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<1>
Accession Number
2010677094
Authors
Luciani G.B. Forni A. Rigatelli G. Chiominto B. Cardaioli P. Mazzucco A.
Faggian G.
Institution
(Luciani, Forni, Chiominto, Mazzucco, Faggian) Division of Cardiac
Surgery, University of Verona, O.C.M. Piazzale Stefani 1, 37126 Verona,
Italy
(Rigatelli, Cardaioli) Division of Cardiology, Regional Hospital Rovigo,
Rovigo, Italy
Title
Myocardial protection in heart transplantation using blood cardioplegia:
12-year outcome of a prospective randomized trial.
Source
Journal of Heart and Lung Transplantation. 30 (1) (pp 29-36), 2011. Date
of Publication: January 2011.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Background Blood cardioplegia yields a lower prevalence of right heart
failure, arrhythmias, and myocardial ischemia early after heart
transplantation (HTx). Because depolarizing (high [K<sup>+</sup>])
cardioplegic solutions may alledgedly cause endothelial damage, the
12-year outcome of a prospective randomized trial was reviewed. Methods
Between January 1997 and March 1998, 47 consecutive patients received
crystalloid (Group 1, n = 27) or blood cardioplegia (Group 2, n = 20). The
groups were similarly matched: recipient age (54 +/- 11 vs 55 +/- 7 years,
p = 0.9), sex (89% vs 90% males, p = 0.9), diagnosis (63% vs 65% dilated
cardiomyopathy, p = 0.8), elevated (>4 WU) pulmonary vascular resistance
(30% vs 30%, p = 0.9), prior operations (22% vs 30%, p = 0.5), urgent HTx
(7% vs 20%, p = 0.2), donor age (32 +/- 11 vs 31 +/- 13 years, p = 0.7),
donor sex (78% vs 70% males, p = 0.5), donor cause of death (33% vs 40%
vascular, p = 0.5), and global myocardial ischemia (176 +/- 51 vs 180 +/-
58 minutes p = 0.5). Hemodynamically unstable donors were more prevalent
in Group 2 (15% vs 45%, p = 0.02). The 45 hospital survivors underwent
yearly echocardiography, coronary angiography, and coronary intravascular
ultrasound (IVUS) imaging during follow-up. Results During follow-up (10.4
+/- 5.2, range, 0.912.7 years), Groups 1 and 2 had comparable mortality
(46% vs 42%, p = 0.7) and cause of death (chronic rejection: 50% vs 50%;
neoplasia: 33% vs 25%, p = 0.8). Survival at 12 years was 50% +/- 12% vs
52% +/- 11% (p = 0.9). Follow-up echocardiogram showed similar mean left
ventricular ejection fraction (LVEF; 47% +/- 12% vs 49% +/- 11%, p = 0.7)
and prevalence of LVEF < 35% (21% vs 18%, p = 0.8). Prevalence of chronic
rejection was comparable (42% vs 32%, p = 0.1), yet severe allograft
vasculopathy (International Society for Heart and Lung Transplantation
cardiac allograft vasculopathy 3) was more prevalent in Group 1 (64% vs
17%, p = 0.04). Freedom from chronic rejection was higher in Group 2 (44%
+/- 15% vs 63% +/- 13%), albeit not significantly (p = 0.5). A trend
toward greater prevalence of intimal disease at IVUS (thickness > 0.5 mm)
in the proximal and distal left anterior descending artery (67% vs 40%;
58% vs 45%) and higher number of percutaneous coronary interventions (2.7
+/- 0.5 vs 1.8 +/- 0.3, p = 0.3) was noted in Group 1. Conclusions Use of
blood cardioplegia is safe and results in comparable survival and
prevalence of adverse events late after HTx. The trend towards greater
freedom from chronic rejection and more limited extent of coronary artery
disease in grafts protected with blood cardioplegia awaits confirmation.
2011 International Society for Heart and Lung Transplantation.
<2>
Accession Number
70313211
Authors
Jett J.R.
Institution
(Jett) Mayo Clinic, College of Medicine, Rochester, MN, United States
Source
Respirology. Conference: 15th Congress of the Asian Pacific Society of
Respirology Manila Philippines. Conference Start: 20101122 Conference End:
20101125. Conference Publication: (var.pagings). 15 (pp 22), 2010.
Date of Publication: November 2010.
Publisher
Blackwell Publishing
Abstract
Screening for lung cancer is not currently recommended by any major
medical organization. Multiple Phase II non-randomized trials of computed
tomography (CT) screening have yielded enticing results. They have
demonstrated that CT screening detects smaller size lung cancer of 12-15
mm in diameter. It has been documented that the chest radiographs miss
70-80% of the cancers detected by screening CT. In prevalence studies,
60-80% of detected cancers are stage I. When CT screening results were
compared to a validated control group, CT has been shown to detect 3 times
more lung cancer than would be expected and results in ten times more
thoracic operation than would be expected. Additionally, no decrease in
advanced stage cancers or decrease in lung cancer deaths were observed. To
date, multiple small randomized controlled screening trials (RCT) have
been reported, but they have been too small to assess if CT screening
reduces mortality. A meta-analysis of baseline findings from six small
randomized controlled trials observed more stage I and more total lung
cancers in the CT screened group. For every 1000 individuals screened with
low dose CT, 9 stage I NSCLC and 235 false positive nodules were detected
and 4 thoracic operations were performed for benign nodules. The two large
RCT of CT screening that may definatively answer the question of CT
screening and its ability to decrease lung cancer mortality are the
National Cancer Screening Trial (NLST) and the Nederlands-Leuvens
Longkanker Screenings Onderzoek (NELSON) trial. Mortality results from
those two trials are anticipated in 2011 and 2015 respectively. A recent
report from the NELSON trial validated the use of CT volumetric assessment
of nodules to assess malignancy and determine which nodules should be
treated surgically. Currently, there is considerable effort to identify
susceptibility genes for lung cancer with particular interest in 15q 24-25
which is strongly associated. This region contains several genes of
interest, including three genes that encode nicotinic acetylcholine
receptor subunits. However, these genes may just be associated with
nicotine dependence. A recent report utilizing GWAS (genome wide
association scan) methodology identified 2 SNPs at 13q31.3 associated with
lung cancer susceptibility in never smokers. An enormous research effort
is underway related to biomarkers in airway epithelial cells, blood,
sputum, breath, and urine for early diagnosis or prediction of high risk.
Intense efforts are devoted to develop models of risk for determining
which individuals should be offered screening.
<3>
Accession Number
2010656509
Authors
Guo S.-Z. Wang N.-F. Zhou L. Ye X.-H. Pan H. Tong G.-X. Yang J.-M. Xu J.
Institution
(Guo, Wang, Zhou, Ye, Pan, Tong, Yang, Xu) Department of Cardiology, First
Municipal Hospital of Hangzhou, Affiliated Hangzhou Hospital of Nanjing
Medical University, Hangzhou, Zhejiang, 310006, China
Title
Influence of Granulocyte colony-stimulating factor on cardiac function in
patients with acute myocardial infarction and leukopenia after
revascularization.
Source
Chinese Medical Journal. 123 (14) (pp 1827-1832), 2010. Date of
Publication: July 2010.
Publisher
Chinese Medical Association (42 Dongsi Xidajie, Beijing 100710, China)
Abstract
Background Granulocyte colony-stimulating factor (G-CSF) seems to improve
cardiac function and perfusion when used systemically through mobilization
of stem cells into peripheral blood, but results of previous clinical
trials remain controversial. This study was designed to investigate safety
and efficacy of subcutaneous injection of G-CSF on left ventricular
function in patients with impaired left ventricular function after
ST-segment elevation myocardial infarction (STEMI). Methods Thirty-three
patients (22 men; age, (68.5+/-6.1) years) with STEMI and with comorbidity
of leukopenia were included after successful primary percutaneous coronary
intervention within 12 hours after symptom onset. Patients were randomized
into G-CSF group who received G-CSF (10 mug/kg of body weight, daily) for
continuous 7 days and control group. Results of blood analyses,
echocardiography and angiography were documented as well as possibly
occurred adverse events. Results No severe adverse events occurred in both
groups. Mean segmental wall thickening in infract segments increased
significantly at 6-month follow up compared with baseline in both groups,
but the longitudinal variation between two groups had no significant
difference (P >0.05). The same change could also be found in longitudinal
variation of wall motion score index of infarct segments (P >0.05). At
6-month follow-up, left ventricular end-diastolic volume of both groups
increased to a greater extent, but there were no significant differences
between the two groups when comparing the longitudinal variations (P
>0.05). In both groups, left ventricular ejection fraction measured by
echocardiography ameliorated significantly at 6-month follow-up (P <0.05),
but difference of the longitudinal variation between two groups was not
significant (P >0.05). When pay attention to left ventricular ejection
fraction measured by angiocardiography, difference of the longitudinal
variation between groups was significant (P=0.046). Early diastolic mitral
flow velocity deceleration time changed significantly at 6- month
follow-up in both groups (P=0.05). Conclusions Mobilization of stem cells
by G-CSF after reperfusion of infarct myocardium is safe and seems to
offer a pragmatic strategy for recovery of myocardial global function.
<4>
Accession Number
2010663554
Authors
Bilinska M. Kosydar-Piechna M. Gasiorowska A. Mikulski T. Piotrowski W.
Nazar K. Piotrowicz R.
Institution
(Bilinska, Kosydar-Piechna, Piotrowicz) Department of Cardiac
Rehabilitation and Noninvasive Electrocardiology, Institute of Cardiology,
Warsaw, Poland
(Gasiorowska, Mikulski, Nazar) Department of Applied Physiology,
Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw,
Poland
(Piotrowski) Department of Epidemiology, Cardiovascular Disease Prevention
and Health Promotion, Institute of Cardiology, Warsaw, Poland
Title
Influence of dynamic training on hemodynamic, neurohormonal responses to
static exercise and on inflammatory markers in patients after coronary
artery bypass grafting.
Source
Circulation Journal. 74 (12) (pp 2598-2604), 2010. Date of Publication:
2010.
Publisher
Japanese Circulation Society (14 Yoshida Kawaharacho, Sakyo-ku, Kyoto 606,
Japan)
Abstract
Background: Little is known about the influence of dynamic training on the
hemodynamic and neurohormonal responses to static exercise and on
inflammatory markers in optimally treated post-coronary artery bypass
grafting (CABG) patients. Methods and Results: One hundred and twenty male
patients, aged 55+/-6 years, 3 months after receiving CABG, were
randomized to either 6 weeks of aerobic training on a cycloergometer, 3
times a week, at a 70-80% of the maximum tolerated heart rate (HR)
(training group, n=60) or to a control group (n=60). At baseline and at
the end of the study, all patients underwent: (1) a cardiopulmonary test;
(2) handgrip at 30% of maximal voluntary contraction for 3 min in a
sitting position during in which HR, blood pressure (BP), stroke volume
(SV, by impedance cardiography), cardiac output (CO) and total peripheral
resistance (TPR) were monitored; and (3) plasma level assessment of
catecholamines, nitric oxide and inflammatory markers. During the final
tests, handgrip- induced increases in HR, BP, and TPR (14% vs 27%, P<0.01)
were lower, whereas SV and CO were higher (by 13% and 15%, respectively,
P<0.05) in trained patients compared with controls. Moreover, a higher
increase in nitric oxide level (46% vs 14%, P<0.01) and a lower increase
in noradrenaline (11% vs 20%, P<0.05) were observed in trained patients
compared with controls. Accordingly, training caused significant
improvement in peak oxygen uptake per kilogram body weight (peak
VO<sub>2</sub>) and inflammatory markers. Conclusions: Short-term dynamic
training caused significant improvement of hemodynamic and neurohormonal
responses to handgrip, cardiovascular fitness and inflammatory state.
<5>
Accession Number
2010663578
Authors
Takagi H. Umemoto T.
Institution
(Takagi, Umemoto) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Title
Effect of preoperative statin therapy on postoperative atrial fibrillation
in cardiac surgery.
Source
Circulation Journal. 74 (12) (pp 2788-2789), 2010. Date of Publication:
2010.
Publisher
Japanese Circulation Society (14 Yoshida Kawaharacho, Sakyo-ku, Kyoto 606,
Japan)
<6>
Accession Number
2010676704
Authors
Alton G.Y. Rempel G.R. Robertson C.M.T. Newburn-Cook C.V. Norris C.M.
Institution
(Alton) Glenrose Rehabilitation Hospital, Stollery Childrens Hospital,
Edmonton, AB, Canada
(Rempel, Newburn-Cook, Norris) Faculty of Nursing, University of Alberta,
Edmonton, AB, Canada
(Robertson) Outcome Evaluation and Research, Glenrose Rehabilitation
Hospital, Edmonton, AB, Canada
(Rempel, Robertson) Department of Pediatrics, Edmonton, AB, Canada
(Norris) Department of Cardiovascular Surgery, Faculty of Medicine,
University of Alberta, Edmonton, AB, Canada
Title
Functional outcomes after neonatal open cardiac surgery: Comparison of
survivors of the Norwood staged procedure and the arterial switch
operation.
Source
Cardiology in the Young. 20 (6) (pp 668-675), 2010. Date of Publication:
December 2010.
Publisher
Cambridge University Press (Shaftesbury Road, Cambridge CB2 2RU, United
Kingdom)
Abstract
Background: Improvements in long-term survival of children undergoing the
Norwood staged procedure and the arterial switch operation have resulted
in the need to prepare these at-risk children for each stage of their
developmental trajectory, including school readiness. This study describes
and compares functional outcomes following the Norwood staged procedure
and arterial switch operations.Methods This prospective inception cohort
study comprised a sample of 73 children (71% boys) who had the Norwood
staged procedure (n = 28) or the arterial switch operation (n = 45) at the
age of 6 weeks or younger at the Stollery Childrens Hospital, Edmonton,
Alberta, between 2002 and 2005. We excluded children who had chromosomal
abnormalities or cerebral palsy. When children were 18-24 months of age,
parents completed the Adaptive Behavioral Assessment System II. Standard
scores for the domains are mean 100, standard deviation (15); skill area
scaled scores, 10 (3). Students t-test with Bonferonni correction was used
to compare groups.Results This population has greater than four times the
number of children delayed on the General Adaptive Composite than the
normative group. Functional outcomes were similar in the two groups other
than those of home living (Norwood: 8.8 (2.8) compared with arterial
switch: 11.2 (3.1), t = 3.389, p = 0.001) and self-care (Norwood: 5.9
(3.5) versus arterial switch: 8.1 (2.6), t = 3.140, p = 0.002).Conclusion
These survivors are at increased risk for delayed functional abilities.
Self-care, necessary for independence and confidence as children reach
school age, was particularly low in the Norwood group. Reasons for low
self-care abilities require further study. Copyright Cambridge University
Press 2010.
<7>
Accession Number
2010677455
Authors
El-Sobkey S.B. Salem N.A.
Institution
(El-Sobkey) King Saud University, College of Applied Medical Sciences,
Rehabilitation Health Sciences Department, Riyadh, Saudi Arabia
(Salem) Faculty of Physical Therapy, Cairo University, Cairo, Egypt
Title
Can lung volumes and capacities be used as an outcome measure for phrenic
nerve recovery after cardiac surgeries?.
Source
Journal of the Saudi Heart Association. 23 (1) (pp 23-30), 2011. Date of
Publication: January 2011.
Publisher
Elsevier (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
Phrenic nerve is the main nerve drive to the diaphragm and its injury is a
well-known complication following cardiac surgeries. It results in
diaphragmatic dysfunction with reduction in lung volumes and capacities.
This study aimed to evaluate the objectivity of lung volumes and
capacities as an outcome measure for the prognosis of phrenic nerve
recovery after cardiac surgeries. In this prospective experimental study,
patients were recruited from Cardio-Thoracic Surgery Department,
Educational-Hospital of College of Medicine, Cairo University. They were
11 patients with right phrenic nerve injury and 14 patients with left
injury. On the basis of receiving low-level laser irradiation, they were
divided into irradiated group and non-irradiated group. Measures of
phrenic nerve latency, lung volumes and capacities were taken pre and
post-operative and at 3-months follow up. After 3. months of low-level
laser therapy, the irradiated group showed marked improvement in the
phrenic nerve recovery. On the other hand, vital capacity and forced
expiratory volume in the first second were the only lung capacity and
volume that showed improvement consequent with the recovery of right
phrenic nerve (P value <0.001 for both). Furthermore, forced vital
capacity was the single lung capacity that showed significant statistical
improvement in patients with recovered left phrenic nerve injury (P value
<0.001). Study concluded that lung volumes and capacities cannot be used
as an objective outcome measure for recovery of phrenic nerve injury after
cardiac surgeries. 2010.
<8>
Accession Number
2010674449
Authors
Ikonomidis I. Iliodromitis E.K. Tzortzis S. Antoniadis A. Paraskevaidis I.
Andreadou I. Fountoulaki K. Farmakis D. Kremastinos D.T. Anastasiou-Nana
M.
Institution
(Ikonomidis, Iliodromitis, Tzortzis, Antoniadis, Paraskevaidis,
Fountoulaki, Farmakis, Kremastinos, Anastasiou-Nana) Second Department of
Cardiology, Athens University Medical School, University Hospital, Athens,
Greece
(Andreadou) Department of Pharmaceutical Chemistry, University of Athens
School of Pharmacy, Athens, Greece
Title
Staccato reperfusion improves myocardial microcirculatory function and
long-term left ventricular remodelling: A randomised contrast
echocardiography study.
Source
Heart. 96 (23) (pp 1898-1903), 2010. Date of Publication: December 2010.
Publisher
BMJ Publishing Group (Tavistock Square, London WC1H 9JR, United Kingdom)
Abstract
Objective: To investigate the effects of staccato reperfusion (SR) during
percutaneous coronary intervention (PCI) on myocardial microcirculatory
function as assessed by myocardial contrast echocardiography. Setting:
Tertiary centre. Methods: Thirty-nine patients were randomised to SR
(n=20) or abrupt reperfusion (AR, n=19) within 48 h of an acute coronary
syndrome. Contrast intensity replenishment curves were constructed to
assess the blood volume (An), velocity (beta) and flow (AXbeta) of the
segments associated with the PCI-treated artery before, 48 h, 1 and 12
months after PCI. Left ventricular (LV) end-diastolic (EDVs) and systolic
volumes (ESVs) were evaluated. Plasma malondialdehyde (MDA) was determined
immediately before and 18 min after PCI to assess oxidative stress.
Results: SR was related to a greater improvement in A<sub>n</sub>, beta
and AXbeta at 48 h, 1 and 12 months after intervention compared with AR
(mean AXbeta: 0.91, 5.5, 7.14, 6.9 for SR vs 1.02, 3.34, 4.28, 3.71 for
AR, p<0.01). After PCI, the mean MDA change was -27% in SR patients and
+55% in the AR patients (p<0.05). The percentage change in MDA correlated
with the percentage change in A<sub>n</sub> at all time points (r=0.468,
r=0.682, r=0.674, p<0.01). Compared with AR, SR was related to a greater
percentage decrease in EDV (-11.61% vs -4.13%) and ESV (-34.68% vs
-14.83%) at 12 months after PCI (p<0.05). The percentage change in ESV at
12 months correlated with the corresponding percentage changes in
A<sub>n</sub>, beta and AXbeta (r=-0.410, r=-0.509, r=-0.577,
respectively, p<0.05). Conclusions: SR improves myocardial
microcirculatory function after PCI, leading to a concomitant improvement
in LV geometry, probably through reduction of oxidative stress.
<9>
Accession Number
2010662800
Authors
Grossi E.A. Patel N. Woo Y.J. Goldberg J.D. Schwartz C.F. Subramanian V.
Feldman T. Bourge R. Baumgartner N. Genco C. Goldman S. Zenati M. Wolfe
J.A. Mishra Y.K. Trehan N. Mittal S. Shang S. Mortier T.J. Schweich Jr.
C.J.
Institution
(Grossi, Goldberg, Schwartz, Shang) New York University, School of
Medicine, New York Harbor Veterans Healthcare System, New York, NY, United
States
(Patel, Subramanian) Lenox Hill Hospital, New York, NY, United States
(Woo) Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
(Feldman) Evanston Hospital, Evanston, IL, United States
(Bourge) University Alabama at Birmingham, Birmingham, AB, United States
(Baumgartner, Genco) Covenant Health Center, Saginaw, MI, United States
(Goldman) Lankenau Hospital, Lancaster, PA, United States
(Zenati) Veterans Administration Hospital, Pittsburgh, PA, United States
(Wolfe) St. Joseph's Hospital, Atlanta, GA, United States
(Mishra) Escorts Heart Institute, New Delhi, India
(Trehan, Mittal) Indrapratha Apollo, New Delhi, India
(Mortier, Schweich Jr.) Myocor, Inc. (Dissolved), Maple Grove, MN, United
States
Title
Outcomes of the RESTOR-MV trial (Randomized Evaluation of a Surgical
Treatment for Off-Pump Repair of the Mitral Valve).
Source
Journal of the American College of Cardiology. 56 (24) (pp 1984-1993),
2010. Date of Publication: 07 Dec 2010.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives We sought to determine whether patients with functional mitral
regurgitation (FMR) would benefit from ventricular reshaping by the
Coapsys device (Myocor, Inc., Maple Grove, Minnesota). Background FMR
occurs when ventricular remodeling impairs valve function. Coapsys is a
ventricular shape change device placed without cardiopulmonary bypass to
reduce FMR. It compresses the mitral annulus and reshapes the ventricle.
We hypothesized that Coapsys for FMR would improve clinical outcomes
compared with standard therapies. Methods RESTOR-MV (Randomized Evaluation
of a Surgical Treatment for Off-Pump Repair of the Mitral Valve) was a
randomized, prospective, multicenter study of patients with FMR and
coronary disease with core laboratory analysis. After enrollment, patients
were stratified to the standard indicated surgery: either coronary artery
bypass graft alone or coronary artery bypass graft with mitral valve
repair. In each stratum, randomization was to either control (indicated
surgery) or treatment (coronary artery bypass graft with Coapsys
ventricular reshaping). Results The study was terminated when the sponsor
failed to secure ongoing funding; 165 patients were randomized. Control
and Coapsys both produced decreases in left ventricular (LV) end-diastolic
dimension and MR at 2 years (p < 0.001); Coapsys provided a greater
decrease in LV end-diastolic dimension (p = 0.021). Control had lower MR
grades during follow-up (p = 0.01). Coapsys showed a survival advantage
compared with control at 2 years (87% vs. 77%) (hazard ratio: 0.421; 95%
confidence interval: 0.200 to 0.886; stratified log-rank test; p = 0.038).
Complication-free survival (including death, stroke, myocardial
infarction, and valve reoperation) was significantly greater with Coapsys
at 2 years (85% vs. 71%) (hazard ratio: 0.372; 95% confidence interval:
0.185 to 0.749; adjusted log-rank test; p = 0.019). Conclusions Analysis
of RESTOR-MV indicates that patients with FMR requiring revascularization
treated with ventricular reshaping rather than standard surgery had
improved survival and a significant decrease in major adverse outcomes.
This trial validates the concept of the ventricular reshaping strategy in
this subset of patients with heart failure. (Randomized Evaluation of a
Surgical Treatment for Off-Pump Repair of the Mitral Valve [RESTOR-MV];
NCT00120276) 2010 American College of Cardiology Foundation.
<10>
Accession Number
2010650489
Authors
Dekker R.L.
Institution
(Dekker) University of Kentucky, College of Nursing, 760 Rose Street,
Lexington, KY 40536-0232, United States
Title
Cognitive Therapy for Depression in Patients with Heart Failure: A
Critical Review.
Source
Heart Failure Clinics. 7 (1) (pp 127-141), 2011. Date of Publication:
January 2011.
Publisher
Elsevier Inc. (170 S Independence Mall W 300 E, Philadelphia PA
19106-3399, United States)
Abstract
Depression is a significant problem in patients with heart failure (HF).
This article examines the evidence for the use of cognitive therapy (CT)
in treating depression and depressive symptoms in patients with HF and
cardiovascular related illnesses. In 8 of the 14 studies reviewed,
researchers found that CT reduced depressive symptoms; however, the
limitations of the studies prevent wide generalization of the results.
Evidence to support the use of CT for the treatment of depressive symptoms
in patients with cardiovascular illness is insufficient at this time.
Large randomized controlled trials that demonstrate the efficacy of CT are
needed before clinicians routinely refer patients with HF to CT for the
purpose of improving depression or depressive symptoms. 2011 Elsevier
Inc.
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