tbuckley/cabot-search huggingface dataset:
ENDOSCOPIC HISTOACRYL INJECTION FOR HEMOSTASIS OF NON-VARICEAL BLEEDING IS SAFE AND EFFECTIVE MODALITY
Authors: JS Moon, DH Lee, SH Lee, YJ Shin, WE Yoon, SH Kim, YS Kim, SH Ryu, TY Park, SY Seol
Journal: Endoscopy (2020)

Aims Histoacryl is one of the materials that can be used as a sclerosing agent and is known to be effective in endoscopic hemostasis of acute gastric variceal bleeding. In addition, it can be applied to hemostasis of non-variceal GI bleeding with relatively simple manipulation and is also effective. However its effect has not clearly known in ulcer bleeding. We reviewed patients who had undergone treatment endoscopically with Histoacryl and assessed the effectiveness and side effects according to ulcer bleeding.
Shortlist of Quality Indicators for End-of-Life Cancer Care
Authors: Claire E. O’Hanlon, Anne M. Walling, Charlotta Lindvall
Journal: JAMA Oncology (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Oncology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Oncology journal
LOW DIAGNOSTIC YIELD OF STANDARD DEFINITION SURVEILLANCE COLONOSCOPY FOR PATIENTS WITH LYNCH SYNDROME
Authors: NM Farrelly, T Ryan, A Keogh, J Aird, P MacMathuna, C Lahiff
Journal: Endoscopy (2020)

Aims Lynch syndrome (LS) is the most common form of inherited colorectal cancer. Surveillance colonoscopy using high definition (HD) systems is recommended by ESGE guidelines. Our aim was to evaluate historical endoscopic surveillance for LS using standard definition (SD) colonoscopy.
Mucosal inflammation predicts response to systemic steroids in immune checkpoint inhibitor colitis
Authors: Meghan J Mooradian, Daniel Y Wang, Alexandra Coromilas, Melissa Lumish, Tianqi Chen, Anita Giobbie-Hurder, Douglas B. Johnson, Ryan J. Sullivan, Michael Dougan
Journal: Journal for ImmunoTherapy of Cancer (2020)

Immune-related colitis is a common, often serious complication of immune checkpoint inhibition (ICI). Although endoscopy is not strictly recommended for any grade of diarrhea/colitis, emerging evidence suggests that endoscopic evaluation may have important therapeutic implications. In this retrospective study, we sought to comprehensively characterize the clinical and histologic features of ICI-induced colitis with a specific focus on evaluating the prognostic role of endoscopy.Data were collected from the medical records of 130 patients with confirmed ICI-induced colitis. In a subset of patients (n=44) with endoscopic and pathologic data, endoscopic data were scored using the Mayo Endoscopic Score (MES) with scores ranging from 0 (no inflammation) to 3 (colonic ulceration). The impact of infliximab on antitumor outcomes was evaluated using progression-free survival (PFS) and overall survival (OS).We identified 130 patients with ICI-induced colitis across two institutions. All patients were treated with corticosteroids. Additional and/or alternative immunosuppression was employed in 59 cases, with 52 patients (42%) requiring at least one infusion of infliximab 5 mg/kg. Endoscopic assessment with biopsy was performed in 123 cases of suspected colitis (95%), with 44 cases available for MES tabulation. Presence of ulceration (MES 3) was associated with use of infliximab (p=0.008) and MES was significantly higher in patients who received infliximab compared with those who did not (p=0.003) with a median score of 2.5; conversely, those with an MES of zero rarely required secondary immunosuppression. Notably, symptoms of colitis based on Common Terminology Criteria for Adverse Events grade had no association with endoscopic findings based on MES classification. After adjustment for baseline patient and disease characteristics, there was no significant difference in steroid duration or cancer-related outcomes in patients treated with infliximab.In our study, we demonstrate the association of endoscopic features, specifically the MES, with immunosuppressive needs. Importantly, we also show that MES was not related to severity of patient symptoms. The data suggest that endoscopic features can guide clinical decision-making better than patient symptoms, both identifying high-risk patients who will require infliximab and those who are likely to respond to initial corticosteroids.
Abstract 15671: Histidyl Dipeptides Improves Contractile Function During Heart Failure by Enhancing Myosin ATPase Activity
Authors: Jingjing Zhao, Sujith Dassanayaka, David Hoetker, Kenneth Brittian, Steven P Jones, Aruni Bhatnagar, Shahid P Baba
Journal: Circulation (2019)

Background: Systolic dysfunction at molecular level is characterized by impaired contractile function in actomyosin cross-bridge cycle, which determines magnitude of force generation in cardiac mus...
COMPLETE AURICULOVENTRICULAR DISSOCIATION DUE TO DIGITALIS, WITHOUT SYSTEMIC EFFECTS OF OVERDOSAGE: REPORT OF A CASE
Authors: THOMAS J.  DRY, GILES A.  KOELSCHE
Journal: Annals of Internal Medicine (1938)

Case Reports1 May 1938COMPLETE AURICULOVENTRICULAR DISSOCIATION DUE TO DIGITALIS, WITHOUT SYSTEMIC EFFECTS OF OVERDOSAGE: REPORT OF A CASETHOMAS J. DRY, M.B., GILES A. KOELSCHE, M.D.THOMAS J. DRY, M.B.Search for more papers by this author, GILES A. KOELSCHE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-11-11-2043 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe protean manifestations of digitalis intoxication, which consist of gastrointestinal disturbances, color vision phenomena and digitalis delirium, are well recognized. A group of electrocardiographic changes, including coupled beats, extrasystoles, ectopic rhythm, and conductive defects of varying degrees, is not infrequently encountered. It has long been known that changes in the T-wave (one variety of which is characteristic of digitalis poisoning) occur with great frequency and that they may be noted before any digestive disturbances have occurred. It is doubtful, however, whether it is universally recognized that certain instances of gross overdigitalization, which are characterized by profound electrocardiographic changes, may not... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, Minnesota†There was an excess of basophilic elements in the anterior hypophysis in this case also. Page (1936) did not find any clinical signs or symptoms suggestive of pituitary dysfunction in his case, however.*Submitted for publication May 7, 1937. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEine atypische Veränderung der Zwischenstrecke und der Endzacke im Elektrokardiogramm bei der Digitalisbehandlung HerzkrankerLiteraturübersicht 1 May 1938Volume 11, Issue 11Page: 2043-2047KeywordsDeliriumElectrocardiographyIntoxicationPituitary glandSigns and symptomsVision ePublished: 1 December 2008 Issue Published: 1 May 1938 PDF downloadLoading ...
SYSTEMATIC UPPER ENDOSCOPY CONCOMITANT WITH COLONOSCOPY PERFORMED WITHIN THE COLO-RECTAL CANCER SCREENING PROGRAM: IMPACT ON THE PATIENT-MANAGEMENT STRATEGY
Authors: O Planade, B Dessomme, N Chapelle, M Verdier, E Duchalais, E Coron, JF Mosnier, T Matysiak-Budnik, Y Touchefeu
Journal: Endoscopy (2020)

Aims The French screening program for colorectal cancer is based on a fecal immunological test (FIT), followed by colonoscopy in case of its positivity. The interest of adding a concomitant upper endoscopy, to detect upper digestive lesions (precancerous or others), is still debated. We aimed to evaluate the frequency of upper digestive lesions detected by upper endoscopy, performed concomitantly with colonoscopy for positive FIT, and their impact on the management of patients (i.e. surveillance, medical treatment, endoscopic or surgical procedure).
CORRECT IDENTIFICATION AND REMOVAL OF HYPERPLASTIC/SESSILE SERRATED LESIONS AMONG COLORECTAL CANCER SCREENING PATIENTS
Authors: I Muhammad Wazir, B Uddin, R Krishnamoorthy
Journal: Endoscopy (2020)

Methods All the patients who have had colonoscopy as part of bowel cancer screening programme from Jan 2018 till Dec 2018, their colonoscopy reports were screened as how accurately HP/SSL were identified, we then compared endoscopy findings with the histology report.
PEDUNCULATED GIANT GASTRIC POLYP RESECTED BY ENDOSCOPIC SUBMUCOSAL DISSECTION
Authors: A Aguilar, I Iborra, N Caballero, JC Hernández, Í Marín, VM de Vega, D Luna, F Cañete, E Domènech, H Uchima
Journal: Endoscopy (2020)

Clinical case Elderly patient, ASA III, anticoagulated, presented with melena. Endoscopy revealed an ulcerated antral polyp with a 4 cm twisted pedicle that prolapsed through pylorus. Endoscopic resection was planned.
COMPARISON OF ENDOSCOPIC ULTRASOUND FINE NEEDLE ASPIRATION (FNA) VERSUS FINE NEEDLE BIOPSY (FNB) AND IMPACT OF RAPID ON-SITE EVALUATION IN THE DIAGNOSIS OF SUBEPITHELIAL LESIONS
Authors: DTH de Moura, TR McCarty, P Jirapinyo, IB Ribeiro, VK Flumignan, M Ryou, LS Lee, M Coronel, EGH de Moura, CC Thompson
Journal: Endoscopy (2020)

Aims While conventional endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) remains first-line for sampling subepithelial lesions (SELs), variable accuracy has resulted in increased utilization of fine needle biopsy (FNB) to improve diagnostic yield. The primary aim of this study was to compare FNA versus FNB for diagnosis of SEL.
ENDOSCOPIC SPECTRUM OF SMALL BOWEL ULCERATIVE DISEASES
Authors: AMA García, L Fry, PT Kroener, CO Gossweiller, K Mönkemüller
Journal: Endoscopy (2020)

The aim of this presentation are to present the large spectrum of ulcerative diseases of the small bowel and to serve as a video atlas for reference. We present several examples of ulcerative diseases of the small bowel.
Phase I study of ispinesib (SB-715992) in combination with docetaxel in patients with advanced solid tumors.
Authors: S Blagden, A Seebaran, R Molife, M Payne, A Reid, A Protheroe, S Kathman, D Williams, C Bowen, J Hodge, M Dar, J de-Bono, M Middleton
Journal: Clinical Cancer Research (2005)
The Azygos "Steal" Syndrome in Cava-Pulmonary Anastomosis
Authors: F ROBICSEK, P W SANGER, F H TAYLOR, A NAJIB
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
In Vivo Generation of CAR T Cells Selectively in Human CD4+ Lymphocytes
Authors: Shiwani Agarwal, Julia D.S. Hanauer, Annika M. Frank, Vanessa Riechert, Frederic B. Thalheimer, Christian J. Buchholz
Journal: Molecular Therapy (2020)

T cells modified with CD19-specific chimeric antigen receptors (CARs) result in significant clinical benefit for leukemia patients but constitute a challenge for manufacturing. We have recently demonstrated the in vivo generation of CD19-CAR T cells using the CD8-targeted lentiviral vector (CD8-LV). In this study, we investigated the in vivo generation of CD4+ CAR T cells using CD4-targeted LV (CD4-LV). Administration of CD4-LV into NSG mice transplanted with human peripheral blood mononuclear cells (PBMCs) led to 40%–60% of human CD4+ lymphocytes being CAR positive while CD8+ cells remained CAR negative. CAR+ T cells displayed a T helper 1 (Th1)/Th2 phenotype, which was accompanied by CD19+ B cell elimination. Intravenous administration of CD4-LV into NSG mice reconstituted with human CD34+ cells induced CAR expression and B cell elimination within 2–3 weeks post-injection. Preclinical analysis in a tumor mouse model revealed that mice administered CD4-LV exhibited faster and superior tumor cell killing compared to mice injected with CD8-LV alone or as a mixture with CD4-LV. Further analysis suggests that CD4+CAR+ cells may outperform CD8+CAR+ cells, especially at a high burden of target antigen, mainly since CD8 cells are more prone to exhaustion. This first description of in vivo-generated CD4+ CAR T cells supports their importance for cellular therapy. T cells modified with CD19-specific chimeric antigen receptors (CARs) result in significant clinical benefit for leukemia patients but constitute a challenge for manufacturing. We have recently demonstrated the in vivo generation of CD19-CAR T cells using the CD8-targeted lentiviral vector (CD8-LV). In this study, we investigated the in vivo generation of CD4+ CAR T cells using CD4-targeted LV (CD4-LV). Administration of CD4-LV into NSG mice transplanted with human peripheral blood mononuclear cells (PBMCs) led to 40%–60% of human CD4+ lymphocytes being CAR positive while CD8+ cells remained CAR negative. CAR+ T cells displayed a T helper 1 (Th1)/Th2 phenotype, which was accompanied by CD19+ B cell elimination. Intravenous administration of CD4-LV into NSG mice reconstituted with human CD34+ cells induced CAR expression and B cell elimination within 2–3 weeks post-injection. Preclinical analysis in a tumor mouse model revealed that mice administered CD4-LV exhibited faster and superior tumor cell killing compared to mice injected with CD8-LV alone or as a mixture with CD4-LV. Further analysis suggests that CD4+CAR+ cells may outperform CD8+CAR+ cells, especially at a high burden of target antigen, mainly since CD8 cells are more prone to exhaustion. This first description of in vivo-generated CD4+ CAR T cells supports their importance for cellular therapy.
THE ROLE OF RECTAL EUS-FNA/B IN PRE-SACRAL UNDEFINED LESIONS IN PATIENTS WITH HISTORY OF LOWER GI NEOPLASIA
Authors: B Mangiavillano, S Carrara, E Dabizzi, F Auriemma, V Cennamo, MD Leo, M Bianchetti, D Rahal, LD Tommaso, A Repici
Journal: Endoscopy (2020)

Aims Colo-rectal neoplasia is one of the most commonly diagnosed malignancies. Pre-sacral lesions may arise in the follow up after colo-rectal surgery, after adjuvant chemotherapy (CT), or neo-adjuvant chemo-radiotherapy. CT scan and pelvic RM are the two most used diagnostic tool in these patients, but they can be inconclusive in the diagnosis of pre-sacral lesions. PET scan adds more information but, in presence of inflammation, can show false positive results.To evaluate the role and the efficacy of endoscopy ultrasound (EUS) and Fine Needle Aspiration or Biopsy (FNA/FNB) in the multimodal restaging of suspected local recurrence or progression disease in patients with history of rectal cancer. The number of EUS FNA/FNB passes was based on the gross morphology of the specimen.
USE OF INTRAGASTRIC BALLOON FOR OBESITY TREATMENT: SINGLE-CENTER EXPERIENCE
Authors: E Dantas, M Coelho, C Sequeira, I Santos, C Teixeira, C Martins, C Cardoso, J Mangualde, AP Oliveira
Journal: Endoscopy (2020)

Aims Obesity is a public health problem associated with high morbidity and mortality. New endoscopic therapies have emerged in recent years, with intragastric balloon (BIG) being the most popular option.
Genetic polymorphisms in DNA repair genes, sunlight exposure, and skin cancer risk
Authors: Jiali Han, Graham A. Colditz, David J. Hunter
Journal: Cancer Research (2004)

1491  INTRODUCTION: UV radiation is capable of causing a wide range of lesions in DNA. UVB can cause pyrimidine dimmers, which can not only lead to fingerprint mutations (C to T), but also cause blockage of DNA replication, leading to the formation of double strand breaks, chromosomal aberrations, and recombination during the course of replication arrest. UVA can indirectly cause oxidative DNA damage and strand breaks. One important defense mechanism against skin cancer is the ability to repair UV-induced DNA damage. We assessed the association of five candidate DNA repair genes (21 polymorphisms) in three DNA repair pathways (XRCC1 (4) in base excision repair; XPD (6) in nucleotide excision repair; XRCC2 (5), XRCC3 (3), and LigaseIV (3) in double strand break repair) with the risks for melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in a nested case-control study within the Nurses’ Health Study (219 melanoma, 286 SCC, and 300 BCC, and 873 controls). METHODS: Haplotype-tagging SNPs were selected based on the resequencing data from the Environmental Genome Project and genotyped by Taqman. We evaluated the main effects of these SNPs by logistic regression models and inferred the haplotype structures for these 5 genes utilizing PLEM. Detailed sunlight exposure information was collected by administering retrospective questionnaires (90% overall response rate). We further examined whether the candidate polymorphisms modify the associations between the sunlight-related exposures and the risk of skin cancer. RESULTS: We observed that XRCC1 194Trp carriers were at borderline significantly increased risk of SCC, and the XRCC1 399Gln allele was associated with significantly decreased risk of SCC. We also observed significant interactions between the XRCC1 399Gln allele and family history of skin cancer and history of severe lifetime sunburns on SCC risk. There were non-significantly inverse relationships between the XPD Lys751Gln and Asp312Asn polymorphisms and the risks of melanoma and SCC. We also observed that the association of the XPD 751Gln allele with melanoma risk was significantly modified by a constitutional susceptibility score, lifetime severe sunburns, and cumulative sun exposure while wearing a bathing suit. We observed that the variant allele of XRCC3 Thr241Met was significantly inversely associated with the risks of SCC and BCC. The variant alleles of XRCC2 G30833A and XRCC3 A4552C were significantly associated with an increased risk of BCC. We also observed a significant interaction between the XRCC3 Thr241Met and cumulative sun exposure while wearing a bathing suit on SCC risk, and a significant interaction between the XRCC3 Thr241Met and lifetime sunburns on melanoma risk. CONCLUSION: These data suggest that the genetic polymorphisms in DNA repair genes may confer inherited predisposition to skin cancer and modify the relationship of sunlight exposure with skin cancer risk.
THU0125 Is anxiety a more common disorder than depression in rheumatoid arthritis?
Authors: YM El Miedany, AM Haroun
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Most of the previous clinical researches published payed more attention to study depressive disorders and/or symptoms in patients with rheumatoid arthritis (RA). Fewer research studies were done to investigate the prevalence of anxiety in patients with RA patients. <h3>Objectives</h3> This study was performed to investigate whether anxiety disorder is as common as depressive disorder in RA patients and to look for the sociodemographic as well as the clinical characteristics of the patients developing these disorders. <h3>Methods</h3> A detailed physical assessment of 80 patients with RA was performed. Also psychiatric assessment was done using Research Diagnostic Criteria for the International Classification of Disease (ICD-10). In addition, patients answered a Health Assessment Questionaire (HAQ) to assess their functional capacity. <h3>Results</h3> Depression was diagnosed in 66.25% of the total sample while anxiety was diagnosed in 70%. Functional disability, social stress and morning stiffness were the factors highly associated with depression. Using multiple regression analysis, anxiety was also highly associated with depression. On the other hand, Ritchie articular index as well as depression were positively associated with anxiety disorder. <h3>Conclusion</h3> Psychiatric illness is a relatively common disorder in patients with RA, with frequency higher than that of other general medical conditions. Anxiety is a more common disorder than depression. The first step in correct management is recognition of anxiety and depression so that appropriate treatment can be tried. Particular attention has to be paid to social stress and lack of social support.
REMOVAL OF RETAINED METALLIC CLIPS WITH UNDERLYING ADENOMA BY STAR (SNARE TIP ASSISTED RESECTION) TECHNIQUE
Authors: N Idrees, S Hebbar
Journal: Endoscopy (2020)

We report 3 cases of clip-retention with residual adenoma formation on follow-up at 4months. EMR was done for adenomas in 2 cases and for < 1cm R0 SM1 adenocarcinoma in the last case. All the retained clips were in rectum.
FIRST EXPERIENCES WITH THE ENDOSCOPIC SLEEVE GASTROPLASTY (ESG) WITH THE ENDOMINA-SYSTEM© AS A BRIDGE TO SURGERY FOR SUPEROBESE PATIENTS - A ONE-YEAR FOLLOW UP
Authors: F Prinz, R Paschwitz, T Kuegler, S Wasserberg, M Anthuber, S Nau, H Messmann, S Gölder
Journal: Endoscopy (2020)

Aims According to the German guidelines, behavioral therapy and surgery are the first line treatment options for obesity. For superobese patients (BMI > 50 kg/m2) with multiple comorbidities, an endoscopic bridge to surgery to reduce the perioperative risk may be a further treatment option.
CONVENTIONAL ENDOSCOPIC SPHINTEROTOMY VS. TINY ENDOSCOPIC SPHINTEROTOMY FOLLOWED BY BALLOON DILATION AND THE RISK OF POST-CPRE HEMORRHAGE IN PATIENTS WITH PERIAMPULAR DIVERTICULUM
Authors: CS Bernal, AR Ortega, FJN León, JB González, DM López, R Gómez Rodríguez
Journal: Endoscopy (2020)

Determine the rate of post-ERCP hemorrhage in patients with periampular diverticulum (papilla located inside or on the margin of a duodenal diverticulum).
Dual kinase/bromodomain inhibitors for rationally designed polypharmacology
Authors: E R Quinn, P Ciceri, S Mueller-Knapp, A O'Mahony, O Fedorov, P Filippakopoulos, J P Hunt, E A Lasater, G Pallares, S Picaud, C Wells, L M Wodicka, N P Shah, S Knapp, D K Treiber
Journal: Cancer Research (2014)

Concomitant inhibition of multiple cancer-driving kinases is an established strategy to improve the durability of clinical responses to targeted therapies. The difficulty of discovering kinase inhibitors with an appropriate multitarget profile has, however
Abstract 16296: Safety of First in Human Triple-Gene Therapy Candidate for Heart Failure Patients
Authors: Ewa Jaruga-Killeen, David A Bull, Kapildeo Lotun, Timothy D Henry, Gregory Egnaczyk, Thomas D Reed, Amit N Patel
Journal: Circulation (2019)

Introduction: Single molecule targeted gene therapies have not succeeded in addressing the multifaceted mechanisms of cardiac remodeling which culminate in heart failure. Our triple gene approach f...