المؤلفون: Delombaerde, Danielle, De Sutter, Johan, Croes, Lieselot, Vervloet, Delphine, Moerman, Veronique, Van De Veire, Nico, Willems, Anne Marie, Wouters, Kristien, Peeters, Michel, Prenen, Hans, Vulsteke, Christof

المصدر: Pharmaceuticals, 16 (4

مصطلحات موضوعية: Sciences pharmaceutiques, Biologie moléculaire, biomarker, cardiac troponin, cardio-oncology, cardiotoxicity, diastolic function, immune checkpoint inhibitor, immune-related adverse event, myocarditis, subclinical cardiotoxicity

الوصف: Background: The increasing use of immune checkpoint inhibitors (ICIs) in the treatment of both advanced and early stages of various malignancies has resulted in a substantial increase in the incidence of cardiovascular (CV) immune-related adverse events (irAEs). The current follow-up guidelines are based on anecdotal evidence and expert opinions, due to a lack of solid data and prospective studies. As many questions remain unanswered, cardiac monitoring, in patients receiving ICIs, is not always implemented by oncologists. Hence, an urgent need to investigate the possible short- and long-term CV effects of ICIs, as ICI approval is continuing to expand to the (neo)adjuvant setting. Methods: We have initiated a prospective, multicenter study, i.e. the CAVACI trial, in which a minimum of 276 patients with a solid tumor, eligible for ICI treatment, will be enrolled. The study consists of routine investigations of blood parameters (troponin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, in particular) and a thorough CV follow-up (electrocardiograms, transthoracic echocardiograms, and coronary calcium scoring) at fixed time points for a total period of two years. The primary endpoint is the cumulative incidence of troponin elevation in the first three months of ICI treatment, compared to baseline levels. Furthermore, secondary endpoints include incidence above the upper limit of normal of both troponin and NT-proBNP levels, evolution in troponin and NT-proBNP levels, the incidence of CV abnormalities/major adverse cardiac events, evaluation of associations between patient characteristics/biochemical parameters and CV events, transthoracic echocardiography parameters, electrocardiography parameters, and progression of coronary atherosclerosis. Recruitment of patients started in January 2022. Enrolment is ongoing in AZ Maria Middelares, Antwerp University Hospital, AZ Sint-Vincentius Deinze, and AZ Sint-Elisabeth Zottegem. Trial registration: ClinicalTrials.gov Identifier: NCT05699915, registered 26 ...

وصف الملف: 1 full-text file(s): application/pdf

العلاقة: uri/info:doi/10.3390/ph16040625; uri/info:scp/85154555043; https://dipot.ulb.ac.be/dspace/bitstream/2013/371130/1/doi_354774.pdfTest; http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/371130Test

الإتاحة: http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/371130Test

المؤلفون: Manganaro, Roberta, MARCHETTA, Stella, DULGHERU, Raluca Elena, Sugimoto, Tadafumi, Tsugu, Toshimitsu, Ilardi, Federica, Cicenia, Marianna, ANCION, Arnaud, Postolache, Adriana, Martinez, Christophe, Kacharava, George, Athanassopoulos, George D., Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andreas, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A., Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Dragos, Zamorano, Jose Luis, Rosca, Monica, Calin, Andreea, Moonen, Marie, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Carerj, Scipione, Zito, Concetta, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P., Lang, Roberto M., Lancellotti, Patrizio

المصدر: European Heart Journal. Cardiovascular Imaging, 21, 533-541 (2020-05)

مصطلحات موضوعية: adult echocardiography, myocardial strain, myocardial work, speckle tracking echocardiography, Human health sciences, Cardiovascular & respiratory systems, Sciences de la santé humaine, Systèmes cardiovasculaire & respiratoire

الوصف: peer reviewed ; AIMS: The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE). METHODS AND RESULTS: A total of 226 (85 men, mean age: 45 +/- 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = -0.23, P < 0.001), ejection fraction (EF) (standardized beta-coefficient = 0.15, P = 0.02), systolic blood pressure (SBP) (standardized beta-coefficient = 0.56, P < 0.001) and GRS (standardized beta-coefficient = 0.19, P = 0.004), while GCW was correlated with GLS (standardized beta-coefficient = -0.55, P < 0.001), SBP (standardized beta-coefficient = 0.71, P < 0.001), GRS (standardized beta-coefficient = 0.11, P = 0.02), and GCS (standardized beta-coefficient = -0.10, P = 0.01). GWE was directly correlated with EF and inversely correlated with Tei index (standardized beta-coefficient = 0.18, P = 0.009 and standardized beta-coefficient = -0.20, P = 0.004, respectively), the opposite occurred for GWW (standardized beta-coefficient =--0.14, P = 0.03 and standardized beta-coefficient = 0.17, P = 0.01, respectively). CONCLUSION: The non-invasive MW indices show a good correlation with traditional 2DE ...

العلاقة: urn:issn:2047-2404; urn:issn:2047-2412; https://orbi.uliege.be/handle/2268/248109Test; info:hdl:2268/248109; https://orbi.uliege.be/bitstream/2268/248109/1/jez203.pdfTest; scopus-id:2-s2.0-85083913496; info:pmid:31408147

الإتاحة: https://doi.org/10.1093/ehjci/jez203Test
https://orbi.uliege.be/handle/2268/248109Test
https://orbi.uliege.be/bitstream/2268/248109/1/jez203.pdfTest

المؤلفون: Tsugu, Toshimitsu, Postolache, Adriana, DULGHERU, Raluca Elena, Sugimoto, Tadafumi, TRIDETTI, Julien, NGUYEN TRUNG, Mai-Linh, PIETTE, Caroline, MOONEN, Marie, Manganaro, Roberta, Ilardi, Federica, Chitroceanu, Alexandra Maria, Sperlongano, Simona, Go, Yun Yun, Kacharava, George, Athanassopoulos, George D., Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andreas, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A., Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Dragos, Zamorano, Jose Luis, Rosca, Monica, Calin, Andreea, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P., Lang, Roberto M., Lancellotti, Patrizio

المصدر: European Heart Journal. Cardiovascular Imaging (2020)

مصطلحات موضوعية: 2D echocardiography, adult echocardiography, deformation imaging, reference values, Human health sciences, Cardiovascular & respiratory systems, Sciences de la santé humaine, Systèmes cardiovasculaire & respiratoire

الوصف: peer reviewed ; AIMS : To obtain the normal range for 2D echocardiographic (2DE) measurements of left ventricular (LV) layer-specific strain from a large group of healthy volunteers of both genders over a wide range of ages. METHODS AND RESULTS : A total of 287 (109 men, mean age: 46 +/- 14 years) healthy subjects were enrolled at 22 collaborating institutions of the EACVI Normal Reference Ranges for Echocardiography (NORRE) study. Layer-specific strain was analysed from the apical two-, three-, and four-chamber views using 2DE software. The lowest values of layer-specific strain calculated as +/-1.96 standard deviations from the mean were -15.0% in men and -15.6% in women for epicardial strain, -16.8% and -17.7% for mid-myocardial strain, and -18.7% and -19.9% for endocardial strain, respectively. Basal-epicardial and mid-myocardial strain decreased with age in women (epicardial; P = 0.008, mid-myocardial; P = 0.003) and correlated with age (epicardial; r = -0.20, P = 0.007, mid-myocardial; r = -0.21, P = 0.006, endocardial; r = -0.23, P = 0.002), whereas apical-epicardial, mid-myocardial strain increased with the age in women (epicardial; P = 0.006, mid-myocardial; P = 0.03) and correlated with age (epicardial; r = 0.16, P = 0.04). End/Epi ratio at the apex was higher than at the middle and basal levels of LV in men (apex; 1.6 +/- 0.2, middle; 1.2 +/- 0.1, base 1.1 +/- 0.1) and women (apex; 1.6 +/- 0.1, middle; 1.1 +/- 0.1, base 1.2 +/- 0.1). CONCLUSION : The NORRE study provides useful 2DE reference ranges for novel indices of layer-specific strain.

العلاقة: urn:issn:2047-2404; urn:issn:2047-2412; https://orbi.uliege.be/handle/2268/249469Test; info:hdl:2268/249469; https://orbi.uliege.be/bitstream/2268/249469/1/Echocardiographic%20reference%20ranges%20for%20normal%20left%20ventricular%20layer-specific%20strain-%20results%20from%20the%20EACVI%20NORRE%20study.pdfTest; scopus-id:2-s2.0-85088494543; info:pmid:32259844

الإتاحة: https://doi.org/10.1093/ehjci/jeaa050Test
https://orbi.uliege.be/handle/2268/249469Test
https://orbi.uliege.be/bitstream/2268/249469/1/Echocardiographic%20reference%20ranges%20for%20normal%20left%20ventricular%20layer-specific%20strain-%20results%20from%20the%20EACVI%20NORRE%20study.pdfTest

المؤلفون: Reiber, Johan H. C., Pereira, Gabriel T. R., Dallan, Luis A. P., Bezerra, Hiram G., De Sutter, Johan, Stillman, Arthur E., Van de Veire, Nico R. L., Lotz, Joachim

المصدر: The International Journal of Cardiovascular Imaging ; volume 36, issue 5, page 769-787 ; ISSN 1569-5794 1573-0743

مصطلحات موضوعية: Cardiology and Cardiovascular Medicine, Radiology, Nuclear Medicine and imaging

الإتاحة: https://doi.org/10.1007/s10554-020-01845-1Test

المؤلفون: Delgado, Victoria, Ajmone Marsan, Nina, de Waha, Suzanne, Bonaros, Nikolaos, Brida, Margarita, Burri, Haran, Caselli, Stefano, Doenst, Torsten, Ederhy, Stephane, Erba, Paola Anna, Foldager, Dan, Fosbøl, Emil L, Kovac, Jan, Mestres, Carlos A, Miller, Owen I, Miro, Jose M, Pazdernik, Michal, Pizzi, Maria Nazarena, Quintana, Eduard, Rasmussen, Trine Bernholdt, Ristić, Arsen D, Rodés-Cabau, Josep, Sionis, Alessandro, Zühlke, Liesl Joanna, Borger, Michael A, Iung, Bernard, Prendergast, Bernard, Abdelhamid, Magdy, Adamo, Marianna, Asteggiano, Riccardo, Baddour, Larry M, Čelutkienė, Jelena, Chambers, John, Deharo, Jean-Claude, Doehner, Wolfram, Dos Subira, Laura, Duval, Xavier, Falk, Volkmar, Fauchier, Laurent, Fernandez-Hidalgo, Nuria, Giske, Christian, Gombošová, Anežka, Habib, Gilbert, Ibanez, Borja, Jaarsma, Tiny, Køber, Lars, Koskinas, Konstantinos C, Kotecha, Dipak, Landmesser, Ulf, Lauck, Sandra B, Lewis, Basil S, Løchen, Maja-Lisa, McEvoy, John William, Mihaylova, Borislava, Mindham, Richard, Neubeck, Lis, Nielsen, Jens Cosedis, Obadia, Jean-François, Pasquet, Agnes A, Petersen, Steffen, Prescott, Eva, Price, Susanna, Rakisheva, Amina, Rao, Archana, Rouzet, François, Sandoe, Jonathan, Schnabel, Renate B, Selton-Suty, Christine, Sondergaard, Lars, Thornhill, Martin, Toutouzas, Konstantinos, Van de Veire, Nico, Vilacosta, Isidre, Vrints, Christiaan, Wendler, Olaf, Benchabi, Yasmina, Chilingaryan, Aram, Reinstadler, Sebastian J, Samadov, Fuad, Paelinck, Bernard, Kušljugić, Zumreta, Kinova, Elena, Cikes, Maja, Michaloliakos, Ioannis, Mates, Martin, Povlsen, Jonas Agerlund, Abdelghani, Mohammad, Küünal-Arge, Liisi, Rajala, Helena, Pagava, Zurab, Franz, Marcus, Patrianakos, Alexandros, Barta, Judit, Hrafnkelsdóttir, Þórdís Jóna, Moore, David, Orvin, Katia, Oliva, Fabrizio, Zhussupova, Gyulnar, Bajraktari, Gani, Kerimkulova, Alina, Kamzola, Ginta, Habib, Pierrette, Mizarienė, Vaida, Sow, Rouguiatou, Demarco, Daniela Cassar, Panfile, Elena, Bendriss, Laila, Tanis, Wilco, Mitevska, Irena, Aune, Erlend, Antunes, Manuel, Popescu, Bogdan A, Bini, Roberto, Tesic, Milorad, Orban, Marek, Bervar, Mojca, Christersson, Christina, Frank, Michelle, Zakhama, Lilia, Guler, Gamze Babur, Cherniuk, Sergii, Woldman, Simon, Srojidinova, Nigora, James, Stefan, Arbelo, Elena, Baigent, Colin, Buccheri, Sergio, Rocca, Bianca, Rossello, Xavier, Vaartjes, Ilonca, Witkowski, Adam, Zeppenfeld, Katja

المصدر: https://academic.oup.com/eurheartj/article/44/39/3948/7243107Test ; European Heart Journal ; Volume 44 ; Issue 39 ; ISSN 0195-668X (Print) ; ISSN 1522-9645 (Online.

مصطلحات موضوعية: BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine

وصف الملف: application/pdf

العلاقة: Sveučilište u Rijeci. Medicinski fakultet. Katedra za internu medicinu.; University of Rijeka. Faculty of Medicine. Department of Internal Medicine.; https://www.unirepository.svkri.uniri.hr/islandora/object/medri:8329Test; https://urn.nsk.hr/urn:nbn:hr:184:842119Test; https://www.unirepository.svkri.uniri.hr/islandora/object/medri:8329/datastream/FILE0Test

الإتاحة: https://doi.org/10.1093/eurheartj/ehad193Test
https://www.unirepository.svkri.uniri.hr/islandora/object/medri:8329Test
https://urn.nsk.hr/urn:nbn:hr:184:842119Test
https://www.unirepository.svkri.uniri.hr/islandora/object/medri:8329/datastream/FILE0Test

المؤلفون: Manganaro, Roberta, MARCHETTA, Stella, Dulgheru, Raluca Elena, Ilardi, Federica, Sugimoto, Tadafumi, ROBINET, Sébastien, Cimino, Sara, Go, Yun Yun, Bernard, Anne, Kacharava, George, Athanassopoulos, George, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andreas, Hristova, Krasimira, Lopez-Fernandez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan Alexandru, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Dragos, Zamorano, Jose Luis, Rosca, Monica, Calin, Andreea, Moonen, Marie, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Carerj, Scipione, Zito, Concetta, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P., Lang, Roberto M., Oury, Cécile, Lancellotti, Patrizio

المصدر: European Heart Journal. Cardiovascular Imaging (2019)

مصطلحات موضوعية: Human health sciences, Cardiovascular & respiratory systems, Sciences de la santé humaine, Systèmes cardiovasculaire & respiratoire

الوصف: peer reviewed ; Aims: To obtain the normal ranges for 2D echocardiographic (2DE) indices of myocardial work (MW) from a large group of healthy volunteers over a wide range of ages and gender. Methods and results: A total of 226 (85 men, mean age: 45 +/- 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from left ventricle (LV) pressure-strain loops. Peak LV systolic pressure was non-invasively derived from brachial artery cuff pressure. The lowest values of MW indices in men and women were 1270 mmHg% and 1310 mmHg% for GWI, 1650 mmHg% and 1544 mmHg% for GCW, and 90% and 91% for GWE, respectively. The highest value for GWW was 238 mmHg% in men and 239 mmHg% in women. Men had significant lower values of GWE and higher values of GWW. GWI and GCW significantly increased with age in women. Conclusion: The NORRE study provides useful 2DE reference ranges for novel indices of non-invasive MW.

العلاقة: urn:issn:2047-2404; urn:issn:2047-2412; https://orbi.uliege.be/handle/2268/231043Test; info:hdl:2268/231043; https://orbi.uliege.be/bitstream/2268/231043/1/Manganaro%20et%20al%20EHJ_Cardiovasc%20Imaging%202018.pdfTest; scopus-id:2-s2.0-85068205398; info:pmid:30590562

الإتاحة: https://doi.org/10.1093/ehjci/jey188Test
https://orbi.uliege.be/handle/2268/231043Test
https://orbi.uliege.be/bitstream/2268/231043/1/Manganaro%20et%20al%20EHJ_Cardiovasc%20Imaging%202018.pdfTest

المؤلفون: Reiber, Johan H. C., Pereira, Gabriel Tensol R., Bezerra, Hiram G., De Sutter, Johan, Schoenhagen, Paul, Stillman, Arthur E., Van de Veire, Nico R. L.

المصدر: The International Journal of Cardiovascular Imaging ; volume 35, issue 7, page 1175-1188 ; ISSN 1569-5794 1573-0743

مصطلحات موضوعية: Cardiology and Cardiovascular Medicine, Radiology, Nuclear Medicine and imaging

الإتاحة: https://doi.org/10.1007/s10554-019-01579-9Test

المؤلفون: Motoc, Andreea, Kessels, Jolien, Roosens, Bram, Lacor, Patrick, Van de Veire, Nico, De Sutter, Johan, Magne, Julien, Droogmans, Steven, Cosyns, Bernard

المصدر: Cardiology Journal; May2023, Vol. 30 Issue 3, p385-390, 6p

المؤلفون: Sugimoto, Tadafumi, ROBINET, Sébastien, DULGHERU, Raluca Elena, Bernard, Anne, Ilardi, Federica, Contu, Laura, Addetia, Karima, Caballero, Luis, Kacharava, George, Athanassopoulos, George, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andreas, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan Alexandru, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Dragos, Zamorano, Jose Luis, Go, Yun Yun, MARCHETTA, Stella, Nchimi Longang, Alain, Rosca, Monica, Calin, Andreea, MOONEN, Marie, Cimino, Sara, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Habib, Gilbert, Esposito, Roberta, Galderisi, Maurizio, Badano, Luigi P., Lang, Roberto M., Lancellotti, Patrizio

المصدر: European Heart Journal. Cardiovascular Imaging, 19 (6), 630-638 (2018)

مصطلحات موضوعية: Human health sciences, Cardiovascular & respiratory systems, Sciences de la santé humaine, Systèmes cardiovasculaire & respiratoire

الوصف: peer reviewed ; Aims: To obtain the normal ranges for echocardiographic measurements of left atrial (LA) function from a large group of healthy volunteers accounting for age and gender. Methods and results: A total of 371 (median age 45 years) healthy subjects were enrolled at 22 collaborating institutions collaborating in the Normal Reference Ranges for Echocardiography (NORRE) study of the European Association of Cardiovascular Imaging (EACVI). Left atrial data sets were analysed with a vendor-independent software (VIS) package allowing homogeneous measurements irrespective of the echocardiographic equipment used to acquire data sets. The lowest expected values of LA function were 26.1%, 48.7%, and 41.4% for left atrial strain (LAS), 2D left atrial emptying fraction (LAEF), and 3D LAEF (reservoir function); 7.7%, 24.2%, and -0.53/s for LAS-active, LAEF-active, and LA strain rate during LA contraction (SRa) (pump function) and 12.0% and 21.6% for LAS-passive and LAEF-passive (conduit function). Left atrial reservoir and conduit function were decreased with age while pump function was increased. All indices of reservoir function and all LA strains had no difference in both gender and vendor. However, inter-vendor differences were observed in LA SRa despite the use of VIS. Conclusion: The NORRE study provides contemporary, applicable echocardiographic reference ranges for LA function. Our data highlight the importance of age-specific reference values for LA functions.

العلاقة: urn:issn:2047-2404; urn:issn:2047-2412; https://orbi.uliege.be/handle/2268/229247Test; info:hdl:2268/229247; https://orbi.uliege.be/bitstream/2268/229247/1/NORRE.pdfTest; scopus-id:2-s2.0-85048197377; info:pmid:29529180

الإتاحة: https://doi.org/10.1093/ehjci/jey018Test
https://orbi.uliege.be/handle/2268/229247Test
https://orbi.uliege.be/bitstream/2268/229247/1/NORRE.pdfTest

المؤلفون: Manganaro, Roberta, Marchetta, Stella, Dulgheru, Raluca, Ilardi, Federica, Sugimoto, Tadafumi, Robinet, Sébastien, Cimino, Sara, Go, Yun Yun, Bernard, Anne, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andreas, Hristova, Krasimira, López-Fernández, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Dragos, Zamorano, Jose Luis, Rosca, Monica, Calin, Andreea, Moonen, Marie, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Carerj, Scipione, Zito, Concetta, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P, Lang, Roberto M, Oury, Cecile, Lancellotti, Patrizio

المساهمون: EACVI Research and Innovation Committee, Heart House, NORRE, GE Healthcare, Philips Healthcare

المصدر: European Heart Journal - Cardiovascular Imaging ; volume 20, issue 5, page 582-590 ; ISSN 2047-2404 2047-2412

الإتاحة: https://doi.org/10.1093/ehjci/jey188Test
http://academic.oup.com/ehjcimaging/article-pdf/20/5/582/28496487/jey188.pdfTest