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Patel J, Kittleson M, Vescio R, Aintablian T, Sharoff R, Levine R, Geft D, Chang D, Czer L, Trento A, Kobashigawa J. Transthyretin Amyloid Patients >70 Years of Age Appear as Good Candidates for Heart Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kobashigawa J, Kittleson M, Aintablian T, Azarbal B, Hage A, Kransdorf E, Geft D, Chang D, Czer L, Esmailian F, Zhang X, Reinsmoen N, Patel J. Only Persistent Donor Specific Antibodies are Associated with Subsequent Cardiac Allograft Vasculopathy After Heart Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Reich H, Ramzy D, Mirocha J, De Robertis M, Chung J, Esmailian F, Chang D, Moriguchi J, Czer L, Trento A, Arabia F. Not All INTERMACS Level 1’s Are the Same: Survival After Total Artificial Heart Implantation with or without Temporary Circulatory Support. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Mohan R, Neyer J, Patel J, Kittleson M, Aintablian T, Levine R, Chang D, Czer L, Moriguchi J, Kobashigawa J, Arabia F. Pre-Implant Moderate-Severe Fibrosis on Liver Biopsy Predicts Adverse Outcomes After Mechanical Circulatory Support. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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105
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Conte A, Hajj J, Yang S, Passano E, Barone H, Chang D, Esmailian F, Czer L, Kobashigawa J, Moriguchi J, Arabia F. Utilization of Transverse Abdominis Plexus Block for Treatment of Left Ventricular Assist Device Associated Driveline Pain / Abdominal Pain Refractory to Conventional Multi-Modal Therapy: A Case Series. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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106
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Chang D, Kittleson M, Patel J, Aintablian T, Rodriguez G, Levine R, Geft D, Kransdorf E, Czer L, Esmailian F, Kobashigawa J. Coronary Vasospasm After Heart Transplantation: Does It Portend Poor Outcome? J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hickethier T, Mammadov K, Baeßler B, Maintz D, Chang D. Polytrauma CT Diagnostik: Signifikante Reduktion des Zeitbedarfs durch optimierte Lagerung bei erhaltener Bildqualität. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1601385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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108
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Große Hokamp N, Slebocki K, Mammadov K, Salem J, Herden J, Maintz D, Chang D. Einfluss iterativer, Modell-basierter Rekonstruktionsalgorithmen (IMR) auf die Bildqualität von ultra-low-dose Steinsuche CT in adipösen Patienten. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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109
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Hickethier T, Kroeger J, Baeßler B, Doerner J, Maintz D, Chang D. Spectral-Detector-CT bei Staging Untersuchungen des Thorax: Erste Erfahrungen zur Kontrastmittelreduktion mittels monoenergetischer Rekonstruktionen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fahey R, Gilmore W, Papageorge M, Chang D, Azzouni L, Chaudhary S, Balint A, Ashrafi A, Darwish G, Oreadi D, Viswanath A, English R, Mehtani A, Alharthi K, Vyas H, Decoteau C, Stark P. Evaluation of postoperative oedema and pain following third molar extraction with application of pulsed electromagnetic field therapy. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Swaroop S, Milder M, Vishwanath A, Chang D. Is piezoelectric safer than hall drill during an external sinus lift? A retrospective study. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sugarbaker PH, Chang D. Long-term regional chemotherapy for patients with epithelial malignant peritoneal mesothelioma results in improved survival. Eur J Surg Oncol 2017; 43:1228-1235. [PMID: 28189456 DOI: 10.1016/j.ejso.2017.01.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/16/2016] [Accepted: 01/10/2017] [Indexed: 01/30/2023] Open
Abstract
PURPOSE Malignant peritoneal mesothelioma (MPM) is a rare disease with about 300 new cases per year in the USA. Its natural history is described as local progression within the peritoneal space in the absence of liver metastases or systemic disease. METHODS Cytoreductive surgery (CRS) is a series of peritonectomy procedures and visceral resections with a goal of complete removal of all visible disease from the abdomen and pelvis. Over 20 years, three protocols investigating increasing efficacy of additional chemotherapy treatments added to CRS have been initiated. Initially, hyperthermic perioperative chemotherapy (HIPEC) with doxorubicin and cisplatin was used in the operating room. Then, early postoperative intraperitoneal chemotherapy (EPIC) with paclitaxel was added for the first 5 days after CRS. The third protocol employed HIPEC, then EPIC, and then long-term intraperitoneal (IP) paclitaxel or IP pemetrexed plus intravenous (IV) cisplatin as a adjuvant normothermic intraperitoneal chemotherapy (NIPEC). RESULT The 5-year survival of 42 patients treated with CRS and HIPEC was 44%, for 58 patients treated with EPIC and HIPEC was 52% and 29 patients who received HIPEC, EPIC, and NIPEC was 75% (p = 0.0374). Prognostic variables of age, gender, treatment administered, peritoneal cancer index (PCI) and completeness of cytoreduction were significant by univariate analysis and treatments administered and completeness of cytoreduction significant by multivariate analysis. CONCLUSIONS Long-term regional chemotherapy was associated with improved survival in patients with MPM. In this rare disease, additional phase 2 investigations are suggested.
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Welsh AW, Maheshwari P, Wang J, Henry A, Chang D, Crispi F, Gardiner HM, Hernandez-Andrade E, Meriki N, Redmond S, Yagel S. Evaluation of an automated fetal myocardial performance index. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2016; 48:496-503. [PMID: 26423314 DOI: 10.1002/uog.15770] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/17/2015] [Accepted: 09/26/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To compare automated measurements of the fetal left myocardial performance index (MPI) with manual measurements for absolute value, repeatability and waveform acceptability. METHODS This was a multicenter international online study using images from uncomplicated, morphologically normal singleton pregnancies (16-38 weeks' gestation). Single Doppler ultrasound cardiac cycle images of 25 cases were selected, triplicated and randomized (n = 75). Six senior observers, unaware of the repetition of images, manually calculated MPI for each waveform and the results were compared with automation. Intraobserver repeatability and interobserver reproducibility were assessed using intraclass correlation coefficients (ICCs) and 95% CI. The agreement between each observer's manual MPI measurements and corresponding automated measurements was evaluated using Bland-Altman plots and ICCs with 95% CI. The degree of variation between experts in the classification of fetal MPI waveform quality was assessed using individual cardiac cycle left MPI images previously classified by two authors as 'optimal', 'suboptimal' or 'unacceptable', with 30 images selected for each quality group. Ten images in each category were duplicated and the resulting 120 images were randomized and then classified online by five observers. The kappa statistic (κ) was used to demonstrate interobserver and intraobserver agreement and agreement of classifications by the five observers. RESULTS The automated measurement software returned the same value for any given image, resulting in an ICC of 1.00. Manual measurements had intraobserver repeatability ICC values ranging from 0.69 to 0.97, and the interobserver reproducibility ICC was 0.78. Comparison of automated vs manual MPI absolute measurements for each observer gave ICCs ranging from 0.77 to 0.96. Interobserver image quality classification agreement gave k = 0.69 (P < 0.001), and the intraobserver agreement was variable (κ ranging from 0.40 to 0.81). CONCLUSIONS Automated fetal MPI provides superior repeatability and reproducibility to manual methodology. Additionally, experts vary significantly when classifying suitability of fetal MPI waveforms. Automated MPI may facilitate clinical translation by removing human subjectivity. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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Gallais Sérézal I, Cheuk S, Chang D, Eidsmo L. 365 Activation of resident T cells in a human ex-vivo model induces tissue responses in resolved psoriasis. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Duan X, Cui Y, Li H, Shi G, Wu B, Liu M, Chang D, Wang T, Kong Y. High preoperative and postoperative levels of carcinoembryonic antigen and CYFRA 21-1 indicate poor prognosis in patients with pathological Stage I nonsmall cell lung cancer. Indian J Cancer 2016; 52 Suppl 3:E158-63. [PMID: 27453414 DOI: 10.4103/0019-509x.186564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Serum carcinoembryonic antigen (CEA) and the soluble fragment of cytokeratin 19 (CYFRA 21-1) are supposed to have a prognostic role in patients with nonsmall cell lung cancer (NSCLC) after surgery, but it has not been used as an adjunct to the tumor-node-metastasis (TNM) staging system to provide therapy options for patients with pathological Stage I NSCLC. This study was designed to investigate the effect of serum levels of CEA and CYFRA 21-1 before and after surgery on the prognosis of patients with Stage I NSCLC. MATERIALS AND METHODS A retrospective review was performed regarding the medical records and follow-ups of 169 patients with Stage I NSCLC before and after surgery. The patients were divided into three groups based on levels of serum CEA and CYFRA 21-1 before and after surgery: (1) continuously normal-level groups (CEA [NN] and CYFRA 21-1 [NN] groups); (2) declined to normal-level groups (CEA [HN] and CYFRA 21-1 [HN] groups); and (3) continuously high-level groups (CEA [HH] and CYFRA 21-1 [HH] groups). Survival analysis was conducted using the Kaplan-Meier method for each group. The Chi-square or Fisher exact test was employed to compare clinical and pathologic factors at the level of P < 0.05. The prognostic factor was evaluated by the Cox proportional hazards model. RESULTS Compared with the continuously normal-level groups, the CEA [HN] group was significantly correlated to tumor size (P = 0.011), and the CYFRA 21-1 [HN] group was significantly correlated to tumor type and pathological TNM in addition to tumor size. Five-year survivals were significantly lower (P = 0.004) in the CEA [HH] group (67.3%) and the CEA [HN] group (86.5%) than in the CEA [NN] group (85.7%) and were significantly lower (P < 0.001) in the CYFRA 21-1 [HH] group (47.2%) and the CYFRA 21-1 [HN] group (70.1%) than in the CYFRA 21-1 [NN] group (90.1%). Multivariate analysis demonstrated that tumor size (21-50 mm), CEA [HH], and CYFRA 21-1 [HH] were independent unfavorable prognostic factors for overall survival (OS), whereas tumor size (21-50 mm), CEA [HH], CYFRA 21-1 [HN], and CYFRA 21-1 [HH] were independent significant prognostic factors for progression-free survival (PFS). CONCLUSION Patients with a persistently high serum CEA or CYFRA 21-1 before and after surgery had shortest OS and PFS. These patients had worst prognosis. Adjuvant chemotherapy was likely to improve survival for these patients.
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Chen LT, Siveke J, Wang-Gillam A, Hubner R, Pant S, Dragovich T, Chung V, Chang D, Ross P, Cooray P, Tebbutt N, Franke F, Belanger B, Dhindsa N, de Jong F, Mamlouk K, Von Hoff D. PD-023 Safety across subgroups in NAPOLI-1: a phase 3 study of nal-IRI (MM-398) ± 5-fluorouracil and leucovorin (5-FU/LV) versus 5-FU/LV in metastatic pancreatic cancer (mPAC) previously treated with gemcitabine-based therapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Patel J, Kittleson M, Czer L, Aintablian T, Stimpson E, Daun T, Manayan T, Rodriguez G, Chang D, Ramzy D, Kobashigawa J. Chronic Lung Disease Fev1/Fvc <70% and Primary Graft Dysfunction; a Marker for Prolonged Intubation Immediately Post-Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cheng R, Azarbal B, Vanichsarn C, Patel J, Chang D, Kittleson M, Kobashigawa J. Cardiac Allograft Donor Age Is Associated with Increased Baseline Coronary Plaque Burden but Not with Its Progression as Assessed by Intravascular Ultrasound. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kobashigawa J, Kittleson M, Patel J, Aintablian T, Zarrini P, Lipson A, Kao T, Daun T, Chang D, Trento A, Hage A, Czer L. Thymoglobulin Provides Protection Against Ischemia Reperfusion in the Immediate Post-Transplant Period. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Luu M, Patel J, Kittleson M, Czer L, Aintablian T, Norland K, Perry N, Chang D, Hamilton M, Geft D, Kobashigawa J. Lower Dose Tacrolimus Monotherapy in Heart Transplant Patients: Is It Safe. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kittleson M, Patel J, Czer L, Aintablian T, Rodriguez G, Velleca A, Kearney B, Chang D, Hamilton M, Esmailian F, Zhang X, Reinsmoen N, Kobashigawa J. Proliferation Signal Inhibitors Prevent Donor-Specific Antibody Production in Sensitized Patients after Heart Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Runyan C, Henry H, Huie N, Moriguchi J, Kittleson M, Czer L, Chang D, Passano E, Aintablian T, Kobashigawa J, Esmailian F, Arabia F. Can Patients with Restrictive Physiology Be Successfully Bridged to Transplant with Left Ventricular Support Alone Versus Biventricular Support? J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Sogomonian R, Alkhawam H, Lee S, Chang D, Moradoghli Haftevani EA. ID: 6: HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY IN THE SETTING OF SYSTEMIC SCLERODERMA. J Investig Med 2016. [DOI: 10.1136/jim-2016-000120.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Restrictive cardiomyopathy has been a common variant seen in systemic sclerosis (SS) with myocardial fibrosis. The association of SS with restrictive cardiomyopathy has well been established, but that with HOCM is not clearly understood. Herein, we report a case of a patient with SS, identified to have both HOCM and myocardial fibrosis.A 54-year-old woman with systemic sclerosis, idiopathic lung disease with moderate pulmonary hypertension, presented with fatigue, decreased appetite and shortness of breath. Vital signs were significant for oxygen saturation of 86% on room air, tachycardia of 117 bpm, and blood pressure of 110/53 mm Hg. Physical examination revealed diffuse rhonchi in all lung fields, malar rash and skin excoriation in bilateral lower extremities without edema. Laboratory studies were significant for elevated brain natriuretic peptide (BNP) of 858 pg/mL. Transthoracic echocardiography revealed left ventricular hypertrophy (LVH) with ejection fraction of 78%. Electrocardiography illustrated LVH. Cardiac magnetic resonance imaging (cMRI) was significant for severe left ventricular cardiac asymmetric septal hypertrophy with outflow obstruction caused by anterior motion of the mitral valve. Cardiac biopsy revealed evidence of diffuse fibrosis, but did not show iron, glycogen, or amyloid depositions.Patient was maintained on mycophenolate mofetil, low dose of methylprednisolone, morphine, clonazepam and transferred to hospice care.Hypertrophic obstructive cardiomyopathy (HOCM) is the most common genetic cardiac disorder with an autosomal dominant transmission. It is characterized by asymmetric LVH out of proportion of systemic after load. The most common cardiac involvement in SS is myocardial fibrosis in a restrictive pattern, while HOCM is rarely seen in SS.Abstract ID: 6 Figure 1Cardiac MRI demonstrating hypertrophied ventricle with fibrosis. This image demonstrates the features of both hypertrophic and restrictive cardiomyopathy.
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Kittleson M, Patel J, Czer L, Passano E, Aintablian T, Runyan C, Huie N, Chang D, Esmailian F, Moriguchi J, Kobashigawa J. Comparison of 6 Month Hospitalizations in Mechanical Circulatory Support Patients vs Heart Transplant Patients. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Patel J, Kittleson M, Czer L, Aintablian T, Johl M, Daun T, Kearney B, Chang D, Azarbal B, Hamilton M, Esmailian F, Kobashigawa J. Does ACE Inhibitor Use in Heart Transplantation Decrease the Development of Cardiac Allograft Vasculopathy? J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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