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Chen PH, Hsiao CY, Chiang SJ, Chung KH, Tsai SY. Association of lipids and inflammatory markers with left ventricular wall thickness in patients with bipolar disorder. J Affect Disord 2024; 358:12-18. [PMID: 38705523 DOI: 10.1016/j.jad.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/04/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Individuals with bipolar disorder (BD) face a high risk of heart failure and left ventricular (LV) dysfunction. Despite strong evidence that high LV relative wall thickness (RWT) is a risk marker for heart failure, few studies have evaluated LV RWT and aggravating factors in individuals with BD. METHODS We recruited 104 participants (52 patients with BD and 52 age- and sex-matched mentally healthy controls) to undergo echocardiographic imaging and biochemistry, high-sensitivity C-reactive protein (hs-CRP), and blood cell count measurements. LV RWT was estimated using the following equation: (2 × LV posterior wall end-diastolic thickness)/LV end-diastolic diameter. Clinical data were obtained through interviews and chart reviews. RESULTS The BD group exhibited a significantly greater LV RWT (Cohen's d = 0.53, p = 0.003) and a less favorable mitral valve E/A ratio (Cohen's d = 0.54, p = 0.023) and LV global longitudinal strain (Cohen's d = 0.57, p = 0.047) than did the control group. Multiple linear regression revealed that in the BD group, serum triglyceride levels (β = 0.466, p = 0.001), platelet-to-lymphocyte ratios (β = 0.324, p = 0.022), and hs-CRP levels (β = 0.289, p = 0.043) were all significantly and positively associated with LV RWT. LIMITATIONS This study applied a cross-sectional design, meaning that the direction of causation could not be inferred. CONCLUSIONS Patients with BD are at a risk of heart failure, as indicated by their relatively high LV RWT. Lipid levels and systemic inflammation may explain this unfavorable association.
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Affiliation(s)
- Pao-Huan Chen
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Yi Hsiao
- Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shuo-Ju Chiang
- Division of Cardiology, Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan; School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Hsuan Chung
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shang-Ying Tsai
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Zhang Z, Li G, Gao Y, Zhou S, Xie J, Liu S, Zhao Z, Zhu C, Ordovas K, Pohost GM, Sun K, Li K. Healthy Adult Left and Right Ventricular Torsion and Torsion Rates With MR-Feature Tracking. J Magn Reson Imaging 2023. [PMID: 38156373 DOI: 10.1002/jmri.29201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND The clinical value of myocardial torsion quantification in prognostic assessment and risk stratification of various cardiovascular diseases is gradually being recognized. However, normal values of left and right ventricular (LV and RV) torsion and torsion rates (TRs) have not been fully determined, and their correlation with age and gender has not been well studied. PURPOSE To establish normal ranges of biventricular torsion, peak systolic and diastolic TRs using magnetic resonance feature tracking (MR-FT) technique based on a large sample of healthy adults, and further investigate their relationship with age and gender. STUDY TYPE Retrospective. POPULATION 566 Healthy adults (312 males, aged 43 ± 10 years; 254 females, aged 43 ± 11 years). FIELD STRENGTH/SEQUENCE 1.5T/gradient echo. ASSESSMENT Biventricular torsion, peak systolic, and diastolic TRs. STATISTICAL TESTS Shapiro-Wilk test, Student's t-test, Mann-Whitney-U test, linear regression, intraclass correlation coefficient, Bland-Altman analysis. Differences were regarded as statistically significant at P < 0.05. RESULTS Women demonstrated greater magnitudes of left ventricle (LV) torsion (1.23 ± 0.44 vs. 1.00 ± 0.42°/cm), peak systolic TR (9.69 ± 3.70 vs. 8.27 ± 3.73°/cm*sec), peak diastolic TR (-7.78 ± 2.82 vs. -6.06 ± 2.44°/cm*sec), and RV torsion (2.20 ± 1.23 vs. 1.65 ± 1.11°/cm*sec), peak systolic TR (16.07 ± 8.18 vs. 12.62 ± 7.08°/cm*sec), peak diastolic TR (-15.39 ± 6.53 vs. -11.70 ± 6.03°/cm*sec). For both genders, the magnitudes of LV and RV torsion, peak systolic, and diastolic TRs increased linearly with age. All the measurements of biventricular torsion, peak systolic and diastolic TRs achieved good to excellent intraobserver and interobserver reproducibility, with all intraclass correlation coefficients >0.70. DATA CONCLUSION The present study systematically provided age- and sex-stratified reference values for LV and RV torsion and TRs using MR-FT technique. Women and aging are associated with greater magnitudes of biventricular torsion, peak systolic, and diastolic TRs. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhen Zhang
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Gengxiao Li
- Department of Radiology, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yiyuan Gao
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shanshan Zhou
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Jianan Xie
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Shurong Liu
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Zhiwei Zhao
- Zhouxin Medical Imaging and Health Screening Center, Xiamen, Fujian, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Karen Ordovas
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Gerald M Pohost
- Zhouxin Medical Imaging and Health Screening Center, Xiamen, Fujian, China
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Kai Sun
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Kuncheng Li
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
- Zhouxin Medical Imaging and Health Screening Center, Xiamen, Fujian, China
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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Balligand JL, Brito D, Brosteanu O, Casadei B, Depoix C, Edelmann F, Ferreira V, Filippatos G, Gerber B, Gruson D, Hasenclever D, Hellenkamp K, Ikonomidis I, Krakowiak B, Lhommel R, Mahmod M, Neubauer S, Persu A, Piechnik S, Pieske B, Pieske-Kraigher E, Pinto F, Ponikowski P, Senni M, Trochu JN, Van Overstraeten N, Wachter R, Pouleur AC. Repurposing the β3-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease: The Beta3-LVH Phase 2b Randomized Clinical Trial. JAMA Cardiol 2023; 8:1031-1040. [PMID: 37728907 PMCID: PMC10512168 DOI: 10.1001/jamacardio.2023.3003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/23/2023] [Indexed: 09/22/2023]
Abstract
Importance Left ventricular (LV) hypertrophy contributes to the onset and progression of heart failure (HF), particularly for patients with pre-HF (stage B) for whom no treatment has yet proven effective to prevent transition to overt HF (stage C). The β3-adrenergic receptors (β3ARs) may represent a new target, as their activation attenuates LV remodeling. Objective To determine whether activation of β3ARs by repurposing a β3AR agonist, mirabegron, is safe and effective in preventing progression of LV hypertrophy and diastolic dysfunction among patients with pre- or mild HF. Design, Setting, and Participants The Beta3-LVH prospective, triple-blind, placebo-controlled phase 2b randomized clinical trial enrolled patients between September 12, 2016, and February 26, 2021, with a follow-up of 12 months. The trial was conducted at 10 academic hospitals in 8 countries across Europe (Germany, Poland, France, Belgium, Italy, Portugal, Greece, and the UK). Patients aged 18 years or older with or without HF symptoms (maximum New York Heart Association class II) were screened for the presence of LV hypertrophy (increased LV mass index [LVMI] of ≥95 g/m2 for women or ≥115 g/m2 for men) or maximum wall thickness of 13 mm or greater using echocardiography. Data analysis was performed in August 2022. Intervention Participants were randomly assigned (1:1) to mirabegron (50 mg/d) or placebo, stratified by the presence of atrial fibrillation and/or type 2 diabetes, for 12 months. Main Outcomes and Measures The primary end points were LVMI determined using cardiac magnetic resonance imaging and LV diastolic function (early diastolic tissue Doppler velocity [E/e'] ratio assessed using Doppler echocardiography) at 12 months. Patients with at least 1 valid measurement of either primary end point were included in the primary analysis. Safety was assessed for all patients who received at least 1 dose of study medication. Results Of the 380 patients screened, 296 were enrolled in the trial. There were 147 patients randomized to mirabegron (116 men [79%]; mean [SD] age, 64.0 [10.2] years) and 149 to placebo (112 men [75%]; mean [SD] age, 62.2 [10.9] years). All patients were included in the primary intention-to-treat analysis. At 12 months, the baseline and covariate-adjusted differences between groups included a 1.3-g/m2 increase in LVMI (95% CI, -0.15 to 2.74; P = .08) and a -0.15 decrease in E/e' (95% CI, -0.69 to 0.4; P = .60). A total of 213 adverse events (AEs) occurred in 82 mirabegron-treated patients (including 31 serious AEs in 19 patients) and 215 AEs occurred in 88 placebo-treated patients (including 30 serious AEs in 22 patients). No deaths occurred during the trial. Conclusions In this study, mirabegron therapy had a neutral effect on LV mass or diastolic function over 12 months among patients who had structural heart disease with no or mild HF symptoms. Trial Registration ClinicalTrials.gov Identifier: NCT02599480.
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Affiliation(s)
- Jean-Luc Balligand
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Dulce Brito
- Department of Cardiology, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
- Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Medicina, Centro Cardiovascular, Universidade de Lisboa, Lisboa, Portugal
| | - Oana Brosteanu
- Clinical Trial Centre Leipzig, Universität Leipzig, Leipzig, Germany
| | - Barbara Casadei
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
- National Institute of Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom
| | - Christophe Depoix
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Frank Edelmann
- Department of Cardiology, German Centre for Cardiovascular Research, Charité University Campus Virchow, Berlin, Germany
| | - Vanessa Ferreira
- Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
| | - Gerasimos Filippatos
- Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Bernhard Gerber
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Damien Gruson
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics, and Epidemiology, Universität Leipzig, Leipzig, Germany
| | - Kristian Hellenkamp
- Department of Cardiology and Pneumology, German Centre for Cardiovascular Research, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Ignatios Ikonomidis
- Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Bartosz Krakowiak
- Department of Cardiology, Centre for Heart Diseases, Clinical Military Hospital, Wrocław Medical University, Wrocław, Poland
| | - Renaud Lhommel
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Masliza Mahmod
- Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
| | - Stefan Neubauer
- Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
| | - Alexandre Persu
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Stefan Piechnik
- Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
| | - Burkert Pieske
- Department of Cardiology, German Centre for Cardiovascular Research, Charité University Campus Virchow, Berlin, Germany
| | - Elisabeth Pieske-Kraigher
- Department of Cardiology, German Centre for Cardiovascular Research, Charité University Campus Virchow, Berlin, Germany
| | - Fausto Pinto
- Department of Cardiology, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
- Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Medicina, Centro Cardiovascular, Universidade de Lisboa, Lisboa, Portugal
| | - Piotr Ponikowski
- Department of Cardiology, Centre for Heart Diseases, Clinical Military Hospital, Wrocław Medical University, Wrocław, Poland
| | - Michele Senni
- Department of Cardiology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, University of Milano-Bicocca, Bergamo, Italy
| | - Jean-Noël Trochu
- Institut du Thorax, Centre National de la Recherche Scientifique, Nantes Université, Nantes, France
- L’Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire de Nantes, Nantes Université, Nantes, France
| | - Nancy Van Overstraeten
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Rolf Wachter
- Department of Cardiology and Pneumology, German Centre for Cardiovascular Research, Universitätsmedizin Göttingen, Göttingen, Germany
- Department of Cardiology, University Hospital Leipzig, Leipzig, Germany
| | - Anne-Catherine Pouleur
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Pezeshki PS, Ghorashi SM, Houshmand G, Ganjparvar M, Pouraliakbar H, Rezaei-Kalantari K, Fazeli A, Omidi N. Feature tracking cardiac magnetic resonance imaging to assess cardiac manifestations of systemic diseases. Heart Fail Rev 2023:10.1007/s10741-023-10321-6. [PMID: 37191926 PMCID: PMC10185959 DOI: 10.1007/s10741-023-10321-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 05/17/2023]
Abstract
Feature-tracking cardiac magnetic resonance (FT-CMR), with the ability to quantify myocardial deformation, has a unique role in the evaluation of subclinical myocardial abnormalities. This review aimed to evaluate the clinical use of cardiac FT-CMR-based myocardial strain in patients with various systemic diseases with cardiac involvement, such as hypertension, diabetes, cancer-therapy-related toxicities, amyloidosis, systemic scleroderma, myopathies, rheumatoid arthritis, thalassemia major, and coronavirus disease 2019 (COVID-19). We concluded that FT-CMR-derived strain can improve the accuracy of risk stratification and predict cardiac outcomes in patients with systemic diseases prior to symptomatic cardiac dysfunction. Furthermore, FT-CMR is particularly useful for patients with diseases or conditions which are associated with subtle myocardial dysfunction that may not be accurately detected with traditional methods. Compared to patients with cardiovascular diseases, patients with systemic diseases are less likely to undergo regular cardiovascular imaging to detect cardiac defects, whereas cardiac involvement in these patients can lead to major adverse outcomes; hence, the importance of cardiac imaging modalities might be underestimated in this group of patients. In this review, we gathered currently available data on the newly introduced role of FT-CMR in the diagnosis and prognosis of various systemic conditions. Further research is needed to define reference values and establish the role of this sensitive imaging modality, as a robust marker in predicting outcomes across a wide spectrum of patients.
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Affiliation(s)
| | - Seyyed Mojtaba Ghorashi
- Cardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical Science, Tehran, Iran
| | - Golnaz Houshmand
- Cardiovascular Imaging Ward, Rajaei Heart Center, Iran University of Medicals Sciences, Tehran, Iran
| | - Mojdeh Ganjparvar
- Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Kiara Rezaei-Kalantari
- Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Fazeli
- Cardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical Science, Tehran, Iran
| | - Negar Omidi
- Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Kargar St. Jalal Al-Ahmad Cross, 1411713138, Tehran, Iran.
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Manning WJ. 2021-2022 state of our JCMR. J Cardiovasc Magn Reson 2022; 24:75. [PMID: 36587219 PMCID: PMC9804242 DOI: 10.1186/s12968-022-00909-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 01/01/2023] Open
Abstract
In 2021, there were 136 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR), including 122 original research papers, six reviews, four technical notes, one Society for Cardiovascular Magnetic Resonance (SCMR) guideline, one SCMR position paper, one study protocol, and one obituary (Nathaniel Reichek). The volume was up 53% from 2020 (n = 89) with a corresponding 21% decrease in manuscript submissions from 435 to 345. This led to an increase in the acceptance rate from 24 to 32%. The quality of the submissions continues to be high. The 2021 JCMR Impact Factor (which is released in June 2022) markedly increased from 5.41 to 6.90 placing us in the top quartile of Society and cardiac imaging journals. Our 5 year impact factor similarly increased from 6.52 to 7.25. Fifteen years ago, the JCMR was at the forefront of medical and medical society journal migration to the Open-Access format. The Open-Access system has dramatically increased the availability and JCMR citation. Full-text article requests in 2021 approached 1.5 M!. As I have mentioned, it takes a village to run a journal. JCMR is very fortunate to have a group of very dedicated Associate Editors, Guest Editors, Journal Club Editors, and Reviewers. I thank each of them for their efforts to ensure that the review process occurs in a timely and responsible manner. These efforts have allowed the JCMR to continue as the premier journal of our field. My role, and the entire editorial process would not be possible without the ongoing high dedication and efforts of our managing editor, Jennifer Rodriguez. Her premier organizational skills have allowed for streamlining of the review process and marked improvement in our time-to-decision (see later). As I conclude my 6th and final year as your editor-in-chief, I thank you for entrusting me with the JCMR editorship and appreciate the time I have had at the helm. I am very confident that our Journal will reach new heights under the stewardship of Dr. Tim Leiner, currently at the Mayo Clinic with a seamless transition occurring as I write this in late November. I hope that you will continue to send your very best, high quality CMR manuscripts to JCMR, and that our readers will continue to look to JCMR for the very best/state-of-the-art CMR publications.
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Affiliation(s)
- Warren J Manning
- Departments of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School and JCMR Editorial Office, Boston, MA, 02215, USA.
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