British Heart Journal最新文献

{"title":"Response to: Correspondence on “Tetralogy of Fallot: management of residual hemodynamic and electrophysiological abnormalities” by Yalta et al","authors":"A. Zaidi","doi":"10.1136/heartjnl-2022-320823","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-320823","url":null,"abstract":"","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1157 - 1158"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46522147","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":"Heartbeat: calcium belongs in bones not hearts","authors":"C. Otto","doi":"10.1136/heartjnl-2022-321376","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-321376","url":null,"abstract":"Calcific aortic stenosis (AS) is characterised at the tissue level by inflammation, lipid deposition and calcification of the valve leaflets. Yet, the potential role of dietary calcium supplements in the development or progression of AS is not clear. In this issue of Heart, Kassis and colleagues report the association between dietary calcium supplementation and cardiovascular (CV) outcomes in a retrospective longitudinal study of 2657 patients age 60 years or older with mildtomoderate AS. In the 39% of patients taking calcium supplements, with or without vitamin D supplementation, there was a higher risk of allcause mortality (absolute rate (AR)=43.0/1000 personyears; HR=1.31, 95% CI (1.07 to 1.62); p=0.009), CV mortality (AR=13.7/1000 personyears; HR=2.0, 95% CI (1.31 to 3.07); p=0.001) and aortic valve replacement (AVR) (AR=88.2/1000 personyears; HR=1.48, 95% CI (1.24 to 1.78); p<0.001), compared with those not on calcium supplementation (figure 1). However, there was no association between calcium supplementation and echocardiographic changes in transaortic pressure gradient or valve area. In the accompanying editorial BerglerKlein points out that, compared with calcium supplements, dietary calcium has little influence on serum calcium availability. Importantly, ‘vitamin D supplementation alone remained neutral with respect to AVR and was not linked to any mortality increase in multivariable analyses, so that the assumed beneficial effects concerning osteoporosis and bone metabolism are maintained in patients with AS.’ Hopefully, future osteoporosis studies will focus both on benefits due to improved bone strength and risks related to adverse cardiovascular outcomes (figure 2). For now, ‘In patients with calcific AS and highrisk CV, the present study strongly adds to the evidence that longterm continuous calcium supplementation should be avoided if not mandatory.’ Another important study in this issue of Heart evaluated whether outcomes with","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"899 - 901"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46426726","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":"The importance of right ventricular remodelling in pulmonary arterial hypertension","authors":"M. D'alto, R. Badagliacca","doi":"10.1136/heartjnl-2022-321143","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-321143","url":null,"abstract":"The major determinant of symptoms and outcome in patients with pulmonary arterial hypertension (PAH) is right ventricle (RV) function and its coupling to the pulmonary circulation. To preserve a suffi-cient cardiac output, the RV adapts to increased afterload by increased contrac-tility (homeometric adaptation) and, when this mechanism becomes exhausted, by increased volumes (heterometric adaptation).Recent evidence 1 has shown that PAH progression is characterised by changes in RV dimension and function (increased volumes and decreased ejection frac-tion), even in apparently stable patients, highlighting the importance of RV in determining the prognosis. The study from Goh and colleagues 2 underscores the relevance of RV remodelling in PAH. The authors analysed a large cohort of 505 patients from the ASPIRE (Assessing the Spectrum of Pulmonary hypertension Identified at a REferral centre) registry. Cardiac magnetic resonance allowed to identify four different RV adaptation clusters according to its volume and mass. Patients with a favourable adaptive remodelling (low volume and low mass) had the best prognosis. Interestingly, these patients showed the highest cardiac index, mixed venous oxygen saturation, RV ejection fraction and RV- pulmonary arterial coupling, the lowest mean pulmonary artery pressure and pulmonary vascular resistance (PVR), and the smallest right atrium area. All these prognostic indicators are associated with better RV function. On the contrary, patients with a maladaptive remodelling (high- volume- low- mass) the worst prognosis. study important clin-ical implications.RV reverse remodelling an excellent long- term survival and quality of life, it by For an reverse","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1338 - 1339"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42070333","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":"Correspondence on \"Tetralogy of Fallot: management of residual hemodynamic and electrophysiological abnormalities\" by Zaidi","authors":"K. Yalta, T. Yalta, Cihan Ozturk","doi":"10.1136/heartjnl-2022-320821","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-320821","url":null,"abstract":"To the Editor In clinical practice, tetralogy of Fallot (TOF) has been a specific form of cyanotic congenital heart disease particularly requiring a lifelong followup. The recently published article by Zaidi has focused on residual abnormalities in the setting of repaired tetralogy of Fallot (rTOF). In this context, functional tricuspid regurgitation (TR) and its management might also have important implications in patients with rTOF requiring pulmonary valve replacement (PVR). It is well known that functional TR might potentially follow a progressive course after cardiac surgeries performed for leftsided valvular pathologies with pulmonary hypertension (despite a transient postoperative improvement in TR severity) largely due to the ongoing structural changes of tricuspid annulus. 3 As expected, this most likely occurs in patients with significant degrees of preoperative TR and/or tricuspid annular dilatation potentially mandating concomitant tricuspid and leftsided valve interventions in these patients. 3 These notions 3 might also apply to the setting of rTOF with a significant pulmonary infundibular or valvular pathology (associated with right ventricular (RV) pressure or volume overload) requiring reintervention. In the recently reported largest study comprising 542 subjects with rTOF or pulmonary stenosis requiring PVR, concomitant tricuspid valve intervention (TVI) led to an additional 2.3fold decrease in TR severity without any significant increases in length of hospital stay and early adverse outcomes. The authors particularly suggested concomitant TVI as an efficient and safe option that might further improve TR grade beyond the favourable impact of RV offloading obtained with PVR in isolation. In this context, patients with preoperative significant TR or tricuspid annulus diameter of >40 mm or those with structural leaflet pathologies including leaflet entrapment, leadrelated injury and congenital anomalies have been suggested to be particularly eligible for combined TVI and PVR. Based on the abovementioned notions, functional TR with highrisk features (including increased annulus diameter) might also be labelled as an important residual haemodynamic abnormality usually emerging in association with pulmonary regurgitation and/or infundibular restenosis in patients with rTOF. Importantly, this form of TR might have the potential to hamper RV reverse remodelling, and might even lead to endstage right heart failure (even after successful PVR) potentially mandating TVI at the time of PVR in this specific group of relatively young patients.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1157 - 1157"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46061017","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":"Perioperative outcomes and readmissions following cardiac operations in kidney transplant recipients.","authors":"Josef Madrigal, Shannon Richardson, Joseph Hadaya, Arjun Verma, Zachary Tran, Yas Sanaiha, Peyman Benharash","doi":"10.1136/heartjnl-2022-321030","DOIUrl":"10.1136/heartjnl-2022-321030","url":null,"abstract":"<p><strong>Objective: </strong>Although kidney transplant (KTx) recipients are at significant risk for cardiovascular disease, outcomes following cardiac operations have been examined in limited series. The present study thus aimed to assess the impact of KTx on in-hospital perioperative outcomes and readmissions in a nationally representative cohort.</p><p><strong>Methods: </strong>All adults undergoing elective coronary artery bypass grafting, valve repair/replacement or a combination thereof were identified from the 2010-2018 Nationwide Readmissions Database. Patients were stratified by history of KTx. Transplant-capable centres were defined as hospitals performing at least one KTx annually. To perform risk-adjustment in assessing outcomes, multivariable regression models were developed.</p><p><strong>Results: </strong>Of an estimated 1 407 351 patients included for analysis, 0.2% (n=2849) were KTx recipients. Compared with the general cardiac surgical population, patients with prior KTx experienced higher adjusted odds of in-hospital mortality (adjusted OR (AOR) 2.44, 95% CI 1.72 to 3.47, p<0.001) and perioperative complication (AOR 1.67, 95% CI 1.44 to 1.94, p<0.001). Additionally, KTx was independently associated with greater readmission rates within 30 days (AOR 1.96, 95% CI 1.65 to 2.34, p<0.001) with kidney injury contributing significantly to the burden of rehospitalisation (4.6 vs 1.8%, p=0.005). In a subpopulation comprised of only KTx recipients, treatment at a transplant-capable centre reduced odds of kidney injury with non-transplant hospitals as reference (AOR 0.65, 95% CI 0.43 to 0.98, p=0.037).</p><p><strong>Conclusions: </strong>Kidney transplant recipients undergoing cardiac operations encounter significant risks compared with the general surgical population. Referral to transplant-capable centres should be explored to improve outcomes and to preserve allograft function in this population.</p>","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44555593","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":"Intensive care of adults with congenital heart disease","authors":"P. Guedes Ramallo, L. Dos-Subirà","doi":"10.1136/heartjnl-2022-320926","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-320926","url":null,"abstract":"Congenital heart diseases (CHD) are a variety of heart conditions that afflict an increasing number of adults. Significant advances in paediatric cardiology and paediatric cardiac surgery over the past decades have modified mortality trends and currently nearly 90% of children born with these defects reach adulthood. As a result, there are nowadays more adults than children living with CHD. However, these are repaired hearts with residual lesions that may require subsequent interventions over time and that are exposed to longterm complications, predominantly arrhythmias and heart failure. Moreover, the particular physiology of some CHD has a multisystemic impact that may lead to complications in organs far from the heart. Some of these cardiovascular and noncardiovascular complications are lifethreatening and require intensive care unit (ICU) admission. Such is the case of severe arrhythmias, acute pulmonary oedema, haemoptysis due to major aortopulmonary collateral arteries, acute cholecystitis due to gallstones in patients with cyanosis, infective endocarditis or stroke, among others. Approximately 16% of patients with adult congenital heart disease (ACHD) will require an ICU admission by the age of 40, particularly those with more complex forms of CHD. Management of these patients during this critical situation is challenging and requires a complete understanding of the anatomy, physiology and associated comorbidities to tailor an individualised approach that achieves the optimal care.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1424 - 1425"},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41620222","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":"Representation of women in heart failure trials: does it matter?","authors":"P. Parwani, H. V. Van Spall, M. Mamas","doi":"10.1136/heartjnl-2022-321094","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-321094","url":null,"abstract":"Heart failure (HF) is a leading cause of hospitalisation, morbidity, and mortality in men and women, accounting for 46 076 annual HF deaths in women and 2.6 million women living with HF between 2015 and 2018 in the USA. Sex differences across the HF spectrum are well defined and pertain to risk factors, aetiology, provision of evidencebased therapies, referral to services, treatment response and clinical outcomes in both the acute and chronic HF syndrome setting. Much of our evidence base for the management of HF is derived from randomised clinical trials (RCTs) that inform best practice for the treatment of HF and shape guideline recommendations. The value of such trials in informing the management of HF in both men and women depends on representativeness of trial populations. Underenrolment of women in HF trials is well documented, including in landmark trials that have informed care. Since 2000, multiple studies have examined the recruitment of women in HF RCTs and reported that enrolment of women has varied between 21% and 29%, which is significantly below the prevalence of HF at the population level. In an attempt to quantify the representativeness in trials, recent studies have used the ratio of trial participation to disease prevalence ratio (PPR). A PPR <0.8 is considered low and indicates underrepresentation. A recent analysis of 740 cardiovascular trials (102 trials in HF) registered between 2010 and 2017 has shown the lowest PPR of 0.48 in HF trials. This is despite the fact that legislature such as the National Institutes of Health Revitalization Act stipulates the inclusion of women and men in clinical trials proportionate to the sexrelated prevalence of the disease under investigation, to provide data on the treatment effect of interventions/treatments studied in both women and men. Recent studies have tried to understand the factors responsible for low enrolment of women in HF trials. The low enrolment rates of women in cardiovascular clinical trials have historically been attributed to agerecruitment bias since cardiovascular disease is seen predominantly in older women. However, recent multivariable analyses have revealed trial characteristics such as ambulatory recruitment, sexspecific exclusion criteria, drug, device and surgical interventions, exclusively male trial leadership and trial coordination in North America, Europe and Asia to be independently associated with underenrolment of women in HFrEF RCTs. Moreover, poor awareness of HF trials, concerns around greater perceived risks from trial participation and childcare responsibilities have been reported as additional barriers to more equitable participation of women in clinical trials. It is important to highlight that randomised control trials led by women have greater odds of enrolling a representative sample of women and women steering committee members. 8 9 In the present study, Morgan et al have undertaken a systemic review of HF trials published in seven highimpact c","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1508 - 1509"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45106748","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":"Early and long-term outcomes of conventional and valve-sparing aortic root replacement","authors":"M. Jahangiri, K. Mani, M. Acharya, R. Bilkhu, Paul Quinton, F. Schroeder, R. Morgan, M. Edsell","doi":"10.1136/heartjnl-2022-320870","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-320870","url":null,"abstract":"Objective To determine the early and long-term outcomes of conventional aortic root (ARR) and valve-sparing root replacement (VSRR) using a standard perioperative and operative approach. Methods We present prospectively collected data of 609 consecutive patients undergoing elective and urgent aortic root surgery (470 ARR, 139 VSRR) between 2006 and 2020. Primary outcomes were operative mortality and incidence of postoperative complications. Secondary outcomes were long-term survival and requirement for reintervention. Median follow-up was 7.6 years (range 0.5–14.5). Results 189 patients (31%) had bicuspid aortic valves and 17 (6.9%) underwent redo procedures. Median cross-clamp time was 88 (range 54–208) min with cardiopulmonary bypass of 108 (range 75–296) min. In-hospital mortality was 10 (1.6%), with transient ischaemic attacks/strokes occurring in 1.1%. In-hospital mortality for VSRR was 0.7%. 12 patients (2.0%) required a resternotomy for bleeding and 14 (2.3%) received haemofiltration. Intensive care unit and hospital stay were 1.7 and 7.0 days, respectively. During follow-up, redo surgery for native aortic valve replacement was required in 1.4% of the VSRR group. Overall survival was 95.1% at 3 years, 93.1% at 5 years, 91.2% at 7 years and 88.6% at 10 years. Conclusions ARR and VSRR can be performed with low mortality and morbidity as well as a low rate of reintervention during the period of long-term follow-up, if performed by an experienced team with a consistent perioperative approach. This series provides contemporary evidence to balance the risks of aortic aneurysms and their rupture at diameters of <5.5 cm against the risks and benefits of surgery.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1858 - 1863"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44769496","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":"How electrically silent is the pericardium?","authors":"Y. Birnbaum, B. Uretsky","doi":"10.1136/heartjnl-2021-320728","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320728","url":null,"abstract":"Acute pericarditis is a clinical inflamma-tory syndrome. The diagnosis is made when at least two of the following four criteria are present: (1) characteristic chest pain; (2) presence of pericardial friction rub; (3) ECG changes (up to 60% of patients); and (4) pericardial effusion (detected by imaging techniques in up to 60% of patients). 1 While it is commonly believed that diffuse ST segment elevation with concomitant ST depression in lead aVR (and V1) and with PR segment depression is typically detected in patients with acute pericarditis, this classic pattern is seen in less than 60% of patients. For example, Imazio et al 2 reported ST segment elevation in only 25% of their cohort of 240 patients with pericarditis. The classic ECG findings are seen mainly in the early phase (stage 1) of acute pericarditis and typically persist up to 2 weeks after symptom onset. 3 Later on, ST segment elevation resolves, and T waves become flat or inverted. These changes can persist for several weeks until complete resolution (stage 4). 3 However, it should be noted that similar ECG pattern with PR segment depression, diffuse ST elevation and ST depression in aVR can be seen with ‘early repolarisation’. 4 Thus, it could be that in some patients overdiag-nosis of acute pericarditis is made if diagnosis relies on the ECG in the presence of chest pain (that can be due to other aetiologies). the considered to be electric silent, inflammation limited to the not result in ST segment deviation. 1 3 Concomitant the 1 in","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1428 - 1429"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49155240","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":"Fractional flow reserve versus angiography alone in guiding myocardial revascularisation: a systematic review and meta-analysis of randomised trials","authors":"A. Elbadawi, Ramy Sedhom, Alexander T. Dang, M. Gad, Faisal Rahman, E. Brilakis, I. Elgendy, H. Jneid","doi":"10.1136/heartjnl-2021-320768","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320768","url":null,"abstract":"Background Randomised trials evaluating the efficacy and safety of fractional flow reserve (FFR)-guided versus angiography-guided revascularisation among patients with obstructive coronary artery disease (CAD) have yielded mixed results. Aims To examine the comparative efficacy and safety of FFR-guided versus angiography-guided revascularisation among patients with obstructive CAD. Methods An electronic search of MEDLINE, SCOPUS and Cochrane databases without language restrictions was performed through November 2021 for randomised controlled trials that evaluated the outcomes of FFR-guided versus angiography-guided revascularisation. The primary outcome was major adverse cardiac events (MACE). Data were pooled using a random-effects model. Results The final analysis included seven trials with 5094 patients. The weighted mean follow-up duration was 38 months. Compared with angiography guidance, FFR guidance was associated with fewer number of stents during revascularisation (standardised mean difference=−0.80; 95% CI −1.33 to −0.27), but no difference in total hospital cost. There was no difference between FFR-guided and angiography-guided revascularisation in long-term MACE (13.6% vs 13.9%; risk ratio (RR) 0.97, 95% CI 0.85 to 1.11). Meta-regression analyses did not reveal any evidence of effect modification for MACE with acute coronary syndrome (p=0.36), proportion of three-vessel disease (p=0.88) or left main disease (p=0.50). There were no differences between FFR-guided and angiography-guided revascularisation in the outcomes all-cause mortality (RR 1.16, 95% CI 0.80 to 1.68), cardiovascular mortality (RR 1.27, 95% CI 0.50 to 3.26), repeat revascularisation (RR 0.99, 95% CI 0.81 to 1.21), recurrent myocardial infarction (RR 0.92, 95% CI 0.74 to 1.14) or stent thrombosis (RR 0.61, 95% CI 0.31 to 1.21). Conclusion Among patients with obstructive CAD, FFR-guided revascularisation did not reduce the risk of long-term adverse cardiac events or the individual outcomes. However, FFR-guided revascularisation was associated with fewer number of stents. PROSPERO registration number CRD42021291596.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1699 - 1706"},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45164903","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}