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Cardiovascular Diseases Commons

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The "Double Loaded" Lv: High Prevalence Of Hypertensive Lvh Preceding The Development Of Severe Aortic Stenosis, Summer Aldrugh, Neha Varma, Colleen Harrington, Matthew Parker, Nikolaos Kakouros, Gerard P. Aurigemma 2017 University of Massachusetts Medical School

The "Double Loaded" Lv: High Prevalence Of Hypertensive Lvh Preceding The Development Of Severe Aortic Stenosis, Summer Aldrugh, Neha Varma, Colleen Harrington, Matthew Parker, Nikolaos Kakouros, Gerard P. Aurigemma

UMass Center for Clinical and Translational Science Research Retreat

Background: It is generally assumed that left ventricular hypertrophy (LVH) in aortic stenosis (AS) is a compensatory adaptation to chronic outflow obstruction. However the advent of TAVR has stimulated more focus on AS in older patients, most of whom have antecedent hypertension (HTN). Accordingly our aim was to investigate the interaction between HTN and AS on LV remodeling in contemporary practice.

Methods: We studied 33 consecutive patients with AV peak velocity (PV) >2.5 m/s on their initial echo and a PV of >3.5 m/s on a subsequent study performed at least 5 years later. Patients’ demographics ...


Association Between Psychosocial Factors, Quality Of Life And Atrial Fibrillation, Summer Aldrugh, Mayank Sardana, Darleen M. Lessard, Jane S. Saczynski, David D. McManus 2017 University of Massachusetts Medical School

Association Between Psychosocial Factors, Quality Of Life And Atrial Fibrillation, Summer Aldrugh, Mayank Sardana, Darleen M. Lessard, Jane S. Saczynski, David D. Mcmanus

UMass Center for Clinical and Translational Science Research Retreat

Background: Atrial fibrillation (AF) is associated with cognitive and psychosocial comorbidities, and poorer quality of life (QOL). In this study, we aimed to study the association between cognition, psychosocial status and QOL at baseline and AF recurrence.

Methods: We enrolled 222 symptomatic AF patients (64±10.0 years, 36% women) treated with a rhythm-control strategy. We performed cognitive, psychosocial, and QOL assessments using Montreal cognitive assessment (MOCA, cognitive impairment

Results: A total of 123 (55%) participants experienced an AF recurrence over the 6-month follow-up period. Participants with an AF recurrence had higher rates of depression (31% vs.14%, p=0 ...


Survivors Of An Acute Coronary Syndrome With Lower Patient Activation Are More Likely To Experience Declines In Health-Related Quality Of Life, Nathaniel A. Erskine, Barbara L. Gandek, Molly E. Waring, Rebecca L. Kinney, Darleen M. Lessard, Randolph S. Devereaux, Stavroula A. Chrysanthopoulou, Catarina I. Kiefe, Robert J. Goldberg 2017 University of Massachusetts Medical School

Survivors Of An Acute Coronary Syndrome With Lower Patient Activation Are More Likely To Experience Declines In Health-Related Quality Of Life, Nathaniel A. Erskine, Barbara L. Gandek, Molly E. Waring, Rebecca L. Kinney, Darleen M. Lessard, Randolph S. Devereaux, Stavroula A. Chrysanthopoulou, Catarina I. Kiefe, Robert J. Goldberg

UMass Center for Clinical and Translational Science Research Retreat

Background: Patient activation comprises the knowledge, skills, and confidence for self-care, and may lead to better health outcomes.

Objectives: We examined the relationship between patient activation and changes in health-related quality of life (HRQOL) following hospitalization for an acute coronary syndrome (ACS).

Methods: We studied patients from 6 medical centers in central Massachusetts and Georgia who had been hospitalized for an ACS between 2011 and 2013. At 1 month after hospital discharge, patients completed the 6-item Patient Activation Measure and were categorized into 4 levels of activation. Multinomial logistic regression analyses compared activation level with clinically meaningful changes (≥ 3.0 ...


Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. McManus 2017 University of Massachusetts Medical School

Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. Mcmanus

UMass Center for Clinical and Translational Science Research Retreat

BACKGROUND: Atrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India. Moreover, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF.

OBJECTIVE: The objectives of this study are to evaluate the age- and sex-stratified epidemiology of AF in Anand District, Gujarat India; characterize the profile of individuals who are diagnosed with AF; and determine the performance of two mobile technologies for ...


Transcriptional Regulation Of Cardiac Remodeling In A Porcine Model With Validation In Human Subjects, Aditya Vaze, David D. McManus, Kevin Donahue 2017 University of Massachusetts Medical School

Transcriptional Regulation Of Cardiac Remodeling In A Porcine Model With Validation In Human Subjects, Aditya Vaze, David D. Mcmanus, Kevin Donahue

UMass Center for Clinical and Translational Science Research Retreat

Introduction: The majority of new atrial fibrillation (AF) cases occur in elderly patients with cardiac remodeling (CR) in the setting of structural heart disease and heart failure (HF). We leveraged a unique animal model to identify cardiac microRNAs (miRNAs) and gene regulatory mechanisms that drive this process.

Methods: We prospectively quantified atrial expression of 48 miRNAs by high-throughput qRT-PCR in 15 pigs with right-atrial pacing-induced heart disease (5 pigs with AF/severe HF, 5 pigs with AF/mild HF, and 5 control pigs) as well as in 21 patients (11 with AF and CR and 10 controls) undergoing cardiac surgery ...


Effect Of Exercise Training On Microvascular Function In African American And Caucasian Women, Huimin Yan, Keyshla M. Melendex-Rosado, Robert C. Hickner 2017 University of Massachusetts Boston

Effect Of Exercise Training On Microvascular Function In African American And Caucasian Women, Huimin Yan, Keyshla M. Melendex-Rosado, Robert C. Hickner

UMass Center for Clinical and Translational Science Research Retreat

African Americans (AA), especially women, exhibit long-standing disparities in cardiovascular disease (CVD) and obesity. The prevalence of endothelial dysfunction, directly linked to hypertension, is considerably greater in AA than Caucasians (C). Vascular smooth muscle function (mediating endothelium-independent vasodilation) is also related to CVD risk factors but is underappreciated because most literature in C suggest endothelium-independent vasodilatory response is resistance to change with disease (hypertension) or exercise training. Furthermore, the regulation of local skeletal muscle blood flow (an important site of peripheral resistance) has not been sufficiently assessed. Microdialysis is the only method that allows monitoring of microvascular blood flow while ...


Altered Baroreflex-Mediated Cardiovascular Responses To Acute Hypotension In Heart Failure Patients Compared To Healthy Adults, Rachel C. Drew, Chelsea N. Lindblad, Soraya M. Samii, Cheryl A. Blaha, Michael J. White, Lawrence I. Sinoway 2017 University of Massachusetts Boston

Altered Baroreflex-Mediated Cardiovascular Responses To Acute Hypotension In Heart Failure Patients Compared To Healthy Adults, Rachel C. Drew, Chelsea N. Lindblad, Soraya M. Samii, Cheryl A. Blaha, Michael J. White, Lawrence I. Sinoway

UMass Center for Clinical and Translational Science Research Retreat

Patients with heart failure (HF) exhibit baroreflex dysfunction, which is associated with increased morbidity and mortality. Orthostatic hypotension, a decrease in blood pressure (BP) upon standing, is a condition that often occurs in HF, and may be linked with altered baroreflex responsiveness in this population. However, data on baroreflex-mediated cardiovascular responses to acute hypotension in HF patients are limited. Therefore, 8 HF patients (7 men; mean±SEM 65±3y; ejection fraction 30.5±3.1%) and 7 healthy control (CON) adults (6 men; 65±2y) underwent 7.5 minutes of unilateral lower-limb ischemia via inflation of a thigh cuff on ...


Accuracy And Coverage Of Using The Assigned International Classification Of Diseases, 9th And 10th Revision, Clinical Modification Codes For Detecting Bleeding Events In Electronic Health Record, Victoria J. Wang, David D. McManus, Hong Yu 2017 University of Massachusetts Medical School

Accuracy And Coverage Of Using The Assigned International Classification Of Diseases, 9th And 10th Revision, Clinical Modification Codes For Detecting Bleeding Events In Electronic Health Record, Victoria J. Wang, David D. Mcmanus, Hong Yu

UMass Center for Clinical and Translational Science Research Retreat

Background: Hemorrhages are common events that confer significant risk for in-hospital and post-discharge morbidity and mortality among cardiovascular disease (CVD) patients treated with anticoagulation. International Classification of Diseases, 9th and 10th Revision, Clinical Modification (ICD-9-CM, ICD-10-CM) codes have been widely used in CVD research and managements.

Objective: To determine the accuracy and coverage of assigned ICD-CM codes for reporting bleeding events.

Methods: From the University of Massachusetts Medical School electronic health record (EHR) database we identified 21k patients on anticoagulation with high bleeding risks based on their ICD-9-CM or ICD-10-CM codes. Through manual chart review, we selected one unstructured note ...


A Randomized Controlled Trial Of Community Health Workers Using Patient Stories To Support Hypertension Management: Preliminary Results, J. Lee Hargraves, Debra Bonollo, Warren J. Ferguson, Elizabeth Aaker Orvek 2017 University of Massachusetts Medical School

A Randomized Controlled Trial Of Community Health Workers Using Patient Stories To Support Hypertension Management: Preliminary Results, J. Lee Hargraves, Debra Bonollo, Warren J. Ferguson, Elizabeth Aaker Orvek

UMass Center for Clinical and Translational Science Research Retreat

Background: Uncontrolled hypertension is a significant public health problem in the U.S. with about one half of people able to keep blood pressure under control. Furthermore, the social and economic costs of poor hypertension control are staggering. Community Health Worker (CHW) interventions are a low-cost, culturally tailored approach to improve chronic disease outcomes.

Methods: This randomized trial conducted at two Community Health Centers (CHCs) in Massachusetts assessed the effect of CHWs assisting patients with hypertension. CHWs, trained in motivational interviewing, used video narratives from patients who have worked to control their BP through diet, exercise, and better medication ...


Pharmacotherapy Use In Older Patients With Heart Failure And Reduced Ejection Fraction Living In Skilled Nursing Facilities, Lin Li, William M. Jesdale, Anne Hume, Giovanni Gambassi, Robert J. Goldberg, Kate L. Lapane 2017 University of Massachusetts Medical School

Pharmacotherapy Use In Older Patients With Heart Failure And Reduced Ejection Fraction Living In Skilled Nursing Facilities, Lin Li, William M. Jesdale, Anne Hume, Giovanni Gambassi, Robert J. Goldberg, Kate L. Lapane

UMass Center for Clinical and Translational Science Research Retreat

Background: Little is known about the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and β-blockers among older adults with heart failure and reduced ejection fraction (HFrEF) in skilled nursing facilities (SNFs).

Methods: Using national data Minimum Data Set 3.0 cross-linked with Medicare data (2011-2012), we studied 31,675 patients with HFrEF (ICD-9 codes: 428.2 or 428.4) aged ≥65 years admitted to 9,659 SNFs. We estimated the prevalence of a Part D claim for ACEIs/ARBs or β-blockers during 3 months before the SNF stay and used log-binomial models to evaluate correlates of ...


Change In Physical Activity And Sitting Time After Myocardial Infarction And Mortality Among Postmenopausal Women In The Women's Health Initiative-Observational Study., Anna M Gorczyca, Charles B Eaton, Michael J LaMonte, JoAnn E Manson, Jeanne D Johnston, Aurelian Bidulescu, Molly E Waring, Todd Manini, Lisa W Martin, Marcia L Stefanick, Ka He, Andrea K Chomistek 2017 George Washington University

Change In Physical Activity And Sitting Time After Myocardial Infarction And Mortality Among Postmenopausal Women In The Women's Health Initiative-Observational Study., Anna M Gorczyca, Charles B Eaton, Michael J Lamonte, Joann E Manson, Jeanne D Johnston, Aurelian Bidulescu, Molly E Waring, Todd Manini, Lisa W Martin, Marcia L Stefanick, Ka He, Andrea K Chomistek

Medicine Faculty Publications

Background

How physical activity (PA) and sitting time may change after first myocardial infarction (MI) and the association with mortality in postmenopausal women is unknown.

Methods and Results

Participants included postmenopausal women in the Women's Health Initiative‐Observational Study, aged 50 to 79 years who experienced a clinical MI during the study. This analysis included 856 women who had adequate data on PA exposure and 533 women for sitting time exposures. Sitting time was self‐reported at baseline, year 3, and year 6. Self‐reported PA was reported at baseline through year 8. Change in PA and sitting time ...


A Historical Perspective On Presentations Of Hypertensive Acute Heart Failure, Chad E. Darling, Jiaoyuan Elisabeth Sun, Jordan Goldberg, Peter Pang, Christopher W. Baugh, Darleen M. Lessard, David D. McManus 2017 University of Massachusetts Medical School

A Historical Perspective On Presentations Of Hypertensive Acute Heart Failure, Chad E. Darling, Jiaoyuan Elisabeth Sun, Jordan Goldberg, Peter Pang, Christopher W. Baugh, Darleen M. Lessard, David D. Mcmanus

Emergency Medicine Publications and Presentations

BACKGROUND: The initial systolic blood pressure (SBP) in patients presenting to the hospital with acute heart failure (AHF) informs prognosis, diagnosis, and guides initial treatment. However, over time AHF presentations with elevated SBP appear to have declined. The present study examined whether the frequency of AHF presentations with systolic hypertension (SBP > 160 mmHg) declined over a nearly two-decade time interval.

METHODS: This study compares four historical, cross-sectional cohorts with AHF who were admitted to tertiary care medical centres in the North-eastern USA in 1995, 2000, 2006, and 2011-13. The main outcome was the proportion of AHF patients presenting with an ...


Change In Physical Activity And Sitting Time After Myocardial Infarction And Mortality Among Postmenopausal Women In The Women's Health Initiative-Observational Study, Anna M. Gorczyca, Charles Eaton, Michael J. Lamonte, JoAnn E. Manson, Jeanne D. Johnston, Aurelian Bidulescu, Molly E. Waring, Todd Manini, Lisa W. Martin, Marcia L. Stefanick, Ka He, Andrea K. Chomistek 2017 The University of Kansas Medical Center

Change In Physical Activity And Sitting Time After Myocardial Infarction And Mortality Among Postmenopausal Women In The Women's Health Initiative-Observational Study, Anna M. Gorczyca, Charles Eaton, Michael J. Lamonte, Joann E. Manson, Jeanne D. Johnston, Aurelian Bidulescu, Molly E. Waring, Todd Manini, Lisa W. Martin, Marcia L. Stefanick, Ka He, Andrea K. Chomistek

University of Massachusetts Medical School Faculty Publications

BACKGROUND: How physical activity (PA) and sitting time may change after first myocardial infarction (MI) and the association with mortality in postmenopausal women is unknown.

METHODS AND RESULTS: Participants included postmenopausal women in the Women's Health Initiative-Observational Study, aged 50 to 79 years who experienced a clinical MI during the study. This analysis included 856 women who had adequate data on PA exposure and 533 women for sitting time exposures. Sitting time was self-reported at baseline, year 3, and year 6. Self-reported PA was reported at baseline through year 8. Change in PA and sitting time were calculated as ...


Patient Preferences For Cardiovascular Preventive Medication: A Systematic Review, Loai Albarqouni, Jenny Doust, Paul Glasziou 2017 Bond University

Patient Preferences For Cardiovascular Preventive Medication: A Systematic Review, Loai Albarqouni, Jenny Doust, Paul Glasziou

Faculty of Health Sciences & Medicine Publications

OBJECTIVE:

To systematically review current evidence regarding the minimum acceptable risk reduction of a cardiovascular event that patients feel would justify daily intake of a preventive medication.

METHODS:

We used the Web of Science to track the forward and backward citations of a set of five key articles until 15 November 2016. Studies were eligible if they quantitatively assessed the minimum acceptable benefit-in absolute values-of a cardiovascular disease preventive medication among a sample of the general population and required participants to choose if they would consider taking the medication.

RESULTS:

Of 341 studies screened, we included 22, involving a total ...


Single-Trait And Multi-Trait Genome-Wide Association Analyses Identify Novel Loci For Blood Pressure In African-Ancestry Populations., Jingjing Liang, Thu H Le, Digna R Velez Edwards, Bamidele O Tayo, Kyle J Gaulton, Jennifer A Smith, Lisa W Martin, +several additional authors 2017 George Washington University

Single-Trait And Multi-Trait Genome-Wide Association Analyses Identify Novel Loci For Blood Pressure In African-Ancestry Populations., Jingjing Liang, Thu H Le, Digna R Velez Edwards, Bamidele O Tayo, Kyle J Gaulton, Jennifer A Smith, Lisa W Martin, +Several Additional Authors

Medicine Faculty Publications

Hypertension is a leading cause of global disease, mortality, and disability. While individuals of African descent suffer a disproportionate burden of hypertension and its complications, they have been underrepresented in genetic studies. To identify novel susceptibility loci for blood pressure and hypertension in people of African ancestry, we performed both single and multiple-trait genome-wide association analyses. We analyzed 21 genome-wide association studies comprised of 31,968 individuals of African ancestry, and validated our results with additional 54,395 individuals from multi-ethnic studies. These analyses identified nine loci with eleven independent variants which reached genome-wide significance (P < 1.25×10−8) for either systolic and diastolic blood pressure, hypertension, or for combined traits. Single-trait analyses identified two loci (TARID/TCF21 and LLPH ...


The Association Of Calcium Intake And Other Risk Factors With Cardiovascular Disease Among Obese Adults In Usa, Yang Chen, Sheryl Strasser, Katie Callahan, David Blackley, Yan Cao, Liang Wang, Shimin Zheng 2017 East Tennessee State University

The Association Of Calcium Intake And Other Risk Factors With Cardiovascular Disease Among Obese Adults In Usa, Yang Chen, Sheryl Strasser, Katie Callahan, David Blackley, Yan Cao, Liang Wang, Shimin Zheng

Shimin Zheng

In this study, we used a cross-sectional study design to examine the relationship between the calcium intake and risk factors for CVD among obese adults by using continuous waves of National Health and Nutrition Examination Survey (NHANES) data 1999-2010. The association between calcium intake and risk factors of CVD (hypertension, total cholesterol, HDL, glycohemoglobin), CRP, albuminuria) is assessed among obese adults in USA. The incidence of Cardiovascular Disease (CVD) is high among obese people. The potential effects of inadequate calcium intake on CVD are receiving increased epidemiologic attention. Understanding the association between risk factors for CVD and calcium intake among ...


The Contribution Of Individual Exercise Training Components To Clinical Outcomes In Randomised Controlled Trials Of Cardiac Rehabilitation: A Systematic Review And Meta-Regression, Bridget Abell, Paul Glasziou, Tammy Hoffmann 2017 Bond University

The Contribution Of Individual Exercise Training Components To Clinical Outcomes In Randomised Controlled Trials Of Cardiac Rehabilitation: A Systematic Review And Meta-Regression, Bridget Abell, Paul Glasziou, Tammy Hoffmann

Faculty of Health Sciences & Medicine Publications

Background

While the clinical benefits of exercise-based cardiac rehabilitation are well established, there is extensive variation in the interventions used within these trials. It is unknown whether variations in individual components of these exercise interventions provide different relative contributions to overall clinical outcomes. This study aims to systematically examine the relationship between individual components of the exercise intervention in cardiac rehabilitation (such as intensity and frequency) and clinical outcomes for people with coronary heart disease.

Methods

In this systematic review, eligible trials were identified via searches of databases (PubMed, Allied and Complementary Medicine, EMBASE, PEDro, Science Citation Index Expanded, CINAHL ...


Race And Place Differences In Patients Hospitalized With An Acute Coronary Syndrome: Is There Double Jeopardy? Findings From Trace-Core, Robert J. Goldberg, Joel M. Gore, David D. McManus, Richard H. McManus, Mayra Tisminetzky, Darleen M. Lessard, Jerry H. Gurwitz, David C. Parish, Jeroan J. Allison, Connie Ng Hess, Tracy Wang, Catarina I. Kiefe 2017 University of Massachusetts Medical School

Race And Place Differences In Patients Hospitalized With An Acute Coronary Syndrome: Is There Double Jeopardy? Findings From Trace-Core, Robert J. Goldberg, Joel M. Gore, David D. Mcmanus, Richard H. Mcmanus, Mayra Tisminetzky, Darleen M. Lessard, Jerry H. Gurwitz, David C. Parish, Jeroan J. Allison, Connie Ng Hess, Tracy Wang, Catarina I. Kiefe

Catarina I. Kiefe

The objectives of this longitudinal study were to examine differences between whites and blacks, and across two geographical regions, in the socio-demographic, clinical, and psychosocial characteristics, hospital treatment practices, and post-discharge mortality for hospital survivors of an acute coronary syndrome (ACS). In this prospective cohort study, we performed in-person interviews and medical record abstractions for patients discharged from the hospital after an ACS at participating sites in Central Massachusetts and Central Georgia during 2011-2013. Among the 1143 whites in Central Massachusetts, 514 whites in Central Georgia, and 277 blacks in Central Georgia, we observed a gradient of socioeconomic position with ...


Relations Of Liver Fat With Prevalent And Incident Atrial Fibrillation In The Framingham Heart Study, Michelle T. Long, Xiaoyan Yin, Martin G. Larson, Patrick T. Ellinor, Steven A. Lubitz, David D. McManus, Jared W. Magnani, Laila Staerk, Darae Ko, Robert H. Helm, Udo Hoffmann, Raymond T. Chung, Emelia J. Benjamin 2017 Boston University School of Medicine

Relations Of Liver Fat With Prevalent And Incident Atrial Fibrillation In The Framingham Heart Study, Michelle T. Long, Xiaoyan Yin, Martin G. Larson, Patrick T. Ellinor, Steven A. Lubitz, David D. Mcmanus, Jared W. Magnani, Laila Staerk, Darae Ko, Robert H. Helm, Udo Hoffmann, Raymond T. Chung, Emelia J. Benjamin

Open Access Articles

BACKGROUND: Obesity is an important risk factor for nonalcoholic fatty liver disease and atrial fibrillation (AF). Less is known about the relations between nonalcoholic fatty liver disease and AF. We sought to evaluate the association between fatty liver and prevalent and incident AF in the community.

METHODS AND RESULTS: We examined Framingham Heart Study participants who underwent a study-directed computed tomography scan, had hepatic steatosis (HS) evaluated, and did not report heavy alcohol use between 2002 and 2005. We evaluated cross-sectional associations between liver fat and prevalent AF with logistic regression models. We assessed the relations between liver fat and ...


An Exploratory Study Of The Utilization Of Evidence-Based Pharmacological Treatment On Heart Failure Patients In Mississippi And Its Impact On Readmission, Keri A. Barron 2017 University of Southern Mississippi

An Exploratory Study Of The Utilization Of Evidence-Based Pharmacological Treatment On Heart Failure Patients In Mississippi And Its Impact On Readmission, Keri A. Barron

Dissertations

The purpose of this study was to explore the relationship of adherence to evidence-based guidelines for pharmacologic management by select Mississippi hospitals and their hospital readmission rates. This was an exploratory study with a retrospective design. This design offered insight into the relationship between readmissions of heart failure patients and adherence to the national guidelines for the pharmacologic treatment of heart failure. The study took place in a hospital in the southeastern section of the United States. Data were collected from a database of patients with heart failure seen between January 2011 and June 2014.

The unit of analysis for ...


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