Loading…

Novel Mechanism for Disrupted Circadian Blood Pressure Rhythm in a Rat Model of Metabolic Syndrome—The Critical Role of Angiotensin II

Background This study was performed to determine the characteristics and mechanism of hypertension in SHR/NDmcr‐cp(+/+) rats (SHRcp), a new model of metabolic syndrome, with a focus on the autonomic nervous system, aldosterone, and angiotensin II. Methods and Results We measured arterial blood press...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American Heart Association 2013-06, Vol.2 (3), p.e000035-n/a
Main Authors: Sueta, Daisuke, Kataoka, Keiichiro, Koibuchi, Nobutaka, Toyama, Kensuke, Uekawa, Ken, Katayama, Tetsuji, MingJie, Ma, Nakagawa, Takashi, Waki, Hidefumi, Maeda, Masanobu, Yasuda, Osamu, Matsui, Kunihiko, Ogawa, Hisao, Kim‐Mitsuyama, Shokei
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c5041-8e86b19076ea2e97149292f68d5741e01f89b4ed8ff303a60227e5a48486f4573
cites cdi_FETCH-LOGICAL-c5041-8e86b19076ea2e97149292f68d5741e01f89b4ed8ff303a60227e5a48486f4573
container_end_page n/a
container_issue 3
container_start_page e000035
container_title Journal of the American Heart Association
container_volume 2
creator Sueta, Daisuke
Kataoka, Keiichiro
Koibuchi, Nobutaka
Toyama, Kensuke
Uekawa, Ken
Katayama, Tetsuji
MingJie, Ma
Nakagawa, Takashi
Waki, Hidefumi
Maeda, Masanobu
Yasuda, Osamu
Matsui, Kunihiko
Ogawa, Hisao
Kim‐Mitsuyama, Shokei
description Background This study was performed to determine the characteristics and mechanism of hypertension in SHR/NDmcr‐cp(+/+) rats (SHRcp), a new model of metabolic syndrome, with a focus on the autonomic nervous system, aldosterone, and angiotensin II. Methods and Results We measured arterial blood pressure (BP) in SHRcp by radiotelemetry combined with spectral analysis using a fast Fourier transformation algorithm and examined the effect of azilsartan, an AT1 receptor blocker. Compared with control Wistar‐Kyoto rats (WKY) and SHR, SHRcp exhibited a nondipper‐type hypertension and displayed increased urinary norepinephrine excretion and increased urinary and plasma aldosterone levels. Compared with WKY and SHR, SHRcp were characterized by an increase in the low‐frequency power (LF) of systolic BP and a decrease in spontaneous baroreflex gain (sBRG), indicating autonomic dysfunction. Thus, SHRcp are regarded as a useful model of human hypertension with metabolic syndrome. Oral administration of azilsartan once daily persistently lowered BP during the light period (inactive phase) and the dark period (active phase) in SHRcp more than in WKY and SHR. Thus, angiotensin II seems to be involved in the mechanism of disrupted diurnal BP rhythm in SHRcp. Azilsartan significantly reduced urinary norepinephrine and aldosterone excretion and significantly increased urinary sodium excretion in SHRcp. Furthermore, azilsartan significantly reduced LF of systolic BP and significantly increased sBRG in SHRcp. Conclusions These results strongly suggest that impairment of autonomic function and increased aldosterone in SHRcp mediate the effect of angiotensin II on circadian blood pressure rhythms.
doi_str_mv 10.1161/JAHA.113.000035
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3698757</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1347465173</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5041-8e86b19076ea2e97149292f68d5741e01f89b4ed8ff303a60227e5a48486f4573</originalsourceid><addsrcrecordid>eNqFkctu1DAUhiNERavSNTvkJZtpfYsvG6RhuHRQL2goa8uTnDRGTjzYSdHsuuwD8IQ8CQ7TVmWFNz5H5_N3LP1F8YrgY0IEOfk8P53nih3jfFj5rDigmMuZ1go_f1LvF0cpfZ8YQSUr9YtinzJB86Q8KO4uwg14dA5Va3uXOtSEiN67FMfNADVauFjZ2tkevfMh1OhLhJTGCGjVboe2Q65HFq3sgM5DnTWhyabBroN3Ffq67esYOvh9--uqBbSIbnCV9WgVPEzkvL92YYA-Zcly-bLYa6xPcHR_HxbfPn64WpzOzi4_LRfzs1lVYk5mCpRYE42lAEtBS8I11bQRqi4lJ4BJo_SaQ62ahmFmBaZUQmm54ko0vJTssHi7827GdQd1Bf0QrTeb6DobtyZYZ_6d9K411-HGMKGV_Ct4cy-I4ccIaTCdSxV4b3sIYzKEcclFSSTL6MkOrWJIKULzuIZgM0Vopghzxcwuwvzi9dPfPfIPgWWA74CfzsP2f76pZzT3fwDZfaeT</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1347465173</pqid></control><display><type>article</type><title>Novel Mechanism for Disrupted Circadian Blood Pressure Rhythm in a Rat Model of Metabolic Syndrome—The Critical Role of Angiotensin II</title><source>Wiley-Blackwell Open Access Collection</source><source>Open Access: PubMed Central</source><creator>Sueta, Daisuke ; Kataoka, Keiichiro ; Koibuchi, Nobutaka ; Toyama, Kensuke ; Uekawa, Ken ; Katayama, Tetsuji ; MingJie, Ma ; Nakagawa, Takashi ; Waki, Hidefumi ; Maeda, Masanobu ; Yasuda, Osamu ; Matsui, Kunihiko ; Ogawa, Hisao ; Kim‐Mitsuyama, Shokei</creator><creatorcontrib>Sueta, Daisuke ; Kataoka, Keiichiro ; Koibuchi, Nobutaka ; Toyama, Kensuke ; Uekawa, Ken ; Katayama, Tetsuji ; MingJie, Ma ; Nakagawa, Takashi ; Waki, Hidefumi ; Maeda, Masanobu ; Yasuda, Osamu ; Matsui, Kunihiko ; Ogawa, Hisao ; Kim‐Mitsuyama, Shokei</creatorcontrib><description>Background This study was performed to determine the characteristics and mechanism of hypertension in SHR/NDmcr‐cp(+/+) rats (SHRcp), a new model of metabolic syndrome, with a focus on the autonomic nervous system, aldosterone, and angiotensin II. Methods and Results We measured arterial blood pressure (BP) in SHRcp by radiotelemetry combined with spectral analysis using a fast Fourier transformation algorithm and examined the effect of azilsartan, an AT1 receptor blocker. Compared with control Wistar‐Kyoto rats (WKY) and SHR, SHRcp exhibited a nondipper‐type hypertension and displayed increased urinary norepinephrine excretion and increased urinary and plasma aldosterone levels. Compared with WKY and SHR, SHRcp were characterized by an increase in the low‐frequency power (LF) of systolic BP and a decrease in spontaneous baroreflex gain (sBRG), indicating autonomic dysfunction. Thus, SHRcp are regarded as a useful model of human hypertension with metabolic syndrome. Oral administration of azilsartan once daily persistently lowered BP during the light period (inactive phase) and the dark period (active phase) in SHRcp more than in WKY and SHR. Thus, angiotensin II seems to be involved in the mechanism of disrupted diurnal BP rhythm in SHRcp. Azilsartan significantly reduced urinary norepinephrine and aldosterone excretion and significantly increased urinary sodium excretion in SHRcp. Furthermore, azilsartan significantly reduced LF of systolic BP and significantly increased sBRG in SHRcp. Conclusions These results strongly suggest that impairment of autonomic function and increased aldosterone in SHRcp mediate the effect of angiotensin II on circadian blood pressure rhythms.</description><identifier>ISSN: 2047-9980</identifier><identifier>EISSN: 2047-9980</identifier><identifier>DOI: 10.1161/JAHA.113.000035</identifier><identifier>PMID: 23629805</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aldosterone - physiology ; angiotensin ; Angiotensin II - physiology ; Animals ; Blood Pressure - physiology ; Circadian Rhythm ; Disease Models, Animal ; hypertension ; Hypertension - complications ; Hypertension - physiopathology ; Male ; Metabolic Syndrome - complications ; Metabolic Syndrome - physiopathology ; nervous system ; obesity ; Original Research ; Rats, Inbred SHR ; Rats, Inbred WKY ; sympathetic</subject><ispartof>Journal of the American Heart Association, 2013-06, Vol.2 (3), p.e000035-n/a</ispartof><rights>2013 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley‐Blackwell.</rights><rights>2013 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley-Blackwell. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5041-8e86b19076ea2e97149292f68d5741e01f89b4ed8ff303a60227e5a48486f4573</citedby><cites>FETCH-LOGICAL-c5041-8e86b19076ea2e97149292f68d5741e01f89b4ed8ff303a60227e5a48486f4573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698757/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698757/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11561,27923,27924,46051,46475,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23629805$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sueta, Daisuke</creatorcontrib><creatorcontrib>Kataoka, Keiichiro</creatorcontrib><creatorcontrib>Koibuchi, Nobutaka</creatorcontrib><creatorcontrib>Toyama, Kensuke</creatorcontrib><creatorcontrib>Uekawa, Ken</creatorcontrib><creatorcontrib>Katayama, Tetsuji</creatorcontrib><creatorcontrib>MingJie, Ma</creatorcontrib><creatorcontrib>Nakagawa, Takashi</creatorcontrib><creatorcontrib>Waki, Hidefumi</creatorcontrib><creatorcontrib>Maeda, Masanobu</creatorcontrib><creatorcontrib>Yasuda, Osamu</creatorcontrib><creatorcontrib>Matsui, Kunihiko</creatorcontrib><creatorcontrib>Ogawa, Hisao</creatorcontrib><creatorcontrib>Kim‐Mitsuyama, Shokei</creatorcontrib><title>Novel Mechanism for Disrupted Circadian Blood Pressure Rhythm in a Rat Model of Metabolic Syndrome—The Critical Role of Angiotensin II</title><title>Journal of the American Heart Association</title><addtitle>J Am Heart Assoc</addtitle><description>Background This study was performed to determine the characteristics and mechanism of hypertension in SHR/NDmcr‐cp(+/+) rats (SHRcp), a new model of metabolic syndrome, with a focus on the autonomic nervous system, aldosterone, and angiotensin II. Methods and Results We measured arterial blood pressure (BP) in SHRcp by radiotelemetry combined with spectral analysis using a fast Fourier transformation algorithm and examined the effect of azilsartan, an AT1 receptor blocker. Compared with control Wistar‐Kyoto rats (WKY) and SHR, SHRcp exhibited a nondipper‐type hypertension and displayed increased urinary norepinephrine excretion and increased urinary and plasma aldosterone levels. Compared with WKY and SHR, SHRcp were characterized by an increase in the low‐frequency power (LF) of systolic BP and a decrease in spontaneous baroreflex gain (sBRG), indicating autonomic dysfunction. Thus, SHRcp are regarded as a useful model of human hypertension with metabolic syndrome. Oral administration of azilsartan once daily persistently lowered BP during the light period (inactive phase) and the dark period (active phase) in SHRcp more than in WKY and SHR. Thus, angiotensin II seems to be involved in the mechanism of disrupted diurnal BP rhythm in SHRcp. Azilsartan significantly reduced urinary norepinephrine and aldosterone excretion and significantly increased urinary sodium excretion in SHRcp. Furthermore, azilsartan significantly reduced LF of systolic BP and significantly increased sBRG in SHRcp. Conclusions These results strongly suggest that impairment of autonomic function and increased aldosterone in SHRcp mediate the effect of angiotensin II on circadian blood pressure rhythms.</description><subject>Aldosterone - physiology</subject><subject>angiotensin</subject><subject>Angiotensin II - physiology</subject><subject>Animals</subject><subject>Blood Pressure - physiology</subject><subject>Circadian Rhythm</subject><subject>Disease Models, Animal</subject><subject>hypertension</subject><subject>Hypertension - complications</subject><subject>Hypertension - physiopathology</subject><subject>Male</subject><subject>Metabolic Syndrome - complications</subject><subject>Metabolic Syndrome - physiopathology</subject><subject>nervous system</subject><subject>obesity</subject><subject>Original Research</subject><subject>Rats, Inbred SHR</subject><subject>Rats, Inbred WKY</subject><subject>sympathetic</subject><issn>2047-9980</issn><issn>2047-9980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNqFkctu1DAUhiNERavSNTvkJZtpfYsvG6RhuHRQL2goa8uTnDRGTjzYSdHsuuwD8IQ8CQ7TVmWFNz5H5_N3LP1F8YrgY0IEOfk8P53nih3jfFj5rDigmMuZ1go_f1LvF0cpfZ8YQSUr9YtinzJB86Q8KO4uwg14dA5Va3uXOtSEiN67FMfNADVauFjZ2tkevfMh1OhLhJTGCGjVboe2Q65HFq3sgM5DnTWhyabBroN3Ffq67esYOvh9--uqBbSIbnCV9WgVPEzkvL92YYA-Zcly-bLYa6xPcHR_HxbfPn64WpzOzi4_LRfzs1lVYk5mCpRYE42lAEtBS8I11bQRqi4lJ4BJo_SaQ62ahmFmBaZUQmm54ko0vJTssHi7827GdQd1Bf0QrTeb6DobtyZYZ_6d9K411-HGMKGV_Ct4cy-I4ccIaTCdSxV4b3sIYzKEcclFSSTL6MkOrWJIKULzuIZgM0Vopghzxcwuwvzi9dPfPfIPgWWA74CfzsP2f76pZzT3fwDZfaeT</recordid><startdate>201306</startdate><enddate>201306</enddate><creator>Sueta, Daisuke</creator><creator>Kataoka, Keiichiro</creator><creator>Koibuchi, Nobutaka</creator><creator>Toyama, Kensuke</creator><creator>Uekawa, Ken</creator><creator>Katayama, Tetsuji</creator><creator>MingJie, Ma</creator><creator>Nakagawa, Takashi</creator><creator>Waki, Hidefumi</creator><creator>Maeda, Masanobu</creator><creator>Yasuda, Osamu</creator><creator>Matsui, Kunihiko</creator><creator>Ogawa, Hisao</creator><creator>Kim‐Mitsuyama, Shokei</creator><general>Blackwell Publishing Ltd</general><scope>24P</scope><scope>WIN</scope><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><scope>5PM</scope></search><sort><creationdate>201306</creationdate><title>Novel Mechanism for Disrupted Circadian Blood Pressure Rhythm in a Rat Model of Metabolic Syndrome—The Critical Role of Angiotensin II</title><author>Sueta, Daisuke ; Kataoka, Keiichiro ; Koibuchi, Nobutaka ; Toyama, Kensuke ; Uekawa, Ken ; Katayama, Tetsuji ; MingJie, Ma ; Nakagawa, Takashi ; Waki, Hidefumi ; Maeda, Masanobu ; Yasuda, Osamu ; Matsui, Kunihiko ; Ogawa, Hisao ; Kim‐Mitsuyama, Shokei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5041-8e86b19076ea2e97149292f68d5741e01f89b4ed8ff303a60227e5a48486f4573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aldosterone - physiology</topic><topic>angiotensin</topic><topic>Angiotensin II - physiology</topic><topic>Animals</topic><topic>Blood Pressure - physiology</topic><topic>Circadian Rhythm</topic><topic>Disease Models, Animal</topic><topic>hypertension</topic><topic>Hypertension - complications</topic><topic>Hypertension - physiopathology</topic><topic>Male</topic><topic>Metabolic Syndrome - complications</topic><topic>Metabolic Syndrome - physiopathology</topic><topic>nervous system</topic><topic>obesity</topic><topic>Original Research</topic><topic>Rats, Inbred SHR</topic><topic>Rats, Inbred WKY</topic><topic>sympathetic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sueta, Daisuke</creatorcontrib><creatorcontrib>Kataoka, Keiichiro</creatorcontrib><creatorcontrib>Koibuchi, Nobutaka</creatorcontrib><creatorcontrib>Toyama, Kensuke</creatorcontrib><creatorcontrib>Uekawa, Ken</creatorcontrib><creatorcontrib>Katayama, Tetsuji</creatorcontrib><creatorcontrib>MingJie, Ma</creatorcontrib><creatorcontrib>Nakagawa, Takashi</creatorcontrib><creatorcontrib>Waki, Hidefumi</creatorcontrib><creatorcontrib>Maeda, Masanobu</creatorcontrib><creatorcontrib>Yasuda, Osamu</creatorcontrib><creatorcontrib>Matsui, Kunihiko</creatorcontrib><creatorcontrib>Ogawa, Hisao</creatorcontrib><creatorcontrib>Kim‐Mitsuyama, Shokei</creatorcontrib><collection>Wiley-Blackwell Open Access Collection</collection><collection>Wiley Online Library Open Access</collection><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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American Heart Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sueta, Daisuke</au><au>Kataoka, Keiichiro</au><au>Koibuchi, Nobutaka</au><au>Toyama, Kensuke</au><au>Uekawa, Ken</au><au>Katayama, Tetsuji</au><au>MingJie, Ma</au><au>Nakagawa, Takashi</au><au>Waki, Hidefumi</au><au>Maeda, Masanobu</au><au>Yasuda, Osamu</au><au>Matsui, Kunihiko</au><au>Ogawa, Hisao</au><au>Kim‐Mitsuyama, Shokei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Novel Mechanism for Disrupted Circadian Blood Pressure Rhythm in a Rat Model of Metabolic Syndrome—The Critical Role of Angiotensin II</atitle><jtitle>Journal of the American Heart Association</jtitle><addtitle>J Am Heart Assoc</addtitle><date>2013-06</date><risdate>2013</risdate><volume>2</volume><issue>3</issue><spage>e000035</spage><epage>n/a</epage><pages>e000035-n/a</pages><issn>2047-9980</issn><eissn>2047-9980</eissn><abstract>Background This study was performed to determine the characteristics and mechanism of hypertension in SHR/NDmcr‐cp(+/+) rats (SHRcp), a new model of metabolic syndrome, with a focus on the autonomic nervous system, aldosterone, and angiotensin II. Methods and Results We measured arterial blood pressure (BP) in SHRcp by radiotelemetry combined with spectral analysis using a fast Fourier transformation algorithm and examined the effect of azilsartan, an AT1 receptor blocker. Compared with control Wistar‐Kyoto rats (WKY) and SHR, SHRcp exhibited a nondipper‐type hypertension and displayed increased urinary norepinephrine excretion and increased urinary and plasma aldosterone levels. Compared with WKY and SHR, SHRcp were characterized by an increase in the low‐frequency power (LF) of systolic BP and a decrease in spontaneous baroreflex gain (sBRG), indicating autonomic dysfunction. Thus, SHRcp are regarded as a useful model of human hypertension with metabolic syndrome. Oral administration of azilsartan once daily persistently lowered BP during the light period (inactive phase) and the dark period (active phase) in SHRcp more than in WKY and SHR. Thus, angiotensin II seems to be involved in the mechanism of disrupted diurnal BP rhythm in SHRcp. Azilsartan significantly reduced urinary norepinephrine and aldosterone excretion and significantly increased urinary sodium excretion in SHRcp. Furthermore, azilsartan significantly reduced LF of systolic BP and significantly increased sBRG in SHRcp. Conclusions These results strongly suggest that impairment of autonomic function and increased aldosterone in SHRcp mediate the effect of angiotensin II on circadian blood pressure rhythms.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>23629805</pmid><doi>10.1161/JAHA.113.000035</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2047-9980
ispartof Journal of the American Heart Association, 2013-06, Vol.2 (3), p.e000035-n/a
issn 2047-9980
2047-9980
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3698757
source Wiley-Blackwell Open Access Collection; Open Access: PubMed Central
subjects Aldosterone - physiology
angiotensin
Angiotensin II - physiology
Animals
Blood Pressure - physiology
Circadian Rhythm
Disease Models, Animal
hypertension
Hypertension - complications
Hypertension - physiopathology
Male
Metabolic Syndrome - complications
Metabolic Syndrome - physiopathology
nervous system
obesity
Original Research
Rats, Inbred SHR
Rats, Inbred WKY
sympathetic
title Novel Mechanism for Disrupted Circadian Blood Pressure Rhythm in a Rat Model of Metabolic Syndrome—The Critical Role of Angiotensin II
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T08%3A41%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Novel%20Mechanism%20for%20Disrupted%20Circadian%20Blood%20Pressure%20Rhythm%20in%20a%20Rat%20Model%20of%20Metabolic%20Syndrome%E2%80%94The%20Critical%20Role%20of%20Angiotensin%20II&rft.jtitle=Journal%20of%20the%20American%20Heart%20Association&rft.au=Sueta,%20Daisuke&rft.date=2013-06&rft.volume=2&rft.issue=3&rft.spage=e000035&rft.epage=n/a&rft.pages=e000035-n/a&rft.issn=2047-9980&rft.eissn=2047-9980&rft_id=info:doi/10.1161/JAHA.113.000035&rft_dat=%3Cproquest_pubme%3E1347465173%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c5041-8e86b19076ea2e97149292f68d5741e01f89b4ed8ff303a60227e5a48486f4573%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1347465173&rft_id=info:pmid/23629805&rfr_iscdi=true