Cardiology Commons^™

Plasma Proteomic Biomarkers Of Physical Frailty In Heart Failure: A Propensity Score Matched Discovery-Based Pilot Study, Quin Denfeld, Noelle Pavlovic, Christopher Lee, Jon Jacobs, Mary Roberts Davis, Samantha Powell, Marina Gritsenko, Susan Joseph, Beth Habecker

Division of Cardiology Faculty Papers

BACKGROUND: Physical frailty is highly prevalent in heart failure (HF), but we lack an understanding of the underlying pathophysiology. Proteomic evaluation of plasma samples may elucidate potential mechanisms and biomarkers of physical frailty in HF.

OBJECTIVES: We aimed to identify plasma proteomic biomarkers that are differentially expressed between physically frail and non-physically frail adults with HF.

METHODS: This was a secondary analysis of a subset of data and plasma samples from a study of frailty among patients with New York Heart Association (NYHA) Functional Classification I-IV HF. Physical frailty was measured using the Frailty Phenotype Criteria. Propensity score matching was …

Addressing Frailty In Heart Failure: Essential Tools & Strategies For Occupational Therapists, Malachy Clancy, Phd, Otr/L, Bcpr

Department of Occupational Therapy Posters and Presentations

Learning Objectives

• Understand and describe the concept of frailty and its impact on occupational performance for patients with heart failure (HF).
• Identify comprehensive assessments that encompass physical, cognitive, and psychosocial domains to provide a holistic assessment of frailty.

Heart Failure In Black Populations: Epidemiology, Pathophysiology, And Treatment Disparities, Kazi N. Islam, Rahib K. Islam, Ivan Nguyen, Yasmeen Magherahabed, Humza Pirzadah, M. Bazlur Rashid

School of Medicine Faculty Publications

Heart failure (HF) remains a significant health challenge globally, placing a heavy burden on individuals, families, and healthcare systems. The prevalence of HF continues to rise, posing substantial public health concerns. This burden is particularly pronounced among the Black Population, who face higher prevalence, earlier onset, and greater severity of HF compared to other racial and ethnic groups. This review explores the multifaceted landscape of HF in Black individuals by examining epidemiological patterns, pathophysiological mechanisms, clinical presentations, treatment disparities, and clinical outcomes. Black individuals exhibit distinct pathophysiological characteristics, such as genetic variations contributing to heightened susceptibility and severity of HF. …

Acute Heart Failure Secondary To Coxsackie Dilated Cardiomyopathy In An Immunocompetent Adult: A Case Report From A Social Disparities Perspective, Barbara Malaga-Espinoza, Donnel Dockery-Joseph, Jessica Daza, Oscar Lopez, Andres Suarez Parraga

Research Symposium

Introduction: Cardiomyopathies (CM) are defined as myocardial disorders in the absence of coronary artery disease, hypertension, valvular or congenital heart conditions. Dilated CM is characterized by dilation and impaired contraction of one or both ventricles. The prevalence of this condition is underestimated because of variable disease expression and challenging diagnosis. We present the case of an undocumented and immunocompetent patient who debuted with acute heart failure after being exposed to significant environmental stressors.

Case Presentation: A 44-year-old Hispanic gentleman with a history of untreated hypertension presented to the ED with severely persistent left-sided chest pain at rest associated with frontoparietal …

Echocardiography And Heart Failure: An Echocardiographic Decision Aid For The Diagnosis And Management Of Cardiomyopathies., Ashley Pender, Jessica Lewis-Owona, Abdulmojeed Ekiyoyo, Marcus Stoddard

Division of Cardiology Faculty Papers

PURPOSE OF REVIEW: The purpose of this review is to highlight the utility of echocardiography in the diagnosis and management of cardiomyopathies.

RECENT FINDINGS: Echocardiographic parameters function synergistically to guide decision-making ranging from early detection of disease and screening to risk stratification of complex disease. The collective wealth of information available from 2D/3D assessment, Doppler, diastology and strain makes echocardiography an invaluable decision aid.

Novel Device Therapies In Heart Failure: Focus On Patient Selection, Amrita Balgobind, Daniel Asemota, Emily Rodriguez, Phuuwadith Wattanachayakul, Marat Fudim, Miguel Alvarez Villela

Einstein Health Papers

The increasing prevalence of heart failure (HF) has led to advancements in therapeutic strategies, including the development of new pharmacological treatments and the expansion of guideline recommendations across the spectrum of left ventricular ejection fractions. Despite these advancements, the full benefits of guideline-directed medical therapy (GDMT) are often limited by various barriers that result in incomplete implementation or suboptimal responses. For patients who cannot tolerate or only partially respond to GDMT, therapeutic options remain limited. This gap is particularly significant for those with contraindications to heart replacement therapies (HRT), such as left ventricular assist device (LVAD) or heart transplant. In …

Erythritol, Erythronate, And Cardiovascular Outcomes In Older Adults In The Aric Study, Layla A Abushamat, Bing Yu, Ron C Hoogeveen, Caroline Sun, Chao Cheng, Sean M Hartig, Mark A Herman, Ashok Balasubramanyam, Jane Eb Reusch, Elizabeth Selvin, Chiadi E Ndumele, Vijay Nambi, Christie M Ballantyne

Faculty, Staff and Student Publications

BACKGROUND: Circulating erythritol, an endogenously produced metabolite and an artificial sweetener, is associated with cardiovascular outcomes.

OBJECTIVES: The authors assessed associations of erythritol and its downstream metabolite, erythronate, with cardiovascular risk factors and events in older adults in the ARIC (Atherosclerosis Risk In Communities) study (visit 5, 2011-2013).

METHODS: We included 4,006 participants without prevalent cardiovascular disease and with metabolomic profiling. Erythritol and erythronate were measured by mass spectrometry. We analyzed associations of log-transformed erythritol and erythronate with cardiovascular risk factors and events using Cox proportional hazard models.

RESULTS: Participants in the highest tertiles of erythritol or erythronate were older, …

Takotsubo Cardiomyopathy: A Case Of The Broken Heart, Lilian Huynh, Kaylee Putney

Annual Research Symposium

Takotsubo cardiomyopathy (TC), or "broken heart syndrome," is a rare cardiac condition causing temporary left ventricular dysfunction due to severe stress. Though the exact cause is unclear, it mimics myocardial infarction and can lead to cardiogenic shock. Current treatment lacks specific guidelines and relies on heart failure protocols. We report a case of a patient with TC-induced cardiogenic shock, likely triggered by emotional stress. She required vasopressors, a percutaneous intervention, an Impella device, and guideline-directed medication therapies. This case underscores the significance of establishing guideline optimizations for managing TC and cardiogenic shock.

Sex-Based Differences In The Utility And Outcomes Of Left Ventricular Assist Devices, Mirvat Alasnag, Waleed Alhabeeb, Feras Khaliel

Journal of the Saudi Heart Association

The totality of evidence suggests that there remains a significant disparity in the use of left ventricular assist devices (LVADs) and heart transplantation (HT) in women. This disparity persists even after accounting for differences in baseline characteristics, comorbidities, and cardiovascular risk factors between men and women undergoing LVAD implantation as a bridge to HT. Generally, women are less likely to undergo HT, leading to a higher mortality rate in women on the HT waiting list. The differences in risk profiles and device-related complications may account for the sex-related disparities in the assignment of device therapies. These findings warrant an urgent …

Characteristics And Outcomes Of Patients With Cardiogenic Shock And Clinically Significant Valvular Heart Disease: From The Critical Care Cardiology Trials Network., Anthony P Carnicelli, P Elliott Miller, David D Berg, Nijat Aliyev, Carlos L Alviar, Erin A Bohula, Sunit-Preet Chaudhry, Meshe Chonde, Christine Chow, Howard A Cooper, Lori B Daniels, Christopher B Fordyce, Shahab Ghafghazi, Michael J Goldfarb, Kari L Gorder, Madeleine M Hamilton, Ryan R Keane, Michael C Kontos, Jonathan J Kusner, Evan Leibner, Daniel B Loriaux, Venu Menon, Raunak M Nair, L Kristin Newby, Mary-Tiffany Oduah, Michael G Palazzolo, Harsh Patolia, Jacob B Pierce, Matthew J Pierce, Brian J Potter, Alastair Proudfoot, Robert O Roswel, Gregory Schnell, Jeffrey Shaw, Kiran Sidhu, Shashank S Sinha, Anubodh S Varshney, Jason N Katz, Sean Van Diepen, David A Morrow

Heart and Vascular Articles

BACKGROUND: Cardiogenic shock (CS) can be complicated by severe valvular heart disease (VHD). We analyzed cardiac intensive care unit (CICU) admissions according to VHD status.

METHODS AND RESULTS: The Critical Care Cardiology Trials Network is a multicenter network of tertiary CICUs. Centers contributed data from consecutive admissions during 2-month annual snapshots from 2017-2023. CS admissions were classified as having CS attributed to VHD, CS with noncausative VHD or CS without severe VHD. Demographics and therapies were compared. Unadjusted and adjusted odds ratios for in-hospital mortality were calculated. We analyzed 5242 admissions with CS (4.1% attributed to VHD, 18.8% with noncausative …

Infection-Related Hospitalization And Incident Heart Failure: The Atherosclerosis Risk In Communities Study, Rebecca L Molinsky, Amil Shah, Melana Yuzefpolskaya, Bing Yu, Jeffrey R Misialek, Bruno Bohn, David Vock, Richard Maclehose, Barry A Borlaug, Paolo C Colombo, Chiadi E Ndumele, Junichi Ishigami, Kunihiro Matsushita, Pamela L Lutsey, Ryan T Demmer

Faculty, Staff and Student Publications

Background: The immune response to infections may become dysregulated and promote myocardial damage contributing to heart failure (HF). We examined the relationship between infection-related hospitalization (IRH) and HF, HF with preserved ejection fraction, and HF with reduced ejection fraction.

Methods and results: We studied 14 468 adults aged 45 to 64 years in the ARIC (Atherosclerosis Risk in Communities) Study who were HF free at visit 1 (1987-1989). IRH was identified using select International Classification of Diseases (ICD) codes in hospital discharge records and was treated as a time-varying exposure. HF incidence was defined as the first occurrence …

Recent Advances In Cardiac Resynchronization Therapy: Current Treatment And Future Direction, Arasalan Siddiqui, Vasiliki Tasouli-Drakou, Marc Ringor, Micael V. Dicaro, Brianna Yee, Kachon Lei, Tahir Tak

Department of Internal Medicine Faculty Research

Cardiac Resynchronization Therapy (CRT) has been established as a major component of heart failure management, resulting in a significant reduction in patient morbidity and death for patients with increased QRS duration, low left ventricular ejection fraction (LVEF), and high risk of arrhythmias. The ability to synchronize both ventricles, lower heart failure hospitalizations, and optimize clinical outcomes are some of the attractive characteristics of biventricular pacing, or CRT. However, the high rate of CRT non-responders has led to the development of new modalities including leadless CRT pacemakers (CRT-P) and devices focused on conduction system pacing (CSP). This comprehensive review aims to …

Thyroid Storm And High Output Heart Failure, A Perfect Storm, Gunjan Mundhra, Haris Ahmed, Rebecca Schuyler, Karina Bidani, Justin Gisel

South Atlantic Division GME Research Day 2025

No abstract provided.

Novel Insights Into Beta Cell Er Stress Chop And It's Role In Hfpef Development, Balaji Srinivas, Paula Fortuno, Hongmei Peng, Jiang Xu, Hamid Suhail, Hani N. Sabbah, Nour-Eddine Rhaleb, Khalid Matrougui

Department of Physiological Sciences Faculty Publications

Introduction: Heart failure with preserved ejection fraction (HFpEF) is a multifactorial cardiovascular disorder characterized by diastolic dysfunction and often associated with hypertension and metabolic disturbances. We aimed to determine the inter-relationship between C/EBP homologous protein (CHOP) in b-cells and HFpEF development.

Methods: Eight-week-old male mice b-cell^flox/flox and b-cell^CHOP-/- were randomly divided into four groups: control b-cell^flox/flox and b-cell^CHOP-/- mice subjected to standard diet and water. b -cell^flox/flox and b-cell^CHOP-/- mice fed a high-fat diet (HFD) and L-NAME (0.5 g/L) for five weeks. A comprehensive cardiovascular, metabolic, and histological evaluation was conducted.

Results: Following …

Biochemical And Biophysical Properties Of Failing Myocardium In Rare Patient Populations, Gregory Nathaniel Milburn

Theses and Dissertations--Physiology

Heart failure has diverse underlying etiologies, complicating research. While some types, like ischemic disease or inherited mutations, are well-studied, research on rarer forms has lagged. Understanding the molecular drivers in these populations may enhance diagnostics and therapies. This work examines two rare groups: patients with ATTR cardiac amyloidosis and those receiving mechanical assist device support. We show that myocardium from patients with amyloidosis has increased fibrosis and reduced force production without changes in cross-bridge kinetics. Additionally, we show that the passive stiffness of amyloidosis myocardium is not different from non-failing myocardium, indicating increased ventricular wall thickness may cause restrictive filling. …

Hydroxychloroquine-Induced Cardiomyopathy: A Case Report, Ahmed Hussein, Aya Salih, Tebyan Mohammedali, Yousif Mohamed, L Maximilian Buja

Faculty, Staff and Student Publications

Hydroxychloroquine (HCQ) is an immunomodulatory medication used for decades. HCQ is a weak base accumulating in acidic cytoplasmic vesicles, such as lysosomes. This accumulation raises the pH and interferes with the functions of the lysosomal enzymes, including α-galactosidase A, resulting in a unique clinical and pathologic feature. We present a case with severe HCQ-induced cardiomyopathy to show the pattern of cardiac involvement and available imaging and pathologic modalities. The case involves a 76-year-old woman with a history of Sjögren's disease who had been treated with HCQ for 13 years and presented with symptoms of heart failure. An echocardiogram showed thick …

Daily Weights, Better Outcomes: The Positive Impact Of Daily Weight Tracking In Hospitalized Patients On The Telemetry Floor, Sophia Zia, David Ortega, Lailany Agront-Davo, Merid Moqattash, William Lopez, Sirin Khajaviyan, Yagmur Beaman, Michael Craig

South Atlantic Division GME Research Day 2025

No abstract provided.

Baroreceptor Activating Therapy And Subcutaneous Implantable Cardioverter-Defibrillators: An Electrical Mismatch?, Eboselumen Aigbe, Gunjan Mundhra, Munachiso Egbo, Yuhning Linda Hu

South Atlantic Division GME Research Day 2025

No abstract provided.

No Patient Left Behind: Improving Transition Of Care In Coronary Artery Disease And Heart Failure Patients, Rebecca Schuyler, Gunjan Mundhra, Mubbasher Syed

South Atlantic Division GME Research Day 2025

No abstract provided.

Body Composition In Patients With Obesity-Related Heart Failure With Preserved Ejection Fraction: A Comparison Study, Hannah Salmons, Syed Imran Ahmed, Hayley E. Billingsley, Alex Reavey-Cantwell, Roshanak Markley, Michele Golino, Marco Giuseppe Del Buono, Juan Ignacio Damonte, Sebastian Pinel, R. Lee Franco, Antonio Abbate, Carrie P. Earthman, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Background

Appendicular lean mass index is a major determinant of cardiorespiratory fitness in patients with obesity-related heart failure with preserved ejection fraction (HFpEF). Moreover, appendicular lean mass index can be used to diagnose sarcopenia and sarcopenic obesity in this population. We aimed to validate the ability of segmental single-frequency bioelectrical impedance analysis (SF-BIA) to assess body composition compared with dual-energy x-ray absorptiometry (DXA) in patients with HFpEF and obesity, with a focus on appendicular lean mass index for its critical role in diagnosing sarcopenia and sarcopenic obesity.

Methods

We analyzed 62 euvolemic patients from a heart failure outpatient clinic with …

The Short And Sweet On Sodium-Glucose Cotransporter Inhibitors And Glucagon-Like Peptide-1 Receptor Agonists In Heart Failure, Jose L. Batista, Tracy Makuvire, Jonathan D. Davis, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Heart failure (HF) affects 6 million people in the US, and type 2 diabetes (T2D) is a significant risk factor for HF. Since 2008, regulatory agencies have required cardiovascular safety trials for new T2D therapies, and these have consistently demonstrated the cardiovascular benefits of glucose-lowering drugs. Sodium-glucose cotransporter inhibitors (SGLTi) and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs)/glucose-dependent insulinotropic polypeptide (GIP) reduce major adverse cardiovascular events and deaths, regardless of diabetes status, and improve cardiorespiratory fitness. SGLTis, such as dapagliflozin and empagliflozin, benefit patients with reduced and preserved ejection fraction, significantly reducing HF hospitalizations and cardiovascular deaths. The DAPA-HF and EMPEROR-Reduced …

Role Of Device Therapy In Complementing Contemporary Medical Management, Yoel Benarroch, Natalie Tapaskar, Amin Yehya

Department of Medicine Faculty Publications

Heart failure (HF) is a clinical syndrome characterized by signs and symptoms resulting from any structural or functional deficiency of ventricular filling or blood ejection. The mainstay of initial treatment remains lifestyle modifications, guideline-directed medical therapy, and addressing contributing factors. However, the past two decades have come with significant advances in device therapies to improve morbidity and mortality in HF despite evidence-based management as above. Given the rapidly evolving area of HF research and therapeutic development, it is important for clinicians to be familiar with novel therapies and how they can complement medical management. In this review we discuss the …

Cardiomyopathies Of Endocrine Origin: A State-Of-The-Art Review, Jenyfer M. Fuentes-Mendoza, Marcio J. Concepción-Zavaleta, Juan C. Morón-Siguas, Juan M. Muñoz-Moreno, Aranza I. Pérez-Reyes, Rodrigo Martinez-Galaviz, Raúl D. Aguilar-Castañeda, Oziel González-Godoy, Luis A. Concepción-Urteaga, José Paz-Ibarra

Department of Medicine Faculty Publications

Endocrine disorders are increasingly recognized as potentially reversible causes of secondary cardiomyopathies, yet they often remain underdiagnosed in clinical practice. These conditions-including thyroid dysfunction, acromegaly, pheochromocytoma, diabetes mellitus, adrenal disorders, among others-can significantly alter cardiac structure and function through hormonal excess, metabolic remodeling, and neurohumoral activation. Hyperthyroidism may lead to high-output heart failure (HF) and atrial fibrillation, while hypothyroidism is associated with diastolic dysfunction, pericardial effusion, and accelerated atherosclerosis. Acromegaly promotes biventricular hypertrophy and myocardial fibrosis via insulin-like growth factor 1 overproduction. Pheochromocytoma triggers catecholamine-induced cardiomyopathy, resembling Takotsubo syndrome and carrying a high risk of mortality if left untreated. Diabetes …

Emcreg-International Multidisciplinary Consensus Panel On Management Of Hyperkalemia In Chronic Kidney Disease And Heart Failure, Natalie Kreitzer, Nancy M. Albert, Alpesh N. Amin, Craig J. Beavers, Richard C. Becker, Gregg Fonarow, W. Brian Gibler, Katherine W. Kwon, Robert J. Mentz, Biff F. Palmer, Charles V. Pollack, Iliana L. Piña

Division of Cardiology Faculty Papers

BACKGROUND: Hyperkalemia, generally defined as serum potassium levels greater than 5.0 mEq/L, poses significant clinical risks, including cardiac toxicity and muscle weakness. Its prevalence and severity increase in patients with chronic kidney disease (CKD), diabetes mellitus, and heart failure (HF), particularly when compounded by medications like angiotensin converting inhibitors, angiotensin receptor blockers, and potassium sparing diuretics. Hyperkalemia arises from disruptions in potassium regulation involving intake, excretion, and intracellular-extracellular distribution. In CKD and acute kidney injury, these regulatory mechanisms are impaired, leading to heightened risk. The management of chronic hyperkalemia presents a challenge due to the necessity of balancing effective cardiovascular …

Guideline-Directed Medical Therapy After Hospitalization For Acute Heart Failure: Insights From The Connect-Hf, Satoshi Shoji, Lisa Kaltenbach, Bradi B. Granger, Gregg C. Fonarow, Hussein R. Al-Khalidi, Nancy M. Albert, Javed Butler, Larry A. Allen, David E. Lanfear, Jennifer T. Thibodeau, Brittany M. Chapman, Sandra M. Oliver-Mcneil, G. Michael Felker, Ileana L. Piña, Christopher B. Granger, Adrian F. Hernandez, Adam D. Devore

Division of Cardiology Faculty Papers

BACKGROUND: Significant gap remains in the implementation of guideline-directed medical therapy (GDMT) in patients with heart failure after a hospitalization. We aimed to evaluate the use and titration of GDMT at discharge and over a 12-month period after hospital discharge and to identify factors associated with GDMT use and titration.

METHODS AND RESULTS: The CONNECT-HF (Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure) trial evaluated the effect of a hospital and postdischarge quality improvement intervention in participants with heart failure with reduced ejection fraction. In this secondary analysis, we examined use and titration to at least …

Impact Of An Interdisciplinary Team On Patients Seen At A Heart Failure Clinic, Nilda Pelegrino, Faaria Quadri, Elaina Rosario, Jacqualine Igwe, Sandra Chaparro, Lourdes Labrada, Sara Panella, Maria Pulido, Stephen Breazeale, Zhenwei Zhang

Nursing & Health Sciences Research Journal

Background: Heart failure is a complex clinical syndrome that requires the involvement of interdisciplinary teams to address patient needs and optimize therapy. Interdisciplinary teams, including physicians, advanced practice practitioners, and pharmacists, play a crucial role in implementing guideline-directed medical therapy and addressing barriers to self-care that ultimately improve patients’ overall survival. This study assessed the impact of an interdisciplinary team on patients’ heart failure outcomes compared to patients solely managed by clinical cardiologists. Methods: This was a single-center retrospective chart review study of Baptist Health patients seen at the heart failure clinic. The study compared patients seen by an interdisciplinary …

Management Of Aorto-Right Ventricular Fistulas After Tavr, Ricardo Chia, Chamaka Kalutota, Kerry Cao, Steven Douedi, William Chang, Dominic Pinciotti, Mohammad Beizaeipour, Jennifer Joiner, Daniel Ice, Ronald Ross, Richard Kovach, Chunguang Chen, Muhammad Raza

Division of Cardiology Faculty Papers

This clinical case series reviews the diagnosis and management of aorto-right ventricular fistulas post-transcatheter aortic valve replacement, highlighting 3 cases. We emphasize early detection, individualized treatment strategies, and the role of multidisciplinary heart teams in achieving favorable outcomes. Comprehensive imaging and procedural planning are crucial for successful intervention and management of this rare complication.

Analysis Of The Correlation Between In-Hospital Adverse Events And Transcatheter Aortic Valve Replacement Outcomes, Stanislava Matejin, Pavel Poredos, Anja Boc, Vinko Boc, Wahaj Aman, Igor D. Gregoric, Biswajit Kar

Journal of Shock and Hemodynamics

Transcatheter aortic valve replacement (TAVR) has been recommended as the standard treatment for elderly patients with severe aortic stenosis (AS) and those at increased risk for conventional surgical procedures. Recently, TAVR has been recognized as the treatment of choice for intermediate-risk patients or even low-risk populations with AS. Our study aimed to identify factors influencing adverse events after TAVR procedures. This single-center, retrospective cohort study involved patients with severe AS treated with TAVR from 2016 to 2019. The patient’s electronic medical record was reviewed, and those with valve-in-valve replacements and missing demographical data were excluded. We analyzed risk factors related …

Atrial Fibrillation Status And Physical Rehabilitation In Older Patients With Acute Decompensated Heart Failure: An Analysis From The Rehab-Hf Trial, Douglas Corsi, Sean Dikdan, Naman Upadhyay, Haiying Chen, Dalane W Kitzman, Robert Mentz, David J Whellan, Daniel R Frisch

SKMC Student Presentations and Publications

BACKGROUND: The REHAB-HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) trial demonstrated that a transitional, tailored, progressive rehabilitation intervention improved physical function, 6-minute walk distance, frailty, quality-of-life, and depression in older patients hospitalized for acute decompensated heart failure. This analysis assessed the impact of atrial fibrillation (AF) on intervention benefits.

METHODS AND RESULTS: Of 349 enrolled patients hospitalized for acute decompensated heart failure (mean age 72.7±8.1 years), 176 (50.4%) had AF. Participants were randomly assigned to 12-week rehabilitation intervention or attention control. The primary outcome was Short Physical Performance Battery score at 3 months. Participants with AF were older …

Recent Developments In Cardiac Contractility Modulation For Heart Failure, Joshua R Hirsch, Hamid Afshar

The Texas Heart Institute Journal

No abstract provided.