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  • 1
    Language: English
    In: The Lancet (British edition), 2010, Vol.376 (9744), p.875-885
    Description: Summary Background Chronic heart failure is associated with high mortality and morbidity. Raised resting heart rate is a risk factor for adverse outcomes. We aimed to assess the effect of heart-rate reduction by the selective sinus-node inhibitor ivabradine on outcomes in heart failure. Methods Patients were eligible for participation in this randomised, double-blind, placebo-controlled, parallel-group study if they had symptomatic heart failure and a left-ventricular ejection fraction of 35% or lower, were in sinus rhythm with heart rate 70 beats per min or higher, had been admitted to hospital for heart failure within the previous year, and were on stable background treatment including a β blocker if tolerated. Patients were randomly assigned by computer-generated allocation schedule to ivabradine titrated to a maximum of 7·5 mg twice daily or matching placebo. Patients and investigators were masked to treatment allocation. The primary endpoint was the composite of cardiovascular death or hospital admission for worsening heart failure. Analysis was by intention to treat. This trial is registered, number ISRCTN70429960. Findings 6558 patients were randomly assigned to treatment groups (3268 ivabradine, 3290 placebo). Data were available for analysis for 3241 patients in the ivabradine group and 3264 patients allocated placebo. Median follow-up was 22·9 (IQR 18–28) months. 793 (24%) patients in the ivabradine group and 937 (29%) of those taking placebo had a primary endpoint event (HR 0·82, 95% CI 0·75–0·90, p〈0·0001). The effects were driven mainly by hospital admissions for worsening heart failure (672 [21%] placebo vs 514 [16%] ivabradine; HR 0·74, 0·66–0·83; p〈0·0001) and deaths due to heart failure (151 [5%] vs 113 [3%]; HR 0·74, 0·58–0·94, p=0·014). Fewer serious adverse events occurred in the ivabradine group (3388 events) than in the placebo group (3847; p=0·025). 150 (5%) of ivabradine patients had symptomatic bradycardia compared with 32 (1%) of the placebo group (p〈0·0001). Visual side-effects (phosphenes) were reported by 89 (3%) of patients on ivabradine and 17 (1%) on placebo (p〈0·0001). Interpretation Our results support the importance of heart-rate reduction with ivabradine for improvement of clinical outcomes in heart failure and confirm the important role of heart rate in the pathophysiology of this disorder. Funding Servier, France.
    Subject(s): Internal Medicine ; Cardiology. Vascular system ; Heart ; Biological and medical sciences ; General aspects ; Medical sciences ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Severity of Illness Index ; Heart Failure - complications ; Cardiovascular Agents - administration & dosage ; Double-Blind Method ; Benzazepines - adverse effects ; Humans ; Middle Aged ; Heart Failure - physiopathology ; Kaplan-Meier Estimate ; Male ; Treatment Outcome ; Sinoatrial Node - drug effects ; Heart Failure - drug therapy ; Cardiovascular Agents - therapeutic use ; Heart Rate - drug effects ; Benzazepines - therapeutic use ; Electrocardiography ; Adult ; Female ; Aged ; Benzazepines - administration & dosage ; Cardiovascular Agents - adverse effects ; Chronic Disease ; Heart Failure - mortality ; Heart failure ; Complications and side effects ; Heart beat ; Patient outcomes ; Dosage and administration ; Drug therapy ; Health aspects ; Cardiovascular agents ; Index Medicus ; Abridged Index Medicus ; use ; Sinoatrial Node/drug effects ; Heart Failure/complications/drug therapy/mortality/physiopathology ; Kardiologi ; Cardiac and Cardiovascular Systems ; Benzazepines/administration & dosage/adverse effects/therapeutic use ; Heart Rate/drug effects ; Cardiovascular Agents/administration & dosage/adverse effects/therapeutic ; Kaplan-Meiers Estimate
    ISSN: 0140-6736
    E-ISSN: 1474-547X
    Source: Backfile Package - All of Back Files EBS [ALLOFBCKF]
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  • 2
    Language: English
    In: The Lancet (British edition), 2010, Vol.376 (9744), p.886-894
    Description: Summary Background Raised resting heart rate is a marker of cardiovascular risk. We postulated that heart rate is also a risk factor for cardiovascular events in heart failure. In the SHIFT trial, patients with chronic heart failure were treated with the selective heart-rate-lowering agent ivabradine. We aimed to test our hypothesis by investigating the association between heart rate and events in this patient population. Methods We analysed cardiovascular outcomes in the placebo (n=3264) and ivabradine groups (n=3241) of this randomised trial, divided by quintiles of baseline heart rate in the placebo group. The primary composite endpoint was cardiovascular death or hospital admission for worsening heart failure. In the ivabradine group, heart rate achieved at 28 days was also analysed in relation to subsequent outcomes. Analysis adjusted to change in heart rate was used to study heart-rate reduction as mechanism for risk reduction by ivabradine directly. Findings In the placebo group, patients with the highest heart rates (≥87 beats per min [bpm], n=682, 286 events) were at more than two-fold higher risk for the primary composite endpoint than were patients with the lowest heart rates (70 to 〈72 bpm, n=461, 92 events; hazard ratio [HR] 2·34, 95% CI 1·84–2·98, p〈0·0001). Risk of primary composite endpoint events increased by 3% with every beat increase from baseline heart rate and 16% for every 5-bpm increase. In the ivabradine group, there was a direct association between heart rate achieved at 28 days and subsequent cardiac outcomes. Patients with heart rates lower than 60 bpm at 28 days on treatment had fewer primary composite endpoint events during the study (n=1192; event rate 17·4%, 95% CI 15·3–19·6) than did patients with higher heart rates. The effect of ivabradine is accounted for by heart-rate reduction, as shown by the neutralisation of the treatment effect after adjustment for change of heart rate at 28 days (HR 0·95, 0·85–1·06, p=0·352). Interpretation Our analysis confirms that high heart rate is a risk factor in heart failure. Selective lowering of heart rates with ivabradine improves cardiovascular outcomes. Heart rate is an important target for treatment of heart failure. Funding Servier, France.
    Subject(s): Internal Medicine ; Cardiology. Vascular system ; Heart ; Public health. Hygiene-occupational medicine ; Public health. Hygiene ; General aspects ; Biological and medical sciences ; Medical sciences ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Epidemiology ; Benzazepines - adverse effects ; Humans ; Middle Aged ; Heart Failure - physiopathology ; Male ; Sinoatrial Node - drug effects ; Heart Rate - drug effects ; Electrocardiography ; Adult ; Female ; Heart Failure - mortality ; Severity of Illness Index ; Heart Failure - complications ; Cardiovascular Agents - administration & dosage ; Double-Blind Method ; Risk Factors ; Kaplan-Meier Estimate ; Treatment Outcome ; Heart Failure - drug therapy ; Cardiovascular Agents - therapeutic use ; Benzazepines - therapeutic use ; Aged ; Benzazepines - administration & dosage ; Cardiovascular Agents - adverse effects ; Chronic Disease ; Heart failure ; Prevention ; Heart beat ; Dosage and administration ; Drug therapy ; Health aspects ; Risk factors ; Cardiovascular agents ; Index Medicus ; Abridged Index Medicus ; use ; Sinoatrial Node/drug effects ; Heart Failure/complications/drug therapy/mortality/physiopathology ; Kardiologi ; Cardiac and Cardiovascular Systems ; Benzazepines/administration & dosage/adverse effects/therapeutic use ; Heart Rate/drug effects ; Cardiovascular Agents/administration & dosage/adverse effects/therapeutic ; Kaplan-Meiers Estimate
    ISSN: 0140-6736
    E-ISSN: 1474-547X
    Source: Backfile Package - All of Back Files EBS [ALLOFBCKF]
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 3
    Language: English
    In: The Lancet (British edition), 2016, Vol.388 (10056), p.2142-2152
    Description: Summary Background The optimum blood pressure target in hypertension remains debated, especially in coronary artery disease, given concerns for reduced myocardial perfusion if diastolic blood pressure is too low. We aimed to study the association between achieved blood pressure and cardiovascular outcomes in patients with coronary artery disease and hypertension. Methods We analysed data from 22 672 patients with stable coronary artery disease enrolled (from Nov 26, 2009, to June 30, 2010) in the CLARIFY registry (including patients from 45 countries) and treated for hypertension. Systolic and diastolic blood pressures before each event were averaged and categorised into 10 mm Hg increments. The primary outcome was the composite of cardiovascular death, myocardial infarction, or stroke. Hazard ratios (HRs) were estimated with multivariable adjusted Cox proportional hazards models, using the 120–129 mm Hg systolic blood pressure and 70–79 mm Hg diastolic blood pressure subgroups as reference. Findings After a median follow-up of 5·0 years, increased systolic blood pressure of 140 mm Hg or more and diastolic blood pressure of 80 mm Hg or more were each associated with increased risk of cardiovascular events. Systolic blood pressure of less than 120 mm Hg was also associated with increased risk for the primary outcome (adjusted HR 1·56, 95% CI 1·36–1·81). Likewise, diastolic blood pressure of less than 70 mm Hg was associated with an increase in the primary outcome (adjusted HR 1·41 [1·24–1·61] for diastolic blood pressure of 60–69 mm Hg and 2·01 [1·50–2·70] for diastolic blood pressure of less than 60 mm Hg). Interpretation In patients with hypertension and coronary artery disease from routine clinical practice, systolic blood pressure of less than 120 mm Hg and diastolic blood pressure of less than 70 mm Hg were each associated with adverse cardiovascular outcomes, including mortality, supporting the existence of a J-curve phenomenon. This finding suggests that caution should be taken in the use of blood pressure-lowering treatment in patients with coronary artery disease. Funding Servier.
    Subject(s): Internal Medicine ; Blood Pressure ; Stroke ; Humans ; Middle Aged ; Hypertension - drug therapy ; Male ; Treatment Outcome ; Coronary Artery Disease - mortality ; Antihypertensive Agents - therapeutic use ; Hypotension - complications ; Myocardial Infarction ; Hypotension - mortality ; Coronary Artery Disease - complications ; Female ; Aged ; Cohort Studies ; Hypertension ; Medical research ; Patient outcomes ; Analysis ; Mortality ; Cardiac patients ; Medicine, Experimental ; Blood pressure ; France ; Coronary heart disease ; Cardiovascular agents ; Index Medicus ; Abridged Index Medicus
    ISSN: 0140-6736
    E-ISSN: 1474-547X
    Source: Backfile Package - All of Back Files EBS [ALLOFBCKF]
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 4
    Language: English
    In: The American journal of medicine, 2015, Vol.128 (5), p.509-518.e2
    Description: Abstract Objective Atrial fibrillation is often asymptomatic, but outcomes require further characterization. The study objective was to investigate the clinical presentation, management, and outcomes in asymptomatic and symptomatic patients with atrial fibrillation who were prospectively enrolled in the EurObservational Research Programme – Atrial Fibrillation (EORP-AF) Pilot General Registry. Methods A total of 3119 patients were enrolled, and 1237 (39.7%) were asymptomatic (European Heart Rhythm Association [EHRA] score I). Among symptomatic patients, 963 (51.2%) had mild symptoms (EHRA score II) and 919 (48.8%) had severe or disabling symptoms (EHRA III-IV). Permanent atrial fibrillation was 3-fold more common in asymptomatic patients than in symptomatic patients. Results On multivariate analysis, male gender (odds ratio [OR], 1.630; 95% confidence interval [CI], 1.384-1.921), older age (OR, 1.019; 95% CI, 1.012-1.026), previous myocardial infarction (OR, 1.681; 95% CI, 1.350-2.093), and limited physical activity (OR, 1.757; 95% CI, 1.495-2.064) were associated significantly with asymptomatic (EHRA I) atrial fibrillation. Fully asymptomatic atrial fibrillation (absence of current and previous symptoms) was present in 520 patients (16.7%) and was associated independently with male gender, age, and previous myocardial infarction. Appropriate guideline-based prescription of oral anticoagulants was lower in these patients, and aspirin was prescribed more frequently. Mortality at 1 year was more than 2-fold higher in asymptomatic patients compared with symptomatic patients (9.4% vs 4.2%, P 〈 .0001) and was associated independently with older age and comorbidities, including chronic kidney disease and chronic heart failure. Conclusions Asymptomatic atrial fibrillation is common in daily cardiology practice and is associated with elderly age, more comorbidities, and high thromboembolic risks. A higher 1-year mortality was found in asymptomatic patients compared with symptomatic patients.
    Subject(s): Internal Medicine ; Stroke ; Registry ; Atrial fibrillation ; Mortality ; Bleeding ; Multivariate Analysis ; Prognosis ; Comorbidity ; Atrial Fibrillation - therapy ; Humans ; Middle Aged ; Male ; Asymptomatic Diseases ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - mortality ; Sex Factors ; Female ; Registries ; Aged ; Atrial Fibrillation - diagnosis ; Medical colleges ; Medical equipment and supplies industry ; Pharmaceutical industry ; Medical test kit industry ; Pharmacy ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-9343
    E-ISSN: 1555-7162
    Source: ScienceDirect Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 5
    Language: English
    In: Journal of the American College of Cardiology, 2007, Vol.50 (9), p.823-830
    Description: Resting Heart Rate in Cardiovascular Disease Kim Fox, Jeffrey S. Borer, A. John Camm, Nicolas Danchin, Roberto Ferrari, Jose L. Lopez Sendon, Philippe Gabriel Steg, Jean-Claude Tardif, Luigi Tavazzi, Michal Tendera, for the Heart Rate Working Group Recent large epidemiologic studies have confirmed earlier studies that showed resting heart rate (HR) to be an independent predictor of cardiovascular and all-cause mortality in men and women with and without cardiovascular disease. Clinical trial data suggest that HR reduction is an important mechanism of benefit of beta-blockers and other HR lowering drugs. Pathophysiological studies indicate that a relatively high HR has direct detrimental effects on the progression of coronary atherosclerosis, on the occurrence of myocardial ischemia and ventricular arrhythmias, and on left ventricular function. Studies have found a continuous increase in risk with HR above 60 beats/min.
    Subject(s): Cardiovascular ; Internal Medicine ; Cardiology. Vascular system ; Biological and medical sciences ; Medical sciences ; Multivariate Analysis ; Myocardial Infarction - mortality ; Prognosis ; Cardiovascular Diseases - drug therapy ; Humans ; Coronary Disease - physiopathology ; Arrhythmias, Cardiac - physiopathology ; Coronary Disease - mortality ; Adrenergic beta-Antagonists - pharmacology ; Heart Rate - drug effects ; Exercise Test ; Propanolamines - therapeutic use ; Coronary Artery Disease - physiopathology ; Cardiovascular Diseases - mortality ; Heart Rate - physiology ; Myocardial Ischemia - physiopathology ; Timolol - therapeutic use ; Cardiovascular Diseases - physiopathology ; Risk Assessment ; Risk Factors ; Metoprolol - therapeutic use ; Coronary Artery Disease - drug therapy ; Calcium Channel Blockers - pharmacology ; Ventricular Dysfunction, Left - physiopathology ; Arrhythmias, Cardiac - drug therapy ; Animals ; Cardiac Output, Low - mortality ; Carbazoles - therapeutic use ; Development and progression ; Arrhythmia ; Heart attack ; Atherosclerosis ; Index Medicus ; Abridged Index Medicus
    ISSN: 0735-1097
    E-ISSN: 1558-3597
    Source: Alma/SFX Local Collection
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  • 6
    Language: English
    In: Journal of the American College of Cardiology, 2014, Vol.64 (3), p.304-318
    Description: Abstract Most cardiomyopathies are familial diseases. Cascade family screening identifies asymptomatic patients and family members with early traits of disease. The inheritance is autosomal dominant in a majority of cases, and recessive, X-linked, or matrilinear in the remaining. For the last 50 years, cardiomyopathy classifications have been based on the morphofunctional phenotypes, allowing cardiologists to conveniently group them in broad descriptive categories. However, the phenotype may not always conform to the genetic characteristics, may not allow risk stratification, and may not provide pre-clinical diagnoses in the family members. Because genetic testing is now increasingly becoming a part of clinical work-up, and based on the genetic heterogeneity, numerous new names are being coined for the description of cardiomyopathies associated with mutations in different genes; a comprehensive nosology is needed that could inform the clinical phenotype and involvement of organs other than the heart, as well as the genotype and the mode of inheritance. The recently proposed MOGE(S) nosology system embodies all of these characteristics, and describes the morphofunctional phenotype (M), organ(s) involvement (O), genetic inheritance pattern (G), etiological annotation (E) including genetic defect or underlying disease/substrate, and the functional status (S) of the disease using both the American College of Cardiology/American Heart Association stage and New York Heart Association functional class. The proposed nomenclature is supported by a web-assisted application and assists in the description of cardiomyopathy in symptomatic or asymptomatic patients and family members in the context of genetic testing. It is expected that such a nomenclature would help group cardiomyopathies on their etiological basis, describe complex genetics, and create collaborative registries.
    Subject(s): Cardiovascular ; Internal Medicine ; Cardiology. Vascular system ; Heart ; Biological and medical sciences ; Myocarditis. Cardiomyopathies ; Medical sciences ; Cardiomyopathies - genetics ; Genetic Predisposition to Disease - genetics ; Genetic Predisposition to Disease - classification ; Physicians ; Humans ; Cardiomyopathies - diagnosis ; Cardiomyopathies - classification ; Genetic Testing - methods ; Cardiology - trends ; Cardiology - methods ; Sects ; Cardiomyopathy ; Heart diseases ; Index Medicus ; Abridged Index Medicus
    ISSN: 0735-1097
    E-ISSN: 1558-3597
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 7
    Article
    Article
    2014
    ISSN: 0002-9343 
    Language: English
    In: The American journal of medicine, 2014, Vol.127 (3), p.e11-e11
    Subject(s): Internal Medicine ; Cardiotonic Agents - therapeutic use ; Heart Failure, Systolic - drug therapy ; Humans ; Female ; Male ; Digoxin - therapeutic use ; Hospitalization - economics ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-9343
    E-ISSN: 1555-7162
    Source: ScienceDirect Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 8
    Language: English
    In: The New England journal of medicine, 2017-07-06, Vol.377 (1), p.41-51
    Description: Data were analyzed from 40,195 patients with heart failure with reduced ejection fraction enrolled in 12 clinical trials in the 1995–2014 period. Sudden-death rates declined substantially over time, a finding consistent with a cumulative effect of evidence-based medical therapy.
    Subject(s): Death, Sudden - epidemiology ; Age Factors ; Follow-Up Studies ; Humans ; Middle Aged ; Heart Failure - physiopathology ; Male ; Risk ; Confounding Factors, Epidemiologic ; Cause of Death ; Incidence ; Randomized Controlled Trials as Topic ; Stroke Volume ; Regression Analysis ; Sex Factors ; Adult ; Female ; Aged ; Heart Failure - mortality ; Heart failure ; Clinical trials ; Care and treatment ; Cardiac output ; Patient outcomes ; Analysis ; Cardiac arrhythmia ; Mortality ; Regression analysis ; Patients ; Defibrillators ; Ischemia ; Peptidyl-dipeptidase A ; Angiotensin ; Death ; Cardiovascular diseases ; Health risk assessment ; Cardiology ; Heart diseases ; Index Medicus ; Abridged Index Medicus ; metaanalysis ; ventricular systolic ; Klinisk medicin ; dysfunction ; candesartan ; randomized controlled-trials ; Clinical Medicine ; myocardial-infarction ; cardiac death ; converting-enzyme inhibitors ; mortality ; General & Internal Medicine ; implantable cardioverter-defibrillator ; prevention
    ISSN: 0028-4793
    E-ISSN: 1533-4406
    Source: Single Journals
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  • 9
    Language: English
    In: Journal of the American College of Cardiology, 2013, Vol.62 (21), p.1977-1985
    Description: Objectives The study aimed to determine whether isolated heart rate (HR) reduction with ivabradine reduces afterload of patients with systolic heart failure. Background The effective arterial elastance (Ea) represents resistive and pulsatile afterload of the heart derived from the pressure volume relation. HR modulates Ea, and, therefore, afterload burden. Methods Among the patients with systolic heart failure (ejection fraction ≤35%) randomized to either placebo or ivabradine in the SHIFT (Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial), 275 patients (n = 132, placebo; n = 143, ivabradine 7.5 mg twice a day) were included in the echocardiographic substudy. Ea, total arterial compliance (TAC), and end-systolic elastance (Ees) were calculated at baseline and after 8 months of treatment. Blood pressure was measured by arm cuff; stroke volume (SV), ejection fraction, and end-diastolic volume were assessed by echocardiography. Results At baseline Ea, TAC, HR, and Ees did not differ significantly between ivabradine- and placebo-treated patients. After 8 months of treatment, HR was significantly reduced in the ivabradine group (p 〈 0.0001) and was accompanied by marked reduction in Ea (p 〈 0.0001) and improved TAC (p = 0.004) compared with placebo. Although contractility remained unchanged, ventricular-arterial coupling was markedly improved (p = 0.002), resulting in a higher SV (p 〈 0.0001) in the ivabradine-treated patients. Conclusions Isolated HR reduction by ivabradine improves TAC, thus reducing Ea. Because Ees is unaltered, improved ventricular-arterial coupling is responsible for increased SV. Therefore, unloading of the heart may contribute to the beneficial effect of isolated HR reduction in patients with systolic heart failure. (Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial [SHIFT]; ISRCTN70429960 )
    Subject(s): Cardiovascular ; Internal Medicine ; heart rate reduction ; systolic heart failure ; ventricular-arterial coupling ; Cardiovascular system ; Cardiology. Vascular system ; Heart ; Pharmacology. Drug treatments ; Biological and medical sciences ; Medical sciences ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Antiarythmic agents ; Heart Rate - physiology ; Cardiovascular Agents - therapeutic use ; Heart Ventricles - physiopathology ; Humans ; Heart Failure - physiopathology ; Heart failure ; Sects ; Heart beat ; Cardiac patients ; Cardiovascular agents ; Index Medicus ; Abridged Index Medicus ; Klinisk medicin ; Clinical Medicine ; heart rate reduction; systolic heart failure; ventricular-arterial coupling
    ISSN: 0735-1097
    ISSN: 1558-3597
    E-ISSN: 1558-3597
    Source: Alma/SFX Local Collection
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  • 10
    Language: English
    In: European heart journal, 2008-01, Vol.29 (2), p.270-276
    Description: In biology, classification systems are used to promote understanding and systematic discussion through the use of logical groups and hierarchies. In clinical medicine, similar principles are used to standardise the nomenclature of disease. For more than three decades, heart muscle diseases have been classified into primary or idiopathic myocardial diseases (cardiomyopathies) and secondary disorders that have similar morphological appearances, but which are caused by an identifiable pathology such as coronary artery disease or myocardial infiltration (specific heart muscle diseases). In this document, The European Society of Cardiology Working Group on Myocardial and Pericardial Diseases presents an update of the existing classification scheme. The aim is to help clinicians look beyond generic diagnostic labels in order to reach more specific diagnoses.
    Subject(s): Cardiology. Vascular system ; Heart ; Biological and medical sciences ; Myocarditis. Cardiomyopathies ; Medical sciences ; Diseases of the pericardium ; Ventricular Dysfunction - classification ; Cardiomyopathies - classification ; Societies, Medical ; Europe ; Humans ; Cardiomyopathies - diagnosis ; Index Medicus ; Kardiologi ; Cardiac and Cardiovascular Systems ; Ventricular Dysfunction ; Cardiomyopathies ; diagnosis ; Medical ; Societies ; classification
    ISSN: 0195-668X
    E-ISSN: 1522-9645
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: Oxford Journals 2016 Current and Archive A-Z Collection
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