%PDF-1.7
%
1 0 obj
<>>>
endobj
2 0 obj
<>stream
2021-03-11T09:36:30-05:00
2021-03-11T09:36:37-05:00
2021-03-11T09:36:37-05:00
Adobe InDesign CC 13.1 (Windows)
uuid:3416a772-af57-434e-ab64-0e042a178296
xmp.did:4A42F9656056E111960DCE8E95F0DF9D
xmp.id:8e4a393d-2c5d-6243-905a-0e87613ee272
proof:pdf
xmp.iid:ada69194-25dc-494b-9fa4-d652037663d3
xmp.did:f0c51d60-75c3-4d4a-a803-1752032646e5
xmp.did:4A42F9656056E111960DCE8E95F0DF9D
default
converted
from application/x-indesign to application/pdf
Adobe InDesign CC 13.1 (Windows)
/
2021-03-11T09:36:30-05:00
application/pdf
Adobe PDF Library 15.0
False
endstream
endobj
12 0 obj
<>
endobj
3 0 obj
<>
endobj
5 0 obj
<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
6 0 obj
<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
7 0 obj
<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
8 0 obj
<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
9 0 obj
<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
10 0 obj
<>/Font<>/ProcSet[/PDF/Text/ImageB]/Properties<>/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
11 0 obj
<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
14 0 obj
<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
46 0 obj
<>stream
q
/GS0 gs
0 TL/Fm0 Do
Q
BT
/CS0 cs 1 scn
/GS0 gs
/T1_0 1 Tf
-0.01 Tc 8.5 0 0 8.5 171.2281 417.438 Tm
(1.)Tj
/Span<>> BDC
[( )-94.4 ( )]TJ
EMC
1.588 0 Td
[(Adding a sodium-glucose cotransporter)55 (-2 to)-10 ( )]TJ
0 -1.2 Td
[(optimal heart failure treatment, including)-10 ( )]TJ
0 -1.2 Td
[(a neprilysin inhibitor/angiotensin receptor)-10 ( )]TJ
0 -1.2 Td
[(blocker)74 (, resulted in:)]TJ
0 0 0 1 k
/GS1 gs
/T1_1 1 Tf
0 Tc 0 -1.729 Td
(a. signi\036cantly more hypotension.)Tj
0 -1.729 Td
(b. worse renal function.)Tj
0 -1.729 Td
(c. a lower mortality rate.)Tj
0 -1.729 Td
(d. fewer heart failure hospitalizations.)Tj
/CS0 cs 1 scn
/GS0 gs
/T1_0 1 Tf
-0.01 Tc -1.588 -2.894 Td
(2.)Tj
/Span<>> BDC
[( )-94.4 ( )]TJ
EMC
1.588 0 Td
[(Low brain natriuretic peptide levels often are)-10 ( )]TJ
0 -1.2 Td
(seen in heart failure patients with:)Tj
0 0 0 1 k
/GS1 gs
/T1_1 1 Tf
0 Tc 0 -1.729 Td
[(a. obesity)92 (.)]TJ
0 -1.729 Td
(b. preserved left ventricular ejection fraction.)Tj
0 -1.729 Td
[(c. acute kidney injury)92 (.)]TJ
0 -1.729 Td
(d. advanced age.)Tj
/CS0 cs 1 scn
/GS0 gs
/T1_0 1 Tf
-0.01 Tc -1.588 -2.894 Td
(3.)Tj
/Span<>> BDC
[( )-94.4 ( )]TJ
EMC
1.588 0 Td
[(A meta-analysis of two recent randomized)-10 ( )]TJ
0 -1.2 Td
[(trials of patent foramen ovale closure for)-10 ( )]TJ
0 -1.2 Td
(migraines vs. medical therapy failed to show:)Tj
0 0 0 1 k
/GS1 gs
/T1_1 1 Tf
0 Tc 0 -1.729 Td
(a. fewer migraine days/month.)Tj
0 -1.729 Td
(b. fewer monthly migraine attacks.)Tj
0 -1.729 Td
(c. more patients with complete cessation of )Tj
0 -1.2 Td
(migraines.)Tj
0 -1.729 Td
(d. an improved responder rate \(reduction in )Tj
0 -1.2 Td
(migraine attacks and adverse events\).)Tj
/CS0 cs 1 scn
/GS0 gs
/T1_0 1 Tf
-0.01 Tc 21.308 36.141 Td
(4.)Tj
/Span<>> BDC
[( )-94.4 ( )]TJ
EMC
1.588 0 Td
[(Comparing surveillance of cancer)-9.9 ( )]TJ
0 -1.2 Td
[(chemotherapy patients with global)-10 ( )]TJ
0 -1.2 Td
[(longitudinal strain \(GLS\) vs. ejection fraction)-10 ( )]TJ
0 -1.2 Td
[(\(EF\) for detecting cardiac damage and treating)-10 ( )]TJ
0 -1.2 Td
(it revealed:)Tj
0 0 0 1 k
/GS1 gs
/T1_1 1 Tf
0 Tc 0 -1.729 Td
(a. EF after one year was higher in the GLS )Tj
0 -1.2 Td
(group.)Tj
0 -1.729 Td
(b. cardiac damage developed in more EF )Tj
0 -1.2 Td
[(group patients at one year)111 (.)]TJ
0 -1.729 Td
(c. less cardiac protective therapy was used in )Tj
0 -1.2 Td
(the GLS group.)Tj
0 -1.729 Td
(d. fewer GLS group patients slowed or )Tj
0 -1.2 Td
[(stopped chemotherapy)92 (.)]TJ
/CS0 cs 1 scn
/GS0 gs
/T1_0 1 Tf
-0.01 Tc -1.588 -2.894 Td
(5.)Tj
/Span<>> BDC
[( )-94.4 ( )]TJ
EMC
1.588 0 Td
[(A sophisticated MRI study of the intracranial)-9.9 ( )]TJ
0 -1.2 Td
[(circulation showed atherosclerotic plaques)-10 ( )]TJ
0 -1.2 Td
[(in what percentage of patients with embolic)-10 ( )]TJ
0 -1.2 Td
(stroke of undetermined source?)Tj
0 0 0 1 k
/GS1 gs
/T1_1 1 Tf
0 Tc 0 -1.729 Td
(a. 24%)Tj
0 -1.729 Td
(b. 43%)Tj
0 -1.729 Td
(c. 69%)Tj
0 -1.729 Td
(d. 78%)Tj
-0.01 Tc 10 0 0 10 163.2662 730.28 Tm
[(The authors\222 analysis did not include this)-9.9 ( )]TJ
0.01 Tw 0 -1.206 Td
(consideration.)Tj
0 Tw 0 -2.412 Td
[(The authors accepted a surprisingly wide)-10 ( )]TJ
0 -1.206 Td
[(period between BNP measurement and)-10 ( )]TJ
0 -1.206 Td
[(echo study)92 (. Unfortunately)92 (, this was a)-10 ( )]TJ
0 -1.206 Td
[(signi\036cant limitation of their study)92 (. It is not)-10 ( )]TJ
0 -1.206 Td
[(uncommon for cardiac function to change)-10 ( )]TJ
0 -1.206 Td
[(dramatically over a 90-day period. For)-10 ( )]TJ
0 -1.206 Td
[(example, an acute myocardial infarction)-10 ( )]TJ
0 -1.206 Td
[(or stress cardiomyopathy often exhibit)-9.9 ( )]TJ
0 -1.206 Td
[(marked improvement in left ventricular)-10 ( )]TJ
0 -1.206 Td
[(function within days of hospitalization,)-10 ( )]TJ
0 -1.206 Td
[(making interpretation of widely spaced)-9.9 ( )]TJ
0 -1.206 Td
[(echo and BNP results dif\036cult at best. The)-10 ( )]TJ
0 -1.206 Td
[(hemodynamically de\036ned patients are the)-10 ( )]TJ
0 -1.206 Td
[(most compelling. Signi\036cantly elevated)-9.9 ( )]TJ
0 -1.206 Td
[(\036lling pressures or low cardiac index closely)-10 ( )]TJ
0 -1.206 Td
(correlated with BNP measurements.)Tj
0 -2.412 Td
[(Management of obese patients with heart)-10 ( )]TJ
0 -1.206 Td
[(failure can be challenging. Assessment)-10 ( )]TJ
20.286 25.328 Td
[(of volume status by physical exam is)-10 ( )]TJ
0 -1.23 Td
[(limited: neck veins can be hard to visualize,)-10 ( )]TJ
0 -1.23 Td
[(hepatomegaly hard to appreciate, and)-10 ( )]TJ
0 -1.23 Td
[(peripheral edema from venous stasis is)-10 ( )]TJ
0 -1.23 Td
[(common. As demonstrated in this study)92 (,)-10 ( )]TJ
0 -1.23 Td
[(BNP levels can be low)92 (, too, taking away)-10 ( )]TJ
0 -1.23 Td
[(another diagnostic tool. Implantable)-10 ( )]TJ
0 -1.23 Td
[(pulmonary artery pressure sensors can)-10 ( )]TJ
0 -1.23 Td
[(be helpful, although patients with large)-10 ( )]TJ
0 -1.23 Td
[(chest circumferences are not candidates)-10 ( )]TJ
0 -1.23 Td
[(for this device. Further compounding the)-10 ( )]TJ
0 -1.23 Td
[(problem: Obese patients are more likely to)-10 ( )]TJ
0 -1.23 Td
[(be excluded from clinical trials based on)-10 ( )]TJ
0 -1.23 Td
[(low BNP levels, limiting our understanding)-9.9 ( )]TJ
0 -1.23 Td
[(of heart failure therapies in this signi\036cant)-10 ( )]TJ
0 -1.23 Td
[(patient population. )-9.9 ( )]TJ
/C2_0 1 Tf
0 Tc 8.647 0 Td
<0084>Tj
/TT0 1 Tf
0.01 Tc -0.01 Tw 9.25 0 0 9.25 366.1287 522.1962 Tm
(REFERENCE)Tj
/TT1 1 Tf
-0.025 Tc 0 Tw 0 -1.222 Td
(1.)Tj
/Span<>> BDC
( )Tj
EMC
1.946 0 Td
[(Maisel AS, Krishnaswamy P)239.8 (, Nowak RM, et al.)-24.9 ( )]TJ
0 -1.222 Td
[(R)-36.7 (apid measurement of B)-27.7 (-type natriuretic peptide)-25 ( )]TJ
0 -1.222 Td
(in the emergency diagnosis of heart failure. )Tj
/TT2 1 Tf
[(N Engl J)-24.8 ( )]TJ
0.025 Tw 0 -1.222 Td
(Med)Tj
/TT1 1 Tf
0 Tw ( 2002;347:161-167.)Tj
ET
endstream
endobj
48 0 obj
<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Subtype/Form>>stream
/CS0 cs 0.07 scn
/GS0 gs
18 99.617 120.33 656.383 re
f
18 36 539.325 53.473 re
f
BT
0 0 0 1 k
/GS1 gs
/TT0 1 Tf
0 Tc 0 Tw 0 Ts 100 Tz 0 Tr 7 0 0 7 27.8983 78.3659 Tm
(Interested in reprints or posting an article to your )Tj
0 -1.143 Td
[(company)-55.8 (\222s site? There are numerous opportunities for )]TJ
0 -1.143 Td
(you to leverage editorial recognition for the benefit of )Tj
0 -1.143 Td
(your brand. Call us at \(800\) 688-2421 or email us at )Tj
0 -1.143 Td
(reliasmedia)Tj
/C2_0 1 Tf
<0014>Tj
/TT0 1 Tf
(@gmail.com.)Tj
25.217 4.571 Td
(Discounts are available for group subscriptions, multiple )Tj
0 -1.143 Td
(copies, site licenses, or electronic distribution. For pricing )Tj
0 -1.143 Td
(information, please contact our Group Account Managers )Tj
0 -1.143 Td
(at groups@reliasmedia.com or \(866\) 213-0844.)Tj
19.248 0 Td
( )Tj
5.969 3.429 Td
[(T)175 (o reproduce any part of R)17.6 (elias Media newsletters for )]TJ
0 -1.143 Td
(educational purposes, please contact The Copyright )Tj
0 -1.143 Td
(Clearance Center for permission at info@copyright.com )Tj
0 -1.143 Td
(or \(978\) 750-8400.)Tj
ET
/CS0 CS 1 SCN
3 w 4 M 0 j 0 J
/GS0 gs
q 1 0 0 1 138.6633 754.5 cm
0 0 m
437.337 0 l
S
Q
/CS0 cs 1 scn
163.328 434.32 392.414 17.367 re
f
0.25 w
163.391 99.742 392.225 335.013 re
S
BT
0 0 0 0 k
12 0 0 12 304.0168 438.4156 Tm
(CME/CE QUESTIONS)Tj
0 0 0 1 k
/GS1 gs
/T1_0 1 Tf
7 0 0 7 26.64 742.5959 Tm
(PHYSICIAN EDITOR)Tj
( )Tj
/TT0 1 Tf
0 -1.214 Td
[(Michael H)17.9 (. Crawford, MD)]TJ
/TT1 1 Tf
0 -1.214 Td
[(P)35.7 (rofessor of Medicine)]TJ
0 -1.214 Td
[(L)17.4 (ucy Stern Chair in Cardiology)]TJ
0 -1.214 Td
(University of California)Tj
0 -1.214 Td
[(San F)54.9 (rancisco)]TJ
/T1_0 1 Tf
0 -2.429 Td
(PEER REVIEWER)Tj
/TT0 1 Tf
0 -1.214 Td
(Susan Zhao, MD)Tj
/TT1 1 Tf
0 -1.214 Td
(Director )Tj
( )Tj
0 -1.214 Td
[(Adult Echocardiography L)17.3 (aboratory)]TJ
0 -1.214 Td
(Associate Chief)Tj
5.804 0 Td
( )Tj
-5.804 -1.214 Td
(Division of Cardiology)Tj
8.454 0 Td
( )Tj
-8.454 -1.214 Td
(Department of Medicine)Tj
0 -1.214 Td
[(Santa Clara V)53.9 (alley Medical Center)]TJ
/T1_0 1 Tf
0 -2.429 Td
(NURSE PLANNER)Tj
/TT0 1 Tf
0 -1.214 Td
[(Aurelia Macabasco)-18.9 (-)-36.5 (O)17.8 (\222Connell, PhD, )]TJ
0 -1.214 Td
[(A)17.5 (CNP)78 (-BC, RN, PHN, F)36.7 (AHA)]TJ
/TT1 1 Tf
0 -1.214 Td
[(Associate P)35.3 (rofessor)]TJ
0 -1.214 Td
[(Azusa P)54.6 (acific University )]TJ
9.021 0 Td
( )Tj
-9.021 -1.214 Td
(School of Nursing)Tj
/T1_0 1 Tf
0 -2.715 Td
[(EDITORIAL ADVISOR)92.1 (Y BOARD)]TJ
/TT0 1 Tf
0 -1.214 Td
[(Jamie L. W)123.9 (. K)17.8 (ennedy)87.4 (, MD, F)35.6 (A)17.5 (CC)]TJ
( )Tj
/TT1 1 Tf
0 -1.214 Td
[(Associate P)35.3 (rofessor)]TJ
( )Tj
0 -1.214 Td
(Division of Cardiology)Tj
8.454 0 Td
( )Tj
-8.454 -1.214 Td
[(Advanced Heart F)35.4 (ailure )]TJ
( )Tj
0 -1.214 Td
[(& T)155.6 (ransplant Cardiology)]TJ
9.12 0 Td
( )Tj
-9.12 -1.214 Td
(University of California)Tj
8.642 0 Td
( )Tj
-8.642 -1.214 Td
[(San F)54.9 (rancisco)]TJ
/TT0 1 Tf
0 -2.429 Td
(Joshua D. Moss, MD)Tj
/TT1 1 Tf
0 -1.214 Td
[(Associate P)35.3 (rofessor )]TJ
( )Tj
0 -1.214 Td
(of Clinical Medicine)Tj
0 -1.214 Td
(Cardiac Electrophysiology)Tj
0 -1.214 Td
(Division of Cardiology)Tj
0 -1.214 Td
(University of California)Tj
8.642 0 Td
( )Tj
-8.642 -1.214 Td
[(San F)54.9 (rancisco)]TJ
/TT0 1 Tf
0 -2.429 Td
(Jeffrey Zimmet, MD, PhD)Tj
/TT1 1 Tf
0 -1.214 Td
[(Associate P)35.3 (rofessor of Medicine)]TJ
0 -1.214 Td
(University of California)Tj
8.642 0 Td
( )Tj
-8.642 -1.214 Td
[(San F)54.9 (rancisco)]TJ
0 -1.214 Td
[(Director)100.5 (, Cardiac )]TJ
6.807 0 Td
( )Tj
-6.807 -1.214 Td
[(Catheterization L)16.4 (aboratory)]TJ
0 -1.214 Td
[(San F)54.9 (rancisco V)54.9 (A Medical Center)]TJ
/T1_0 1 Tf
0 -2.429 Td
(EDITOR)Tj
/TT1 1 Tf
( )Tj
/TT0 1 Tf
0 -1.214 Td
(Jonathan Springston)Tj
/T1_0 1 Tf
0 -2.429 Td
(EDITOR)Tj
/TT1 1 Tf
( )Tj
/TT0 1 Tf
0 -1.214 Td
(Jason Schneider)Tj
/T1_0 1 Tf
0 -2.429 Td
(EDITORIAL GROUP MANAGER)Tj
/TT0 1 Tf
0 -1.214 Td
(Leslie Coplin)Tj
/T1_0 1 Tf
0 -2.429 Td
[(ACCREDIT)74.1 (A)74 (TIONS DIRECTOR)]TJ
/TT2 1 Tf
( )Tj
/TT0 1 Tf
0 -1.214 Td
(Amy M. Johnson, MSN, RN, CPN)Tj
ET
endstream
endobj
49 0 obj
<>
endobj
50 0 obj
<>
endobj
51 0 obj
<>
endobj
52 0 obj
<>
endobj
53 0 obj
<>
endobj
62 0 obj
<>
endobj
63 0 obj
<>stream
H|y|ϼ>3$m杙R7r7ՠ\ʽ*ZY Aj-";BB[ľm'gȍ?!