A Randomized Study of Cardiac Resynchronization Therapy Defibrillator Versus Dual-Chamber Implantable Cardioverter-Defibrillator in Ischemic Cardiomyopathy With Narrow QRS: The NARROW-CRT Study
BACKGROUND—Current recommendations require a QRS duration of ≥120 ms as a condition for prescribing cardiac resynchronization therapy (CRT). This study was designed to test the hypothesis that patients with heart failure (HF) of ischemic origin, current indications for defibrillator implantation, an...
Gespeichert in:
| Veröffentlicht in: | Circulation. Arrhythmia and electrophysiology 2013-06, Vol.6 (3), p.538-545 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 545 |
|---|---|
| container_issue | 3 |
| container_start_page | 538 |
| container_title | Circulation. Arrhythmia and electrophysiology |
| container_volume | 6 |
| creator | Muto, Carmine Solimene, Francesco Gallo, Paolo Nastasi, Maurizio La Rosa, Concetto Calvanese, Raimondo Iengo, Raffaele Canciello, Michelangelo Sangiuolo, Raffaele Diemberger, Igor Ciardiello, Carmine Tuccillo, Bernardino |
| description | BACKGROUND—Current recommendations require a QRS duration of ≥120 ms as a condition for prescribing cardiac resynchronization therapy (CRT). This study was designed to test the hypothesis that patients with heart failure (HF) of ischemic origin, current indications for defibrillator implantation, and QRS |
| doi_str_mv | 10.1161/CIRCEP.113.000135 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1370124356</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1370124356</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2984-ffa4487af44fc175cda964960797f3d76ced9ae5089fe8d770cf97c95482d3303</originalsourceid><addsrcrecordid>eNpVkcFu1DAURSMEoqXwAWyQl2xS7NiJY3ajtNCRqhbSgS4jj_2sGJJ4aieM0r_rn-FRpkisfBf3nuf3bpK8J_ickIJ8qtZ1dfktanqOMSY0f5GcEsFISnHJXj5rwsRJ8iaEXxgXpCTF6-Qko7nISkpPk6cVquWgXW8fQaO7cdIzcgZV0msrFaohzINqvRvsoxytG9CmBS93M7oAY7fedp0cnUc_wYcpoItJdmnVyn4LHq37XSeHUW47WHjuD_gRfPp_1A5oHVQLvVVHWz-7nRzbGd3bsUU30nu3R9_ru8-H4ehmVde392lVb5bvvk1eGdkFeHd8z5IfXy431VV6fft1Xa2uU5WJkqXGSMZKLg1jRhGeKy1FwUSBueCGal4o0EJCjkthoNScY2UEVyJnZaYpxfQs-bhwd949TBDGprdBQdxiADeFhlCOScZoXkQrWazKuxA8mGbnbS_93BDcHJprluaips3SXMx8OOKnbQ_6X-K5qmhgi2HvunjF8Lub9uCbFmQ3tk1kUM4ETbOocBGh6QHM6F8fbKcG</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1370124356</pqid></control><display><type>article</type><title>A Randomized Study of Cardiac Resynchronization Therapy Defibrillator Versus Dual-Chamber Implantable Cardioverter-Defibrillator in Ischemic Cardiomyopathy With Narrow QRS: The NARROW-CRT Study</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Muto, Carmine ; Solimene, Francesco ; Gallo, Paolo ; Nastasi, Maurizio ; La Rosa, Concetto ; Calvanese, Raimondo ; Iengo, Raffaele ; Canciello, Michelangelo ; Sangiuolo, Raffaele ; Diemberger, Igor ; Ciardiello, Carmine ; Tuccillo, Bernardino</creator><creatorcontrib>Muto, Carmine ; Solimene, Francesco ; Gallo, Paolo ; Nastasi, Maurizio ; La Rosa, Concetto ; Calvanese, Raimondo ; Iengo, Raffaele ; Canciello, Michelangelo ; Sangiuolo, Raffaele ; Diemberger, Igor ; Ciardiello, Carmine ; Tuccillo, Bernardino</creatorcontrib><description>BACKGROUND—Current recommendations require a QRS duration of ≥120 ms as a condition for prescribing cardiac resynchronization therapy (CRT). This study was designed to test the hypothesis that patients with heart failure (HF) of ischemic origin, current indications for defibrillator implantation, and QRS <120 ms may benefit from CRT in the presence of marked mechanical dyssynchrony.
METHODS AND RESULTS—Patients with intraventricular dyssynchrony on echocardiography were randomly assigned to CRT or dual-chamber defibrillator implantation (CRT defibrillator and dual-chamber implantable cardioverter-defibrillator arm, respectively). The primary end point was the HF clinical composite response, which scores patients as improved, unchanged, or worsened. The secondary end point was the cumulative survival from HF hospitalization and HF death. An additional secondary end point was the composite of HF hospitalization, HF death, and spontaneous ventricular fibrillation. Twenty-three of 56 patients with CRT defibrillator showed an improvement in their clinical composite response at 1 year, compared with 9 of 55 patients with dual-chamber implantable cardioverter-defibrillator (41% versus 16%; P=0.004). After a median follow-up of 16 months, the CRT defibrillator arm showed a nonsignificant higher survival from HF hospitalization and HF death (P=0.077), and a significantly higher survival from the combined end point of HF hospitalization, HF death, and spontaneous ventricular fibrillation (P=0.028).
CONCLUSIONS—In this comparison of CRT defibrillator and dual-chamber implantable cardioverter-defibrillator, CRT improved clinical status in some patients with ischemic cardiomyopathy, mild-to-moderate symptoms, narrow QRS duration, and mechanical dyssynchrony on echocardiography.
CLINICAL TRIAL REGISTRATION—URLhttp://clinicaltrials.gov. Unique identifierNCT01577446.</description><identifier>ISSN: 1941-3149</identifier><identifier>EISSN: 1941-3084</identifier><identifier>DOI: 10.1161/CIRCEP.113.000135</identifier><identifier>PMID: 23592833</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Cardiac Pacing, Artificial - methods ; Cardiac Resynchronization Therapy - methods ; Cardiomyopathies - diagnosis ; Cardiomyopathies - mortality ; Cardiomyopathies - therapy ; Defibrillators, Implantable ; Echocardiography, Doppler ; Electrocardiography - methods ; Female ; Follow-Up Studies ; Heart Failure - diagnosis ; Heart Failure - mortality ; Heart Failure - therapy ; Humans ; Kaplan-Meier Estimate ; Male ; Myocardial Ischemia - diagnostic imaging ; Myocardial Ischemia - mortality ; Myocardial Ischemia - therapy ; Prospective Studies ; Risk Assessment ; Statistics, Nonparametric ; Survival Rate ; Tachycardia, Ventricular - diagnosis ; Tachycardia, Ventricular - therapy ; Treatment Outcome ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - mortality ; Ventricular Dysfunction, Left - therapy</subject><ispartof>Circulation. Arrhythmia and electrophysiology, 2013-06, Vol.6 (3), p.538-545</ispartof><rights>2013 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2984-ffa4487af44fc175cda964960797f3d76ced9ae5089fe8d770cf97c95482d3303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,3674,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23592833$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Muto, Carmine</creatorcontrib><creatorcontrib>Solimene, Francesco</creatorcontrib><creatorcontrib>Gallo, Paolo</creatorcontrib><creatorcontrib>Nastasi, Maurizio</creatorcontrib><creatorcontrib>La Rosa, Concetto</creatorcontrib><creatorcontrib>Calvanese, Raimondo</creatorcontrib><creatorcontrib>Iengo, Raffaele</creatorcontrib><creatorcontrib>Canciello, Michelangelo</creatorcontrib><creatorcontrib>Sangiuolo, Raffaele</creatorcontrib><creatorcontrib>Diemberger, Igor</creatorcontrib><creatorcontrib>Ciardiello, Carmine</creatorcontrib><creatorcontrib>Tuccillo, Bernardino</creatorcontrib><title>A Randomized Study of Cardiac Resynchronization Therapy Defibrillator Versus Dual-Chamber Implantable Cardioverter-Defibrillator in Ischemic Cardiomyopathy With Narrow QRS: The NARROW-CRT Study</title><title>Circulation. Arrhythmia and electrophysiology</title><addtitle>Circ Arrhythm Electrophysiol</addtitle><description>BACKGROUND—Current recommendations require a QRS duration of ≥120 ms as a condition for prescribing cardiac resynchronization therapy (CRT). This study was designed to test the hypothesis that patients with heart failure (HF) of ischemic origin, current indications for defibrillator implantation, and QRS <120 ms may benefit from CRT in the presence of marked mechanical dyssynchrony.
METHODS AND RESULTS—Patients with intraventricular dyssynchrony on echocardiography were randomly assigned to CRT or dual-chamber defibrillator implantation (CRT defibrillator and dual-chamber implantable cardioverter-defibrillator arm, respectively). The primary end point was the HF clinical composite response, which scores patients as improved, unchanged, or worsened. The secondary end point was the cumulative survival from HF hospitalization and HF death. An additional secondary end point was the composite of HF hospitalization, HF death, and spontaneous ventricular fibrillation. Twenty-three of 56 patients with CRT defibrillator showed an improvement in their clinical composite response at 1 year, compared with 9 of 55 patients with dual-chamber implantable cardioverter-defibrillator (41% versus 16%; P=0.004). After a median follow-up of 16 months, the CRT defibrillator arm showed a nonsignificant higher survival from HF hospitalization and HF death (P=0.077), and a significantly higher survival from the combined end point of HF hospitalization, HF death, and spontaneous ventricular fibrillation (P=0.028).
CONCLUSIONS—In this comparison of CRT defibrillator and dual-chamber implantable cardioverter-defibrillator, CRT improved clinical status in some patients with ischemic cardiomyopathy, mild-to-moderate symptoms, narrow QRS duration, and mechanical dyssynchrony on echocardiography.
CLINICAL TRIAL REGISTRATION—URLhttp://clinicaltrials.gov. Unique identifierNCT01577446.</description><subject>Cardiac Pacing, Artificial - methods</subject><subject>Cardiac Resynchronization Therapy - methods</subject><subject>Cardiomyopathies - diagnosis</subject><subject>Cardiomyopathies - mortality</subject><subject>Cardiomyopathies - therapy</subject><subject>Defibrillators, Implantable</subject><subject>Echocardiography, Doppler</subject><subject>Electrocardiography - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Myocardial Ischemia - diagnostic imaging</subject><subject>Myocardial Ischemia - mortality</subject><subject>Myocardial Ischemia - therapy</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Statistics, Nonparametric</subject><subject>Survival Rate</subject><subject>Tachycardia, Ventricular - diagnosis</subject><subject>Tachycardia, Ventricular - therapy</subject><subject>Treatment Outcome</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><subject>Ventricular Dysfunction, Left - mortality</subject><subject>Ventricular Dysfunction, Left - therapy</subject><issn>1941-3149</issn><issn>1941-3084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkcFu1DAURSMEoqXwAWyQl2xS7NiJY3ajtNCRqhbSgS4jj_2sGJJ4aieM0r_rn-FRpkisfBf3nuf3bpK8J_ickIJ8qtZ1dfktanqOMSY0f5GcEsFISnHJXj5rwsRJ8iaEXxgXpCTF6-Qko7nISkpPk6cVquWgXW8fQaO7cdIzcgZV0msrFaohzINqvRvsoxytG9CmBS93M7oAY7fedp0cnUc_wYcpoItJdmnVyn4LHq37XSeHUW47WHjuD_gRfPp_1A5oHVQLvVVHWz-7nRzbGd3bsUU30nu3R9_ru8-H4ehmVde392lVb5bvvk1eGdkFeHd8z5IfXy431VV6fft1Xa2uU5WJkqXGSMZKLg1jRhGeKy1FwUSBueCGal4o0EJCjkthoNScY2UEVyJnZaYpxfQs-bhwd949TBDGprdBQdxiADeFhlCOScZoXkQrWazKuxA8mGbnbS_93BDcHJprluaips3SXMx8OOKnbQ_6X-K5qmhgi2HvunjF8Lub9uCbFmQ3tk1kUM4ETbOocBGh6QHM6F8fbKcG</recordid><startdate>201306</startdate><enddate>201306</enddate><creator>Muto, Carmine</creator><creator>Solimene, Francesco</creator><creator>Gallo, Paolo</creator><creator>Nastasi, Maurizio</creator><creator>La Rosa, Concetto</creator><creator>Calvanese, Raimondo</creator><creator>Iengo, Raffaele</creator><creator>Canciello, Michelangelo</creator><creator>Sangiuolo, Raffaele</creator><creator>Diemberger, Igor</creator><creator>Ciardiello, Carmine</creator><creator>Tuccillo, Bernardino</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201306</creationdate><title>A Randomized Study of Cardiac Resynchronization Therapy Defibrillator Versus Dual-Chamber Implantable Cardioverter-Defibrillator in Ischemic Cardiomyopathy With Narrow QRS: The NARROW-CRT Study</title><author>Muto, Carmine ; Solimene, Francesco ; Gallo, Paolo ; Nastasi, Maurizio ; La Rosa, Concetto ; Calvanese, Raimondo ; Iengo, Raffaele ; Canciello, Michelangelo ; Sangiuolo, Raffaele ; Diemberger, Igor ; Ciardiello, Carmine ; Tuccillo, Bernardino</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2984-ffa4487af44fc175cda964960797f3d76ced9ae5089fe8d770cf97c95482d3303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Cardiac Pacing, Artificial - methods</topic><topic>Cardiac Resynchronization Therapy - methods</topic><topic>Cardiomyopathies - diagnosis</topic><topic>Cardiomyopathies - mortality</topic><topic>Cardiomyopathies - therapy</topic><topic>Defibrillators, Implantable</topic><topic>Echocardiography, Doppler</topic><topic>Electrocardiography - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - therapy</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Myocardial Ischemia - diagnostic imaging</topic><topic>Myocardial Ischemia - mortality</topic><topic>Myocardial Ischemia - therapy</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Statistics, Nonparametric</topic><topic>Survival Rate</topic><topic>Tachycardia, Ventricular - diagnosis</topic><topic>Tachycardia, Ventricular - therapy</topic><topic>Treatment Outcome</topic><topic>Ventricular Dysfunction, Left - diagnostic imaging</topic><topic>Ventricular Dysfunction, Left - mortality</topic><topic>Ventricular Dysfunction, Left - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Muto, Carmine</creatorcontrib><creatorcontrib>Solimene, Francesco</creatorcontrib><creatorcontrib>Gallo, Paolo</creatorcontrib><creatorcontrib>Nastasi, Maurizio</creatorcontrib><creatorcontrib>La Rosa, Concetto</creatorcontrib><creatorcontrib>Calvanese, Raimondo</creatorcontrib><creatorcontrib>Iengo, Raffaele</creatorcontrib><creatorcontrib>Canciello, Michelangelo</creatorcontrib><creatorcontrib>Sangiuolo, Raffaele</creatorcontrib><creatorcontrib>Diemberger, Igor</creatorcontrib><creatorcontrib>Ciardiello, Carmine</creatorcontrib><creatorcontrib>Tuccillo, Bernardino</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muto, Carmine</au><au>Solimene, Francesco</au><au>Gallo, Paolo</au><au>Nastasi, Maurizio</au><au>La Rosa, Concetto</au><au>Calvanese, Raimondo</au><au>Iengo, Raffaele</au><au>Canciello, Michelangelo</au><au>Sangiuolo, Raffaele</au><au>Diemberger, Igor</au><au>Ciardiello, Carmine</au><au>Tuccillo, Bernardino</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Randomized Study of Cardiac Resynchronization Therapy Defibrillator Versus Dual-Chamber Implantable Cardioverter-Defibrillator in Ischemic Cardiomyopathy With Narrow QRS: The NARROW-CRT Study</atitle><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle><addtitle>Circ Arrhythm Electrophysiol</addtitle><date>2013-06</date><risdate>2013</risdate><volume>6</volume><issue>3</issue><spage>538</spage><epage>545</epage><pages>538-545</pages><issn>1941-3149</issn><eissn>1941-3084</eissn><abstract>BACKGROUND—Current recommendations require a QRS duration of ≥120 ms as a condition for prescribing cardiac resynchronization therapy (CRT). This study was designed to test the hypothesis that patients with heart failure (HF) of ischemic origin, current indications for defibrillator implantation, and QRS <120 ms may benefit from CRT in the presence of marked mechanical dyssynchrony.
METHODS AND RESULTS—Patients with intraventricular dyssynchrony on echocardiography were randomly assigned to CRT or dual-chamber defibrillator implantation (CRT defibrillator and dual-chamber implantable cardioverter-defibrillator arm, respectively). The primary end point was the HF clinical composite response, which scores patients as improved, unchanged, or worsened. The secondary end point was the cumulative survival from HF hospitalization and HF death. An additional secondary end point was the composite of HF hospitalization, HF death, and spontaneous ventricular fibrillation. Twenty-three of 56 patients with CRT defibrillator showed an improvement in their clinical composite response at 1 year, compared with 9 of 55 patients with dual-chamber implantable cardioverter-defibrillator (41% versus 16%; P=0.004). After a median follow-up of 16 months, the CRT defibrillator arm showed a nonsignificant higher survival from HF hospitalization and HF death (P=0.077), and a significantly higher survival from the combined end point of HF hospitalization, HF death, and spontaneous ventricular fibrillation (P=0.028).
CONCLUSIONS—In this comparison of CRT defibrillator and dual-chamber implantable cardioverter-defibrillator, CRT improved clinical status in some patients with ischemic cardiomyopathy, mild-to-moderate symptoms, narrow QRS duration, and mechanical dyssynchrony on echocardiography.
CLINICAL TRIAL REGISTRATION—URLhttp://clinicaltrials.gov. Unique identifierNCT01577446.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>23592833</pmid><doi>10.1161/CIRCEP.113.000135</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-3149 |
| ispartof | Circulation. Arrhythmia and electrophysiology, 2013-06, Vol.6 (3), p.538-545 |
| issn | 1941-3149 1941-3084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1370124356 |
| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Cardiac Pacing, Artificial - methods Cardiac Resynchronization Therapy - methods Cardiomyopathies - diagnosis Cardiomyopathies - mortality Cardiomyopathies - therapy Defibrillators, Implantable Echocardiography, Doppler Electrocardiography - methods Female Follow-Up Studies Heart Failure - diagnosis Heart Failure - mortality Heart Failure - therapy Humans Kaplan-Meier Estimate Male Myocardial Ischemia - diagnostic imaging Myocardial Ischemia - mortality Myocardial Ischemia - therapy Prospective Studies Risk Assessment Statistics, Nonparametric Survival Rate Tachycardia, Ventricular - diagnosis Tachycardia, Ventricular - therapy Treatment Outcome Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - mortality Ventricular Dysfunction, Left - therapy |
| title | A Randomized Study of Cardiac Resynchronization Therapy Defibrillator Versus Dual-Chamber Implantable Cardioverter-Defibrillator in Ischemic Cardiomyopathy With Narrow QRS: The NARROW-CRT Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T17%3A04%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Randomized%20Study%20of%20Cardiac%20Resynchronization%20Therapy%20Defibrillator%20Versus%20Dual-Chamber%20Implantable%20Cardioverter-Defibrillator%20in%20Ischemic%20Cardiomyopathy%20With%20Narrow%20QRS:%20The%20NARROW-CRT%20Study&rft.jtitle=Circulation.%20Arrhythmia%20and%20electrophysiology&rft.au=Muto,%20Carmine&rft.date=2013-06&rft.volume=6&rft.issue=3&rft.spage=538&rft.epage=545&rft.pages=538-545&rft.issn=1941-3149&rft.eissn=1941-3084&rft_id=info:doi/10.1161/CIRCEP.113.000135&rft_dat=%3Cproquest_cross%3E1370124356%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1370124356&rft_id=info:pmid/23592833&rfr_iscdi=true |