fistula: Pilot study, methodology and analysis.","authors":"Matthew Bartlett,&nbsp;Vanessa Diaz-Zuccarini,&nbsp;Janice Tsui","doi":"10.1177/20480040211000185","DOIUrl":"https://doi.org/10.1177/20480040211000185","url":null,"abstract":"<p><strong>Objectives: </strong>Following surgical creation of arterio-venous fistulae (AVF), the desired outward remodeling is often accompanied by the development of neointimal hyperplasia (NIH), which can stymie maturation and may lead to thrombosis and access failure. The aim of this study was to investigate the feasibility of using a non-invasive test, to detect and quantify the turbulent flow patterns believed to be associated with NIH development.</p><p><strong>Design: </strong>This was a prospective, observational study. Ultrasound derived turbulence intensity ratios (USTIR) were calculated from spectral Doppler waveforms, recorded from newly formed AVF, and were compared with haemodynamic and structural changes observed during the initial maturation period.</p><p><strong>Setting: </strong>Measurements were obtained by accredited Clinical Vascular Scientists, at the Royal Free Hospital, London.</p><p><strong>Participants: </strong>Patients with newly created AVF were invited to participate in the study. A total of 30 patients were initially recruited with 19 participants completing the 10 week study protocol.</p><p><strong>Outcome measures: </strong>The primary outcome measure was the development of NIH resulting in a haemodynamically significant lesion.The secondary outcome was successful maturation of the AVF at 10 weeks.</p><p><strong>Results: </strong>Elevated USTIR in the efferent vein 2 weeks post surgery corresponded to the development of NIH formation (P = 0.02). A cut off of 6.39% predicted NIH development with a sensitivity of 87.5% and a specificity of 80%.</p><p><strong>Conclusion: </strong>Analysis of Doppler waveforms can successfully identify deleterious flow patterns and predict inward luminal remodelling in maturing AVF. We propose a longitudinal follow up study to assess the viability of this technique as a surveillance tool.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"20480040211000185"},"PeriodicalIF":1.6,"publicationDate":"2021-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/20480040211000185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25540830","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":"Continuous positive airway pressure therapy reduces the levels of catecholamines and blood pressure in pseudophaeochromocytoma with coexisting obstructive sleep apnoea.","authors":"Gie Ken-Dror,&nbsp;Michael Wood,&nbsp;David Fluck,&nbsp;Pankaj Sharma,&nbsp;Christopher H Fry,&nbsp;Thang S Han","doi":"10.1177/2048004021992191","DOIUrl":"https://doi.org/10.1177/2048004021992191","url":null,"abstract":"<p><strong>Background: </strong>Stress from obstructive sleep apnoea (OSA) stimulates catecholamine release and consequently can exacerbate hypertension, even in the absence of a catecholamine-producing tumour (phaeochromocytoma). As such, a positive screening test for suspected phaeochromocytoma may be misleading. There exists only a handful case reports, and no controlled trials, how continuous positive airway pressure (CPAP) to treat OSA influences catecholamine levels. We examined changes to levels of urinary catecholamine and blood pressure in response to CPAP treatment.</p><p><strong>Methods: </strong>We conducted a meta-analysis of data aggregated from published case reports of individual patient data up to April 2020. The quality of the reports was evaluated using the risk of bias in non-randomized studies of interventions (ROBINS-I) tool.</p><p><strong>Results: </strong>A total of 13 cases (seven men and six women) from seven reports met our search criteria. Patients had mean age of 49.1 years (range = 36-62) and body mass index of 37.4 kg/m² (range = 27-56). Most had moderate to severe OSA with CPAP treatment. Nine cases had 24-hour urinary noradrenaline assessment before and after CPAP treatment. CPAP treatment led to a 21% reduction (104 nmol/24-hours, 95% credible interval =59 to 148) in 24-hour urinary noradrenaline to within reference ranges, and 25% reduction (from 131 to 100 mmHg) in mean arterial pressure. The risk of overall bias evaluated by the ROBINS-I tool was found to be low in the majority of reports.</p><p><strong>Conclusions: </strong>Investigations of patients suspected of phaeochromocytoma, particularly obese individuals, should exclude OSA and treat this condition if present before performing screening tests to assess for catecholamine levels.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"2048004021992191"},"PeriodicalIF":1.6,"publicationDate":"2021-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004021992191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39141369","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 smoking-dyslipidaemia dyad: A potent synergistic risk for atherosclerotic coronary artery disease.","authors":"Vineet Prakash, Sams Jaker, Amjad Burgan, Adam Jacques, David Fluck, Pankaj Sharma, Christopher H Fry, Thang S Han","doi":"10.1177/2048004020980945","DOIUrl":"10.1177/2048004020980945","url":null,"abstract":"<p><strong>Background: </strong>Smoking and dyslipidaemia are known individual risk factors of coronary artery disease (CAD). The present study examined the combined risk of smoking and dyslipidaemia on coronary atherosclerosis.</p><p><strong>Methods: </strong>Coronary artery calcium (CAC), measured by cardiac CT, was used to assess the extent of CAD, which was related to smoking and dyslipidaemia using logistic regression, adjusted for age, sex, hypertension, BMI and family history of ischaemic heart disease.</p><p><strong>Results: </strong>Seventy-one patients (46 men, 25 women: median age of 53.7yrs; IQR = 47.0-59.5) were recruited. The mean log₁₀ CAC score in never-smokers without dyslipidaemia (reference group) was 0.37 (SD = 0.73), while the value in those with a history of smoking was 0.44 ± 0.48 (mean difference: 0.07, 95%CI:-0.67 to 0.81, <i>p</i> = 0.844), dyslipidaemia was 1.07 ± 1.08 (mean difference: 0.71, 95%CI: 0.24 to 1.17, <i>p</i> = 0.003), and both risk factors was 1.82 ± 0.64 (mean difference: 1.45, 95%CI:0.88 to 2.02, <i>p</i> < 0.001). For individuals in the reference group, the proportions with none, one and multiple vessel disease were 80.6%, 16.1% and 3.2%; for those with a history of smoking or with dyslipidaemia were 50.0%, 25.0% and 25.0%; and for those with both risk factors were 8.3%, 25.0% and 66.7%. Patients with a history of both risk factors had greater adjusted risks of having one- vessel disease - OR = 14.3 (95%CI = 2.1-98.2) or multiple vessel disease: OR = 51.8 (95%CI = 4.2-609.6).</p><p><strong>Conclusions: </strong>Smoking and dyslipidaemia together are associated with high coronary artery calcification and CAD, independent of other major risk factors.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"2048004020980945"},"PeriodicalIF":1.6,"publicationDate":"2021-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004020980945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25540827","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":"An indirect effect of covid-19 on the heart: A case report.","authors":"Özge Özden Tok,&nbsp;Konstantinos Papadopoulos,&nbsp;Yasin Çakıllı,&nbsp;Gülsüm Bingöl,&nbsp;Ömer Göktekin,&nbsp;Ignatios Ikonomidis","doi":"10.1177/2048004020974238","DOIUrl":"https://doi.org/10.1177/2048004020974238","url":null,"abstract":"<p><p>Covid-19 virus has been recognized to develop major cardiac complications. The indirect effect of the virus though, in terms of fear for hospital admissions, constitutes a greater threat. In this case we present a 69-year old male patient who suffered from a myocardial infarction that has not been given the proper attention due to the fear of in-hospital contact with covid patients. The result was the delayed revascularization and eventually the development of heart failure. This case presents the full range of covid-19 affection to the heart and raises the public awareness for not underestimating symptoms suggesting life-threatening conditions.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"2048004020974238"},"PeriodicalIF":1.6,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004020974238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25540828","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":"Retrospective cross sectional analysis of demographic disparities in outcomes of CPR performed by EMS providers in the United States.","authors":"Tess Hill,&nbsp;Thomas Weber,&nbsp;Marshall Roberts,&nbsp;Hernando Garzon,&nbsp;Alvaro Fraga,&nbsp;Craig Wetterer,&nbsp;Jose Puglisi","doi":"10.1177/20480040211000619","DOIUrl":"https://doi.org/10.1177/20480040211000619","url":null,"abstract":"<p><strong>Objective: </strong>To investigate demographic disparities in prehospital cardiopulmonary resuscitation (CPR) initiation and successful outcomes of patients with out-of-hospital cardiac arrest (OHCA) treated by emergency medical services (EMS) providers.</p><p><strong>Methods: </strong>We analyzed the National Emergency Medical Service Information Systems (NEMSIS) 2017 database, analyzing patient gender, age and race against CPR initiation and Return of Spontaneous Circulation (ROSC). The analysis was performed for a subset of patients who received bystander interventions (n = 3,362), then repeated for the whole cohort of patients (n = 5,833).</p><p><strong>Results: </strong>Within the subgroup of patients that received CPR or AED application prior to the arrival of the paramedics, a logistic regression for CPR initiation rates as a function of race, gender and age reported the following adjusted odds ratios: African American (AA) to White 0.570 (95%CI [0.419, 0.775]), Hispanic to White 0.735 (95%CI [0.470, 1.150]); female to male 0.768 (95%CI [0.598, 0.986]); senior to adult 0.708 (95%CI [0.545, 0.920). Similarly, a logistic regression of ROSC as a function of race, gender and age reported the following adjusted odds ratios: AA to White 0.652 (95%CI [0.533, 0.797]) Hispanic to White 1.018 (95%CI [0.783, 1.323]); female to male 0.887 (95%CI [0.767, 1.025]); senior to adult 0.817 (95%CI [0.709, 0.940]). Similar trends existed in the entire cohort of patients.</p><p><strong>Conclusions: </strong>These results suggest that there are discrepancies in patient care during cardiopulmonary arrest performed by EMS for OHCA, inviting further exploration of healthcare differences in the prehospital EMS approach to OHCA.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"20480040211000619"},"PeriodicalIF":1.6,"publicationDate":"2021-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/20480040211000619","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25532282","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":"Aortic and mitral flow quantification using dynamic valve tracking and machine learning: Prospective study assessing static and dynamic plane repeatability, variability and agreement.","authors":"Julio Garcia,&nbsp;Kailey Beckie,&nbsp;Ali F Hassanabad,&nbsp;Alireza Sojoudi,&nbsp;James A White","doi":"10.1177/2048004021999900","DOIUrl":"https://doi.org/10.1177/2048004021999900","url":null,"abstract":"<p><strong>Background: </strong>Blood flow is a crucial measurement in the assessment of heart valve disease. Time-resolved flow using magnetic resonance imaging (4 D flow MRI) can provide a comprehensive assessment of heart valve hemodynamics but it relies in manual plane analysis. In this study, we aimed to demonstrate the feasibility of automate the detection and tracking of aortic and mitral valve planes to assess blood flow from 4 D flow MRI.</p><p><strong>Methods: </strong>In this prospective study, a total of <i>n</i> = 106 subjects were enrolled: 19 patients with mitral disease, 65 aortic disease patients and 22 healthy controls. Machine learning was employed to detect aortic and mitral location and motion in a cine three-chamber plane and a perpendicular projection was co-registered to the 4 D flow MRI dataset to quantify flow volume, regurgitant fraction, and a peak velocity. Static and dynamic plane association and agreement were evaluated. Intra- and inter-observer, and scan-rescan reproducibility were also assessed.</p><p><strong>Results: </strong>Aortic regurgitant fraction was elevated in aortic valve disease patients as compared with controls and mitral valve disease patients (<i>p</i> < 0.05). Similarly, mitral regurgitant fraction was higher in mitral valve patients (<i>p</i> < 0.05). Both aortic and mitral total flow were high in aortic patients. Static and dynamic were good (r > 0.6, <i>p</i> < 0.005) for aortic total flow and peak velocity, and mitral peak velocity and regurgitant fraction. All measurements showed good inter- and intra-observer, and scan-rescan reproducibility.</p><p><strong>Conclusion: </strong>We demonstrated that aortic and mitral hemodynamics can efficiently be quantified from 4 D flow MRI using assisted valve detection with machine learning.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"2048004021999900"},"PeriodicalIF":1.6,"publicationDate":"2021-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004021999900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25486782","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":"Contemporary approaches to bifurcation stenting.","authors":"Claire E Raphael,&nbsp;Peter D O'Kane","doi":"10.1177/2048004021992190","DOIUrl":"https://doi.org/10.1177/2048004021992190","url":null,"abstract":"<p><p>Bifurcation lesions are common and associated with higher risks of major cardiac events and restenosis after percutaneous coronary intervention (PCI). Treatment requires understanding of lesion characteristics, stent design and therapeutic options. We review the evidence for provisional vs 2-stent techniques. We conclude that provisional stenting is suitable for most bifurcation lesions. We detail situations where a 2-stent technique should be considered and the steps for performing each of the 2-step techniques. We review the importance of lesion preparation, intracoronary imaging, proximal optimization (POT) and kissing balloon inflation.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"2048004021992190"},"PeriodicalIF":1.6,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004021992190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25486779","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":"Plasma apelin level in acute myocardial infarction and its relation with prognosis: A prospective study.","authors":"Ozge Guzelburc,&nbsp;Refik Demirtunc,&nbsp;Servet Altay,&nbsp;Tugba Kemaloglu Oz,&nbsp;Gulsah Tayyareci","doi":"10.1177/2048004020963970","DOIUrl":"https://doi.org/10.1177/2048004020963970","url":null,"abstract":"<p><strong>Objective: </strong>Apelin is a novel adipocytokine with a significant role in ischemia/reperfusion injury that is synthesized and secreted in myocardial cells and coronary endothelium. There is debate on its value for the diagnosis and prognosis of myocardial infarction. We aimed to investigate plasma apelin level in patients with acute ST segment elevation (STEMI) and non-ST segment elevation (NSTEMI) myocardial infarction and its relationship with left ventricular function and prognostic parameters.</p><p><strong>Methods: </strong>Forty-one patients with STEMI, 21 patients with NSTEMI and 10 patients as control group with normal coronary angiograms were included. Plasma apelin level at presentation was investigated regarding its relationship with other diagnostic and prognostic parameters.</p><p><strong>Results: </strong>Apelin level was significantly higher in acute myocardial infarction (0.31 ± 0.56 ng/mL) compared to control group (0.08 ± 0.05 ng/mL) (p < 0.01). Likewise, it was found to be significantly higher in STEMI group (0.45 ± 0.73 ng/mL) compared to control group (0.08 ± 0.05 ng/mL) (p < 0.01). Although apelin was higher in NSTEMI group (0.13 ± 0.10 ng/mL) compared to control group (0.08 ± 0.05 ng/mL), this difference was not statistically significant (p > 0.05). No correlation was found between apelin and NT-proBNP, hsCRP, troponin, ejection fraction (EF) and Killip score (p > 0.05). A positive correlation was found between apelin and TIMI, GRACE and Gensini scores (p < 0.05). Only GRACE score was found to be correlated with apelin in MI groups.</p><p><strong>Conclusion: </strong>Apelin level was found to be high in acute myocardial infarction. With its inotropic and vasodilator effects, apelin was thought to have a protective role against severe ischemia.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"2048004020963970"},"PeriodicalIF":1.6,"publicationDate":"2021-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004020963970","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25421881","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":"How to select patients requiring coronary revascularisation using coronary physiology.","authors":"Bhavik Modi,&nbsp;Divaka Perera","doi":"10.1177/2048004020979476","DOIUrl":"https://doi.org/10.1177/2048004020979476","url":null,"abstract":"<p><p>The coronary angiogram is an indicator of flow limiting coronary artery disease but coronary physiology at the time of angiography is vital in assessing the true functional significance of coronary artery disease. With advances in guidewire technology and the greater use of physiology within the catheter laboratory, there is now a slow evolution of physiological indices in being able to reliably assess the functional significance of individual lesions and also the adequacy of revascularization in a growing range of clinical scenarios. As co-registration of physiology with the angiogram and intravascular imaging will become easier, we will find ourselves increasingly in an era of 'Precision PCI'.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"2048004020979476"},"PeriodicalIF":1.6,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004020979476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25391365","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":"Improved low-risk criteria scores for combination therapy of sildenafil and generic bosentan in patients with congenital heart disease with severe pulmonary hypertension: A prospective open label study.","authors":"Kritvikrom Durongpisitkul,&nbsp;Paweena Chungsomprasong,&nbsp;Chodchanok Vijarnsorn,&nbsp;Prakul Chanthong,&nbsp;Supaluck Kanjanauthai,&nbsp;Jarupim Soongswang","doi":"10.1177/2048004020982213","DOIUrl":"https://doi.org/10.1177/2048004020982213","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the efficacy and safety of the bosentan as a sequential add-on therapy with sildenafil in pulmonary arterial hypertension with congenital heart disease (PAH-CHD) patients.</p><p><strong>Material and method: </strong>Twenty patients who were receiving sildenafil were given generic bosentan for up to a year. Hemodynamic data was collected from cardiac catheterization at pretreatment and at three months. Comparisons were made between the total scores of the four, low-risk criteria adapted from the 2015 ESC/ERS pulmonary hypertension guidelines, which are: 1) WHO functional class of I or II, 2) 6MWD of more than 440 m, 3) right atrial pressure of less than 8 mm Hg, and 4) cardiac index ≥2.5 L/min/m², performed at the beginning of therapy, 3-months, 6-months, and 1 year.</p><p><strong>Results: </strong>Patients' average age was 27 ± 11 years old (12-53). PVRi decreased from 16.7 ± 9.5 to 12.7 ± 10.3 Wood unit (WU) m2 (p = 0.025) and PVRi/SVRi decreased from 0.69 ± 0.33 to 0.49 ± 0.32 (p = 0.001). During the follow-up, the composite scoring of the low risk scores for 19 patients was increased significantly from 1.8 ± 1.0 at baseline to 2.3 ± 0.9 at 3 months, to 2.9 ± 0.8 at 6 months, and 3 ± 0.7 at 1 year (p = 0.001).</p><p><strong>Conclusion: </strong>We demonstrated intermediate term benefits for generic bosentan as an add-on therapy to sildenafil in patients with PAH-CHD by improving PVRi, and PVRi/SVRi at three months. A significant improvement was also seen in the combined scores of the low-risk criteria from below 2 to 3 at one year (p = 0.001).Thai Clinical Trials Registry (TCTR): TCTR identification number is TCTR20200506006.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"2048004020982213"},"PeriodicalIF":1.6,"publicationDate":"2021-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004020982213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25391367","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}