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| 1 | Hypertriglyceridemia-induced pancreatitis: A case-based review显示文摘Hypertriglyceridemia is an established cause of pancreatitis. In a case-based approach, we present a review of hypertriglyceridemia and how it can cause pancreatitis. We outline how to investigate and manage such patients. A 35 year old man presented to the emergency department with abdominal pain and biochemical evidence of acute pancreatitis. There was no history of alcohol consumption and biliary imaging was normal. The only relevant past medical history was that of mild hyperlipidemia, treated with diet alone. Physical exam revealed epigastric tenderness, right lateral rectus palsy, lipemia retinalis, bitemporal hemianopsia and a delay in the relaxation phase of his ankle reflexes. Subsequent laboratory investigation revealed marked hypertriglyceridemia and panhypopituarism. An enhanced CT scan of the head revealed a large suprasellar mass impinging on the optic chiasm and hypothalamus. The patient was treated supportively; thyroid replacement and lipid lowering agents were started. He underwent a successful resection of a craniopharyngioma. Post- operatively, the patient did well on hormone replacement therapy. He has had no further attacks of pancreatitis. This case highlights many of the factors involved in the regulation of triglyceride metabolism. We review the common causes of hypertriglyceridemia and the proposed mechanisms resulting in pancreatitis. The incidence and management of hypertriglyceridemia- induced pancreatitis are also discussed. | S Ian Gan Alun L Edwards Christopher J Symonds Paul L Beck | 2006 | World Journal of Gastroenterology2006，12，44： | 35 |
| 2 | The modulation of co-stimulatory molecules by circulating exosomes in primary biliary cirrhosis显示文摘Exosomes 是 endocytic 起源的 nanoparticles,由由他们调制 cell-to-cell 通讯的能力的优点正在吸引增加的注意的无数房间人口藏匿了。他们也在许多免疫学的问题正在吸引注意,包括 autoimmunity 和,特别地调整 cytokine 和 chemokine 激活的他们的能力。主要胆汁的肝硬化(PBC ) 被认为一个模型自体免疫疾病,它对胆汁的上皮的房间有高度集中的细胞毒素的回答。我们与 PBC 和 30 健康控制(HC ) 从 29 个病人从血浆孤立 exosomes,并且用一个前 vivo 系统在 mononuclear 房间人口在 co-stimulatory 分子表示和 cytokine 生产上学习了这些 exosomes 的效果。我们也与 HC exosomes 相比在 PBC 识别了 microRNA (miRNA ) 人口。我们此处报导尽管 exosomes 不改变 cytokine 生产,他们显著地确实在介绍抗原的人口上改变 co-stimulatory 分子表示。进一步,我们在 CD14 + 单核白血球上表明了那 CD86 起来调整的表情,而在 CD11c + 上起来调整的 CD40 由从有 PBC 的病人的 exosomes 的树枝状的房间。另外,有在有 PBC 的病人的传播 exosomes 的 miRNA 表示的差别。这些数据基于 co-stimulatory 分子玩的观察有重要重要性在 T 房间激活的规定的一个微分角色。我们的观察显示从 PBC 的异常 exosomes 有选择地在介绍抗原的房间的不同子集导致 co-stimulatory 分子的表示。这些改变可以在自体免疫的肝疾病的致病包含。 | Takashi Tomiyama Guo-Xiang Yang Ming Zhao Weici Zhang Hajime Tanaka Jing Wang Patrick SC Leung Kazuiclli Okazaki Xiao-Song He Qianjin Lu Ross L Coppel Christopher L Bowlus M Eric Gershwin | 2017 | Cellular & Molecular Immunology2017，14，3： | 18 |
| 3 | 1990—2017年中国伤害负担:2017年全球疾病负担研究结果(摘译)显示文摘伤害是全球性的公共卫生挑战,涉及各年龄组和不同性别的人群。过去三十年来,中国经济快速发展,人口老龄化趋势加重,社会呈现出城镇化、机动化和老龄化等特征。随着人们生活环境和生活方式的改变,伤害已跃居人群致死原因第五位,仅排在恶性肿瘤、心脑血管疾病、呼吸系统疾病和心肌梗死之后。据估计,中国每年在伤害方面消耗的直接医疗费用约为650亿元人民币. | 林泽婷(译) 吕来文(译) 黄晓晴(译) 李丽萍(审校) Duan Leilei Ye Pengpeng Juanita A Haagsma Jin Ye Wang Yuan Er Yuliang Deng Xiao Gao Xin Ji Cuirong Wang Linhong Marlena S Bannick W Cli Mountjoy-Venning Caitlin N Hawley Zichen Liu Mari Smith Spencer L James Theo Vos Christopher J L Murray | 2020 | 伤害医学(电子版)2020，9，2： | 15 |
| 4 | Encapsulating peritoneal sclerosis显示文摘Encapsulating peritoneal sclerosis(EPS) is a debilitating condition characterized by a fibrocollagenous membrane encasing the small intestine, resulting in recurrent small bowel obstructions. EPS is most commonly associated with long-term peritoneal dialysis, though medications, peritoneal infection, and systemic inflammatory disorders have been implicated. Many cases remain idiopathic. Diagnosis is often delayed given the rarity of the disorder combined with non-specific symptoms and laboratory findings. Although cross-sectional imaging with computed tomography of the abdomen can be suggestive of the disorder, many patients undergo exploratory laparotomy for diagnosis. Mortality approaches 50% one year after diagnosis. Treatment for EPS involves treating the underlying condition or eliminating possible inciting agents(i.e. peritoneal dialysis, medications, infections) and nutritional support, frequently with total parenteral nutrition. EPSspecific treatment depends on the disease stage. In the inflammatory stage, corticosteroids are the treatment of choice, while in the fibrotic stage, tamoxifen may be beneficial. In practice, distinguishing between stages may be difficult and both may be used. Surgical intervention, consisting of peritonectomy and enterolysis, is timeconsuming and high-risk and is reserved for situations in which conservative medical therapy fails in institutions with surgical expertise in this area. Herein we review the available literature of the etiology, pathogenesis, diagnosis, and treatment of this rare, but potentially devastating disease. | Christopher J Danford Steven C Lin Martin P Smith Jacqueline L Wolf | 2018 | World Journal of Gastroenterology2018，24，28： | 13 |
| 5 | Therapeutic options for the management of pancreatic cancer显示文摘Since its initial characterization, pancreatic ductal adenocarcinoma has remained one of the most devastating and difficult cancers to treat. Pancreatic cancer is the fourth leading cause of death in the United States, resulting in an estimated 38460 deaths annually. With few screening tools available to detect this disease at an early stage, 94% of patients will die within five years of diagnosis. Despite decades of research that have led to a better understanding of the molecular and cellular signaling pathways in pancreatic cancer cells, few effective therapies have been developed to target these pathways. Other treatment options have included more sophisticated pancreatic cancer surgeries and combination therapies. While outcomes have improved modestly for these patients, more effective treatmentsare desperately needed. One of the greatest challenges in the future of treating this malignancy will be to develop therapies that target the tumor microenvironment and surrounding pancreatic cancer stem cells in addition to pancreatic cancer cells. Recent advances in targeting pancreatic stellate cells and the stroma have encouraged researchers to shift their focus to the role of desmoplasia in pancreatic cancer pathobiology in the hopes of developing newer-generation therapies. By combining novel agents with current cytotoxic chemotherapies and radiation therapy and personalizing them to each patient based on specific biomarkers, the goal of prolonging a patient's life could be achieved. Here we review the most effective therapies that have been used for the treatment of pancreatic cancer and discuss the future potential of therapeutic options. | Maria L Rossi Azeem A Rehman Christopher S Gondi | 2014 | World Journal of Gastroenterology2014，20，32： | 13 |
| 6 | Management of borderline and locally advanced pancreatic cancer:Where do we stand?显示文摘Many patients with pancreas cancer present with locally advanced pancreatic cancer(LAPC).The principle tools used for diagnosis and staging of LAPC include endoscopic ultrasound,axial imaging with computed tomography and magnetic resonance imaging,and diagnostic laparoscopy.The definition of resectability has historically been vague,as there is considerable debate and controversy as to the definition of LAPC.For the patient with LAPC,there is some level of involvement of the surrounding vascular structures,which include the superior mesenteric artery,celiac axis,hepatic artery,superior mesenteric vein,or portal vein.When feasible,most surgeons would recommend possible surgical resection for patients with borderline LAPC,with the goal of an R0 resection.For initially unresectable LAPC,neoadjuvant should be strongly considered.Specifically,these patients should be offered neoadjuvant therapy,and the tumor should be assessed for possible response and eventual resection.The efficacy of neoadjuvant therapy with this approach as a bridge to potential curative resection is broad,ranging from 3%-79%.The different modalities of neoadjuvant therapy include sin-gle or multi-agent chemotherapy combined with radiation,chemotherapy alone,and chemotherapy followed by chemotherapy with radiation.This review focuses on patients with LAPC and addresses recent advances and controversies in the field. | Jin He Andrew J Page Matthew Weiss Christopher L Wolfgang Joseph M Herman Timothy M Pawlik | 2014 | World Journal of Gastroenterology2014，20，9： | 11 |
| 7 | 系统综述与网状Meta分析的PRISMA扩展声明显示文摘PRISMA声明旨在提高系统综述和META分析报告的完整性,该声明已经广泛用于指导系统综述和META分析的报告和发表。原始的PRISMA声明是针对两种干预措施比较的传统的系统综述与META分析而制定的,然而,随着多种干预措施比较的系统综述的发展,实施和报告这一类系统综述面临较大挑战。此时,针对网状META分析的PRISMA扩展声明应运而生,旨在提高网状META分析系统综述的报告质量。PRISMA扩展声明是由专家们通过DELPHI调查、面对面讨论和共识大会而最终确立的。PRISMA扩展声明是在原始PRISMA声明的报告清单的基础上经过修改,最终确定了32个条目,每个条目均与网状META分析报告的内容直接相关。本文对网状META分析的PRISMA扩展声明进行了阐述,对报告清单各条目进行了举例说明,并详细说明了在原始PRISMA声明的基础上新增和修改各条目的理由。此外,PRISMA扩展声明强调了在网状META分析的实际操作中需要重点关注的信息。本文的目标读者包括网状META分析的作者与读者,以及期刊杂志的编辑与同行评审。 | 李志霞 杨俊 叶欣 周凌波 杨智荣 孙凤 詹思延 Brian Hutton Georgia Salanti Deborah M.Caldwell Anna Chaimani Christopher H.Schmid Chris Cameron John P.A.Ioannidis Sharon Straus Kristian Thorlund Jeroen P.Jansen Cynthia Mulrow Ferrán Catalá-López Peter C.Gozsche Kay Dickersin Isabelle Boutron Douglas G.Altman David Moher | 2016 | 中国循证心血管医学杂志2016，8，6： | 11 |
| 8 | Alcoholic pancreatitis:New insights into the pathogenesisand treatment显示文摘Acute pancreatitis is a necro-inflammatory disease of the exocrine pancreas that is characterized by inappropriate activation of zymogens, infiltration of the pancreas by inflammatory cells, and destruction of the pancreatic exocrine cells. Acute pancreatitis can progress to a severe life-threatening disease. Currently there is no pharmacotherapy to prevent or treat acute pancreatitis. One of the more common factors associated with acute pancreatitis is alcohol abuse. Although commonly associated with pancreatitis alcohol alone is unable to cause pancreatitis. Instead, it appears that alcohol and its metabolic by-products predispose the pancreas to damage from agents that normally do not cause pancreatitis, or to more severe disease from agents that normally cause mild pancreatic damage. Over the last 10 to 20 years, a tremendous amount of work has defined a number of alcohol-mediated biochemical changes in pancreatic cells. Among these changes are: Sustained levels of intracellular calcium, activation of the mitochondrial permeability transition pore, endoplasmic reticulum stress, impairment in autophagy, alteration in the activity of transcriptional activators, and colocalization of lysosomal and pancreatic digestive enzymes. Elucidation of these changes has led to a deeper understanding of the mechanisms by which ethanol predisposes acinar cells to damage. This greater understanding has revealed a number of promising targets for therapeutic intervention. It is hoped that further investigation of these targets will lead to the development of pharmacotherapy that is effective in treating and preventing the progression of acute pancreatitis. | Dahn L Clemens Katrina J Schneider Christopher K Arkfeld Jaclyn R Grode Mark A Wells Shailender Singh | 2016 | World Journal of Gastrointestinal Pathophysiology2016，7，1： | 10 |
| 9 | Quasispecies evolution in NS5A region of hepatitis C virus genotype 1b during interferon or combined interferon-ribavirin therapy显示文摘AIM: To evaluate the implication of substitutions in the hepatitis C virus (HCV) non-structural 5A (NS5A) protein in the resistance of HCV during mono-interferon (IFN) or combined IFN-ribavirin (IFN-R) therapy. Although NS5A has been reported to interact with the HCV RNA- dependent RNA polymerase, NS5B, as well as with many cellular proteins, the function of NS5A in the life cycle of HCV remains unclear. METHODS: HCV quasispecies were studied by clon- ing and sequencing of sequential isolates from patients infected by HCV genotype 1b. Patients were treated by IFN-α2b for 3 mo followed by IFN-α2b alone or com- bined IFN-R therapy for 9 additional months. Patients were categorized intro two groups based on their re- sponse to the treatments: 7 with sustained virological re- sponse (SVR) (quasispecies = 150) and 3 non-respond- ers (NR) to IFN-R (quasispecies = 106). RESULTS: Prior to treatment, SVR patients displayed a lower complexity of quasispecies than NR patients. Most patients had a decrease in the complexity of quasispe- cies during therapy. Analysis of amino acids substitu- tions showed that the degree of the complexity of the interferon sensitivity-determining region (ISDR) and the V3 domain of NS5A protein was able to discriminate thetwo groups of patients. Moreover, SVR patients displayed more variability in the NS5A region than NR patients. CONCLUSION: These results suggest that detailed mo- lecular analysis of the NS5A region may be important for understanding its function in IFN response during HCV 1b infection. | Pascal Veillon Christopher Payan Hélène Le Guillou-Guillemette Catherine Gaudy Franoise Lunel | 2007 | World Journal of Gastroenterology2007，13，8： | 9 |
| 10 | New insights into p53 activation显示文摘肿瘤 suppressor p53 是一多功能,高度调整了,并且对 DNA 特别地敏感的倡导者特定的 transcriptional 因素发信号的损坏和细胞的应力。p53 由指导一个损坏房间的机制击倒小径遗体糟糕理解的房间生长拘捕或 apoptotic。证据建议在里面 p53 的 vivo 功能似乎与发生的损坏的类型和严厉平衡房间命运选择。antirepression 的概念,或通常在海湾保留 p53 的因素的抑制,帮助可以为 p53 激活解释生理的机制。这些因素也在怀有基因的一个野类型的拷贝的肿瘤为 p53 的复活提供新奇化学疗法的目标。 | Christopher L Brooks Wei Gu | 2010 | Cell Research2010，20，6： | 9 |
| 11 | Determinant-Based Classification of Acute Pancreatitis Severity: An International Multidisciplinary Consultation显示文摘 | E. Patchen Dellinger Christopher E. Forsmark Peter Layer Philippe Lévy Enrique Maraví-Poma Maxim S. Petrov Tooru Shimosegawa Ajith K. Siriwardena Generoso Uomo David C. Whitcomb John A. Windsor | 2012 | Annals of Surgery2012，，6： | 7 |
| 12 | Nonalcoholic steatohepatitis severity is defined by a failure in compensatory antioxidant capacity in the setting of mitochondrial dysfunction显示文摘AIM To comprehensively evaluate mitochondrial(dys) function in preclinical models of nonalcoholic steatohepatitis(NASH).METHODS We utilized two readily available mouse models of nonalcoholic fatty liver disease(NAFLD) with or without progressive fibrosis: Lep^(ob)/Lep^(ob)(ob/ob) and FATZO mice on high trans-fat, high fructose and high cholesterol(AMLN) diet. Presence of NASH was assessed using immunohistochemical and pathological techniques, and gene expression profiling. Morphological features of mitochondria were assessed via transmission electron microscopy and immunofluorescence, and function was assessed by measuring oxidative capacity in primary hepatocytes, and respiratory control and proton leak in isolated mitochondria. Oxidative stress was measured by assessing activity and/or expression levels of Nrf1, Sod1, Sod2, catalase and 8-OHdG. RESULTS When challenged with AMLN diet for 12 wk, ob/ob and FATZO mice developed steatohepatitis in the presence of obesity and hyperinsulinemia. NASH development was associated with hepatic mitochondrial abnormalities, similar to those previously observed in humans, including mitochondrial accumulation and increased proton leak. AMLN diet also resulted in increased numbers of fragmented mitochondria in both strains of mice. Despite similar mitochondrial phenotypes, we found that ob/ob mice developed more advanced hepatic fibrosis. Activity of superoxide dismutase(SOD) was increased in ob/ob AMLN mice, whereas FATZO mice displayed increased catalase activity, irrespective of diet. Furthermore, 8-OHd G, a marker of oxidative DNA damage, was significantly increased in ob/ob AMLN mice compared to FATZO AMLN mice. Therefore, antioxidant capacity reflected as the ratio of catalase:SOD activity was similar between FATZO and C57 BL6 J control mice, but significantly perturbed in ob/ob mice. CONCLUSION Oxidative stress, and/or the capacity to compensate for increased oxidative stress, in the setting of mitochondrial dysfunction, is a key factor for development of hepatic injury and fibrosis in these mouse models. | Michelle L Boland Stephanie Oldham Brandon B Boland Sarah Will Jean-Martin Lapointe Silvia Guionaud Christopher J Rhodes James L Trevaskis | 2018 | World Journal of Gastroenterology2018，24，16： | 7 |
| 13 | Five-year mortality and coronary heart disease development after normal coronary angiogram显示文摘 | Jason T McMullan Christopher J Lindsell Andra L Blomkalns | 2011 | World Journal of Emergency Medicine2011，2，1： | 6 |
| 14 | Endovascular treatment of pulmonary embolism: Selective review of available techniques显示文摘Acute pulmonary embolism(PE) is the third most common cause of death in hospitalized patients. The development of sophisticated diagnostic and therapeutic modalities for PE, including endovascular therapy, affords a certain level of complexity to the treatment of patients with this important clinical entity. Furthermore, the lack of level I evidence for the safety and effectiveness of catheter directed therapy brings controversy to a promising treatment approach. In this review paper, we discuss the pathophysiology and clinical presentation of PE, review the medical and surgical treatment of the condition, and describe in detail the tools that are available for the endovascular therapy of PE, including mechanical thrombectomy, suction thrombectomy, and fibrinolytic therapy. We also review the literature available to date on these methods, and describe the function of the Pulmonary Embolism Response Team. | John L Nosher Arjun Patel Sugeet Jagpal Christopher Gribbin Vyacheslav Gendel | 2017 | World Journal of Radiology2017，9，12： | 6 |
| 15 | 基于局部因素和全身因素对急性胰腺炎严重程度的新分级——概要与解读显示文摘急性胰腺炎严重程度的准确分级对于临床实践和研究十分重要。在临床实践中,准确的分型有助于正确地评估疾病的严重程度,监测疾病的发展,制定治疗策略。而临床研究中,准确的分型对于患者的正确入组、实验结果的有效性都有很大影响。一个多世纪以来,急性胰腺炎的严重程度被简单地分为轻型和重型,而且对于轻型和重型的定义尚未统一。近年来,研究发现重型胰腺炎又有不同的亚组,而不同亚组患者的预后有很大差异,轻型和重型二分法的局限性慢慢显现。 | 李维勤 张璐瑶 黎介寿 E.Patchen Dellinger Christopher E.Forsmark Peter Layer Philippe L'evy Enrique Maravi-Poma Maxim S.Petrov | 2014 | 中华外科杂志2014，52，5： | 6 |
| 16 | Hepatic intra-arterial infusion of yttrium-90 microspheres in the treatment of recurrent hepatocellular carcinoma after liver transplantation: A case report显示文摘Hepatocellular carcinoma (HCC) recurs with a reported frequency of 12%-18% after liver transplantation. Recurrence is associated with a mortality rate exceeding 75%. Approximately one-third of recurrences develop in the transplanted liver and are therefore amenable to local therapy. A variety of treatment modalities have been reported including resection, transarterial chemo- embolization (TACE), radiofrequency ablation (RFA), ethanol ablation, cryoablation, and external beam irradiation. Goals of treatment are tumor control and the minimization of toxic effect to functional parenchyma. Efficacy of treatment is mitigated by the need for ongoing immunosuppression. Yttrium-90 microspheres have been used as a treatment modality both for primary HCC and for pre-transplant management of HCC with promising results. Twenty-two months after liver transplantation for hepatitis C cirrhosis complicated by HCC, a 42-year old man developed recurrence of HCC in his transplant allograft. Treatment of multiple right lobe lesions with anatomic resection and adjuvant chemotherapy was unsuccessful. Multifocal recurrence in the remaining liver allograft was treated with hepatic intra-arterial infusion of yttrium-90 microspheres (SIR-Spheres, Sirtex Medica Inc., Lake Forest, IL, USA). Efficacy was demonstrated by tumor necrosis on imaging and a decrease in alpha-fetoprotein (AFP) level. There were no adverse consequences of initial treatment. | Louis Rivera Huan Giap William Miller Jonathan Fisher Donald J Hillebrand Christopher Marsh Randolph L Schaffer | 2006 | World Journal of Gastroenterology2006，12，35： | 6 |
| 17 | Potential risk factors for constipation in the community显示文摘Constipation is a common community health problem.There are many factors that are widely thought to be associated with constipation but real-world evidence of these associations is difficult to locate.These potential risk factors may be categorised as demographic,lifestyle and health-related factors.This review presents the available evidence for each factor by an assessment of quantitative data from cross-sectional studies of community-dwelling adults published over the last 30 years.It appears that there is evidence of an association between constipation and female gender,residential location,physical activity and some health-related factors such as self-rated health,some surgery,certain medical conditions and certain medications.The available evidence for most other factors is either conflicting or insufficient.Therefore,further research is necessary to determine if each factor is truly associated with constipation and whether it can be regarded as a potential risk factor.It is recommended that studies investigating a broad range of factors are conducted in populations in community settings.Multivariate analyses should be performed to account for all possible confounding factors.In this way,valuable evidence can be accumulated for a better understanding of potential risk factors for constipation in the community. | Barry L Werth Sybele-Anne Christopher | 2021 | World Journal of Gastroenterology2021，27，21： | 6 |
| 18 | 纳米技术:基于相关指标及统计数据的述评(Ⅱ)显示文摘3 纳米技术应用领域及机构分析3.1概述研究及分析人员认为,纳米技术可能发展为下一代通用技术,这意味着纳米技术将很可能迅速发展成为在各应用领域及产业广泛应用的技术㈣。其主要依据是纳米技术使得在基本原子和分子水平更深入地认识和控制物质成为可能,从而有助于改进几乎所有产业的制造工艺。 | Christopher Palmberg Hélène Dernis Claire Miguet 张树良 | 2011 | 科技导报2011，29，23： | 5 |
| 19 | Prospective evaluation of small bowel preparation with bisacodyl and sodium phosphate for capsule endoscopy显示文摘AIM: To determine the effect of Prepacol?, a com- bination of sodium phosphate and bisacodyl, on transit and quality of capsule endoscopy (CE). METHODS: Fivety two consecutive patients were included in this prospective study. CE was performed following a 12 h fasting period. Twenty six patients were randomized for additional preparation with Prepacol?. The quality of CE was assessed separately for the proximal and the distal small bowel by 3 experienced endoscopists on the basis of a graduation which was initially developed with 20 previous CE. RESULTS: Preparation with Prepacol? accelerated small bowel transit time (262 ± 55 min vs 287 ± 97 min), but had no effect on the quality of CE. Visibility was significantly reduced in the distal compared to the proximal small bowel. CONCLUSION: The significantly reduced visibility of CE in the distal small bowel allocates the need for a good preparation. Since Prepacol? has no beneficial effect on CE the modality of preparation and the ideal time of application remains unclear. Further standardized examinations are necessary to identify sufficient preparation procedures and to determine the impact of the volume of the preparation solution. | Andreas Franke Frank Hummel Phillip Knebel Christoph Antoni Ulrich Bcker Manfred V Singer Matthias Lhr | 2008 | World Journal of Gastroenterology2008，14，13： | 5 |
| 20 | Shortness of breath in clinical practice: A case for left atrial function and exercise stress testing for a comprehensive diastolic heart failure workup显示文摘The symptom cluster of shortness of breath(SOB) contributes significantly to the outpatient workload of cardiology services. The workup of these patients includes blood chemistry and biomarkers, imaging and functional testing of the heart and lungs. A diagnosis of diastolic heart failure is inferred through the exclusion of systolic abnormalities, a normal pulmonary function test and normal hemoglobin, coupled with diastolic abnormalities on echocardiography. Differentiating confounders such as obesity or deconditioning in a patient with diastolic abnormalities is difficult. While the most recent guidelines provide more avenues for diagnosis, such as incorporating the left atrial size, little emphasis is given to understanding left atrial function, which contributes to at least 25% of diastolic left ventricular filling; additionally, exercise stress testing to elicit symptoms and test the dynamics of diastolic parameters, especially when access to the 'gold standard' invasive tests is lacking, presents clinical translational gaps. It is thus important in diastolic heart failure work up to understand left atrial mechanics and the role of exercise testing to build a comprehensive argument for the diagnosis of diastolic heart failure in a patient presenting with SOB. | Pupalan Iyngkaran Nagesh S Anavekar Christopher Neil Liza Thomas David L Hare | 2017 | World Journal of Methodology2017，7，4： | 5 |
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