Accuracy of Echocardiography to Evaluate Pulmonary Vascular and RV Function During Exercise.
Identifieur interne : 001E98 ( PubMed/Corpus ); précédent : 001E97; suivant : 001E99Accuracy of Echocardiography to Evaluate Pulmonary Vascular and RV Function During Exercise.
Auteurs : Guido Claessen ; Andre La Gerche ; Jens-Uwe Voigt ; Steven Dymarkowski ; Frédéric Schnell ; Thibault Petit ; Rik Willems ; Piet Claus ; Marion Delcroix ; Hein HeidbuchelSource :
- JACC. Cardiovascular imaging [ 1876-7591 ] ; 2016.
English descriptors
- KwdEn :
- Adult, Area Under Curve, Arterial Pressure, Bicycling, Cardiac Output, Case-Control Studies, Echocardiography, Stress (methods), Exercise Test, Feasibility Studies, Female, Humans, Hypertension, Pulmonary (diagnostic imaging), Hypertension, Pulmonary (physiopathology), Magnetic Resonance Imaging, Male, Middle Aged, Predictive Value of Tests, Pulmonary Artery (diagnostic imaging), Pulmonary Artery (physiopathology), Pulmonary Embolism (diagnostic imaging), Pulmonary Embolism (physiopathology), ROC Curve, Reproducibility of Results, Ventricular Function, Right, Ventricular Pressure.
- MESH :
- diagnostic imaging : Hypertension, Pulmonary, Pulmonary Artery, Pulmonary Embolism.
- methods : Echocardiography, Stress.
- physiopathology : Hypertension, Pulmonary, Pulmonary Artery, Pulmonary Embolism.
- Adult, Area Under Curve, Arterial Pressure, Bicycling, Cardiac Output, Case-Control Studies, Exercise Test, Feasibility Studies, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Predictive Value of Tests, ROC Curve, Reproducibility of Results, Ventricular Function, Right, Ventricular Pressure.
Abstract
The authors have compared exercise echocardiography and exercise cardiac magnetic resonance imaging with simultaneous invasive pressure registration (ExCMRip) for the assessment of pulmonary vascular and right ventricular (RV) function.
DOI: 10.1016/j.jcmg.2015.06.018
PubMed: 26508387
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pubmed:26508387Le document en format XML
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Electronic address: guido.claessen@uzleuven.be.</nlm:affiliation></affiliation></author><author><name sortKey="La Gerche, Andre" sort="La Gerche, Andre" uniqKey="La Gerche A" first="Andre" last="La Gerche">Andre La Gerche</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Baker IDI Heart and Diabetes Institute, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Voigt, Jens Uwe" sort="Voigt, Jens Uwe" uniqKey="Voigt J" first="Jens-Uwe" last="Voigt">Jens-Uwe Voigt</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Dymarkowski, Steven" sort="Dymarkowski, Steven" uniqKey="Dymarkowski S" first="Steven" last="Dymarkowski">Steven Dymarkowski</name><affiliation><nlm:affiliation>University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Schnell, Frederic" sort="Schnell, Frederic" uniqKey="Schnell F" first="Frédéric" last="Schnell">Frédéric Schnell</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Physiology, Rennes University, Rennes, France.</nlm:affiliation></affiliation></author><author><name sortKey="Petit, Thibault" sort="Petit, Thibault" uniqKey="Petit T" first="Thibault" last="Petit">Thibault Petit</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Willems, Rik" sort="Willems, Rik" uniqKey="Willems R" first="Rik" last="Willems">Rik Willems</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Claus, Piet" sort="Claus, Piet" uniqKey="Claus P" first="Piet" last="Claus">Piet Claus</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Delcroix, Marion" sort="Delcroix, Marion" uniqKey="Delcroix M" first="Marion" last="Delcroix">Marion Delcroix</name><affiliation><nlm:affiliation>University Hospitals Leuven, Leuven, Belgium; Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Heidbuchel, Hein" sort="Heidbuchel, Hein" uniqKey="Heidbuchel H" first="Hein" last="Heidbuchel">Hein Heidbuchel</name><affiliation><nlm:affiliation>University of Hasselt and Heart Center, Jessa Hospital, Hasselt, Belgium.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26508387</idno><idno type="pmid">26508387</idno><idno type="doi">10.1016/j.jcmg.2015.06.018</idno><idno type="wicri:Area/PubMed/Corpus">001E98</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001E98</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Accuracy of Echocardiography to Evaluate Pulmonary Vascular and RV Function During Exercise.</title><author><name sortKey="Claessen, Guido" sort="Claessen, Guido" uniqKey="Claessen G" first="Guido" last="Claessen">Guido Claessen</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium. Electronic address: guido.claessen@uzleuven.be.</nlm:affiliation></affiliation></author><author><name sortKey="La Gerche, Andre" sort="La Gerche, Andre" uniqKey="La Gerche A" first="Andre" last="La Gerche">Andre La Gerche</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Baker IDI Heart and Diabetes Institute, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Voigt, Jens Uwe" sort="Voigt, Jens Uwe" uniqKey="Voigt J" first="Jens-Uwe" last="Voigt">Jens-Uwe Voigt</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Dymarkowski, Steven" sort="Dymarkowski, Steven" uniqKey="Dymarkowski S" first="Steven" last="Dymarkowski">Steven Dymarkowski</name><affiliation><nlm:affiliation>University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Schnell, Frederic" sort="Schnell, Frederic" uniqKey="Schnell F" first="Frédéric" last="Schnell">Frédéric Schnell</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Physiology, Rennes University, Rennes, France.</nlm:affiliation></affiliation></author><author><name sortKey="Petit, Thibault" sort="Petit, Thibault" uniqKey="Petit T" first="Thibault" last="Petit">Thibault Petit</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Willems, Rik" sort="Willems, Rik" uniqKey="Willems R" first="Rik" last="Willems">Rik Willems</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Claus, Piet" sort="Claus, Piet" uniqKey="Claus P" first="Piet" last="Claus">Piet Claus</name><affiliation><nlm:affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Delcroix, Marion" sort="Delcroix, Marion" uniqKey="Delcroix M" first="Marion" last="Delcroix">Marion Delcroix</name><affiliation><nlm:affiliation>University Hospitals Leuven, Leuven, Belgium; Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Heidbuchel, Hein" sort="Heidbuchel, Hein" uniqKey="Heidbuchel H" first="Hein" last="Heidbuchel">Hein Heidbuchel</name><affiliation><nlm:affiliation>University of Hasselt and Heart Center, Jessa Hospital, Hasselt, Belgium.</nlm:affiliation></affiliation></author></analytic><series><title level="j">JACC. Cardiovascular imaging</title><idno type="eISSN">1876-7591</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Area Under Curve</term><term>Arterial Pressure</term><term>Bicycling</term><term>Cardiac Output</term><term>Case-Control Studies</term><term>Echocardiography, Stress (methods)</term><term>Exercise Test</term><term>Feasibility Studies</term><term>Female</term><term>Humans</term><term>Hypertension, Pulmonary (diagnostic imaging)</term><term>Hypertension, Pulmonary (physiopathology)</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Predictive Value of Tests</term><term>Pulmonary Artery (diagnostic imaging)</term><term>Pulmonary Artery (physiopathology)</term><term>Pulmonary Embolism (diagnostic imaging)</term><term>Pulmonary Embolism (physiopathology)</term><term>ROC Curve</term><term>Reproducibility of Results</term><term>Ventricular Function, Right</term><term>Ventricular Pressure</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Hypertension, Pulmonary</term><term>Pulmonary Artery</term><term>Pulmonary Embolism</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Echocardiography, Stress</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Hypertension, Pulmonary</term><term>Pulmonary Artery</term><term>Pulmonary Embolism</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Area Under Curve</term><term>Arterial Pressure</term><term>Bicycling</term><term>Cardiac Output</term><term>Case-Control Studies</term><term>Exercise Test</term><term>Feasibility Studies</term><term>Female</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Predictive Value of Tests</term><term>ROC Curve</term><term>Reproducibility of Results</term><term>Ventricular Function, Right</term><term>Ventricular Pressure</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The authors have compared exercise echocardiography and exercise cardiac magnetic resonance imaging with simultaneous invasive pressure registration (ExCMRip) for the assessment of pulmonary vascular and right ventricular (RV) function.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26508387</PMID><DateCreated><Year>2016</Year><Month>05</Month><Day>06</Day></DateCreated><DateCompleted><Year>2017</Year><Month>10</Month><Day>24</Day></DateCompleted><DateRevised><Year>2017</Year><Month>10</Month><Day>24</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1876-7591</ISSN><JournalIssue CitedMedium="Internet"><Volume>9</Volume><Issue>5</Issue><PubDate><Year>2016</Year><Month>May</Month></PubDate></JournalIssue><Title>JACC. Cardiovascular imaging</Title><ISOAbbreviation>JACC Cardiovasc Imaging</ISOAbbreviation></Journal><ArticleTitle>Accuracy of Echocardiography to Evaluate Pulmonary Vascular and RV Function During Exercise.</ArticleTitle><Pagination><MedlinePgn>532-43</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jcmg.2015.06.018</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S1936-878X(15)00706-8</ELocationID><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">The authors have compared exercise echocardiography and exercise cardiac magnetic resonance imaging with simultaneous invasive pressure registration (ExCMRip) for the assessment of pulmonary vascular and right ventricular (RV) function.</AbstractText><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Exercise echocardiography may enable early diagnosis of pulmonary vascular disease, but its accuracy is untested.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Exercise imaging was performed in 61 subjects (19 athletes, 9 healthy nonathletes, 8 healthy BMPR2 [bone morphogenetic protein receptor type II] mutation carriers, 5 patients with new or worsening dyspnea after acute pulmonary embolism, and 20 patients with chronic thromboembolic pulmonary hypertension). Echocardiographic variables included mean pulmonary artery pressure (mPAP) and systolic pulmonary artery pressure (sPAP), cardiac output (CO), RV fractional area change, tricuspid annular systolic excursion, and RV end-systolic pressure-area ratio as a surrogate measure of RV contractile reserve. ExCMRip provided measurements of CO, RV ejection fraction, mPAP, sPAP, and RV end-systolic pressure-volume ratio at rest and during exercise. Abnormal pulmonary vascular reserve was defined as mPAP/CO slope >3 mm Hg/l/min by ExCMRip.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Echocardiographic determination of mPAP/CO was possible in 53 of 61 subjects (87%). mPAP/CO by echocardiography was higher than that obtained by ExCMRip (+0.9 mm Hg/l/min; 95% limits of agreement, -3.6 to 5.4), but enabled accurate identification of patients with abnormal pulmonary vascular reserve (area under the receiver-operating characteristic curve, 0.88 [95% confidence interval (CI): 0.77 to 1.00; p < 0.0001]). Simplified relationships between sPAP and exercise intensity had similar accuracy in identifying subjects with pulmonary vascular disease (area under the receiver-operating characteristic curve, 0.95 [95% CI: 0.88 to 1.01]; p < 0.0001). RV fractional area change by echocardiography correlated strongly with RV ejection fraction by ExCMRip, whereas a moderate correlation was found between tricuspid annular systolic excursion and RV ejection fraction. A moderate correlation was found between ratios of peak exercise to resting RV end-systolic pressure-area ratio and RV end-systolic pressure-volume ratio (r = 0.64; p < 0.0001).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Echocardiographic estimates of RV and pulmonary vascular function are feasible during exercise and identify pathology with reasonable accuracy. They represent valid screening tools for the identification of pulmonary vascular disease in routine clinical practice.</AbstractText><CopyrightInformation>Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Claessen</LastName><ForeName>Guido</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium. Electronic address: guido.claessen@uzleuven.be.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>La Gerche</LastName><ForeName>Andre</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Baker IDI Heart and Diabetes Institute, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Voigt</LastName><ForeName>Jens-Uwe</ForeName><Initials>JU</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dymarkowski</LastName><ForeName>Steven</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schnell</LastName><ForeName>Frédéric</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Physiology, Rennes University, Rennes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Petit</LastName><ForeName>Thibault</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Willems</LastName><ForeName>Rik</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Claus</LastName><ForeName>Piet</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Delcroix</LastName><ForeName>Marion</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>University Hospitals Leuven, Leuven, Belgium; Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heidbuchel</LastName><ForeName>Hein</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>University of Hasselt and Heart Center, Jessa Hospital, Hasselt, Belgium.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D023361">Validation Studies</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>10</Month><Day>21</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>JACC Cardiovasc Imaging</MedlineTA><NlmUniqueID>101467978</NlmUniqueID><ISSNLinking>1876-7591</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019540" MajorTopicYN="N">Area Under Curve</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D062186" MajorTopicYN="Y">Arterial Pressure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001642" MajorTopicYN="N">Bicycling</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002302" MajorTopicYN="N">Cardiac Output</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016022" MajorTopicYN="N">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D025401" MajorTopicYN="N">Echocardiography, Stress</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005080" MajorTopicYN="Y">Exercise Test</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005240" MajorTopicYN="N">Feasibility Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006976" MajorTopicYN="N">Hypertension, Pulmonary</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008279" MajorTopicYN="N">Magnetic Resonance Imaging</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011237" MajorTopicYN="N">Predictive Value of Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011651" MajorTopicYN="N">Pulmonary Artery</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011655" MajorTopicYN="N">Pulmonary Embolism</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012372" MajorTopicYN="N">ROC Curve</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015203" MajorTopicYN="N">Reproducibility of Results</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016278" MajorTopicYN="Y">Ventricular Function, Right</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017725" MajorTopicYN="N">Ventricular Pressure</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">cardiac magnetic resonance imaging</Keyword><Keyword MajorTopicYN="N">echocardiography</Keyword><Keyword MajorTopicYN="N">exercise</Keyword><Keyword MajorTopicYN="N">pulmonary artery pressure</Keyword><Keyword MajorTopicYN="N">pulmonary hypertension</Keyword><Keyword MajorTopicYN="N">right ventricular function</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>04</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2015</Year><Month>06</Month><Day>09</Day></PubMedPubDate><PubMedPubDate 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