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The Cardiomyopathies: A Pathophysiologic Approach to Therapeutic Management

The Cardiomyopathies: A Pathophysiologic Approach to Therapeutic Management Abstract • "Cardiomyopathies" are a disparate group of myocardial disorders, usually of unknown or obscure origin, characterized by systolic or diastolic myocardial dysfunction but involving conditions of widely divergent pathophysiology. For purposes of devising appropriate clinical management, a useful classification scheme can be created with reference to the type of pathophysiologic abnormality exhibited. On this basis, three major types can be identified: (1) congestive (poor systolic function, normal diastolic function, left ventricular dilatation without the expected degree of compensatory hypertrophy), (2) hypertrophic (supernormal systolic function, subnormal diastolic function, and pronounced left ventricular hypertrophy, usually asymmetric, without dilatation), and (3) restrictive (normal or near-normal systolic function and subnormal diastolic function, usually mild symmetrical left ventricular, without dilatation). Noninvasive identification of these pathophysiologic features can be useful in optimizing management programs. (Arch Intern Med 1983;143:2157-2162) References 1. Goodwin JF: Congestive and hypertrophic cardiomyopathies: A decade of study. Lancet 1970;1:731-739.Crossref 2. Oakley C: Diagnosis and natural history of congested (dilated) cardiomyopathies. Postgrad Med J 1978;54:440-447.Crossref 3. Henry WL, Borer JS: Echocardiographic assessment of cardiomyopathies , in Bom M (ed): Echocardiography . The Hague, Martinus Nijhoff, 1977, pp 159-173. 4. Krevlen TH, Gorlin R, Herman MV: Ventriculographic patterns and hemodynamics in primary myocardial disease. Circulation 1973;47:299-308.Crossref 5. Olsen EGJ: The pathology of cardiomyopathies: A critical analysis. Am Heart J 1979;98:385-392.Crossref 6. Kuhn H, Breithardt G, Knierim JH, et al: Prognosis and possible presymptomatic manifestations of congestive cardiomyopathy. Postgrad Med J 1978;54:451-459.Crossref 7. Olsen EGJ: Endomyocardial biopsy. Br Heart J 1978;40:95-98.Crossref 8. Mackay EW, Littler WA, Sleight P: Critical assessment of diagnostic value of endomyocardial biopsy. Br Heart J 1978;40:69-78.Crossref 9. Raftery EB, Banks DC, Oram S: Occlusive disease of the coronary arteries presenting as primary congestive cardiomyopathy. Lancet 1969;2: 1147-1150.Crossref 10. Corya BC, Feigenbaum H, Rasmussen S, et al: Echocardiographic features of congestive cardiomyopathy compared with normal subjects and patients with coronary artery disease. Circulation 1974;49:1153-1159.Crossref 11. Burch GE, Giles TD: Prolonged bed rest in the management of patients with cardiomyopathy. Cardiovasc Clin 1972;4:375-387. 12. Abellmann WH: Treatment of congestive cardiomyopathy. Postgrad Med J 1978;54:477-484.Crossref 13. Cohn JN, Franciosa JA: Vasodilator therapy of cardiac failure. N Engl J Med 1977;297:27-31,254-258.Crossref 14. Franciosa JA, Cohn JN: Sustained hemodynamic effects without tolerance during long-term isosorbide dinitrate treatment of chronic left ventricular failure. Am J Cardiol 1980;45:648-654.Crossref 15. Franciosa JA, Pierpont G, Cohn JN: Hemodynamic improvement after oral hydralazine in left ventricular failure: A comparison with nitroprusside infusion in 16 patients. Ann Intern Med 1977;86:388-393.Crossref 16. Massie B, Chatterjee K, Werner J, et al: Hemodynamic advantage of combined administration of hydralazine orally and nitrates nonparenterally in the vasodilator therapy of chronic heart failure. Am J Cardiol 1977;40: 794-801.Crossref 17. Colucci WS, Wynne J, Holman BL, et al: Long-term therapy of heart failure with prazosin: A randomized double-blind trial. Am J Cardiol 1980; 45:337-344.Crossref 18. Davis R, Ribner HS, Keung E, et al: Treatment of chronic congestive heart failure with captopril, an oral inhibitor of angiotensin-converting enzyme. N Engl J Med 1979;301:117-121.Crossref 19. Unverferth DV, Magorien RD, Lewis RP, et al: Long-term benefit of dobutamine in patients with congestive cardiomyopathy. Am Heart J 1980; 100:622-630.Crossref 20. Swedberg K, Hjalmarson A, Waagstein F, et al: Prolongation of survival in congestive cardiomyopathy by beta-receptor blockade. Lancet 1979;1:1374-1376.Crossref 21. Podrid PJ, Schoenberger A, Lown B: Congestive heart failure caused by oral disopyramide. N Engl J Med 1980;302:614-617.Crossref 22. Crawford MH, White DH, O'Rourke RA: Effects of oral quinidine on left ventricular performance in normal subjects and patients with congestive cardiomyopathy. Am J Cardiol 1979;44:714-718.Crossref 23. Lorell B, Alderman EL, Mason JW: Cardiac sarcoidosis: Diagnosis with endomyocardial biopsy and treatment with corticosteroids. Am J Cardiol 1978;42:143-146.Crossref 24. Wynne J, Braunwald E: The cardiomyopathies and myocarditides , in Braunwald E (ed): Heart Disease . Philadelphia, WB Saunders Co, 1980, P 1443. 25. Schroeder JS: Current status of cardiac transplantation: 1978. JAMA 1979;241:2069-2071.Crossref 26. Olsen EGJ: The pathology of idiopathic hypertrophie subaortic stenosis (hypertrophie cardiomyopathy): A critical review. Am Heart J 1980;100:553-562.Crossref 27. Darsee JR, Heymsfield SB, Nutter DO: Hypertrophie cardiomyopathy and human leukocyte antigen linkage. N Engl J Med 1979;300:877-882.Crossref 28. Davies MJ, Pomerance A, Teare RD: Pathologic features of hypertrophic obstructive cardiomyopathy. J Clin Pathol 1974;27:529-535.Crossref 29. Maron BJ, Epstein SE: Hypertrophie cardiomyopathy: Recent observations regarding the specificity of three hallmarks of the disease: Asymmetric septal hypertrophy, septal disorganization, and systolic anterior motion of the anterior mitral leaflet. Am J Cardiol 1980;45:141-154.Crossref 30. Frank S, Braunwald E: Idiopathic hypertrophie subaortic stenosis: Clinical analysis of 126 patients with emphasis on the natural history. Circulation 1968;37:759-788.Crossref 31. Adelman AG, Wigle ED, Ranganathan N, et al: The clinical course in muscular subaortic stenosis: A retrospective and prospective study of 60 hemodynamically proved cases. Ann Intern Med 1972;77:515-525.Crossref 32. Maron BJ, Roberts WC, Edwards JE, et al: Sudden death in patients with hypertrophie cardiomyopathy: Characterization of 26 patients without functional limitation. Am J Cardiol 1978;41:803-810.Crossref 33. Maron BJ, Lipson LC, Roberts WC, et al: 'Malignant' hypertrophie cardiomyopathy: Identification of a subgroup of families with unusually frequent premature death. Am J Cardiol 1978;41:1133-1140.Crossref 34. Savage DD, Seides SF, Maron BJ, et al: Prevalence of arrhythmias during 24-hour electrocardiographic monitoring and exercise testing in patients with obstructive and nonobstructive hypertrophie cardiomyopathy. Circulation 1979;59:866-875.Crossref 35. Epstein SE, Henry WL, Clark CE, et al: NIH Conference: Asymmetric septal hypertrophy. Ann Intern Med 1974;81:650-680.Crossref 36. Doi YL, McKenna WJ, Gehrke J, et al: M-mode echocardiography in hypertrophie cardiomyopathy: Diagnostic criteria and prediction of obstruction. Am J Cardiol 1980;45:6-14.Crossref 37. Martin RP, Rakowski H, French J, et al: Idiopathic hypertrophie subaortic stenosis viewed by wide-angle, phased-array echocardiography. Circulation 1979;59:1206-1217.Crossref 38. Chandraratna PAN, Tolentino AO, Mutricumarana W, et al: Echocardiographic observations on the association between mitral valve prolapse and asymmetric septal hypertrophy. Circulation 1977;55:622-626.Crossref 39. Hanrath P, Mathey DG, Siegert R, et al: Left ventricular relaxation and filling pattern in different forms of left ventricular hypertrophy: An echocardiographic study. Am J Cardiol 1980;45:15-23.Crossref 40. Stenson RE, Flamm MD Jr, Harrison DC, et al: Hypertrophie subaortic stenosis: Clinical and hemodynamic effects of long-term propranolol therapy. Am J Cardiol 1973;31:763-773.Crossref 41. Frank MJ, Abdulla AM, Castdo MI, et al: Long-term medical management of hypertrophie obstructive cardiomyopathy. Am J Cardiol 1978;42:993-1001.Crossref 42. Rosing DR, Kent KM, Borer JS, et al: Verapamil therapy: A new approach to the pharmacologie treatment of hypertrophie cardiomyopathy: I. Hemodynamic effects. Circulation 1979;69:1201-1207.Crossref 43. Rosing DR, Kent KM, Maron BJ, et al: Verapamil therapy: A new approach to the pharmacologie treatment of hypertrophie cardiomyopathy: II. Effects on exercise capacity and symptomatic status. Circulation 1979;60:1208-1213.Crossref 44. Kaltenbach M, Hopf R, Keller M: Calcium antagonistiche Therapie bei hypertroph-obstruktiver Kardiomyopathie. Dtsch Med Wochenschr 1976;101:1284-1287.Crossref 45. Kaplan EL, Anthony BF, Bisno A, et al: AHA Committee Report: Prevention of bacterial endocarditis, abstracted. Circulation 1977;56: 139-143.Crossref 46. Maron BJ, Merrill WH, Freier PA, et al: Long-term clinical course and symptomatic status of patients after operation for hypertrophie subaortic stenosis. Circulation 1978;57:1205-1213.Crossref 47. Tajik AJ, Giulani ER, Weidman WH, et al: Idiopathic hypertrophie subaortic stenosis: Long-term surgical follow-up. Am J Cardiol 1974;34: 815-822.Crossref 48. Morrow AG, Reitz BA, Epstein SE, et al: Operative treatment in hypertrophie subaortic stenosis: Techniques and the results of pre- and postoperative assessments in 83 patients. Circulation 1975;52:88-102.Crossref 49. Borer JS, Baeharach SL, Green MV, et al: Effect of septal myotomy and myectomy on left ventricular systolic function at rest and during exercise in patients with IHSS. Circulation 1979;60( (suppl) ):82,87.Crossref 50. Benotti JR, Grossman W, Cohn PF: Clinical profile of restrictive cardiomyopathy. Circulation 1980;61:1206-1212.Crossref 51. Chew CYC, Ziady GM, Raphael MJ, et al: Primary restrictive cardiomyopathy: Non-tropical endomyocardial fibrosis and hypereosinophilic heart disease. Br Heart J 1977;39:399-413.Crossref 52. Parrillo JE, Borer JS, Henry WL, et al: The cardiovascular manifestations of the hypereosinophilic syndrome: Prospective study of 26 patients with review of the literature. Am J Cardiol 1979;67:572-582. 53. Meaney E, Shabetai R, Bhargava V, et al: Cardiac amyloidosis, constrictive pericarditis and restrictive cardiomyopathy. Am J Cardiol 1976;38:547-556.Crossref 54. Roberts WC, Ferrans VJ: Pathological aspects of certain cardiomyopathies. Cire Res 1974;34,35( (suppl) ):128-144. 55. Wasserman AJ, Richardson DW, Baird CL, et al: Cardiac hemochromatosis simulating constrictive pericarditis. Am J Med 1962;32:316-323.Crossref 56. Ridolfi RL, Bulkley BH, Hutchins GM: The conduction system in cardiac amyloidosis: Clinical and pathologic features of 23 patients. Am J Med 1977;62:677-686.Crossref 57. Borer JS, Henry WL, Epstein SE: Echocardiographic observations in patients with systemic infiltrative disease involving the heart. Am J Cardiol 1977;39:184-188.Crossref 58. Hirschmann JV: Pericardial constriction. Am Heart J 1978;96:110-122.Crossref 59. Schroeder JS, Bilingham ME, Rider AK: Cardiac amyloidosis: Diagnosis by transvenous endomyocardial biopsy. Am J Med 1975;59:269-273.Crossref 60. Sheikhzadeh AH, Tarbiat S, Nazarian I, et al: Constrictive endocarditis: Report of a case with successful surgery. Br Heart J 1979;42:224-228.Crossref 61. Propper RD, Cooper B, Rufo RR, et al: Continuous subcutaneous administration of deferoxamine in patients with iron overload. N Engl J Med 1977;297:418-423.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

The Cardiomyopathies: A Pathophysiologic Approach to Therapeutic Management

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References (67)

Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350110147030
Publisher site
See Article on Publisher Site

Abstract

Abstract • "Cardiomyopathies" are a disparate group of myocardial disorders, usually of unknown or obscure origin, characterized by systolic or diastolic myocardial dysfunction but involving conditions of widely divergent pathophysiology. For purposes of devising appropriate clinical management, a useful classification scheme can be created with reference to the type of pathophysiologic abnormality exhibited. On this basis, three major types can be identified: (1) congestive (poor systolic function, normal diastolic function, left ventricular dilatation without the expected degree of compensatory hypertrophy), (2) hypertrophic (supernormal systolic function, subnormal diastolic function, and pronounced left ventricular hypertrophy, usually asymmetric, without dilatation), and (3) restrictive (normal or near-normal systolic function and subnormal diastolic function, usually mild symmetrical left ventricular, without dilatation). Noninvasive identification of these pathophysiologic features can be useful in optimizing management programs. (Arch Intern Med 1983;143:2157-2162) References 1. Goodwin JF: Congestive and hypertrophic cardiomyopathies: A decade of study. Lancet 1970;1:731-739.Crossref 2. Oakley C: Diagnosis and natural history of congested (dilated) cardiomyopathies. Postgrad Med J 1978;54:440-447.Crossref 3. Henry WL, Borer JS: Echocardiographic assessment of cardiomyopathies , in Bom M (ed): Echocardiography . The Hague, Martinus Nijhoff, 1977, pp 159-173. 4. Krevlen TH, Gorlin R, Herman MV: Ventriculographic patterns and hemodynamics in primary myocardial disease. Circulation 1973;47:299-308.Crossref 5. Olsen EGJ: The pathology of cardiomyopathies: A critical analysis. Am Heart J 1979;98:385-392.Crossref 6. Kuhn H, Breithardt G, Knierim JH, et al: Prognosis and possible presymptomatic manifestations of congestive cardiomyopathy. Postgrad Med J 1978;54:451-459.Crossref 7. Olsen EGJ: Endomyocardial biopsy. Br Heart J 1978;40:95-98.Crossref 8. Mackay EW, Littler WA, Sleight P: Critical assessment of diagnostic value of endomyocardial biopsy. Br Heart J 1978;40:69-78.Crossref 9. Raftery EB, Banks DC, Oram S: Occlusive disease of the coronary arteries presenting as primary congestive cardiomyopathy. Lancet 1969;2: 1147-1150.Crossref 10. Corya BC, Feigenbaum H, Rasmussen S, et al: Echocardiographic features of congestive cardiomyopathy compared with normal subjects and patients with coronary artery disease. Circulation 1974;49:1153-1159.Crossref 11. Burch GE, Giles TD: Prolonged bed rest in the management of patients with cardiomyopathy. Cardiovasc Clin 1972;4:375-387. 12. Abellmann WH: Treatment of congestive cardiomyopathy. Postgrad Med J 1978;54:477-484.Crossref 13. Cohn JN, Franciosa JA: Vasodilator therapy of cardiac failure. N Engl J Med 1977;297:27-31,254-258.Crossref 14. Franciosa JA, Cohn JN: Sustained hemodynamic effects without tolerance during long-term isosorbide dinitrate treatment of chronic left ventricular failure. Am J Cardiol 1980;45:648-654.Crossref 15. Franciosa JA, Pierpont G, Cohn JN: Hemodynamic improvement after oral hydralazine in left ventricular failure: A comparison with nitroprusside infusion in 16 patients. Ann Intern Med 1977;86:388-393.Crossref 16. Massie B, Chatterjee K, Werner J, et al: Hemodynamic advantage of combined administration of hydralazine orally and nitrates nonparenterally in the vasodilator therapy of chronic heart failure. Am J Cardiol 1977;40: 794-801.Crossref 17. Colucci WS, Wynne J, Holman BL, et al: Long-term therapy of heart failure with prazosin: A randomized double-blind trial. Am J Cardiol 1980; 45:337-344.Crossref 18. Davis R, Ribner HS, Keung E, et al: Treatment of chronic congestive heart failure with captopril, an oral inhibitor of angiotensin-converting enzyme. N Engl J Med 1979;301:117-121.Crossref 19. Unverferth DV, Magorien RD, Lewis RP, et al: Long-term benefit of dobutamine in patients with congestive cardiomyopathy. Am Heart J 1980; 100:622-630.Crossref 20. Swedberg K, Hjalmarson A, Waagstein F, et al: Prolongation of survival in congestive cardiomyopathy by beta-receptor blockade. Lancet 1979;1:1374-1376.Crossref 21. Podrid PJ, Schoenberger A, Lown B: Congestive heart failure caused by oral disopyramide. N Engl J Med 1980;302:614-617.Crossref 22. Crawford MH, White DH, O'Rourke RA: Effects of oral quinidine on left ventricular performance in normal subjects and patients with congestive cardiomyopathy. Am J Cardiol 1979;44:714-718.Crossref 23. Lorell B, Alderman EL, Mason JW: Cardiac sarcoidosis: Diagnosis with endomyocardial biopsy and treatment with corticosteroids. Am J Cardiol 1978;42:143-146.Crossref 24. Wynne J, Braunwald E: The cardiomyopathies and myocarditides , in Braunwald E (ed): Heart Disease . Philadelphia, WB Saunders Co, 1980, P 1443. 25. Schroeder JS: Current status of cardiac transplantation: 1978. JAMA 1979;241:2069-2071.Crossref 26. Olsen EGJ: The pathology of idiopathic hypertrophie subaortic stenosis (hypertrophie cardiomyopathy): A critical review. Am Heart J 1980;100:553-562.Crossref 27. Darsee JR, Heymsfield SB, Nutter DO: Hypertrophie cardiomyopathy and human leukocyte antigen linkage. N Engl J Med 1979;300:877-882.Crossref 28. Davies MJ, Pomerance A, Teare RD: Pathologic features of hypertrophic obstructive cardiomyopathy. J Clin Pathol 1974;27:529-535.Crossref 29. Maron BJ, Epstein SE: Hypertrophie cardiomyopathy: Recent observations regarding the specificity of three hallmarks of the disease: Asymmetric septal hypertrophy, septal disorganization, and systolic anterior motion of the anterior mitral leaflet. Am J Cardiol 1980;45:141-154.Crossref 30. Frank S, Braunwald E: Idiopathic hypertrophie subaortic stenosis: Clinical analysis of 126 patients with emphasis on the natural history. Circulation 1968;37:759-788.Crossref 31. Adelman AG, Wigle ED, Ranganathan N, et al: The clinical course in muscular subaortic stenosis: A retrospective and prospective study of 60 hemodynamically proved cases. Ann Intern Med 1972;77:515-525.Crossref 32. Maron BJ, Roberts WC, Edwards JE, et al: Sudden death in patients with hypertrophie cardiomyopathy: Characterization of 26 patients without functional limitation. Am J Cardiol 1978;41:803-810.Crossref 33. Maron BJ, Lipson LC, Roberts WC, et al: 'Malignant' hypertrophie cardiomyopathy: Identification of a subgroup of families with unusually frequent premature death. Am J Cardiol 1978;41:1133-1140.Crossref 34. Savage DD, Seides SF, Maron BJ, et al: Prevalence of arrhythmias during 24-hour electrocardiographic monitoring and exercise testing in patients with obstructive and nonobstructive hypertrophie cardiomyopathy. Circulation 1979;59:866-875.Crossref 35. Epstein SE, Henry WL, Clark CE, et al: NIH Conference: Asymmetric septal hypertrophy. Ann Intern Med 1974;81:650-680.Crossref 36. Doi YL, McKenna WJ, Gehrke J, et al: M-mode echocardiography in hypertrophie cardiomyopathy: Diagnostic criteria and prediction of obstruction. Am J Cardiol 1980;45:6-14.Crossref 37. Martin RP, Rakowski H, French J, et al: Idiopathic hypertrophie subaortic stenosis viewed by wide-angle, phased-array echocardiography. Circulation 1979;59:1206-1217.Crossref 38. Chandraratna PAN, Tolentino AO, Mutricumarana W, et al: Echocardiographic observations on the association between mitral valve prolapse and asymmetric septal hypertrophy. Circulation 1977;55:622-626.Crossref 39. Hanrath P, Mathey DG, Siegert R, et al: Left ventricular relaxation and filling pattern in different forms of left ventricular hypertrophy: An echocardiographic study. Am J Cardiol 1980;45:15-23.Crossref 40. Stenson RE, Flamm MD Jr, Harrison DC, et al: Hypertrophie subaortic stenosis: Clinical and hemodynamic effects of long-term propranolol therapy. Am J Cardiol 1973;31:763-773.Crossref 41. Frank MJ, Abdulla AM, Castdo MI, et al: Long-term medical management of hypertrophie obstructive cardiomyopathy. Am J Cardiol 1978;42:993-1001.Crossref 42. Rosing DR, Kent KM, Borer JS, et al: Verapamil therapy: A new approach to the pharmacologie treatment of hypertrophie cardiomyopathy: I. Hemodynamic effects. Circulation 1979;69:1201-1207.Crossref 43. Rosing DR, Kent KM, Maron BJ, et al: Verapamil therapy: A new approach to the pharmacologie treatment of hypertrophie cardiomyopathy: II. Effects on exercise capacity and symptomatic status. Circulation 1979;60:1208-1213.Crossref 44. Kaltenbach M, Hopf R, Keller M: Calcium antagonistiche Therapie bei hypertroph-obstruktiver Kardiomyopathie. Dtsch Med Wochenschr 1976;101:1284-1287.Crossref 45. Kaplan EL, Anthony BF, Bisno A, et al: AHA Committee Report: Prevention of bacterial endocarditis, abstracted. Circulation 1977;56: 139-143.Crossref 46. Maron BJ, Merrill WH, Freier PA, et al: Long-term clinical course and symptomatic status of patients after operation for hypertrophie subaortic stenosis. Circulation 1978;57:1205-1213.Crossref 47. Tajik AJ, Giulani ER, Weidman WH, et al: Idiopathic hypertrophie subaortic stenosis: Long-term surgical follow-up. Am J Cardiol 1974;34: 815-822.Crossref 48. Morrow AG, Reitz BA, Epstein SE, et al: Operative treatment in hypertrophie subaortic stenosis: Techniques and the results of pre- and postoperative assessments in 83 patients. Circulation 1975;52:88-102.Crossref 49. Borer JS, Baeharach SL, Green MV, et al: Effect of septal myotomy and myectomy on left ventricular systolic function at rest and during exercise in patients with IHSS. Circulation 1979;60( (suppl) ):82,87.Crossref 50. Benotti JR, Grossman W, Cohn PF: Clinical profile of restrictive cardiomyopathy. Circulation 1980;61:1206-1212.Crossref 51. Chew CYC, Ziady GM, Raphael MJ, et al: Primary restrictive cardiomyopathy: Non-tropical endomyocardial fibrosis and hypereosinophilic heart disease. Br Heart J 1977;39:399-413.Crossref 52. Parrillo JE, Borer JS, Henry WL, et al: The cardiovascular manifestations of the hypereosinophilic syndrome: Prospective study of 26 patients with review of the literature. Am J Cardiol 1979;67:572-582. 53. Meaney E, Shabetai R, Bhargava V, et al: Cardiac amyloidosis, constrictive pericarditis and restrictive cardiomyopathy. Am J Cardiol 1976;38:547-556.Crossref 54. Roberts WC, Ferrans VJ: Pathological aspects of certain cardiomyopathies. Cire Res 1974;34,35( (suppl) ):128-144. 55. Wasserman AJ, Richardson DW, Baird CL, et al: Cardiac hemochromatosis simulating constrictive pericarditis. Am J Med 1962;32:316-323.Crossref 56. Ridolfi RL, Bulkley BH, Hutchins GM: The conduction system in cardiac amyloidosis: Clinical and pathologic features of 23 patients. Am J Med 1977;62:677-686.Crossref 57. Borer JS, Henry WL, Epstein SE: Echocardiographic observations in patients with systemic infiltrative disease involving the heart. Am J Cardiol 1977;39:184-188.Crossref 58. Hirschmann JV: Pericardial constriction. Am Heart J 1978;96:110-122.Crossref 59. Schroeder JS, Bilingham ME, Rider AK: Cardiac amyloidosis: Diagnosis by transvenous endomyocardial biopsy. Am J Med 1975;59:269-273.Crossref 60. Sheikhzadeh AH, Tarbiat S, Nazarian I, et al: Constrictive endocarditis: Report of a case with successful surgery. Br Heart J 1979;42:224-228.Crossref 61. Propper RD, Cooper B, Rufo RR, et al: Continuous subcutaneous administration of deferoxamine in patients with iron overload. N Engl J Med 1977;297:418-423.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1983

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