Pub Date : 2024-06-21DOI: 10.1016/j.ahj.2024.06.006
Chinwe Ibeh MD , Erin R. Kulick PhD, MPH , Amelia K. Boehme PhD , Alexander M. Friedman MD , Eliza C. Miller MD, MS , Natalie A. Bello MD, MPH
Background
Peripartum cardiomyopathy (PPCM), a form of heart failure with reduced ejection fraction (HFrEF) that occurs during the final month of pregnancy through the first 5 months postpartum, is associated with heightened risk for maternal morbidity and mortality. Stroke is a common complication of HFrEF but there is limited data on the incidence of stroke in PPCM.
Methods
Using statewide, nonfederal administrative data from 2000 to 2015, we analyzed age-adjusted risk of stroke within 3 years after PPCM-associated pregnancies.
Results
PPCM was associated with a greater than 4-fold increased risk of pregnancy-related stroke (aHR 4.7, 95% CI: 3.0-7.5). This risk was highest at the time of PPCM diagnosis but remained elevated in the first postpartum year.
Conclusion
Our findings confirm the strong association between PPCM and stroke, with risk that persists throughout and after the peripartum period.
{"title":"Incident stroke in individuals with peripartum cardiomyopathy","authors":"Chinwe Ibeh MD , Erin R. Kulick PhD, MPH , Amelia K. Boehme PhD , Alexander M. Friedman MD , Eliza C. Miller MD, MS , Natalie A. Bello MD, MPH","doi":"10.1016/j.ahj.2024.06.006","DOIUrl":"10.1016/j.ahj.2024.06.006","url":null,"abstract":"<div><h3>Background</h3><p>Peripartum cardiomyopathy (PPCM), a form of heart failure with reduced ejection fraction (HFrEF) that occurs during the final month of pregnancy through the first 5 months postpartum, is associated with heightened risk for maternal morbidity and mortality. Stroke is a common complication of HFrEF but there is limited data on the incidence of stroke in PPCM.</p></div><div><h3>Methods</h3><p>Using statewide, nonfederal administrative data from 2000 to 2015, we analyzed age-adjusted risk of stroke within 3 years after PPCM-associated pregnancies.</p></div><div><h3>Results</h3><p>PPCM was associated with a greater than 4-fold increased risk of pregnancy-related stroke (aHR 4.7, 95% CI: 3.0-7.5). This risk was highest at the time of PPCM diagnosis but remained elevated in the first postpartum year.</p></div><div><h3>Conclusion</h3><p>Our findings confirm the strong association between PPCM and stroke, with risk that persists throughout and after the peripartum period.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"275 ","pages":"Pages 138-140"},"PeriodicalIF":3.7,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-15DOI: 10.1016/j.ahj.2024.06.005
Cayla M. Pichan MD , Wil L. Santivasi MD , Robert J. Mentz MD
{"title":"A bridge to comfort: Palliative inotrope infusion for patients with heart failure in hospice care","authors":"Cayla M. Pichan MD , Wil L. Santivasi MD , Robert J. Mentz MD","doi":"10.1016/j.ahj.2024.06.005","DOIUrl":"10.1016/j.ahj.2024.06.005","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"275 ","pages":"Pages 105-107"},"PeriodicalIF":3.7,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141392140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The semiquantitative Clinical Frailty Scale (CFS) is reportedly a useful marker for predicting short- and mid-term mortality after transcatheter aortic valve implantation (TAVI). We assessed the long-term prognostic impact of CFS in patients with severe aortic stenosis undergoing TAVI.
Methods
We prospectively assessed patients undergoing TAVI in Kokura Memorial Hospital using a 9-level CFS and enrolled 1594 patients after excluding patients with CFS 8-9. The patients were divided into the low (CFS level, 1-3; N = 842), intermediate (4; N = 469), and high (5-7; N = 283) groups according to their CFS levels.
Results
In the low, intermediate, and high groups, 3-year all-cause mortality rates were 17.4%, 29.4%, and 41.7% (P < .001) and composite rates of cardiovascular mortality and heart failure hospitalization were 12.1%, 19.1%, and 23.9% (P < .001), respectively. Multivariable analysis showed that higher frailty was independently associated with all-cause mortality (intermediate group: adjusted hazard ratio [HR], 1.63, 95% confidence interval [CI], 1.24-2.15, P < .001; high group: adjusted HR, 2.18, 95% CI, 1.59-2.99, P < .001) and composite of cardiovascular mortality and heart failure hospitalization (intermediate group: adjusted HR, 1.47, 95% CI, 1.04-2.08, P = .030; high group: adjusted HR, 1.66, 95% CI, 1.09-2.51, P = .018) and this result was consistent, irrespective of stratification based on age, sex, body mass index, left ventricular ejection fraction, Society of Thoracic Surgeons score, and New York Heart Association functional class without significant interaction.
Conclusions
The simple CFS tool predicts the long-term adverse outcomes post-TAVI.
{"title":"Impact of the clinical frailty scale on long-term outcomes after transcatheter aortic valve implantation","authors":"Norihisa Miyawaki MD , Kenichi Ishizu MD , Shinichi Shirai MD , Katsunori Miyahara MD , Ko Yamamoto MD, PhD , Tomohiro Suenaga MD , Akira Otani MD, PhD , Kenji Nakano MD , Tadatomo Fukushima MD , Euihong Ko MD , Yasuo Tsuru MD , Miho Nakamura MD , Toru Morofuji MD , Takashi Morinaga MD , Masaomi Hayashi MD , Akihiro Isotani MD , Nobuhisa Ohno MD , Shinichi Kakumoto MD , Kenji Ando MD","doi":"10.1016/j.ahj.2024.05.017","DOIUrl":"10.1016/j.ahj.2024.05.017","url":null,"abstract":"<div><h3>Background</h3><p>The semiquantitative Clinical Frailty Scale (CFS) is reportedly a useful marker for predicting short- and mid-term mortality after transcatheter aortic valve implantation (TAVI). We assessed the long-term prognostic impact of CFS in patients with severe aortic stenosis undergoing TAVI.</p></div><div><h3>Methods</h3><p>We prospectively assessed patients undergoing TAVI in Kokura Memorial Hospital using a 9-level CFS and enrolled 1594 patients after excluding patients with CFS 8-9. The patients were divided into the low (CFS level, 1-3; N = 842), intermediate (4; N = 469), and high (5-7; N = 283) groups according to their CFS levels.</p></div><div><h3>Results</h3><p>In the low, intermediate, and high groups, 3-year all-cause mortality rates were 17.4%, 29.4%, and 41.7% (<em>P</em> < .001) and composite rates of cardiovascular mortality and heart failure hospitalization were 12.1%, 19.1%, and 23.9% (<em>P</em> < .001), respectively. Multivariable analysis showed that higher frailty was independently associated with all-cause mortality (intermediate group: adjusted hazard ratio [HR], 1.63, 95% confidence interval [CI], 1.24-2.15, <em>P</em> < .001; high group: adjusted HR, 2.18, 95% CI, 1.59-2.99, <em>P</em> < .001) and composite of cardiovascular mortality and heart failure hospitalization (intermediate group: adjusted HR, 1.47, 95% CI, 1.04-2.08, <em>P</em> = .030; high group: adjusted HR, 1.66, 95% CI, 1.09-2.51, <em>P</em> = .018) and this result was consistent, irrespective of stratification based on age, sex, body mass index, left ventricular ejection fraction, Society of Thoracic Surgeons score, and New York Heart Association functional class without significant interaction.</p></div><div><h3>Conclusions</h3><p>The simple CFS tool predicts the long-term adverse outcomes post-TAVI.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"275 ","pages":"Pages 141-150"},"PeriodicalIF":3.7,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.1016/j.ahj.2024.04.010
James A. Reiffel MD
{"title":"Comparative effectiveness of monitoring duration for detection of potential or suspected arrhythmias","authors":"James A. Reiffel MD","doi":"10.1016/j.ahj.2024.04.010","DOIUrl":"https://doi.org/10.1016/j.ahj.2024.04.010","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"274 ","pages":"Pages 113-114"},"PeriodicalIF":4.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141303521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.1016/j.ahj.2024.05.006
Cathlyn K Medina MD , Stephanie G Barnes PhD , G Michael Felker MD, MHS , Robert J Mentz MD , Neha J Pagidipati MD , Keri A Seymour DO , Jacob N Schroder MD , Josephine Harrington MD
Background
Patients with obesity and advanced heart failure requiring left ventricular assist device (LVAD) support are more likely to experience LVAD complications and may be disproportionately Black and/or female when compared to patients without obesity. Among these patients, obesity may represent a barrier to transplant eligibility and a marker of inequity in heart transplantation and health outcomes in advanced heart failure.
Methods
To better understand this issue at our institution, we examined our active LVAD cohort and found that almost one-third of all patients had severe obesity with BMI ≥ 35 kg/m2.
Results
Patients with LVADs and severe obesity were significantly younger and more likely to self-identify as Black, and numerically more likely to be female.
Conclusion
Weight management in this group represents a vital area for improved equity in health outcomes and barriers to heart transplantation.
{"title":"Severe obesity among patients with left ventricular assist devices","authors":"Cathlyn K Medina MD , Stephanie G Barnes PhD , G Michael Felker MD, MHS , Robert J Mentz MD , Neha J Pagidipati MD , Keri A Seymour DO , Jacob N Schroder MD , Josephine Harrington MD","doi":"10.1016/j.ahj.2024.05.006","DOIUrl":"https://doi.org/10.1016/j.ahj.2024.05.006","url":null,"abstract":"<div><h3>Background</h3><p>Patients with obesity and advanced heart failure requiring left ventricular assist device (LVAD) support are more likely to experience LVAD complications and may be disproportionately Black and/or female when compared to patients without obesity. Among these patients, obesity may represent a barrier to transplant eligibility and a marker of inequity in heart transplantation and health outcomes in advanced heart failure.</p></div><div><h3>Methods</h3><p>To better understand this issue at our institution, we examined our active LVAD cohort and found that almost one-third of all patients had severe obesity with BMI ≥ 35 kg/m<sup>2</sup>.</p></div><div><h3>Results</h3><p>Patients with LVADs and severe obesity were significantly younger and more likely to self-identify as Black, and numerically more likely to be female.</p></div><div><h3>Conclusion</h3><p>Weight management in this group represents a vital area for improved equity in health outcomes and barriers to heart transplantation.</p></div><div><h3>Trial Registration</h3><p>NA.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"274 ","pages":"Pages 130-133"},"PeriodicalIF":4.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141303520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.1016/j.ahj.2024.04.014
Lauge Østergaard MD, PhD, Sofie Truong MB, Jeppe Petersen MD, Eva Havers-Borgersen MD, Lars Køber MD, DMSc, Emil Loldrup Fosbøl MD, PhD
This report aimed to examine temporal changes in the number of recommendations on management of infective endocarditis in the European and American guidelines. The number of recommendations has increased since 2004 without an increment in evidence base in the European iteration. American guidelines have reduced the number of recommendations with a main evidence base of level B.
{"title":"Temporal changes in the number of European and American guideline recommendations and underlying evidence base for the management of infective: An update of previous published data","authors":"Lauge Østergaard MD, PhD, Sofie Truong MB, Jeppe Petersen MD, Eva Havers-Borgersen MD, Lars Køber MD, DMSc, Emil Loldrup Fosbøl MD, PhD","doi":"10.1016/j.ahj.2024.04.014","DOIUrl":"https://doi.org/10.1016/j.ahj.2024.04.014","url":null,"abstract":"<div><p>This report aimed to examine temporal changes in the number of recommendations on management of infective endocarditis in the European and American guidelines. The number of recommendations has increased since 2004 without an increment in evidence base in the European iteration. American guidelines have reduced the number of recommendations with a main evidence base of level B.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"274 ","pages":"Pages 115-118"},"PeriodicalIF":4.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0002870324001005/pdfft?md5=90b01e82f470a30b4f038f04bbd56a33&pid=1-s2.0-S0002870324001005-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141303519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-09DOI: 10.1016/j.ahj.2024.06.001
Rohini Ramaseshan MD , Dhanuka Perera MD , Alice Reid MA , Mervyn Andiapen RN , Cono Ariti PhD , Matthew Kelham MD , Daniel A. Jones MD PhD , Anthony Mathur MD PhD
Aims
The REGENERATE-COBRA trial (NCT05711849) will assess the safety and efficacy of an intracoronary infusion of autologous bone marrow-derived mononuclear cells in refractory angina patients with no revascularization options who are symptomatic despite optimal medical and device therapy.
Methods
REGENERATE-COBRA is a single site, blinded, randomized, sham-controlled, Phase II clinical trial enrolling 110 refractory angina patients with no revascularization options who are symptomatic despite optimal medical and device therapy. Patients will be randomized to either autologous bone marrow derived-mononuclear cells or a sham procedure. Patients in the cell-treated arm will undergo a bone marrow aspiration and an intracoronary infusion of autologous bone marrow derived-mononuclear cells. Patients in the control arm will undergo a sham bone marrow aspiration and a sham intracoronary infusion. The trial's primary endpoint is an improvement in Canadian Cardiovascular Society (CCS) angina class by 2 classes between baseline and 6 months. Secondary endpoints include change in: CCS class at 12 months, myocardial ischemic burden (as measured by perfusion imaging) at 6 months, quality of life at 6 and 12 months (as measured by EQ-5D-5L, EQ-5D-VAS and Seattle Angina Questionnaire), angina frequency at 6 and 12 months, total exercise time (as measured by a modified Bruce protocol) and major adverse cardiovascular events at 6 and 12 months.
Conclusions
This is the first trial to assess the safety and efficacy of an intracoronary infusion of autologous bone marrow-derived unfractionated mononuclear cells in symptomatic refractory angina patients who have exhausted conventional therapeutic options.
{"title":"REGENERATE-COBRA: A phase II randomized sham-controlled trial assessing the safety and efficacy of intracoronary administration of autologous bone marrow-derived cells in patients with refractory angina","authors":"Rohini Ramaseshan MD , Dhanuka Perera MD , Alice Reid MA , Mervyn Andiapen RN , Cono Ariti PhD , Matthew Kelham MD , Daniel A. Jones MD PhD , Anthony Mathur MD PhD","doi":"10.1016/j.ahj.2024.06.001","DOIUrl":"10.1016/j.ahj.2024.06.001","url":null,"abstract":"<div><h3>Aims</h3><p>The REGENERATE-COBRA trial (NCT05711849) will assess the safety and efficacy of an intracoronary infusion of autologous bone marrow-derived mononuclear cells in refractory angina patients with no revascularization options who are symptomatic despite optimal medical and device therapy.</p></div><div><h3>Methods</h3><p>REGENERATE-COBRA is a single site, blinded, randomized, sham-controlled, Phase II clinical trial enrolling 110 refractory angina patients with no revascularization options who are symptomatic despite optimal medical and device therapy. Patients will be randomized to either autologous bone marrow derived-mononuclear cells or a sham procedure. Patients in the cell-treated arm will undergo a bone marrow aspiration and an intracoronary infusion of autologous bone marrow derived-mononuclear cells. Patients in the control arm will undergo a sham bone marrow aspiration and a sham intracoronary infusion. The trial's primary endpoint is an improvement in Canadian Cardiovascular Society (CCS) angina class by 2 classes between baseline and 6 months. Secondary endpoints include change in: CCS class at 12 months, myocardial ischemic burden (as measured by perfusion imaging) at 6 months, quality of life at 6 and 12 months (as measured by EQ-5D-5L, EQ-5D-VAS and Seattle Angina Questionnaire), angina frequency at 6 and 12 months, total exercise time (as measured by a modified Bruce protocol) and major adverse cardiovascular events at 6 and 12 months.</p></div><div><h3>Conclusions</h3><p>This is the first trial to assess the safety and efficacy of an intracoronary infusion of autologous bone marrow-derived unfractionated mononuclear cells in symptomatic refractory angina patients who have exhausted conventional therapeutic options.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"275 ","pages":"Pages 96-104"},"PeriodicalIF":3.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0002870324001467/pdfft?md5=79592e1b2c7457ddfe555662ee2a5302&pid=1-s2.0-S0002870324001467-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-09DOI: 10.1016/j.ahj.2024.05.016
Background
Cardiovascular health literacy (CVHL) and social determinants of health (SDoH) play interconnected and critical roles in shaping cardiovascular health (CVH) outcomes. However, awareness of CVH risk has declined markedly, from 65% of women being aware that cardiovascular disease (CVD) is the leading cause of death for women in 2009 to just 44% being aware in 2019. The American Heart Association Research Goes Red (RGR) initiative seeks to develop an open-source, longitudinal, dynamic registry that will help women to be aware of and participate in research studies, and to learn about CVD prevention. We proposed to leverage this platform, particularly among Black and Hispanic women of reproductive age, to address CVHL gaps and advance health equity.
Methods
The primary objective of the study is to evaluate the cross-sectional association of CVHL, SDoH using a polysocial score, and CVH in women of reproductive age at increased risk of developing hypertension (HTN). To achieve this we will use a cross-sectional study design, that engages women already enrolled in the RGR registry (registry-enrolled). To enhance the racial and ethnic/social economic diversity of the cohort, we will additionally enroll 300 women from the Baltimore and Washington D.C. community into the Social Determinants of the Risk of Hypertension in Women of Reproductive Age (SAFE HEART) Study. Community-enrolled and registry-enrolled women will undergo baseline social phenotyping including detailed SDoH questionnaire, CVH metrics assessment, and CVHL assessment. The secondary objective is to assess whether a 4-month active health education intervention will result in a change in CVHL in the 300 community-enrolled women.
Discussion
The SAFE HEART study examines the association between CVHL, SDoH, and CVH, with a focus on racial and ethnic minority groups and socioeconomically disadvantaged women of reproductive age, and the ability to improve these parameters by an educational intervention. These findings will inform the future development of community-engaged strategies that address CVHL and SDoH among women of reproductive age.
{"title":"Design and rationale of the social determinants of the risk of hypertension in women of reproductive age (SAFE HEART) study: An American Heart Association research goes red initiative","authors":"","doi":"10.1016/j.ahj.2024.05.016","DOIUrl":"10.1016/j.ahj.2024.05.016","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular health literacy (CVHL) and social determinants of health (SDoH) play interconnected and critical roles in shaping cardiovascular health (CVH) outcomes. However, awareness of CVH risk has declined markedly, from 65% of women being aware that cardiovascular disease (CVD) is the leading cause of death for women in 2009 to just 44% being aware in 2019. The American Heart Association Research Goes Red (RGR) initiative seeks to develop an open-source, longitudinal, dynamic registry that will help women to be aware of and participate in research studies, and to learn about CVD prevention. We proposed to leverage this platform, particularly among Black and Hispanic women of reproductive age, to address CVHL gaps and advance health equity.</p></div><div><h3>Methods</h3><p>The primary objective of the study is to evaluate the cross-sectional association of CVHL, SDoH using a polysocial score, and CVH in women of reproductive age at increased risk of developing hypertension (HTN). To achieve this we will use a cross-sectional study design, that engages women already enrolled in the RGR registry (registry-enrolled). To enhance the racial and ethnic/social economic diversity of the cohort, we will additionally enroll 300 women from the Baltimore and Washington D.C. community into the Social Determinants of the Risk of Hypertension in Women of Reproductive Age (SAFE HEART) Study. Community-enrolled and registry-enrolled women will undergo baseline social phenotyping including detailed SDoH questionnaire, CVH metrics assessment, and CVHL assessment. The secondary objective is to assess whether a 4-month active health education intervention will result in a change in CVHL in the 300 community-enrolled women.</p></div><div><h3>Discussion</h3><p>The SAFE HEART study examines the association between CVHL, SDoH, and CVH, with a focus on racial and ethnic minority groups and socioeconomically disadvantaged women of reproductive age, and the ability to improve these parameters by an educational intervention. These findings will inform the future development of community-engaged strategies that address CVHL and SDoH among women of reproductive age.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"275 ","pages":"Pages 151-162"},"PeriodicalIF":3.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0002870324001388/pdfft?md5=d9c70cd853b434b9279b581c05de4835&pid=1-s2.0-S0002870324001388-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}