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1. Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology

Author

Harjola, V-P, Mebazaa, A, Celutkiene, J, Bettex, D, Bueno, H, Chioncel, O, Crespo-Leiro, MG, Falk, V, Filippatos, G, Gibbs, S, Leite-Moreira, A, Lassus, J, Masip, J, Mueller, C, Mullens, W, Naeije, R, Nordegraaf, AV, Parissis, J, Riley, JP, Ristic, A, Rosano, G, Rudiger, A, Ruschitzka, F, Seferovic, P, Sztrymf, B, Vieillard-Baron, A, Yilmaz, MB, Konstantinides, S, University of Zurich, Harjola, Veli-Pekka, [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Dept Emergency Med & Serv, Emergency Med, Helsinki, Finland -- [Mebazaa, Alexandre] Univers Paris Diderot, Sorbonne Paris Cite, Paris, France -- [Mebazaa, Alexandre] AP HP, Inserm U942, Paris, France -- [Mebazaa, Alexandre] Hop Univ St Louis Lariboisiere, AP HP, Dept Anaesthesia & Crit Care, Paris, France -- [Celutkiene, Jelena] Vilnius Univ, Fac Med, Clin Cardiac & Vasc Dis, Vilnius, Lithuania -- [Bettex, Dominique] Univ Zurich Hosp, Inst Anaesthesiol, Zurich, Switzerland -- [Bueno, Hector] Hosp Univ 12 Octubre, CNIC, Madrid, Spain -- [Bueno, Hector] Hosp Univ 12 Octubre, Inst Invest I 12, Madrid, Spain -- [Bueno, Hector] Hosp Univ 12 Octubre, Dept Cardiol, Madrid, Spain -- [Bueno, Hector] Univ Complutense Madrid, E-28040 Madrid, Spain -- [Chioncel, Ovidiu] Univ Med & Pharm Carol Davila, Inst Emergency Cardiovasc Dis, Bucharest, Romania -- [Crespo-Leiro, Maria G.] CHUAC, Complexo Hosp Univ A Coruna, Unidad Insuficiencia Cardiaca Avanzada & Trasplan, La Coruna, Spain -- [Falk, Volkmar] Deutsch Herzzentrum Berlin, Dept Cardiothorac & Vasc Surg, Berlin, Germany -- [Filippatos, Gerasimos] Athens Univ Hosp Attikon, Athens, Greece -- [Gibbs, Simon -- Riley, Jillian P.] Univ London Imperial Coll Sci Technol & Med, London, England -- [Leite-Moreira, Adelino] Univ Porto, Fac Med, Dept Fisiol & Cirurgia Cardiotorac, Rua Campo Alegre 823, P-4100 Oporto, Portugal -- [Lassus, Johan] Univ Helsinki, Helsinki Univ Hosp, Cardiol, Helsinki, Finland -- [Masip, Josep] Univ Barcelona, Hosp St Joan Despi Moises Broggi, Barcelona, Spain -- [Masip, Josep] Univ Barcelona, Hosp Gen Hosp, Barcelona, Spain -- [Mueller, Christian] Univ Basel Hosp, Dept Cardiol, CH-4031 Basel, Switzerland -- [Mueller, Christian] Univ Basel Hosp, CRIB, CH-4031 Basel, Switzerland -- [Mullens, Wilfried] Hasselt Univ, Fac Med & Life Sci, Genk Biomed Res Inst, Dept Cardiol,Ziekenhuis Oost Limburg, Diepenbeek, Belgium -- [Nordegraaf, Anton Vonk] Free Univ Brussels, Dept Phys, Fac Med, 808 Route Lennik, Brussels, Belgium -- [Parissis, John] Vrije Univ Amsterdam, Medisch Centrum, Amsterdam, Netherlands -- [Parissis, John] Attikon Univ Hosp, Athens, Greece -- [Ristic, Arsen] Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia -- [Ristic, Arsen] Univ Belgrade, Sch Med, Belgrade, Serbia -- [Rosano, Giuseppe] IRCCS San Raffaele Hosp Roma, Rome, Italy -- [Rosano, Giuseppe] St Georges Univ London, Cardiovasc & Cell Sci Inst, London, England -- [Rudiger, Alain] Univ Hosp, Cardiosurg Intens Care Unit, Zurich, Switzerland -- [Ruschitzka, Frank] Univ Heart Ctr Zurich, Dept Cardiol Heart Failure Clin & Transplantat, Zurich, Switzerland -- [Seferovic, Petar] Univ Belgrade, Sch Med, Dept Internal Med, Belgrade, Serbia -- [Seferovic, Petar] Univ Belgrade, Heart Failure Ctr, Med Ctr, Belgrade, Serbia -- [Sztrymf, Benjamin] Hop Univ Paris Sud, AP HP, Hop Antoine Beclere, Reanimat Polyvalente, Clamart, France -- [Vieillard-Baron, Antoine] INSERM U 1018, CESP, UVSQ, Team 5,EpReC Renal & Cardiovasc Epidemiol, Villejuif, France -- [Vieillard-Baron, Antoine] Univ Hosp Ambroise Pare, AP HP, Boulogne, France -- [Yilmaz, Mehmet Birhan] Cumhuriyet Univ, Fac Med, Dept Cardiol, Sivas, Turkey -- [Konstantinides, Stavros] Univ Med Ctr Mainz, CTH, Mainz, Germany -- [Konstantinides, Stavros] Democritus Univ Thrace, Dept Cardiol, Alexandroupolis, Greece, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, Lamonaca, Palma -- 0000-0003-4891-2255, Celutkiene, Jelena -- 0000-0003-3562-9274, Chioncel, Ovidiu -- 0000-0002-3197-3628, Bueno, Hector -- 0000-0003-0277-7596, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, Rudiger, Alain -- 0000-0001-7943-7624, Leite-Moreira, Adelino -- 0000-0001-7808-3596, Mebazaa, Alexandre -- 0000-0001-8715-7753, and Falk, Volkmar -- 0000-0002-7911-8620

Subjects
Pulmonary Circulation, Cardiac & Cardiovascular Systems, INTENSIVE-CARE-UNIT, 10216 Institute of Anesthesiology, Ventricular Dysfunction, Right, RESPIRATORY-DISTRESS-SYNDROME, Heart failure, 610 Medicine & health, TROPONIN-T ASSAY, 1102 Cardiovascular Medicine And Haematology, 2705 Cardiology and Cardiovascular Medicine, ASSIST DEVICE, Humans, cardiovascular diseases, Right ventricular dysfunction, Cardiogenic shock, INFERIOR MYOCARDIAL-INFARCTION, Heart Failure, Science & Technology, Right ventricular function, ACUTE COR-PULMONALE, Cardiovascular System & Hematology, CARDIOVASCULAR-DISEASE, Echocardiography, Intensive care, CARDIOGENIC-SHOCK, Cardiovascular System & Cardiology, cardiovascular system, 10209 Clinic for Cardiology, ARTERIAL-HYPERTENSION, Life Sciences & Biomedicine, TASK-FORCE
Abstract

WOS: 000373160000002, PubMed ID: 26995592, Acute right ventricular (RV) failure is a complex clinical syndrome that results from many causes. Research efforts have disproportionately focused on the failing left ventricle, but recently the need has been recognized to achieve a more comprehensive understanding of RV anatomy, physiology, and pathophysiology, and of management approaches. Right ventricular mechanics and function are altered in the setting of either pressure overload or volume overload. Failure may also result from a primary reduction of myocardial contractility owing to ischaemia, cardiomyopathy, or arrhythmia. Dysfunction leads to impaired RV filling and increased right atrial pressures. As dysfunction progresses to overt RV failure, the RV chamber becomes more spherical and tricuspid regurgitation is aggravated, a cascade leading to increasing venous congestion. Ventricular interdependence results in impaired left ventricular filling, a decrease in left ventricular stroke volume, and ultimately low cardiac output and cardiogenic shock. Identification and treatment of the underlying cause of RV failure, such as acute pulmonary embolism, acute respiratory distress syndrome, acute decompensation of chronic pulmonary hypertension, RV infarction, or arrhythmia, is the primary management strategy. Judicious fluid management, use of inotropes and vasopressors, assist devices, and a strategy focusing on RV protection for mechanical ventilation if required all play a role in the clinical care of these patients. Future research should aim to address the remaining areas of uncertainty which result from the complexity of RV haemodynamics and lack of conclusive evidence regarding RV-specific treatment approaches.

Published
2016
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2. Recommendations on pre-hospitalearly hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine

Author

Ekaterini Lambrinou, Kenneth Dickstein, Holger Thiele, Alexandre Mebazaa, Theresa McDonagh, Stefan D. Anker, Gerasimos Filippatos, Aldo P. Maggioni, Arsen D. Ristić, Phillip D. Levy, Jillian P. Riley, Massimo F Piepoli, Said Laribi, Abdelouahab Bellou, John J.V. McMurray, Adelino F. Leite-Moreira, Kevin Damman, Marco Metra, Josep Masip, W. Frank Peacock, M. Birhan Yilmaz, Piotr Ponikowski, Veli-Pekka Harjola, Christopher DeFilippi, Christian Mueller, Petar M. Seferovic, Frank Ruschitzka, Λαμπρινού, Αικατερίνη, [Mebazaa, Alexandre] Univ Paris Diderot, Sorbonne Paris Cite, INSERM, U942,Hop Lariboisiere,St Louis Univ Hosp, Paris, France -- [Yilmaz, M. Birhan] Cumhuriyet Univ, Fac Med, Dept Cardiol, TR-58140 Sivas, Turkey -- [Levy, Phillip] Wayne State Univ, Sch Med, Dept Emergency Med, Detroit, MI USA -- [Levy, Phillip] Wayne State Univ, Sch Med, Cardiovasc Res Inst, Detroit, MI USA -- [Ponikowski, Piotr] Wroclaw Med Univ, Mil Hosp 4, PL-50981 Wroclaw, Poland -- [Peacock, W. Frank] Baylor Coll Med, Ben Taub Gen Hosp, Houston, TX 77030 USA -- [Laribi, Said] Grp Hosp St Louis Lariboisiere, AP HP, INSERM, U942, Paris, France -- [Ristic, Arsen D.] Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia -- [Ristic, Arsen D.] Univ Belgrade, Sch Med, Belgrade, Serbia -- [Lambrinou, Ekaterini] Cyprus Univ Technol, Sch Hlth Sci, Dept Nursing, Limassol, Cyprus -- [Masip, Josep] Univ Barcelona, Hosp St Joan Despi Moises Broggi, Consorci Sanitari Integral, Barcelona, Spain -- [Masip, Josep] Univ Barcelona, Hosp Gen Hosp, Barcelona, Spain -- [Riley, Jillian P.] Univ London Imperial Coll Sci Technol & Med, London, England -- [McDonagh, Theresa] Kings Coll Hosp London, London, England -- [Mueller, Christian] Univ Basel Hosp, Dept Cardiol, CH-4031 Basel, Switzerland -- [deFilippi, Christopher] Univ Maryland, Sch Med, Div Cardiovasc Med, Baltimore, MD 21201 USA -- [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Helsinki, Finland -- [Thiele, Holger] Med Univ Lubeck, Univ Hosp Schleswig Holstein, Med Clin 2, D-23538 Lubeck, Germany -- [Piepoli, Massimo F.] AUSL Piacenza, Guglielmo da Saliceto Hosp, Dept Cardiac, Heart Failure Unit, Piacenza, Italy -- [Metra, Marco] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Cardiol, Brescia, Italy -- [Maggioni, Aldo] ANMCO Resarch Ctr, Florence, Italy -- [McMurray, John J. V.] Univ Glasgow, BHF Cardiovasc Res Ctr, Glasgow, Lanark, Scotland -- [Dickstein, Kenneth] Univ Bergen, Stavanger Univ Hosp, Bergen, Norway -- [Damman, Kevin] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands -- [Seferovic, Petar M.] Univ Belgrade, Fac Med, Belgrade, Serbia -- [Seferovic, Petar M.] Univ Med Ctr, Dept Cardiol, Belgrade, Serbia -- [Ruschitzka, Frank] Univ Heart Ctr, Dept Cardiol, CH-8091 Zurich, Switzerland -- [Leite-Moreira, Adelino F.] Univ Porto, Fac Med, Dept Physiol & Cardiothorac Surg, P-4100 Oporto, Portugal -- [Leite-Moreira, Adelino F.] Ctr Hosp Sao Joao, Dept Cardiothorac Surg, Oporto, Portugal -- [Bellou, Abdelouahab] Harvard Univ, Sch Med, Boston, MA USA -- [Bellou, Abdelouahab] Beth Israel Deaconess Med Ctr, Dept Emergency Med, Boston, MA 02215 USA -- [Bellou, Abdelouahab] Univ Rennes 1, Fac Med, Rennes, France -- [Anker, Stefan D.] Charite, Dept Cardiol, Div Appl Cachexia Res, Berlin, Germany -- [Anker, Stefan D.] Univ Med Ctr Gottingen UMG, Dept Cardiol, Div Innovat Clin Trials, Gottingen, Germany -- [Filippatos, Gerasimos] Univ Athens, Sch Med, Attikon Univ Hosp, Dept Cardiol, GR-11527 Athens, Greece, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, Leite-Moreira, Adelino -- 0000-0001-7808-3596, piepoli, massimo francesco -- 0000-0003-1124-234X, Ponikowski, Piotr -- 0000-0002-3391-7064, Mebazaa, Alexandre -- 0000-0001-8715-7753, mcmurray, john -- 0000-0002-6317-3975, Bellou, Abdelouahab -- 0000-0003-3457-5585, University of Zurich, Mebazaa, Alexandre, Cardiovascular Centre (CVC), and [Mebazaa, Alexandre] Univ Paris Diderot, Lariboisiere St Louis Univ Hosp, AP HP, Sorbonne Paris Cite, Paris, France -- [Yilmaz, M. Birhan] Cumhuriyet Univ, Fac Med, Dept Cardiol, TR-58140 Sivas, Turkey -- [Levy, Phillip] Wayne State Univ, Sch Med, Dept Emergency Med, Detroit, MI USA -- [Levy, Phillip] Wayne State Univ, Sch Med, Cardiovasc Res Inst, Detroit, MI USA -- [Ponikowski, Piotr] Wroclaw Med Univ, Mil Hosp 4, PL-50981 Wroclaw, Poland -- [Peacock, W. Frank] Ben Taub Gen Hosp, Baylor Coll Med, Houston, TX 77030 USA -- [Laribi, Said] INSERM, UMRS 942, Paris, France -- [Ristic, Arsen D.] Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia -- [Ristic, Arsen D.] Univ Belgrade, Sch Med, Belgrade, Serbia -- [Lambrinou, Ekaterini] Cyprus Univ Technol, Sch Hlth Sci, Dept Nursing, Limassol, Cyprus -- [Masip, Josep] Univ Barcelona, Hosp St Joan DespiMoises Broggi, Consorci Sanitari Integral, Barcelona, Spain -- [Masip, Josep] Univ Barcelona, Hosp Gen Hosp, Barcelona, Spain -- [Riley, Jillian P.] Univ London Imperial Coll Sci Technol & Med, London, England -- [McDonagh, Theresa] Kings Coll Hosp London, London, England -- [Mueller, Christian] Univ Basel Hosp, Dept Cardiol, CH-4031 Basel, Switzerland -- [deFilippi, Christopher] Univ Maryland, Sch Med, Div Cardiovasc Med, Baltimore, MD 21201 USA -- [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Helsinki, Finland -- [Thiele, Holger] Med Univ Lubeck, Univ Hosp Schleswig Holstein, Med Clin 2, D-23538 Lubeck, Germany -- [Piepoli, Massimo F.] AUSL Piacenza, Guglielmo da Saliceto Hosp, Dept Cardiac, Heart Failure Unit, Piacenza, Italy -- [Metra, Marco] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Cardiol, Brescia, Italy -- [Maggioni, Aldo] ANMCO Resarch Ctr, Fireze, Italy -- [McMurray, John] Univ Glasgow, BHF Cardiovasc Res Ctr, Glasgow, Lanark, Scotland -- [Dickstein, Kenneth] Univ Bergen, Stavanger Univ Hosp, Bergen, Norway -- [Damman, Kevin] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands -- [Seferovic, Petar M.] Univ Belgrade, Fac Med, Belgrade, Serbia -- [Seferovic, Petar M.] Univ Med Ctr, Dept Cardiol, Belgrade, Serbia -- [Ruschitzka, Frank] Univ Heart Ctr, Dept Cardiol, CH-8091 Zurich, Switzerland -- [Leite-Moreira, Adelino F.] Univ Porto, Fac Med, Dept Physiol & Cardiothorac Surg, P-4100 Oporto, Portugal -- [Leite-Moreira, Adelino F.] Ctr Hosp Sao Joao, Dept Cardiothorac Surg, Oporto, Portugal -- [Bellou, Abdelouahab] Harvard Univ, Sch Med, Boston, MA USA -- [Bellou, Abdelouahab] Beth Israel Deaconess Med Ctr, Dept Emergency Med, Boston, MA 02215 USA -- [Bellou, Abdelouahab] Univ Rennes 1, Fac Med, Rennes, France -- [Anker, Stefan D.] Charite, Dept Cardiol, Div Appl Cachexia Res, Berlin, Germany -- [Anker, Stefan D.] Univ Med Ctr Groningen, Dept Cardiol, Div Innovat Clin Trials, Gottingen, Germany -- [Filippatos, Gerasimos] Univ Athens, Sch Med, Attikon Univ Hosp, Dept Cardiol, GR-11527 Athens, Greece

Subjects
Male, Cardiac Care Facilities, vasodilators, Vasodilator Agents, law.invention, 0302 clinical medicine, DESIGN, CLINICAL CHARACTERISTICS, Health care, Myocardial infarction, Diuretics, Societies, Medical, Emergency Service, OUTCOMES, Evidence-Based Medicine, Respiration, cardiogenic shock, 3. Good health, Administration, Artificial, Acute Disease, 10209 Clinic for Cardiology, Emergency medicine, TRIAL, Emergency Service, Hospital, Cardiology and Cardiovascular Medicine, Oral, medicine.medical_specialty, Infusions, ACUTE MYOCARDIAL-INFARCTION, Shock, Cardiogenic, Heart failure, Acute, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, Hospital, Intensive care, Medical, Humans, Intensive care medicine, Aged, Heart Failure, Clinical Laboratory Techniques, NATRIURETIC PEPTIDE, Oxygen Inhalation Therapy, Administration, Oral, Algorithms, Consensus, Critical Care, Emergency Medical Services, Female, Heart-Assist Devices, Hospitalization, Infusions, Intravenous, Nurse's Role, Oxygen, Patient Discharge, Respiration, Artificial, Evidence-based medicine, medicine.disease, Coronary care unit, Coronary care units, Treatment decision making, Clinical Medicine, TASK-FORCE, Hospital setting, RATIONALE, 030204 cardiovascular system & hematology, Medical and Health Sciences, Health administration, law, 030212 general & internal medicine, Cardiogenic shock, ISOSORBIDE-DINITRATE, Vasodilators, Shock, Intensive care unit, Europe, Practice Guidelines as Topic, Emergency Medicine, Noninvasive ventilation, Medical emergency, Intravenous, Cardiology, Context (language use), 610 Medicine & health, NONINVASIVE VENTILATION, CARDIOGENIC PULMONARY-EDEMA, medicine, Task force, business.industry, Acute heart failure, diuretics, Emergency department, Cardiogenic, SCIENTIFIC STATEMENT, Hospital administration, RELAX-AHF, Societies, business
Abstract

WOS: 000356799600005, PubMed ID: 25999021, Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to practicing physicians and nurses to manage acute heart failure in the pre-hospital and hospital setting. Criteria of hospitalization and of discharge are described. Gaps in knowledge and perspectives in the management of acute heart failure are also detailed. This consensus paper on acute heart failure might help enable contiguous practice., Bayer; Cardiorentis; Medicine Company; Critical Diagnostics; Novartis; Steering Committee member of Cardiorentis; TUBITAK; Medicines Company; Cornerstone Therapeutics; Otsuka; Janssen; Apex Innovations; Inte-Section Medical; Trevena; Vifor Pharma Ltd; Amgen; Servier; Abbott Vascular; Coridea; Respicardia; Swiss National Science Foundation; Swiss Heart Foundation; Cardiovascular Research Foundation Basel; 8sense; Abbott; ALERE; Brahms; Nanosphere; Roche; Siemens; University Hospital Basel; Astra Zeneca; BG medicine; Biomerieux; Lilly; Orion; Resmed; Roche Diagnostics; Ratiopharm; BMS; Boehringer-Ingelheim; Pfizer; Daiichi Sankyo; Boehinger Ingelheim; AstraZeneca; European Union, A.M. received speaker's honoraria from Alere, Bayer, Edwards Life Sciences, The Medicines Company, Novartis, Orion, Servier, Thermofisher, Vifor Pharma and also received fee as member of advisory board and/or Steering Committee from Bayer, Cardiorentis, The Medicine Company, Critical Diagnostics.; M.B.Y. received speaker's honoraria and research fee from Novartis and received fee as Steering Committee member of Cardiorentis, and is supported by TUBITAK.; P.L. received speaker's honoraria from Beckman Coulter and Novartis and also received fees as a member of advisory board and/or Steering Committee from Bayer, Cardiorentis, The Medicines Company, Cornerstone Therapeutics, Novartis, Otsuka, Janssen, Apex Innovations, Inte-Section Medical, and Trevena.; P.P. received speaker's honoraria from Bayer, Novartis, Servier, Vifor Pharma, Amgen, Pfizer, Cardiorentis, Merck-Serono, Abbott Vascular and Respicardia and also received fee as member of advisory board and/or Steering Committee from Bayer, Cardiorentis, Novartis, Vifor Pharma Ltd, Amgen, Servier, Abbott Vascular, Coridea and Respicardia.; E.L. received consultancy fee from Novartis.; J.M. received honoraria for speaker or advisor from Abbott, Novartis, Orion, Otsuka, and Sanofi and fee as a member of Steering Committee from Corthera, Novartis, and Cardiorentis.; C.M. received research grants from the Swiss National Science Foundation and the Swiss Heart Foundation, the Cardiovascular Research Foundation Basel, 8sense, Abbott, ALERE, Brahms, Critical Diagnostics, Nanosphere, Roche, Siemens, and the University Hospital Basel, as well as speaker/consulting honoraria from Astra Zeneca, Abbott, ALERE, BG medicine, Biomerieux, Brahms, Cardiorentis, Lilly, Novartis, Pfizer, Roche, and Siemens.; V.P.H. received speaker's fee: Bayer, Orion, Resmed, Roche Diagnostics, Ratiopharm; consultation fees: Bayer, BMS, Boehringer-Ingelheim, Novartis, Pfizer, Roche Diagnostics, Servier. H.A.T. received speaker's honoraria from Daiichi Sankyo, Lilly, Medicines Company, AstraZeneca, Boehinger Ingelheim. Advisory board for Maquet Cardiovascular. Institutional research support by Maquet Cardiovascular, Teleflex, Terumo, Lilly, The Medicine Company.; G.F. has received research grants and/or has served as Committee member or Cochair of studies sponsored by Bayer, Novartis, Cardiorentis, Vifor Pharma, and the European Union.

Published
2014

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