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Nielles-Vallespin S, Ferreira P, Scott A, Rajakulasingam R, Sehmi J, Gorodezky M, Kellman P, Xue H, Pennell D, Firmin D, Arai A, De Silva R. Diffusion tensor cardiovascular magnetic resonance predicts adverse remodelling after myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Changes in myocardial microstructure that underlie post-myocardial infarction (MI) left ventricular (LV) remodelling may contribute to progressive deterioration in cardiac function and increased risk of adverse clinical events. Diffusion Tensor Cardiovascular Magnetic Resonance (DT-CMR) derived parameters provide in vivo measures of helix angle (HA) and sheetlet angle (SA), which allow non-invasive characterization of microstructural dynamics associated with cardiac contraction.
Purpose
To evaluate the relationship between DT-CMR metrics of myocardial microstructure with the development of adverse LV remodelling and to determine the relationship between DT-CMR and strain post- MI.
Methods
We performed a longitudinal pre-clinical CMR study whereby DT-CMR, cine imaging and strain were acquired pre-MI and 3 days and 16 weeks post- MI in a pig model. HA (E1A), SA (E2A), and sheetlet angle mobility (ΔE2A = E2Asystole– E2Adiastole), as well as circumferential (Ecc) and radial (Err) strain were calculated at each timepoint and related to change in left ventricular end-diastolic volume (ΔLVEDV) and change in left ventricular end-systolic volume (ΔLVESV) between 3 days post-MI and 16 weeks post-MI. The translational value of this preclinical study was further assessed in six patients with chronic MI.
Results
ΔE2A over the whole LV (global ΔE2A) at 3 days post-MI correlated significantly with ΔLVEDV (R2=0.89, p=0.0013, Fig.1A;) and ΔLVESV (R2=0.81, p=0.0055, Fig.1B). Global Ecc at 3 days post-MI also correlated with both ΔLVEDV (R2=0.75, p=0.012, Fig.1C) and ΔLVESV (R2=0.71, p=0.018, Fig.1D). Global Err at 3 days post-MI did not show significant correlation with either ΔLVEDV (R2=0.32, p=0.19, Fig.1E) or ΔLVESV (R2=0.35, p=0.17, Fig.1F). Global ΔE2A correlated strongly with global Ecc 3 days post-MI (R2=0.9, p=0.00099, Fig.1G) but less strongly with global Err 3 days post-MI (R2=0.57, p=0.049, Fig.1H). Global ΔE2A at the chronic stage correlated significantly with ejection Fraction (EF), in both clinical (R2=0.87, p=0.007) and preclinical data (R2=0.87, p=0.0024). Global ΔE2A correlated well with LVEDV (clinical: R2=0.72, p=0.033; preclinical: R2=0.8, p=0.0066) and LVESV (clinical: R2=0.78, p=0.020; preclinical: R2=0.89, p=0.0013). In vivo E1A maps at 16 weeks post-MI and ex vivo DT-CMR demonstrated reduced right-handed helix angles in the endocardium of the infarct region.
Conclusion
ΔE2A measured at 3 day post-reperfused MI is strongly correlated with the development of increased end-systolic and end-diastolic volumes, and may therefore serve as a novel CMR early predictor of adverse LV remodelling after reperfused MI. Strong correlations between ΔE2A, LV volumes and EF in a small cohort of stable patients with remodelled hearts after chronic MI confirm the feasibility of performing these measurements in patients and the plausibility of further evaluation of ΔE2A as a predictor of adverse remodelling after reperfused MI.
Sheetlet mobility predicts volume change
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): National Institutes of Health by the Division of Intramural Research (NHLBI, NIH, DHHS); British Heart Foundation
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Affiliation(s)
| | | | - A Scott
- Imperial College London, London, United Kingdom
| | | | - J Sehmi
- Imperial College London, London, United Kingdom
| | - M Gorodezky
- Imperial College London, London, United Kingdom
| | - P Kellman
- National Institutes of Health, Bethesda, United States of America
| | - H Xue
- National Institutes of Health, Bethesda, United States of America
| | - D.J Pennell
- Imperial College London, London, United Kingdom
| | - D.N Firmin
- Imperial College London, London, United Kingdom
| | - A.E Arai
- Imperial College London, London, United Kingdom
| | - R De Silva
- Imperial College London, London, United Kingdom
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Gorodezky M. [The impact of medical publications]. Arch Inst Cardiol Mex 1989; 59:445-7. [PMID: 2604484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- M Gorodezky
- Instituto Nacional de Cardiología Ignacio Chávez, México, D.F
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3
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Zamora Muciño A, Gómez Jaume A, Gorodezky M, Pérez Padilla R, Amigo MC, Barrios R. [Cardiovascular abnormalities in Ehlers-Danlos syndrome. Report of a case]. Arch Inst Cardiol Mex 1989; 59:301-7. [PMID: 2782994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This is the case of a 34-year-old woman with Ehlers-Danlos syndrome whose cardiopulmonary manifestations are the following: Prolapse of mitral and tricuspid valves. Aneurysmal dilatation of main arteries without aortic or pulmonary insufficiency. Disturbances in pulmonary function tests and pulmonary arterial hypertension. The diagnosis was verified by skin biopsy and an electron microscopic study. Due to the clinical and histopathological characteristics, we have considered this case to be a non-specified type of the 10 varieties described up to now, and have decided to report it also because of the interesting findings in the hemodynamic and pulmonary function tests.
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Affiliation(s)
- A Zamora Muciño
- Instituto Nacional de Cardiología Ignacio Chávez, México. D.F
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4
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Gorodezky M. [Malignant endocarditis. A historical perspective]. Arch Inst Cardiol Mex 1986; 56:375-7. [PMID: 2948452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Gorodezky M, Flores Mendoza J, Martínez Ríos MA, Soní J. [Clinical impact of the Bezold-Jarisch reflex in coronary arteriography]. Arch Inst Cardiol Mex 1984; 54:173-5. [PMID: 6742941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
To evaluate the role that coronary arteriography has in the induction of the Bezold-Jarisch reflex we study 9 patients (group I) to whom 1 mg. of atropine was administered 45 min. before the coronary arteriography and 9 patients (group II) without pre-medication. The heart rate was measured before, during and after each intracoronary injection. In group I there was no change in heart rate in 6 patients, in 3 cases the heart rate dropped to 15 beats/min. In group II the heart rate decreased in 8 cases. We conclude that the injection of radiologic contrast material in the coronary arteries triggers the Bezold-Jarisch reflex and that this reflex is prevented by the administration of atropine.
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Gorodezky M, Méndez Bello MA, Gutiérrez Fuster E, López Soriano F. [Origin of the left coronary artery from the trunk of the pulmonary artery. Report of a case]. Arch Inst Cardiol Mex 1984; 54:25-28. [PMID: 6721618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The congenital anomalies of the coronary arteries are varied. The left trunk arising from the pulmonary artery is a rare and serious one. With coronary angiography the diagnosis is possible. The surgical technics offer an effective treatment. We report the first case with these anomalies at the Instituto Nacional de Cardiología Ignacio Chávez. It was diagnosed with coronary angiography and it was treated by suturing the left main coronary artery in its origin, and with implantation of a safenous vein graft between the aorta and the left main coronary artery. The results were satisfactory.
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Gorodezky M. [Fibrinolysis. A method for protecting the ischemic myocardium]. Arch Inst Cardiol Mex 1983; 53:185. [PMID: 6625750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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9
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Gorodezky M, Buendía A. [Chorea and chloroquine. A new treatment for an ancient malady]. Arch Inst Cardiol Mex 1981; 51:555-7. [PMID: 7325746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Chloroquine is a drug used mainly as an anti-malaria agent with many other pharmacological properties. It was given to a patient with chorea and disseminated lupus erytematosus seeking the anti-inflammatory effect of the drug. The unexpected result on chorea hastened its use in 7 other patients with the same success. Chloroquine seems to be an effective drug for the relief of chorea. The mechanism of action is unknown.
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Gorodezky M. [Reflexions on diagnostic and therapeutic methods]. Arch Inst Cardiol Mex 1980; 50:429-430. [PMID: 7469585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Gorodezky M, Estandía A, Gaspar J. [Coronary arteriovenous fistula]. Arch Inst Cardiol Mex 1980; 50:505-9. [PMID: 7469594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We present the case of an 8 year old boy with A-V fistula from the right coronary artery to the right ventricle, successfully treated by surgery. The main clinical features with differential diagnosis are discussed and the advantages of early surgical treatment are commented.
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Estandia A, Gorodezky M, Reyes López PA, Castañiedo FJ. [Lupus erythematosus and chorea (report of 3 cases)]. Arch Inst Cardiol Mex 1979; 49:34-9. [PMID: 434958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We present here three cases of systemic Lupus Erythematosus which fulfilled the diagnostic criteria of the American Rheumatism Association. These three cases also had Chorea. This kind of association is not frequent and the cases here described are the last three of 32 published until now. We discusse in this paper the significance of the Chorea Syndrome and the probable causes originating it.
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Rotberg T, Segovia E, Gorodezky M. [Myocardial reinfarction in male and female]. Arch Inst Cardiol Mex 1978; 48:631-52. [PMID: 697461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
1). In 1001 patients with acute myocardial infarction 403 cases were found (40.2%) showing possible relapse. A study was made of 125 cases (12.5%) with positive diagnosis of acute myocardial infarction relapse, and among them, 12 were found to be occurring for the third time. Is possible for the real frequency of the iterative infarction to be even higher, because many cases were dismissed (27.7%) for lacking of conclusive electrocardiographic data pointing to myocardial transmural infarction. 2). Investigations were conducted about the evolutive condition of the danger factors in the coronary profile as well in the male as in the female group. Besides, a comparative study was made about symptoms, complications, morbidity and mortality. Clinical, enzimatic and electrocardiographic proofs were found, in every case, of a new myocardial transmural necrosis which was in evolution, with waves of injury and ischemia. Thirty eight deaths were registered in hospitals (30.4%) and in 25 of these, a necropsic study was conducted. 3). This illness is more frequent among men than among women, in a 3.5 to 1 proportion. The recurrent myocardial necrosis tends to be more frequently present during the first year following the first episode. In women, the first myocardial infarction as well as the iterative infarction occur at an older age than in men. 4). The influence of personality and stress is a very important factor of danger in the iterative infarction. Familiar antecedents of ischemic cardiopathy constitute a danger factor in patients presenting a single episode of myocardial infarction; nevertheless they don't seem to have a determining influence in this group of relapsing infarction. Although this study confirms with statistics that smoking has a decisive influence in the first myocardial infarction, neither frequency nor mortality of the relapsing infarction are in any way modified by the diminishing or suppression of the smoking habit.
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Gorodezky M, Rotberg T, Pérez de Francisco C. [Cardiac neurosis. Study of 100 cases with a healthy heart]. Arch Inst Cardiol Mex 1977; 47:277-80. [PMID: 921385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
One-hundred records taken at chance from the archives of the Instituto Nacional de Cardiología de México, with the diagnosis of healthy heart, were studied. The following factors of these patients were analyzed: age, sex, civil status, socio-economic level, occupation, family antecedents, personal antecedents, smoking, alcoholism, presence of cardiac murmurs, arrhythmias, and electrocardiogram. In 80 of these patients there existed a clear neurotic alteration. The main symptoms which they suffered were: dyspnea, pain, palpitations, dizziness, and headaches. We found that the influence of the medical environment and living with cardiac patients in a neurotic individual were predisposing factors of a cardiac neurosis. In many cases the physician is responsable if he hesitates or does not advice properly. It can be concluded that it is necessary to establish a rehabilitation program for these patients since the illness is serious and invalidating and very frecuent, with repercussions at the familiar, social, and economic levels.
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Gorodezky M. Letter: Angiography and coronary heart disease. Chest 1976; 69:805. [PMID: 1277908 DOI: 10.1378/chest.69.6.805a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Rotberg T, Bassoti R, Caffroni V, Gorodezky M, Estandía A. [Chagas myocardiopathy. Presentation of a case]. Arch Inst Cardiol Mex 1976; 46:336-41. [PMID: 162582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
1. The first case of Chagasic Miocardiopathy with complete immunologic confirmation is described. 2. The clinical, radiological, and electrocardiographic basis of the case were analyzed. 3. The specificity and the sensibility to the different seroimmunologic reactions in the Chagasic Disease was discussed. 4. An emphasis is placed on the fact that Chagas illness is not a rare entity in the Mexican Republic. 5. We recommend that a campaign of serologic investigation is begin to discover the true frequency of this illness.
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Affiliation(s)
- T Rotberg
- Instituto Nacional de Cardiología, México
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Gorodezky M. [Editorial: Revascularization of the myocardium]. Arch Inst Cardiol Mex 1976; 46:1-2. [PMID: 938144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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19
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Gorodezky M, Martínez-Ríos MA, Cárdenas M. [Aneurysm of the left ventricle associated with inactive rheumatic heart disease. Report of a case]. Arch Inst Cardiol Mex 1975; 45:357-61. [PMID: 1156009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A case of aneurism of the left ventricle, confirmed by ventriculogram, associated to an inactive rheumatic cardiopathy with a pure mitral stenosis is presented. Since none of the usual causes that have been reported were found to explain the aneurism of the left ventricle; the possibility of the aneurism resulting from residual myocardiac fibrosis produced by the rheumatic myocarditis is suggested.
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20
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Maroto Montero JM, Lemus JM, Marín-Huerta E, Gorodezky M, Cárdenas M. [Bradyarrhythmias in the acute phase of myocardial infarct]. Arch Inst Cardiol Mex 1975; 45:22-33. [PMID: 1130910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The functioning of the Intensive Care Units has permitted a better study and treatment of the arrhythmias which complicate the acute phase of myocardial infarction. 1,100 charts of patients admitted to the Coronary Unit of the National Institute of Cardiology of Mexico were reviewed. Acute myocardial infarction was demonstrated in 819 of them by the usual methods. The frequency and characteristics of the following bradiarrhythmias were studied: sinus bradicardia, sinus stoppage, seno-atrial block, migration of the atrial pacing, union rhythm and slow ventricular tachycardia. Sinus bradicardia was presented in 23.7% of the infarctions, sinus stoppage in 2.4%, migration of the atrial pacing in 9.4%, nodal rhythm in 7.2% and slow ventricular tachycardia in 7.8%. Bradiarrhythmias, generally considered as "lesser" arrhythmias, favor the appearance of lethal arrhythmias, regardless of the degree of mechanical failure, and thus should be treated actively.
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Ma Maroto MJ, Gorodezky M, Contreras R, C'ardenas M. Aortic bacterial endarteritis. Arch Inst Cardiol Mex 1975; 45:114-24. [PMID: 1173338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Micotic aneurisms are very rare. They are produced as a consequence of a bacterial infection of the endartery. They are divided into "primary", or those of an unknown septic focus, and "secondary" to bacterial endocarditis, to intravascular in infection or to infection located in a neighboring region. Two cases of the National Institute of Cardiology of Mexico are presented, with "primary" micotic aneurysm, which is the least frequent. One of them was because of bacterial endarteritis located in the thoracic aorta, an extremely rate entity. Due to the frequent rupture of these aneurysm with a very high mortality, emphasis is placed on the convenience of rapid surgical treatment of patients diagnosed.
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Gorodezky M. [Editorial: On problems of automation]. Arch Inst Cardiol Mex 1974; 44:687-8. [PMID: 4409328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Gorodezky M, Martínez Ríos MA, Uribe A, Sánchez Cortázar J. [Renal arteriography. Value and complications]. Arch Inst Cardiol Mex 1972; 42:700-3. [PMID: 4653845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Gorodezky M, Contreras R, Espino Vela J. [Cardiopathy of rheumatoid arthritis (study of a case)]. Arch Inst Cardiol Mex 1969; 39:124-32. [PMID: 5792230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Benavides PH, Gorodezky M, Hurtado del Río D. [Anticoagulant therapy in patients with the Starr-Edwards prosthesis]. Arch Inst Cardiol Mex 1968; 38:198-203. [PMID: 5662464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Gorodezky M, Cárdenas Loaeza M, Cavazos Ramírez J. [Epidemiology of myocardial infarct in patients of the Instituto Nacional de Cardiología of Mexico]. Arch Inst Cardiol Mex 1967; 37:102-11. [PMID: 6058085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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