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Masenga SK, Kirabo A. Hypertensive heart disease: risk factors, complications and mechanisms. Front Cardiovasc Med 2023; 10:1205475. [PMID: 37342440 PMCID: PMC10277698 DOI: 10.3389/fcvm.2023.1205475] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/26/2023] [Indexed: 06/22/2023] Open
Abstract
Hypertensive heart disease constitutes functional and structural dysfunction and pathogenesis occurring primarily in the left ventricle, the left atrium and the coronary arteries due to chronic uncontrolled hypertension. Hypertensive heart disease is underreported and the mechanisms underlying its correlates and complications are not well elaborated. In this review, we summarize the current understanding of hypertensive heart disease, we discuss in detail the mechanisms associated with development and complications of hypertensive heart disease especially left ventricular hypertrophy, atrial fibrillation, heart failure and coronary artery disease. We also briefly highlight the role of dietary salt, immunity and genetic predisposition in hypertensive heart disease pathogenesis.
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Affiliation(s)
- Sepiso K. Masenga
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Cam-Pus, Livingstone, Zambia
- School of Medicine, University of Zambia, Lusaka, Zambia
- Department of Medicine, Vanderbilt University Medical Centre, Nashville, TN, United States
| | - Annet Kirabo
- Department of Medicine, Vanderbilt University Medical Centre, Nashville, TN, United States
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The Evaluation of Biomarkers of Physical Activity on Stress Resistance and Wellness. Appl Psychophysiol Biofeedback 2022; 47:121-129. [PMID: 35296973 PMCID: PMC9098580 DOI: 10.1007/s10484-022-09538-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 12/02/2022]
Abstract
Physical activity can improve health as well as reduce stress and the risk of developing several widespread diseases. However, there exists no accepted standard biomedical examination-method for stress evaluation. The purpose of this study was to investigate the effect of regular physical activity on stress and wellness as well as the evaluation of potential biomarkers in this field. This study included 105 people (mean age = 36.57 ± 1.4 years) who were randomly assigned into the exercise group 1 (EG-1) (n = 41), the exercise group 2 (EG-2) (n = 30), and the control group (CG) (n = 34). Measurements of stress and wellness were obtained by Multiscan BC-OXI before and after experimental period. This device presents a multifrequency segmental body composition 3D analyser with digital pulse oximeter. The key indicators of stress as well as for wellness were significantly improved in the EG-1. Parasympathetic activity showed significant changes as potential stress biomarker. Statistically significant gender differences were not observed in the comparable groups. The results suggest that the stress resistance and well-being significantly improved in the EG-1 due to regular physical activity. However, further research is necessary to determine effects of physical activity on integral health indicators.
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Upadhya B, Pajewski NM, Rocco MV, Hundley WG, Aurigemma G, Hamilton CA, Bates JT, He J, Chen J, Chonchol M, Glasser SP, Hung AM, Pisoni R, Punzi H, Supiano MA, Toto R, Taylor A, Kitzman DW. Effect of Intensive Blood Pressure Control on Aortic Stiffness in the SPRINT-HEART. Hypertension 2021; 77:1571-1580. [PMID: 33775127 DOI: 10.1161/hypertensionaha.120.16676] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Bharathi Upadhya
- Cardiovascular Medicine Section (B.U., D.W.K.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Nicholas M Pajewski
- Department of Biostatistics and Data Science (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Michael V Rocco
- Nephrology Section, Department of Internal Medicine (M.V.R.), Wake Forest School of Medicine, Winston-Salem, NC
| | - W Gregory Hundley
- Pauley Heart Center Department of Internal Medicine at Virginia Commonwealth University Health Sciences Richmond (W.G.H.)
| | - Gerard Aurigemma
- Cardiovascular Medicine Section, University of Massachusetts Medical School, Worcester (G.A.)
| | - Craig A Hamilton
- Biomedical Engineering (C.A.H.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Jeffrey T Bates
- Department of Medicine, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX (J.T.B., A.T.)
| | - Jiang He
- Division of Nephrology & Hypertension, Tulane University School of Public Health and Tropical Medicine, Department of Medicine, Tulane University, New Orleans, LA (J.H., J.C.)
| | - Jing Chen
- Division of Nephrology & Hypertension, Tulane University School of Public Health and Tropical Medicine, Department of Medicine, Tulane University, New Orleans, LA (J.H., J.C.)
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora (M.C.)
| | - Steve P Glasser
- UAB School of Public Health, University of Alabama, Birmingham (S.P.G.)
| | - Adriana M Hung
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (A.M.H.)
| | - Roberto Pisoni
- Nephrology Section, Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston (R.P.)
| | - Henry Punzi
- Internal Medicine, Trinity Hypertension and Metabolic Research Institute, Punzi Medical Center, Carrollton, TX (H.P.)
| | - Mark A Supiano
- Geriatrics Division, VA Salt Lake City Geriatric Research, Education, and Clinical Center, University of Utah School of Medicine University of Utah School of Medicine, Salt Lake City (M.A.S.)
| | - Robert Toto
- Nephrology Section, University of Texas Southwestern Medical Center, Dallas (R.T.)
| | - Addison Taylor
- Department of Medicine, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX (J.T.B., A.T.)
| | - Dalane W Kitzman
- Cardiovascular Medicine Section (B.U., D.W.K.), Wake Forest School of Medicine, Winston-Salem, NC
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Lee J, Park W, Sung E, Kim B, Kim N, Park S, Shin C, Park J. The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels. Phys Act Nutr 2021; 24:34-43. [PMID: 33539693 PMCID: PMC7934524 DOI: 10.20463/pan.2020.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 11/23/2022] Open
Abstract
[Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. [Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. [Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. [Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.
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Affiliation(s)
- Jaesong Lee
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Wonil Park
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Eunsook Sung
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Bokbeom Kim
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Nahyun Kim
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Saejong Park
- Department of Sports Science, Korea Institute of Sport Science, Seoul, Republic of Korea
| | - Chulho Shin
- Department of Health Care, Namseoul University, Cheonan, Republic of Korea
| | - Jonghoon Park
- Department of Physical Education, Korea University, Seoul, Republic of Korea
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Reding KW, Brubaker P, D’Agostino R, Kitzman DW, Nicklas B, Langford D, Grodesky M, Hundley WG. Increased skeletal intermuscular fat is associated with reduced exercise capacity in cancer survivors: a cross-sectional study. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2019; 5:3. [PMID: 32154010 PMCID: PMC7048042 DOI: 10.1186/s40959-019-0038-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/17/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cancer survivors experience on average a 20% reduction in peak exercise capacity (VO2 peak) post-cancer treatment. Intermuscular fat (IMF) is a strong predictor of reduced exercise capacity in heart failure (HF) patients; however it is unknown whether increased IMF is related to reduced VO2 peak in cancer survivors. METHODS AND RESULTS Twenty eight individuals: 14 cancer survivors > 12-months post-cancer treatment and 14 individuals without cancer were matched on age, gender, and body mass index (BMI). Participants underwent magnetic resonance imaging (MRI) assessments of IMF within the paraspinal muscles, VO2 peak and exercise-associated measures of left ventricular ejection fraction (LVEF). Blinded analyses were performed. Associations between the ratio of IMF to skeletal muscle (SM) were estimated using Pearson's partial correlation coefficients. Individuals with cancer and non-cancer comparators were of similar age (54 ± 17 versus 54 ± 15 years; p = 1.0), gender (5 men and 9 women, both groups), and BMI (27 ± 4 versus 26 ± 4; p = 0.57). Peak VO2 was 22% lower in cancer survivors versus non-cancer comparators (26.9 vs 34.3 ml/kg/min; p = 0.005), and was correlated with IMF:SM in both cancer survivors and non-cancer individuals after accounting for exercise-associated LVEF, resting LVEF, BMI, other body fat depots, and cardiovascular disease (CVD) co-morbidities (p < 0.001 to 0.08 for all adjusted correlations). CONCLUSION Among cancer survivors that previously received anthracyclines, increased intermuscular fat is associated with reduced VO2 peak even after accounting for exercise-associated cardiac function. This suggests IMF is important in the development of exercise intolerance, an outcome experienced by a large number of cancer survivors.
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Affiliation(s)
- Kerryn W. Reding
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA USA
- Department of Cancer Prevention, Public Health Sciences, Fred Hutch Cancer Research Center, Seattle, WA USA
| | - Peter Brubaker
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC USA
| | - Ralph D’Agostino
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Dalane W. Kitzman
- Department of Internal Medicine (Section on Cardiology), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045 USA
| | - Barbara Nicklas
- Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Dale Langford
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Michael Grodesky
- Department of Psychosocial and Community Health, University of Washington School of Nursing, Seattle, WA USA
| | - W. Gregory Hundley
- Department of Internal Medicine (Section on Cardiology), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045 USA
- Pauley Heart Center, Virginia Commonwealth University Health System, Richmond, VA USA
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Wong C, Chen S, Iyngkaran P. Cardiac Imaging in Heart Failure with Comorbidities. Curr Cardiol Rev 2017; 13:63-75. [PMID: 27492227 PMCID: PMC5324322 DOI: 10.2174/1573403x12666160803100928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 01/19/2023] Open
Abstract
Imaging modalities stand at the frontiers for progress in congestive heart failure (CHF) screening, risk stratification and monitoring. Advancements in echocardiography (ECHO) and Magnetic Resonance Imaging (MRI) have allowed for improved tissue characterizations, cardiac motion analysis, and cardiac performance analysis under stress. Common cardiac comorbidities such as hypertension, metabolic syndromes and chronic renal failure contribute to cardiac remodeling, sharing similar pathophysiological mechanisms starting with interstitial changes, structural changes and finally clinical CHF. These imaging techniques can potentially detect changes earlier. Such information could have clinical benefits for screening, planning preventive therapies and risk stratifying patients. Imaging reports have often focused on traditional measures without factoring these novel parameters. This review is aimed at providing a synopsis on how we can use this information to assess and monitor improvements for CHF with comorbidities.
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Affiliation(s)
- Chiew Wong
- Flinders University, NT Medical School, Darwin Australia
| | - Sylvia Chen
- Flinders University, NT Medical School, Darwin Australia
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Rannelli LA, MacRae JM, Mann MC, Ramesh S, Hemmelgarn BR, Rabi D, Sola DY, Ahmed SB. Sex differences in associations between insulin resistance, heart rate variability, and arterial stiffness in healthy women and men: a physiology study. Can J Physiol Pharmacol 2016; 95:349-355. [PMID: 28099042 DOI: 10.1139/cjpp-2016-0122] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Diabetes confers greater cardiovascular risk to women than to men. Whether insulin-resistance-mediated risk extends to the healthy population is unknown. Measures of insulin resistance (fasting insulin, homeostatic model assessment, hemoglobin A1c, quantitative insulin sensitivity check index, glucose) were determined in 48 (56% female) healthy subjects. Heart rate variability (HRV) was calculated by spectral power analysis and arterial stiffness was determined using noninvasive applanation tonometry. Both were measured at baseline and in response to angiotensin II infusion. In women, there was a non-statistically significant trend towards increasing insulin resistance being associated with an overall unfavourable HRV response and increased arterial stiffness to the stressor, while men demonstrated the opposite response. Significant differences in the associations between insulin resistance and cardiovascular physiological profile exist between healthy women and men. Further studies investigating the sex differences in the pathophysiology of insulin resistance in cardiovascular disease are warranted.
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Affiliation(s)
- Luke Anthony Rannelli
- a Faculty of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada
| | - Jennifer M MacRae
- a Faculty of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada.,b Alberta Kidney Disease Network, 1403-29th St. NW, C210, Calgary, AB T2N 2T9, Canada.,c Libin Cardiovascular Institute of Alberta, 1403-29th St. NW, Calgary, AB T2N 2T9, Canada
| | - Michelle C Mann
- a Faculty of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada.,c Libin Cardiovascular Institute of Alberta, 1403-29th St. NW, Calgary, AB T2N 2T9, Canada
| | - Sharanya Ramesh
- a Faculty of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada.,c Libin Cardiovascular Institute of Alberta, 1403-29th St. NW, Calgary, AB T2N 2T9, Canada
| | - Brenda R Hemmelgarn
- a Faculty of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada.,b Alberta Kidney Disease Network, 1403-29th St. NW, C210, Calgary, AB T2N 2T9, Canada.,c Libin Cardiovascular Institute of Alberta, 1403-29th St. NW, Calgary, AB T2N 2T9, Canada.,d Institute for Public Health, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada
| | - Doreen Rabi
- a Faculty of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada.,c Libin Cardiovascular Institute of Alberta, 1403-29th St. NW, Calgary, AB T2N 2T9, Canada.,d Institute for Public Health, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada
| | - Darlene Y Sola
- b Alberta Kidney Disease Network, 1403-29th St. NW, C210, Calgary, AB T2N 2T9, Canada.,c Libin Cardiovascular Institute of Alberta, 1403-29th St. NW, Calgary, AB T2N 2T9, Canada
| | - Sofia B Ahmed
- a Faculty of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada.,b Alberta Kidney Disease Network, 1403-29th St. NW, C210, Calgary, AB T2N 2T9, Canada.,c Libin Cardiovascular Institute of Alberta, 1403-29th St. NW, Calgary, AB T2N 2T9, Canada
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Vasu S, Little WC, Morgan TM, Stacey RB, Ntim WO, Hamilton C, Thohan V, Chiles C, Hundley WG. Mechanism of decreased sensitivity of dobutamine associated left ventricular wall motion analyses for appreciating inducible ischemia in older adults. J Cardiovasc Magn Reson 2015; 17:26. [PMID: 25885436 PMCID: PMC4389511 DOI: 10.1186/s12968-015-0131-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/13/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dobutamine associated left ventricular (LV) wall motion analyses exhibit reduced sensitivity for detecting inducible ischemia in individuals with increased LV wall thickness. This study was performed to better understand the mechanism of this reduced sensitivity in the elderly who often manifest increased LV wall thickness and risk factors for coronary artery disease. METHODS During dobutamine cardiovascular magnetic resonance (DCMR) stress testing, we assessed rate pressure product (RPP), aortic pulse wave velocity (PWV), LV myocardial oxygen demand (pressure volume area, PVA, mass, volumes, concentricity, and the presence of wall motion abnormalities (WMA) and first pass gadolinium enhanced perfusion defects (PDs) indicative of ischemia in 278 consecutively recruited individuals aged 69 ± 8 years with pre-existing or known risk factors for coronary artery disease. Each variable was assessed independently by personnel blinded to participant identifiers and analyses of other DCMR or hemodynamic variables. RESULTS Participants were 80% white, 90% hypertensive, 43% diabetic and 55% men. With dobutamine, 60% of the participants who exhibited PDs had no inducible WMA. Among these participants, myocardial oxygen demand was lower than that observed in those who had both wall motion and perfusion abnormalities suggestive of ischemia (p = 0.03). Relative to those with PDs and inducible WMAs, myocardial oxygen demand remained different in these individuals with PDs without an inducible WMA after accounting for LV afterload and contractility (p = 0.02 and 0.03 respectively), but not after accounting for either LV stress related end diastolic volume index (LV preload) or resting concentricity (p = 0.31-0.71). CONCLUSIONS During dobutamine stress testing, elderly patients experience increased LV concentricity and declines in LV preload and myocardial oxygen demand, all of which are associated with an absence of inducible LV WMAs indicative of myocardial ischemia. These findings provide insight as to why dobutamine associated wall motion analyses exhibit reduced sensitivity for identifying inducible ischemia in elderly. TRIAL REGISTRATION This study was registered with Clinicaltrials.gov (NCT00542503).
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Affiliation(s)
- Sujethra Vasu
- Department of Internal medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, North Carolina, 27157, USA.
| | - William C Little
- Department of Internal Medicine, University of Mississippi, Jackson, Mississippi, 39216, USA.
| | - Timothy M Morgan
- Department of Biostatistical sciences, Wake Forest School of Medicine, Winston Salem North Carolina, 27157, USA.
| | - Richard B Stacey
- Department of Internal medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, North Carolina, 27157, USA.
| | - William O Ntim
- Mid Carolina Cardiology, Charlotte North Carolina, 28204, USA.
| | - Craig Hamilton
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston Salem, North Carolina, 27157, USA.
| | - Vinay Thohan
- Aurora Cardiovascular Services, Milwaukee, Wisconsin, 53215, USA.
| | - Caroline Chiles
- Department of Radiology, Wake Forest School of Medicine, Winston Salem, North Carolina, 27157, USA.
| | - William Gregory Hundley
- Department of Internal medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, North Carolina, 27157, USA.
- Department of Radiology, Wake Forest School of Medicine, Winston Salem, North Carolina, 27157, USA.
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