Contribution of skeletal muscle atrophy to exercise intolerance and altered muscle metabolism in heart failure
The purpose of this study was to investigate the prevalence of skeletal muscle atrophy and its relation to exercise intolerance and abnormal muscle metabolism in patients with heart failure (HF). Peak VO2, percent ideal body weight (% IBW), 24-hour urine creatinine (Cr), and anthropometrics were mea...
Saved in:
| Published in | Circulation (New York, N.Y.) Vol. 85; no. 4; pp. 1364 - 1373 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Hagerstown, MD
Lippincott Williams & Wilkins
01.04.1992
|
| Subjects | |
| Online Access | Get full text |
Cover
Loading…
| Abstract | The purpose of this study was to investigate the prevalence of skeletal muscle atrophy and its relation to exercise intolerance and abnormal muscle metabolism in patients with heart failure (HF).
Peak VO2, percent ideal body weight (% IBW), 24-hour urine creatinine (Cr), and anthropometrics were measured in 62 ambulatory patients with HF. 31P magnetic resonance spectroscopy (MRS) and imaging (MRI) of the calf were performed in 15 patients with HF and 10 control subjects. Inorganic phosphorus (Pi), phosphocreatine (PCr), and intracellular pH were measured at rest and during exercise. Calf muscle volume was determined from the sum of the integrated area of muscle in 1-cm-thick contiguous axial images from the patella to the calcaneus. A reduced skeletal muscle mass was noted in 68% of patients, as evidenced by a decrease in Cr-to-height ratio of less than 7.4 mg/cm and/or upper arm circumference of less than 5% of normal. Calf muscle volume (MRI) was also reduced in the patients with HF (controls, 675 +/- 84 cm3/m2; HF, 567 +/- 112 cm3/m2; p less than 0.05). Fat stores were largely preserved with triceps skinfold of less than 5% of normal and/or IBW of less than 80% in only 8% of patients. Modest linear correlations were observed between peak VO2 and both calf muscle volume per meter squared (r = 0.48) and midarm muscle area (r = 0.36) (both p less than 0.05). 31P metabolic abnormalities during exercise were observed in the patients with HF, which is consistent with intrinsic oxidative abnormalities. The metabolic changes were weakly correlated with muscle volume (r = -0.42, p less than 0.05).
These findings indicate that patients with chronic HF frequently develop significant skeletal muscle atrophy and metabolic abnormalities. Atrophy contributes modestly to both the reduced exercise capacity and altered muscle metabolism. |
|---|---|
| AbstractList | The purpose of this study was to investigate the prevalence of skeletal muscle atrophy and its relation to exercise intolerance and abnormal muscle metabolism in patients with heart failure (HF).
Peak VO2, percent ideal body weight (% IBW), 24-hour urine creatinine (Cr), and anthropometrics were measured in 62 ambulatory patients with HF. 31P magnetic resonance spectroscopy (MRS) and imaging (MRI) of the calf were performed in 15 patients with HF and 10 control subjects. Inorganic phosphorus (Pi), phosphocreatine (PCr), and intracellular pH were measured at rest and during exercise. Calf muscle volume was determined from the sum of the integrated area of muscle in 1-cm-thick contiguous axial images from the patella to the calcaneus. A reduced skeletal muscle mass was noted in 68% of patients, as evidenced by a decrease in Cr-to-height ratio of less than 7.4 mg/cm and/or upper arm circumference of less than 5% of normal. Calf muscle volume (MRI) was also reduced in the patients with HF (controls, 675 +/- 84 cm3/m2; HF, 567 +/- 112 cm3/m2; p less than 0.05). Fat stores were largely preserved with triceps skinfold of less than 5% of normal and/or IBW of less than 80% in only 8% of patients. Modest linear correlations were observed between peak VO2 and both calf muscle volume per meter squared (r = 0.48) and midarm muscle area (r = 0.36) (both p less than 0.05). 31P metabolic abnormalities during exercise were observed in the patients with HF, which is consistent with intrinsic oxidative abnormalities. The metabolic changes were weakly correlated with muscle volume (r = -0.42, p less than 0.05).
These findings indicate that patients with chronic HF frequently develop significant skeletal muscle atrophy and metabolic abnormalities. Atrophy contributes modestly to both the reduced exercise capacity and altered muscle metabolism. The purpose of this study was to investigate the prevalence of skeletal muscle atrophy and its relation to exercise intolerance and abnormal muscle metabolism in patients with heart failure (HF).BACKGROUNDThe purpose of this study was to investigate the prevalence of skeletal muscle atrophy and its relation to exercise intolerance and abnormal muscle metabolism in patients with heart failure (HF).Peak VO2, percent ideal body weight (% IBW), 24-hour urine creatinine (Cr), and anthropometrics were measured in 62 ambulatory patients with HF. 31P magnetic resonance spectroscopy (MRS) and imaging (MRI) of the calf were performed in 15 patients with HF and 10 control subjects. Inorganic phosphorus (Pi), phosphocreatine (PCr), and intracellular pH were measured at rest and during exercise. Calf muscle volume was determined from the sum of the integrated area of muscle in 1-cm-thick contiguous axial images from the patella to the calcaneus. A reduced skeletal muscle mass was noted in 68% of patients, as evidenced by a decrease in Cr-to-height ratio of less than 7.4 mg/cm and/or upper arm circumference of less than 5% of normal. Calf muscle volume (MRI) was also reduced in the patients with HF (controls, 675 +/- 84 cm3/m2; HF, 567 +/- 112 cm3/m2; p less than 0.05). Fat stores were largely preserved with triceps skinfold of less than 5% of normal and/or IBW of less than 80% in only 8% of patients. Modest linear correlations were observed between peak VO2 and both calf muscle volume per meter squared (r = 0.48) and midarm muscle area (r = 0.36) (both p less than 0.05). 31P metabolic abnormalities during exercise were observed in the patients with HF, which is consistent with intrinsic oxidative abnormalities. The metabolic changes were weakly correlated with muscle volume (r = -0.42, p less than 0.05).METHODS AND RESULTSPeak VO2, percent ideal body weight (% IBW), 24-hour urine creatinine (Cr), and anthropometrics were measured in 62 ambulatory patients with HF. 31P magnetic resonance spectroscopy (MRS) and imaging (MRI) of the calf were performed in 15 patients with HF and 10 control subjects. Inorganic phosphorus (Pi), phosphocreatine (PCr), and intracellular pH were measured at rest and during exercise. Calf muscle volume was determined from the sum of the integrated area of muscle in 1-cm-thick contiguous axial images from the patella to the calcaneus. A reduced skeletal muscle mass was noted in 68% of patients, as evidenced by a decrease in Cr-to-height ratio of less than 7.4 mg/cm and/or upper arm circumference of less than 5% of normal. Calf muscle volume (MRI) was also reduced in the patients with HF (controls, 675 +/- 84 cm3/m2; HF, 567 +/- 112 cm3/m2; p less than 0.05). Fat stores were largely preserved with triceps skinfold of less than 5% of normal and/or IBW of less than 80% in only 8% of patients. Modest linear correlations were observed between peak VO2 and both calf muscle volume per meter squared (r = 0.48) and midarm muscle area (r = 0.36) (both p less than 0.05). 31P metabolic abnormalities during exercise were observed in the patients with HF, which is consistent with intrinsic oxidative abnormalities. The metabolic changes were weakly correlated with muscle volume (r = -0.42, p less than 0.05).These findings indicate that patients with chronic HF frequently develop significant skeletal muscle atrophy and metabolic abnormalities. Atrophy contributes modestly to both the reduced exercise capacity and altered muscle metabolism.CONCLUSIONSThese findings indicate that patients with chronic HF frequently develop significant skeletal muscle atrophy and metabolic abnormalities. Atrophy contributes modestly to both the reduced exercise capacity and altered muscle metabolism. |
| Author | Wilson, J R Lenkinski, R McCully, K K Reichek, N Walter, G Mancini, D M Mullen, J L |
| Author_xml | – sequence: 1 givenname: D M surname: Mancini fullname: Mancini, D M organization: Department of Medicine, University of Pennsylvania, Philadelphia – sequence: 2 givenname: G surname: Walter fullname: Walter, G organization: Department of Medicine, University of Pennsylvania, Philadelphia – sequence: 3 givenname: N surname: Reichek fullname: Reichek, N organization: Department of Medicine, University of Pennsylvania, Philadelphia – sequence: 4 givenname: R surname: Lenkinski fullname: Lenkinski, R organization: Department of Medicine, University of Pennsylvania, Philadelphia – sequence: 5 givenname: K K surname: McCully fullname: McCully, K K organization: Department of Medicine, University of Pennsylvania, Philadelphia – sequence: 6 givenname: J L surname: Mullen fullname: Mullen, J L organization: Department of Medicine, University of Pennsylvania, Philadelphia – sequence: 7 givenname: J R surname: Wilson fullname: Wilson, J R organization: Department of Medicine, University of Pennsylvania, Philadelphia |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5275717$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/1555280$$D View this record in MEDLINE/PubMed |
| BookMark | eNp1kUFrFTEURoO01NfWvRshC3E3Y5LJncws5VG1UBCkXYdM5g6NZpJnkgH7782jTwXBVbh851zI_S7JWYgBCXnNWct5z98z3u5vv7YDtLLlXS9fkB0HIRsJ3XhGdoyxsVGdEC_JZc7f6th3Ci7IBQcAMbAdCfsYSnLTVlwMNC40f0ePxXi6btl6pKakeHh8oiVS_InJuozUhRI9JhNszcNMjS-YcP6trNWfond5rSR9RJMKXYzzW8Jrcr4Yn_HV6b0iDx9v7vefm7svn273H-4aKztWGgG2Z2IUbOSjxUWpCXEAhRxmYDiwxcK4cGHtMI8GmBykmkcJxggQwk6muyLvnvceUvyxYS56ddmi9yZg3LJWYuilZGMF35zAbVpx1ofkVpOe9OlANX97yk22xi_HT7v8BwOhQHFVMfaM2RRzTrj8XcT0sSnNuK5N6QG01MemqtL_o1hXzLGGkuqx_i_-Am6RmQE |
| CODEN | CIRCAZ |
| CitedBy_id | crossref_primary_10_1002_mrm_1910310303 crossref_primary_10_1016_j_ccl_2011_08_012 crossref_primary_10_1016_j_ijcard_2009_08_042 crossref_primary_10_1016_S0735_1097_97_00015_6 crossref_primary_10_1253_circj_CJ_21_0880 crossref_primary_10_1136_archdischild_2020_319955 crossref_primary_10_1016_0735_1097_93_90230_X crossref_primary_10_1007_s10741_016_9573_4 crossref_primary_10_1046_j_1365_2796_1999_00555_x crossref_primary_10_1146_annurev_med_47_1_241 crossref_primary_10_1161_CIRCHEARTFAILURE_117_004129 crossref_primary_10_1152_japplphysiol_00760_2012 crossref_primary_10_1093_ajcn_71_5_1033 crossref_primary_10_1152_ajpheart_00004_2014 crossref_primary_10_1097_TP_0000000000002311 crossref_primary_10_1016_S0167_5273_02_00233_4 crossref_primary_10_1161_CIRCHEARTFAILURE_109_903773 crossref_primary_10_1016_S0033_8389_22_00372_4 crossref_primary_10_1016_j_jacc_2009_11_086 crossref_primary_10_1007_s13539_013_0109_7 crossref_primary_10_1097_HCR_0b013e3181d0c1c1 crossref_primary_10_1152_japplphysiol_01096_2000 crossref_primary_10_1007_s10741_007_9055_9 crossref_primary_10_1016_j_repc_2012_09_001 crossref_primary_10_1097_TXD_0000000000000837 crossref_primary_10_1016_S0002_8703_99_70361_3 crossref_primary_10_1093_gerona_glt011 crossref_primary_10_1016_S1388_9842_00_00114_8 crossref_primary_10_1179_ptr_1999_4_3_195 crossref_primary_10_1006_jmcc_1999_1024 crossref_primary_10_1016_S0167_5273_02_00244_9 crossref_primary_10_1016_0735_1097_93_90340_7 crossref_primary_10_1016_j_ijcard_2010_04_060 crossref_primary_10_1378_chest_109_1_47 crossref_primary_10_1016_j_ijcme_2016_05_007 crossref_primary_10_1007_BF01772518 crossref_primary_10_1016_S0002_9149_96_00830_2 crossref_primary_10_1016_0002_9149_94_90011_6 crossref_primary_10_1186_1532_429X_11_48 crossref_primary_10_1007_s10334_016_0605_9 crossref_primary_10_1016_0735_1097_93_90231_O crossref_primary_10_1016_j_hfc_2014_08_009 crossref_primary_10_1253_circj_CJ_14_1280 crossref_primary_10_1513_AnnalsATS_201710_789KV crossref_primary_10_1016_j_ejheart_2008_09_017 crossref_primary_10_1139_h06_085 crossref_primary_10_1161_01_CIR_92_9_483 crossref_primary_10_1016_j_jacbts_2019_07_009 crossref_primary_10_1136_hrt_76_1_42 crossref_primary_10_1016_j_ejheart_2003_07_008 crossref_primary_10_5507_bp_2012_096 crossref_primary_10_1002_j_1875_9114_1994_tb02825_x crossref_primary_10_1097_00008483_200001000_00008 crossref_primary_10_1007_BF00711617 crossref_primary_10_1097_00005768_199808000_00008 crossref_primary_10_1016_j_cardfail_2003_12_009 crossref_primary_10_1111_j_1753_4887_1994_tb01358_x crossref_primary_10_1378_chest_115_3_836 crossref_primary_10_3389_fcvm_2023_1149065 crossref_primary_10_1161_01_CIR_99_9_1173 crossref_primary_10_1007_s11897_020_00468_w crossref_primary_10_1111_j_1939_1676_1996_tb02019_x crossref_primary_10_1136_pgmj_2007_061267 crossref_primary_10_1152_jappl_2000_88_5_1565 crossref_primary_10_1016_S0167_5273_02_00243_7 crossref_primary_10_1002_jcsm_12612 crossref_primary_10_1053_hl_1999_v28_a97762 crossref_primary_10_1016_0002_8703_94_90277_1 crossref_primary_10_3389_fphys_2017_00689 crossref_primary_10_1089_10430349950018643 crossref_primary_10_1016_0735_1097_93_90549_G crossref_primary_10_1016_S0735_1097_96_00323_3 crossref_primary_10_1111_j_0889_7204_2001_00616_x crossref_primary_10_1007_s00424_006_0072_7 crossref_primary_10_1152_jappl_2000_88_6_2138 crossref_primary_10_1046_j_1365_2613_2003_00351_x crossref_primary_10_1016_j_clnu_2006_01_017 crossref_primary_10_1046_j_1365_201x_2001_00832_x crossref_primary_10_1152_japplphysiol_00747_2017 crossref_primary_10_1016_j_cardfail_2007_11_006 crossref_primary_10_1016_j_jacc_2005_08_022 crossref_primary_10_1249_01_mss_0000191432_87926_41 crossref_primary_10_3892_ijmm_2018_3481 crossref_primary_10_1093_eurjhf_hfp088 crossref_primary_10_1152_japplphysiol_00977_2015 crossref_primary_10_1016_0765_1597_96_81278_0 crossref_primary_10_1016_S1134_2072_05_71232_9 crossref_primary_10_1161_CIRCULATIONAHA_109_882068 crossref_primary_10_1016_j_pharmthera_2008_09_009 crossref_primary_10_1002_art_10237 crossref_primary_10_1007_s10741_006_9193_5 crossref_primary_10_1016_0002_8703_94_90276_3 crossref_primary_10_1016_S0033_0620_05_80018_0 crossref_primary_10_1016_S0735_1097_01_01306_7 crossref_primary_10_1016_j_ijcard_2003_05_050 crossref_primary_10_1042_CS20230226 crossref_primary_10_1016_j_jbc_2021_101540 crossref_primary_10_1097_00005344_199800003_00007 crossref_primary_10_1016_j_cardfail_2016_06_007 crossref_primary_10_3389_fphys_2019_00649 crossref_primary_10_1007_s10741_009_9157_7 crossref_primary_10_1016_j_ijcard_2021_02_004 crossref_primary_10_1111_j_1527_5299_2002_01219_x crossref_primary_10_1016_j_amjcard_2003_11_009 crossref_primary_10_1111_pace_12254 crossref_primary_10_1016_S0002_8703_03_00075_9 crossref_primary_10_1016_S0002_9149_97_00292_0 crossref_primary_10_1016_j_transproceed_2011_08_085 crossref_primary_10_1016_S0168_6054_97_87443_0 crossref_primary_10_1016_j_jshs_2021_06_002 crossref_primary_10_1007_s10741_012_9353_8 crossref_primary_10_1161_01_CIR_94_7_1567 crossref_primary_10_3390_ijms21010088 crossref_primary_10_1016_j_suc_2011_06_001 crossref_primary_10_1016_j_hrtlng_2007_01_002 crossref_primary_10_1016_j_ejim_2013_09_011 crossref_primary_10_1097_00005768_200103000_00017 crossref_primary_10_1002_mrm_28463 crossref_primary_10_1016_S0002_9149_99_00748_1 crossref_primary_10_1007_s10741_011_9273_z crossref_primary_10_1097_00008483_199701000_00003 crossref_primary_10_1016_j_ancard_2004_02_011 crossref_primary_10_1002_ehf2_12035 crossref_primary_10_1016_j_ijcard_2012_03_083 crossref_primary_10_1097_PHM_0b013e318154b592 crossref_primary_10_1016_S1388_9842_00_00058_1 crossref_primary_10_1016_j_jacc_2014_04_083 crossref_primary_10_1016_j_annrmp_2008_04_006 crossref_primary_10_4235_jkgs_2011_15_4_207 crossref_primary_10_1016_j_ccl_2011_06_002 crossref_primary_10_1016_S0002_9149_02_03338_6 crossref_primary_10_1002_ajhb_1310060107 crossref_primary_10_1016_j_bbacli_2016_05_001 crossref_primary_10_1074_jbc_RA119_011081 crossref_primary_10_1002_nbm_1940060504 crossref_primary_10_1016_j_ijcard_2016_03_071 crossref_primary_10_1016_S0002_9149_99_80355_5 crossref_primary_10_1007_BF03040887 crossref_primary_10_1016_0735_1097_95_00416_5 crossref_primary_10_1056_NEJM199901283400404 crossref_primary_10_1161_JAHA_122_027937 crossref_primary_10_1097_MCO_0b013e32832cdb0f crossref_primary_10_1016_j_hfc_2007_07_016 crossref_primary_10_1161_01_CIR_91_2_559 crossref_primary_10_1016_j_ejheart_2004_11_010 crossref_primary_10_1111_apha_12423 crossref_primary_10_1097_00044067_200205000_00009 crossref_primary_10_1111_apha_12307 crossref_primary_10_1016_S1388_9842_02_00177_0 crossref_primary_10_1007_s12265_021_10171_3 crossref_primary_10_1155_2015_382585 crossref_primary_10_1152_ajpheart_00830_2014 crossref_primary_10_1007_s11897_010_0002_z crossref_primary_10_1111_j_1532_5415_2010_02811_x crossref_primary_10_1002_clc_4960170604 crossref_primary_10_1007_s10741_012_9363_6 crossref_primary_10_1016_j_ijcard_2012_03_063 crossref_primary_10_1016_j_ijcard_2012_06_064 crossref_primary_10_1016_S0002_8703_98_70220_0 crossref_primary_10_1016_j_ijcard_2005_09_031 crossref_primary_10_1016_S0002_8703_98_70353_9 crossref_primary_10_1016_S0272_5231_05_70060_5 crossref_primary_10_1111_j_1600_0838_2010_01226_x crossref_primary_10_17116_profmed202023062118 crossref_primary_10_1177_0884533612444537 crossref_primary_10_1016_S0002_9149_98_00927_8 crossref_primary_10_1097_00000441_199709000_00005 crossref_primary_10_1007_s11897_010_0013_9 crossref_primary_10_1111_j_1076_7460_2001_00803_x crossref_primary_10_1016_j_hfc_2007_12_002 crossref_primary_10_1016_j_jsams_2010_01_004 crossref_primary_10_1016_j_jjcc_2020_04_011 crossref_primary_10_1016_S0167_5273_02_00013_X crossref_primary_10_1016_j_ijcard_2013_05_062 crossref_primary_10_1016_S0730_725X_96_00236_6 crossref_primary_10_4070_kcj_2017_0061 crossref_primary_10_3390_biom13111617 crossref_primary_10_1161_CIRCHEARTFAILURE_112_969543 crossref_primary_10_1177_028418519403500202 crossref_primary_10_1016_S0735_1097_97_00262_3 crossref_primary_10_1186_s12872_016_0278_3 crossref_primary_10_4236_ojrad_2015_54026 crossref_primary_10_1152_japplphysiol_91067_2008 crossref_primary_10_1016_0002_9149_94_90239_9 crossref_primary_10_1046_j_1525_1594_1999_06372_x crossref_primary_10_1177_0193945904265400 crossref_primary_10_1016_j_annrmp_2007_03_008 crossref_primary_10_1016_j_annrmp_2007_03_007 crossref_primary_10_1080_17461391_2011_624197 crossref_primary_10_1097_HCR_0b013e3181c56b78 crossref_primary_10_1161_01_CIR_96_2_526 crossref_primary_10_1016_j_pcad_2006_10_003 crossref_primary_10_1080_07853890410017467 crossref_primary_10_1006_cyto_2000_0839 crossref_primary_10_1111_j_1748_1716_1995_tb09840_x crossref_primary_10_1113_JP277616 crossref_primary_10_1007_s10735_011_9325_7 crossref_primary_10_1016_j_jsmc_2013_03_001 crossref_primary_10_1067_mhj_2000_106916 crossref_primary_10_1097_00132580_200203000_00008 crossref_primary_10_32725_jab_2019_006 crossref_primary_10_1016_j_cpcardiol_2003_10_002 crossref_primary_10_1097_00008483_200205000_00008 crossref_primary_10_1016_j_jacc_2011_06_025 crossref_primary_10_1093_eurheartj_ehae284 crossref_primary_10_1016_S0002_8703_98_70252_2 crossref_primary_10_2217_fca_13_74 crossref_primary_10_1152_ajpheart_00455_2016 crossref_primary_10_1161_01_CIR_91_11_2769 crossref_primary_10_1016_j_jvs_2003_08_038 crossref_primary_10_1016_j_mpmed_2007_11_004 crossref_primary_10_1093_ehjsupp_4_suppl_D_D12 crossref_primary_10_1097_00008483_200011000_00007 crossref_primary_10_1002_jcsm_12314 crossref_primary_10_1016_S0167_5273_02_00014_1 crossref_primary_10_2165_00007256_200535120_00006 crossref_primary_10_1097_01_hjr_0000124327_85096_a5 crossref_primary_10_1152_ajpregu_00054_2012 crossref_primary_10_1161_JAHA_118_010554 crossref_primary_10_1016_j_ejim_2015_01_008 crossref_primary_10_1161_01_CIR_91_2_320 crossref_primary_10_1007_s12170_018_0573_x crossref_primary_10_1016_j_ijcard_2007_10_004 crossref_primary_10_1016_S0735_1097_01_01227_X crossref_primary_10_1093_jn_129_1_260S crossref_primary_10_1152_ajpregu_00187_2005 crossref_primary_10_1016_0735_1097_94_00570_G crossref_primary_10_1007_s00421_024_05570_8 crossref_primary_10_1016_S0002_8703_98_70351_5 crossref_primary_10_1152_japplphysiol_01273_2009 crossref_primary_10_1016_j_ijcard_2017_03_155 crossref_primary_10_1097_00149831_200308000_00009 crossref_primary_10_1378_chest_106_4_996 crossref_primary_10_1007_s10741_007_9056_8 crossref_primary_10_1016_j_biopha_2022_113833 crossref_primary_10_1161_01_CIR_98_17_1742 crossref_primary_10_1113_jphysiol_2010_199562 crossref_primary_10_1161_CIRCULATIONAHA_109_192628 crossref_primary_10_1177_0193945916658885 crossref_primary_10_1016_j_cardfail_2003_09_004 crossref_primary_10_1113_JP276678 crossref_primary_10_1016_j_jacc_2014_06_1180 crossref_primary_10_1183_09031936_02_00016702 crossref_primary_10_1016_S0033_0620_05_80011_8 crossref_primary_10_1098_rstb_2019_0607 crossref_primary_10_1016_j_autneu_2015_08_008 crossref_primary_10_1016_j_clnu_2009_04_023 crossref_primary_10_1016_j_jacc_2008_11_013 crossref_primary_10_1016_0167_5273_94_90060_4 crossref_primary_10_1016_j_jacc_2008_11_009 crossref_primary_10_1016_j_jacc_2009_05_015 crossref_primary_10_1016_j_ab_2017_01_018 crossref_primary_10_3390_jcm12103487 crossref_primary_10_1016_j_amjcard_2011_03_057 crossref_primary_10_1016_j_transproceed_2007_10_004 crossref_primary_10_1016_j_ijcard_2015_08_212 crossref_primary_10_1111_j_1365_2613_2006_00497_x crossref_primary_10_1016_1071_9164_95_90001_2 crossref_primary_10_1161_CIRCHEARTFAILURE_117_004800 crossref_primary_10_1002_jcp_25241 crossref_primary_10_2490_prm_20220031 crossref_primary_10_1007_BF03044968 crossref_primary_10_1093_ndt_15_7_953 crossref_primary_10_1161_01_CIR_94_10_2492 crossref_primary_10_1016_0735_1097_94_90858_3 crossref_primary_10_1016_S0002_9149_98_00173_8 crossref_primary_10_3390_cells12101405 crossref_primary_10_1007_s10735_011_9354_2 crossref_primary_10_1002_clc_4960190603 crossref_primary_10_1007_s11897_017_0361_9 crossref_primary_10_1016_j_ejheart_2007_03_010 crossref_primary_10_1161_CIRCHEARTFAILURE_114_001825 crossref_primary_10_1054_jcaf_2003_23 crossref_primary_10_1016_S0735_1097_98_00226_5 crossref_primary_10_1111_j_1755_5922_2010_00175_x crossref_primary_10_1097_00005768_199703000_00004 crossref_primary_10_1253_circj_CJ_17_0927 crossref_primary_10_1016_S1053_2498_01_00776_8 crossref_primary_10_1186_s12872_015_0111_4 crossref_primary_10_1111_aor_12070 crossref_primary_10_1152_ajpheart_00200_2011 crossref_primary_10_1097_00005344_199806321_00007 crossref_primary_10_1177_1741826711418931 crossref_primary_10_1016_S0735_1097_98_00531_2 crossref_primary_10_3109_1354750X_2013_781222 crossref_primary_10_1097_00004424_199902000_00004 crossref_primary_10_1152_jappl_1997_82_1_257 crossref_primary_10_1016_j_ahj_2013_12_021 crossref_primary_10_1093_eurheartj_ehx095 crossref_primary_10_1016_S1071_9164_98_90250_0 crossref_primary_10_1253_circj_68_573 crossref_primary_10_1097_MED_0b013e3283469505 crossref_primary_10_1371_journal_pone_0022695 crossref_primary_10_1152_ajpheart_00169_2015 crossref_primary_10_1007_s11897_012_0087_7 crossref_primary_10_1016_0735_1097_94_00428_S crossref_primary_10_1161_01_CIR_103_17_2195 crossref_primary_10_1016_S1053_2498_02_00475_8 crossref_primary_10_1007_s10741_017_9639_y crossref_primary_10_1210_en_2014_1591 crossref_primary_10_1080_14779072_2018_1424542 crossref_primary_10_1046_j_1463_1326_2000_00058_x crossref_primary_10_1186_1758_5996_6_27 crossref_primary_10_1152_japplphysiol_01098_2018 crossref_primary_10_1002_mus_880170802 crossref_primary_10_1016_j_ebiom_2017_01_040 crossref_primary_10_1097_SPC_0000000000000181 crossref_primary_10_1016_j_ijcard_2007_07_158 crossref_primary_10_1111_j_1475_097X_1996_tb00567_x crossref_primary_10_1177_089686080602600508 crossref_primary_10_1016_S0167_5273_96_02873_2 crossref_primary_10_1016_j_hfc_2017_02_012 crossref_primary_10_1109_TMAG_2005_854853 crossref_primary_10_1097_00008483_199605000_00004 crossref_primary_10_1016_S1053_2498_00_00110_8 crossref_primary_10_1111_j_1469_7793_2000_00863_x crossref_primary_10_1016_j_pcad_2011_02_005 crossref_primary_10_4137_CMC_S453 crossref_primary_10_1016_j_cardfail_2008_01_005 crossref_primary_10_1111_jvim_14570 crossref_primary_10_1016_j_clnu_2020_12_033 crossref_primary_10_1164_rccm_167_2_211 crossref_primary_10_1152_ajpheart_1998_275_3_H1032 crossref_primary_10_1002_ejhf_467 crossref_primary_10_1016_j_heliyon_2022_e11597 crossref_primary_10_1249_MSS_0b013e3181e3e2cb crossref_primary_10_1136_heartjnl_2013_304249 crossref_primary_10_5694_j_1326_5377_2001_tb143375_x crossref_primary_10_1253_circj_66_937 crossref_primary_10_1007_s10741_011_9291_x crossref_primary_10_1016_S0002_9149_96_00829_6 crossref_primary_10_2165_00007256_200434140_00001 crossref_primary_10_3138_physio_60_2_146 crossref_primary_10_1016_0735_1097_96_00126_X crossref_primary_10_3945_ajcn_2009_28160 crossref_primary_10_1111_j_1365_2613_2009_00683_x crossref_primary_10_1016_S0002_9149_99_80230_6 crossref_primary_10_1017_S0029665115002438 crossref_primary_10_1016_S0002_9149_99_80166_0 crossref_primary_10_2185_jrm_2022_029 crossref_primary_10_1111_j_1365_2613_2006_00475_x crossref_primary_10_1155_2012_512857 crossref_primary_10_1016_1062_1458_95_00148_4 crossref_primary_10_1016_S0735_1097_97_00381_1 crossref_primary_10_1111_j_1524_475X_2000_00061_x crossref_primary_10_1002_ejhf_1838 crossref_primary_10_1097_00005768_199707000_00004 crossref_primary_10_1177_1178638819833705 crossref_primary_10_1007_s00424_013_1336_7 crossref_primary_10_1152_ajpcell_00080_2023 crossref_primary_10_1007_s11886_003_0056_6 crossref_primary_10_1007_s12325_011_0091_4 crossref_primary_10_1007_BF00635872 crossref_primary_10_1136_hrt_76_5_393 crossref_primary_10_1016_S1388_9842_02_00022_3 crossref_primary_10_1016_0167_5273_96_02627_7 crossref_primary_10_1152_ajpregu_00347_2010 crossref_primary_10_1007_s00380_017_1076_2 crossref_primary_10_1016_S1053_2498_99_00048_0 crossref_primary_10_3109_08977190903512602 crossref_primary_10_1111_j_1748_1716_1995_tb09929_x crossref_primary_10_1016_S0035_3787_04_70904_2 crossref_primary_10_1016_S0002_9149_99_80571_2 crossref_primary_10_12968_hmed_2015_76_6_330 crossref_primary_10_1016_j_crvasa_2015_08_003 crossref_primary_10_1016_j_ejheart_2005_07_011 crossref_primary_10_1111_j_1600_0838_2005_00457_x crossref_primary_10_1016_0735_1097_94_00568_B crossref_primary_10_1097_01_mco_0000232902_97286_35 crossref_primary_10_1097_00001573_199905000_00004 crossref_primary_10_3390_jcm11010125 crossref_primary_10_1007_s10741_016_9592_1 crossref_primary_10_1152_ajpendo_00517_2002 crossref_primary_10_1016_S0735_1097_96_00272_0 crossref_primary_10_1016_S0735_1097_01_01268_2 crossref_primary_10_1093_cvr_cvab009 crossref_primary_10_14814_phy2_12353 crossref_primary_10_1046_j_1365_201x_2001_00830_x crossref_primary_10_1007_s10741_012_9324_0 crossref_primary_10_1016_j_cardfail_2004_12_002 crossref_primary_10_1111_jcmm_15191 crossref_primary_10_1016_j_annrmp_2006_04_002 crossref_primary_10_1016_j_annrmp_2006_04_003 crossref_primary_10_1007_s12414_018_0325_3 crossref_primary_10_1152_ajpendo_1997_272_3_E469 crossref_primary_10_1002_ajpa_22157 crossref_primary_10_1371_journal_pone_0247140 crossref_primary_10_1161_hc4901_102568 crossref_primary_10_1016_j_lfs_2018_10_015 crossref_primary_10_1054_chec_1999_0063 crossref_primary_10_1016_0735_1097_93_90813_G crossref_primary_10_1083_jcb_200211012 crossref_primary_10_1111_ctr_13170 crossref_primary_10_1371_journal_pone_0188551 crossref_primary_10_1007_BF00810521 crossref_primary_10_1016_0002_9149_94_90825_7 crossref_primary_10_1016_S0002_8703_96_90537_2 crossref_primary_10_1038_s41598_022_23202_z crossref_primary_10_1016_S0167_5273_02_00240_1 crossref_primary_10_15420_cfr_2019_10_2 crossref_primary_10_1007_s00586_016_4889_2 crossref_primary_10_1007_s11886_018_1056_x crossref_primary_10_1113_JP281377 crossref_primary_10_1016_j_biocel_2005_04_017 crossref_primary_10_1054_jcaf_2000_8830 crossref_primary_10_1016_j_repce_2012_04_020 crossref_primary_10_1139_cjpp_2018_0479 crossref_primary_10_1007_s10741_016_9593_0 crossref_primary_10_1118_1_4914448 crossref_primary_10_3390_ijms24031876 crossref_primary_10_1016_S0735_1097_01_01683_7 crossref_primary_10_1152_ajpregu_2001_281_1_R176 crossref_primary_10_1161_CIRCRESAHA_113_300308 crossref_primary_10_1016_j_ejvs_2017_07_018 crossref_primary_10_1097_01_hjr_0000136728_27524_f5 crossref_primary_10_1053_pcad_2002_127490 crossref_primary_10_1113_jphysiol_2010_197632 crossref_primary_10_1378_chest_130_4_1220 crossref_primary_10_3390_ijms24032973 crossref_primary_10_1016_j_ijcard_2011_09_079 crossref_primary_10_1038_nrneph_2013_170 crossref_primary_10_1016_j_cger_2006_08_011 crossref_primary_10_1016_S0002_9149_97_00098_2 crossref_primary_10_1016_0002_9149_94_90211_9 crossref_primary_10_1016_S0167_5273_97_02934_3 crossref_primary_10_1016_S0828_282X_06_70923_0 crossref_primary_10_1016_j_ghir_2007_01_020 crossref_primary_10_1016_j_ijcard_2004_10_059 crossref_primary_10_1016_0735_1097_96_00134_9 crossref_primary_10_3390_antiox12071401 crossref_primary_10_1016_S0735_1097_03_00848_9 crossref_primary_10_1016_j_ijcard_2004_05_030 crossref_primary_10_1097_01_hjr_0000116825_84388_eb crossref_primary_10_1006_jmcc_2001_1453 crossref_primary_10_1016_S0735_1097_03_00946_X crossref_primary_10_1161_01_CIR_0000012466_50373_E8 crossref_primary_10_1152_ajpcell_00046_2002 crossref_primary_10_1016_j_ijcard_2004_11_022 crossref_primary_10_1016_0735_1097_93_90485_J crossref_primary_10_1097_MD_0000000000006579 crossref_primary_10_3390_biomedicines11051429 crossref_primary_10_1053_apmr_2001_25908 crossref_primary_10_1152_ajpcell_1999_277_5_C982 crossref_primary_10_1007_BF02592248 crossref_primary_10_1097_00008483_199807000_00004 crossref_primary_10_1002_ehf2_12408 crossref_primary_10_1007_s10741_011_9289_4 crossref_primary_10_1152_ajpregu_00447_2014 crossref_primary_10_1249_MSS_0000000000000431 crossref_primary_10_1161_01_CIR_92_6_1379 crossref_primary_10_1016_S0033_0620_05_80013_1 crossref_primary_10_1152_ajpcell_00114_2003 crossref_primary_10_1249_01_FIT_0000312433_21312_18 crossref_primary_10_1016_0003_4975_94_91648_9 crossref_primary_10_1016_j_healun_2012_12_011 crossref_primary_10_1016_S0002_9629_15_40190_9 crossref_primary_10_7717_peerj_2447 crossref_primary_10_1097_TGR_0000000000000387 crossref_primary_10_3389_fphys_2019_00129 crossref_primary_10_1016_j_jacc_2012_04_012 crossref_primary_10_1016_j_biocel_2005_03_013 crossref_primary_10_1016_j_cardfail_2005_06_430 crossref_primary_10_1016_j_ghir_2009_11_007 crossref_primary_10_1016_j_ijcard_2005_05_005 crossref_primary_10_1097_00005768_199804000_00003 crossref_primary_10_1097_00008483_199911000_00011 crossref_primary_10_1007_s11897_018_0408_6 crossref_primary_10_1007_s11886_004_0020_0 crossref_primary_10_1016_j_ejim_2019_04_017 crossref_primary_10_1111_j_1365_2362_1995_tb01705_x crossref_primary_10_1016_S0003_9993_99_90221_6 crossref_primary_10_1152_ajpheart_1999_276_3_H913 crossref_primary_10_1186_1471_2466_4_5 crossref_primary_10_1007_s12349_008_0013_4 crossref_primary_10_1378_chest_116_1_88 crossref_primary_10_1152_ajpregu_00161_2019 crossref_primary_10_1111_j_1472_8206_1998_tb00953_x crossref_primary_10_1152_ajpheart_00984_2010 crossref_primary_10_1016_S0143_4160_02_00208_7 crossref_primary_10_5694_j_1326_5377_2006_tb00690_x crossref_primary_10_1007_s10735_010_9262_x crossref_primary_10_1161_CIRCULATIONAHA_109_192065 crossref_primary_10_1161_CIRCULATIONAHA_109_192064 crossref_primary_10_1051_sm_2013087 crossref_primary_10_1016_j_ijcard_2004_05_061 crossref_primary_10_1002_ehf2_12504 crossref_primary_10_1016_j_ijcard_2010_04_006 crossref_primary_10_1016_j_bbadis_2013_03_018 crossref_primary_10_1016_S0002_9149_99_80197_0 crossref_primary_10_1016_S0033_0620_98_80054_6 crossref_primary_10_1006_cyto_2001_0918 crossref_primary_10_1016_j_scispo_2013_07_005 crossref_primary_10_1097_SPC_0000000000000222 crossref_primary_10_1161_01_CIR_95_4_910 |
| ContentType | Journal Article |
| Copyright | 1992 INIST-CNRS |
| Copyright_xml | – notice: 1992 INIST-CNRS |
| DBID | AAYXX CITATION IQODW CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1161/01.CIR.85.4.1364 |
| DatabaseName | CrossRef Pascal-Francis Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine Anatomy & Physiology |
| EISSN | 1524-4539 |
| EndPage | 1373 |
| ExternalDocumentID | 1555280 5275717 10_1161_01_CIR_85_4_1364 |
| Genre | Journal Article |
| GroupedDBID | --- .-D .3C .55 .GJ .XZ .Z2 01R 0R~ 0ZK 18M 1CY 1J1 29B 2FS 2WC 354 40H 41~ 4Q1 4Q2 4Q3 53G 5GY 5RE 5VS 6PF 71W 77Y 7O~ AAAAV AAAXR AAEJM AAFWJ AAGIX AAHPQ AAIQE AAJCS AAMOA AAMTA AAQKA AARTV AASCR AASOK AASXQ AAUEB AAWTL AAXQO AAYOK AAYXX ABASU ABBUW ABDIG ABJNI ABOCM ABPMR ABPXF ABQRW ABVCZ ABXVJ ABXYN ABZAD ABZZY ACCJW ACDDN ACDOF ACEWG ACGFO ACGFS ACILI ACLDA ACOAL ACRKK ACWDW ACWRI ACXJB ACXNZ ACZKN ADBBV ADCYY ADFPA ADGGA ADHPY ADNKB AE3 AE6 AEBDS AEETU AENEX AFBFQ AFCHL AFDTB AFEXH AFFNX AFMBP AFNMH AFSOK AFUWQ AGINI AHMBA AHOMT AHQNM AHQVU AHRYX AHVBC AIJEX AINUH AJCLO AJIOK AJJEV AJNWD AJNYG AJZMW AKCTQ AKULP ALKUP ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW AOQMC ASPBG AVWKF AYCSE AZFZN BAWUL BOYCO BQLVK BS7 BYPQX C1A C45 CITATION CS3 DIK DIWNM DU5 DUNZO E.X E3Z EBS EEVPB EJD ERAAH EX3 F2K F2L F2M F2N F5P FCALG FEDTE FL- FW0 GNXGY GQDEL GX1 H0~ H13 HLJTE HVGLF HZ~ H~9 IKREB IKYAY IN~ IPNFZ J5H JF9 JG8 JK3 JK8 K-A K-F K8S KD2 KMI KQ8 L-C L7B M18 MVM N4W N9A NEJ N~7 N~B N~M O9- OAG OAH OBH OCB OCUKA ODA ODMTH OGEVE OHH OHT OHYEH OK1 OL1 OLB OLG OLH OLU OLV OLY OLZ OPUJH ORVUJ OUVQU OVD OVDNE OVIDH OVLEI OVOZU OWBYB OWU OWV OWW OWX OWY OWZ OXXIT P-K P2P PQQKQ R58 RAH RIG RLZ S4R S4S T8P TEORI TR2 TSPGW UPT V2I VVN W2D W3M W8F WH7 WHG WOQ WOW X3V X3W X7M XXN XYM YFH YOC YQJ YSK YXB YYM YYP YZZ ZFV ZGI ZXP ZY1 ZZMQN ~H1 IQODW ACIJW ACRZS AWKKM CGR CUY CVF ECM EIF NPM OJAPA OLW PKN RHF 7X8 |
| ID | FETCH-LOGICAL-c430t-25c602920919cef77bee857e15d50e80fc59f12cc8d9a504847d945aa2522cba3 |
| ISSN | 0009-7322 |
| IngestDate | Tue Aug 05 08:53:53 EDT 2025 Wed Feb 19 02:31:56 EST 2025 Mon Jul 21 09:17:55 EDT 2025 Tue Jul 01 03:23:38 EDT 2025 Thu Apr 24 23:12:01 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 4 |
| Keywords | Human Heart failure Atrophia Cardiovascular disease Exercise tolerance test Exploration Striated muscle Metabolism |
| Language | English |
| License | CC BY 4.0 |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-c430t-25c602920919cef77bee857e15d50e80fc59f12cc8d9a504847d945aa2522cba3 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| PMID | 1555280 |
| PQID | 72864409 |
| PQPubID | 23479 |
| PageCount | 10 |
| ParticipantIDs | proquest_miscellaneous_72864409 pubmed_primary_1555280 pascalfrancis_primary_5275717 crossref_primary_10_1161_01_CIR_85_4_1364 crossref_citationtrail_10_1161_01_CIR_85_4_1364 |
| ProviderPackageCode | CITATION AAYXX |
| PublicationCentury | 1900 |
| PublicationDate | 1992-04-01 |
| PublicationDateYYYYMMDD | 1992-04-01 |
| PublicationDate_xml | – month: 04 year: 1992 text: 1992-04-01 day: 01 |
| PublicationDecade | 1990 |
| PublicationPlace | Hagerstown, MD |
| PublicationPlace_xml | – name: Hagerstown, MD – name: United States |
| PublicationTitle | Circulation (New York, N.Y.) |
| PublicationTitleAlternate | Circulation |
| PublicationYear | 1992 |
| Publisher | Lippincott Williams & Wilkins |
| Publisher_xml | – name: Lippincott Williams & Wilkins |
| References | 1555301 - Circulation. 1992 Apr;85(4):1621-3 |
| References_xml | – reference: 1555301 - Circulation. 1992 Apr;85(4):1621-3 |
| SSID | ssj0006375 |
| Score | 1.9660614 |
| Snippet | The purpose of this study was to investigate the prevalence of skeletal muscle atrophy and its relation to exercise intolerance and abnormal muscle metabolism... |
| SourceID | proquest pubmed pascalfrancis crossref |
| SourceType | Aggregation Database Index Database Enrichment Source |
| StartPage | 1364 |
| SubjectTerms | Biological and medical sciences Cardiology. Vascular system Exercise - physiology Exercise Test Female Heart Heart Failure - complications Heart Failure - physiopathology Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Magnetic Resonance Imaging Magnetic Resonance Spectroscopy Male Medical sciences Middle Aged Muscles - metabolism Muscular Atrophy - complications Muscular Atrophy - diagnosis Muscular Atrophy - epidemiology Phosphocreatine - metabolism Phosphorus - metabolism Prevalence |
| Title | Contribution of skeletal muscle atrophy to exercise intolerance and altered muscle metabolism in heart failure |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/1555280 https://www.proquest.com/docview/72864409 |
| Volume | 85 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3da9swEBdbB2MwxtauNNu66WEMRnFqy5JlP5bSrhtJByFheTOWLEFoYhfHedj--p1syU627vPFBEdnG99P55Pu44fQWy7yUARCeDyLco_m1BQrE5hXOlRRopUvqKlGHl9HVzP6ac7mfXuCprqkFkP57c66kv_RKpwDvZoq2X_QbHdROAG_Qb9wBA3D8a90bFpLOcIq4_Wtb-AjYqobV5s1DD0x-9zwGo1_6aiVTH-IcqmqrlKgCZeD12lFViAvyqWhzlgUxo2s6hOdLZa28UjX1GBRSUv8dRefz9b-wtg09CjacvZ-6_VLG6UnW9xeE2WyUm92wkMjZZgdLLX2pN-haLNZu8QWZ3UTj4dkx-q2RD0WXXTLhAZh29b8Z9seBU29wlAuqmHMhnTohu620b7-nF7ORqN0ejGf3kcPCKwfDLXFh3mf-xOFnDmKPfNgLn4dBac_Xn_HX3l8m61h6uiW8-TXi5LGOZk-RU_sqgKftRB5hu6pYh8dnBVZXa6-4ne4yfNtAij76OHYplMcoGIbQLjU2AEIt2jAFkC4LrEDEN4CEAYAYQsgJ9IDCEbiBkDYAug5ml1eTM-vPEvA4Uka-rVHmIx8Q2eWBIlUmnOhVMy4CljOfBX7WrJEB0TKOE8yBt8CyvOEsiwj4NVLkYWHaK8oC3WEsIZ_JIvAn2Wa5okWpk8jI8K4sBmJowE6da85lbY7vSFJWabNKjUKUj9Izz9O0pilNDWKGaD3ncRt25nlN2OPdzTXCTDCGQ_4AL1xmkzBvJqYWVaocrNOOTwbpX4yQIetgvt7McZI7L_4o-hL9KifFa_QXl1t1DF4srV43aDyOwdqn_Q |
| linkProvider | Geneva Foundation for Medical Education and Research |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Contribution+of+skeletal+muscle+atrophy+to+exercise+intolerance+and+altered+muscle+metabolism+in+heart+failure&rft.jtitle=Circulation+%28New+York%2C+N.Y.%29&rft.au=Mancini%2C+D+M&rft.au=Walter%2C+G&rft.au=Reichek%2C+N&rft.au=Lenkinski%2C+R&rft.date=1992-04-01&rft.issn=0009-7322&rft.volume=85&rft.issue=4&rft.spage=1364&rft_id=info:doi/10.1161%2F01.cir.85.4.1364&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0009-7322&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0009-7322&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0009-7322&client=summon |