metricas
covid
Buscar en
Clinics
Toda la web
Inicio Clinics The Yin and Yang of dyspnea in the emergency department: heart failure or COPD?
Journal Information

Statistics

Follow this link to access the full text of the article

READERS OPINION
The Yin and Yang of dyspnea in the emergency department: heart failure or COPD?
Uğur Canpolat
Corresponding author
dru_canpolat@yahoo.com

Tel.: 90 542 843 07 71
, Osman Turak, Serkan Topaloğlu, Dursun Aras, Sinan Aydoğdu
Türkiye Yüksek İhtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
Read
802
Times
was read the article
306
Total PDF
496
Total HTML
Share statistics
 array:24 [
  "pii" => "S1807593222016350"
  "issn" => "18075932"
  "doi" => "10.6061/clinics/2013(09)18"
  "estado" => "S300"
  "fechaPublicacion" => "2013-09-01"
  "aid" => "1635"
  "copyright" => "CLINICS"
  "copyrightAnyo" => "2013"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/"
  "subdocumento" => "fla"
  "cita" => "Clinics. 2013;68:1290-1"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1807593222016362"
    "issn" => "18075932"
    "doi" => "10.6061/clinics/2013(09)19"
    "estado" => "S300"
    "fechaPublicacion" => "2013-09-01"
    "aid" => "1636"
    "copyright" => "CLINICS"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/"
    "subdocumento" => "fla"
    "cita" => "Clinics. 2013;68:1292"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">READERS OPINION</span>"
      "titulo" => "Is there a relationship between left atrium size and <span class="elsevierStyleItalic">p</span>-wave dispersion in patients with lichen planus&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "1292"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Bilge Bulbul Sen, Emine Nur Rifaioglu, Ali Erayman, Nihat Sen"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Bilge Bulbul"
              "apellidos" => "Sen"
            ]
            1 => array:2 [
              "nombre" => "Emine Nur"
              "apellidos" => "Rifaioglu"
            ]
            2 => array:2 [
              "nombre" => "Ali"
              "apellidos" => "Erayman"
            ]
            3 => array:2 [
              "nombre" => "Nihat"
              "apellidos" => "Sen"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222016362?idApp=UINPBA00004N"
    "url" => "/18075932/0000006800000009/v1_202212010704/S1807593222016362/v1_202212010704/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1807593222016349"
    "issn" => "18075932"
    "doi" => "10.6061/clinics/2013(09)17"
    "estado" => "S300"
    "fechaPublicacion" => "2013-09-01"
    "aid" => "1634"
    "copyright" => "CLINICS"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/"
    "subdocumento" => "fla"
    "cita" => "Clinics. 2013;68:1289"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">READERS OPINION</span>"
      "titulo" => "Authors&#39; comments on&#58; Higher red cell distribution width in patients with slow coronary flow"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "1289"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Song-Hui Luo, Jian-Jun Li"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Song-Hui"
              "apellidos" => "Luo"
            ]
            1 => array:2 [
              "nombre" => "Jian-Jun"
              "apellidos" => "Li"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222016349?idApp=UINPBA00004N"
    "url" => "/18075932/0000006800000009/v1_202212010704/S1807593222016349/v1_202212010704/en/main.assets"
  ]
  "en" => array:11 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">READERS OPINION</span>"
    "titulo" => "The Yin and Yang of dyspnea in the emergency department&#58; heart failure or COPD&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "1290"
        "paginaFinal" => "1291"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "U&#287;ur Canpolat, Osman Turak, Serkan Topalo&#287;lu, Dursun Aras, Sinan Aydo&#287;du"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "U&#287;ur"
            "apellidos" => "Canpolat"
            "email" => array:1 [
              0 => "dru_canpolat@yahoo.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Osman"
            "apellidos" => "Turak"
          ]
          2 => array:2 [
            "nombre" => "Serkan"
            "apellidos" => "Topalo&#287;lu"
          ]
          3 => array:2 [
            "nombre" => "Dursun"
            "apellidos" => "Aras"
          ]
          4 => array:2 [
            "nombre" => "Sinan"
            "apellidos" => "Aydo&#287;du"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "T&#252;rkiye Y&#252;ksek &#304;htisas Training and Research Hospital&#44; Cardiology Clinic&#44; Ankara&#44; Turkey"
            "identificador" => "aff1"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "Tel&#46;&#58; 90 542 843 07 71"
          ]
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para10" class="elsevierStylePara elsevierViewall">Dear Editor&#44;</p><p id="para20" class="elsevierStylePara elsevierViewall">In a recent issue of your journal&#44; we were grateful to read the enjoyable article by Caram et al&#46; &#40;<a class="elsevierStyleCrossRef" href="#bib1">1</a>&#41;&#44; which evaluated the prevalence of electrocardiographic and echocardiographic abnormalities in patients with chronic obstructive pulmonary disease &#40;COPD&#41; according to disease severity &#40;25 mild&#47;moderate and 25 severe&#47;very severe COPD patients&#41;&#46; The study showed that COPD patients have a high prevalence of left ventricular diastolic dysfunction &#40;LVDD&#41; and that this dysfunction is associated with disease severity&#46; The authors also concluded that because of this close association&#44; it is important to exclude decompensated heart failure &#40;HF&#41; during the evaluation of COPD exacerbation&#46;</p><p id="para30" class="elsevierStylePara elsevierViewall">Heart failure and COPD are the most common causes of mortality worldwide &#40;<a class="elsevierStyleCrossRef" href="#bib2">2</a>&#41;&#46; The two diseases have significant overlap with regard to risk factors and pathophysiological mechanisms &#40;including systemic inflammation&#41;&#44; resulting in diagnostic and therapeutic challenges for both emergency department and outpatient physicians &#40;<a class="elsevierStyleCrossRef" href="#bib3">3</a>&#44;<a class="elsevierStyleCrossRef" href="#bib4">4</a>&#41;&#46; Approximately 10&#8211;40&#37; of patients with HF have reported concomitant COPD &#40;<a class="elsevierStyleCrossRef" href="#bib3">3</a>&#41;&#46; Additionally&#44; the prevalence of unrecognized HF was 20&#46;9&#37; in patients with COPD or asthma presenting to the emergency department &#40;<a class="elsevierStyleCrossRef" href="#bib5">5</a>&#41;&#44; and this prevalence was reported as 20&#46;5 and 17&#37; in community patients with stable COPD &#40;<a class="elsevierStyleCrossRef" href="#bib6">6</a>&#44;<a class="elsevierStyleCrossRef" href="#bib7">7</a>&#41;&#46; In addition to the similarity in mechanism&#44; both conditions may present with highly similar symptoms&#44; including dyspnea&#44; orthopnea&#44; coughing&#44; exercise intolerance&#44; fatigue&#44; muscle weakness&#44; disturbed sleep&#44; anorexia&#44; and anxiety &#40;<a class="elsevierStyleCrossRef" href="#bib8">8</a>&#41;&#46; Caram et al&#46; &#40;<a class="elsevierStyleCrossRef" href="#bib1">1</a>&#41; noted that patients with COPD have significant echocardiographic abnormalities&#44; independent of disease severity &#40;98&#37;&#41;&#46; The most frequently noted echocardiographic abnormality was mild LVDD &#40;88&#37;&#41;&#46; Of the several studied risk factors&#44; COPD severity was the only significant predictor of LVDD&#44; which might explain the common pathophysiological pathways in both conditions&#46; However&#44; this association should be coupled with follow-up data demonstrating that the concurrent presence of HF and COPD can increase morbidity and mortality&#46; The findings of Caram et al&#46; &#40;<a class="elsevierStyleCrossRef" href="#bib1">1</a>&#41; demonstrated that HF and COPD are common and frequently concomitant conditions in patients with COPD that can be screened for using transthoracic echocardiography&#44; an acceptable&#44; safe&#44; valid&#44; and reliable imaging modality applicable to the COPD population&#46; In addition to imaging techniques&#44; concurrent HF and COPD exacerbations can be differentiated by biochemical tests&#44; including natriuretic peptides &#40;such as brain natriuretic peptide&#41;&#46; Natriuretic peptides provide additional diagnostic accuracy and might be the most effective tool in refining the diagnosis for this patient population&#44; given the high negative predictive value of a normal result&#46; However&#44; through the effects on pulmonary artery pressure and right-ventricular overload&#44; COPD can also cause elevated circulating levels of natriuretic peptides &#40;<a class="elsevierStyleCrossRef" href="#bib9">9</a>&#44;<a class="elsevierStyleCrossRef" href="#bib10">10</a>&#41;&#46; Despite this potential confounding factor&#44; the negative predictive accuracy of natriuretic peptides for ruling out acute decompensated HF appears to be preserved&#44; even in cohorts of patients with both HF and COPD diagnoses &#40;<a class="elsevierStyleCrossRef" href="#bib5">5</a>&#44;<a class="elsevierStyleCrossRef" href="#bib11">11</a>&#41;&#46;</p><p id="para40" class="elsevierStylePara elsevierViewall">In conclusion&#44; this study demonstrated that patients with COPD have significant electrocardiographic and echocardiographic abnormalities&#44; independent of disease severity&#46; Among all of the pathological findings&#44; LVDD is of great importance because of the prognostic role it plays in patients with COPD&#46; As diagnosing cardio-pulmonary interaction is a complex process&#44; LVDD in COPD patients can be best addressed through simple clinical measures&#44; including natriuretic peptides and objective measurements of ventricular dysfunction by echocardiography&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:1 [
        "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">No potential conflict of interest was reported&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "cebibsec10"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association between left ventricular diastolic dysfunction and severity of chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              LM Caram \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              R Ferrari \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              CR Naves \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              SE Tanni \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              LS Coelho \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              SG Zanati \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.6061/clinics/2013(06)08"
                      "Revista" => array:7 [
                        "tituloSerie" => "Clinics"
                        "fecha" => "2013"
                        "volumen" => "68"
                        "numero" => "6"
                        "paginaInicial" => "772"
                        "paginaFinal" => "776"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23778477"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010&#58; a systematic analysis for the Global Burden of Disease Study 2010"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              R Lozano \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              M Naghavi \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              K Foreman \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              S Lim \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              K Shibuya \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              V Aboyans \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(12)61728-0"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2012"
                        "volumen" => "380"
                        "numero" => "9859"
                        "paginaInicial" => "2095"
                        "paginaFinal" => "2128"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23245604"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Heart failure and chronic obstructive pulmonary disease&#58; diagnostic pitfalls and epidemiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              NM Hawkins \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MC Petrie \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              PS Jhund \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              GW Chalmers \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              FG Dunn \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              JJ McMurray \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurjhf/hfn013"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2009"
                        "volumen" => "11"
                        "numero" => "2"
                        "paginaInicial" => "130"
                        "paginaFinal" => "139"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19168510"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Heart failure and chronic obstructive pulmonary disease the quandary of Beta-blockers and Beta-agonists"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              NM Hawkins \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MC Petrie \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              MR Macdonald \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              PS Jhund \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              LM Fabbri \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              J Wikstrand \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2011.02.020"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2011"
                        "volumen" => "57"
                        "numero" => "21"
                        "paginaInicial" => "2127"
                        "paginaFinal" => "2138"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21596228"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Uncovering heart failure in patients with a history of pulmonary disease&#58; rationale for the early use of B-type natriuretic peptide in the emergency department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              PA McCullough \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              JE Hollander \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              RM Nowak \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              AB Storrow \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              P Duc \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              T Omland \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1553-2712.2003.tb01990.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Acad Emerg Med"
                        "fecha" => "2003"
                        "volumen" => "10"
                        "numero" => "3"
                        "paginaInicial" => "198"
                        "paginaFinal" => "204"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12615582"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              FH Rutten \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MJ Cramer \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              DE Grobbee \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              AP Sachs \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              JH Kirkels \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              JW Lammers \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehi291"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2005"
                        "volumen" => "26"
                        "numero" => "18"
                        "paginaInicial" => "1887"
                        "paginaFinal" => "1894"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15860516"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unrecognised ventricular dysfunction in COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              A Macchia \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              JJ Rodriguez Moncalvo \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              M Kleinert \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              PD Comignani \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              G Gimeno \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              D Arakaki \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00044411"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2012"
                        "volumen" => "39"
                        "numero" => "1"
                        "paginaInicial" => "51"
                        "paginaFinal" => "58"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21700606"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Symptoms&#44; comorbidities&#44; and health care in advanced chronic obstructive pulmonary disease or chronic heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              DJ Janssen \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MA Spruit \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              NH Uszko-Lencer \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              JM Schols \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              EF Wouters \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/jpm.2010.0479"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Palliat Med"
                        "fecha" => "2011"
                        "volumen" => "14"
                        "numero" => "6"
                        "paginaInicial" => "735"
                        "paginaFinal" => "743"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21510771"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Plasma brain natriuretic peptide as a prognostic indicator in patients with primary pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              N Nagaya \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              T Nishikimi \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              M Uematsu \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              T Satoh \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              S Kyotani \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              F Sakamaki \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.cir.102.8.865"
                      "Revista" => array:7 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2000"
                        "volumen" => "102"
                        "numero" => "8"
                        "paginaInicial" => "865"
                        "paginaFinal" => "870"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10952954"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of B-type natriuretic peptide assays for identifying heart failure in stable elderly patients with a clinical diagnosis of chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              FH Rutten \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MJ Cramer \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              NP Zuithoff \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              JW Lammers \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              W Verweij \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              DE Grobbee \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejheart.2007.01.010"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2007"
                        "volumen" => "9"
                        "numero" => "6-7"
                        "paginaInicial" => "651"
                        "paginaFinal" => "659"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17347037"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              LK Morrison \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              A Harrison \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              P Krishnaswamy \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              R Kazanegra \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              P Clopton \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              A Maisel \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0735-1097(01)01744-2"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2002"
                        "volumen" => "39"
                        "numero" => "2"
                        "paginaInicial" => "202"
                        "paginaFinal" => "209"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11788208"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/18075932/0000006800000009/v1_202212010704/S1807593222016350/v1_202212010704/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/18075932/0000006800000009/v1_202212010704/S1807593222016350/v1_202212010704/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222016350?idApp=UINPBA00004N"
]
Article information
ISSN: 18075932
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 7 1 8
2024 October 35 26 61
2024 September 25 18 43
2024 August 30 18 48
2024 July 25 19 44
2024 June 26 13 39
2024 May 26 16 42
2024 April 30 15 45
2024 March 49 16 65
2024 February 62 14 76
2024 January 43 11 54
2023 December 17 16 33
2023 November 29 16 45
2023 October 20 30 50
2023 September 16 26 42
2023 August 9 5 14
2023 July 15 23 38
2023 June 10 11 21
2023 May 6 2 8
2023 April 4 1 5
2023 March 4 2 6
2023 February 0 3 3
2023 January 2 1 3
2022 December 6 3 9
Show all

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos