{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T05:24:14Z","timestamp":1731043454846,"version":"3.28.0"},"reference-count":37,"publisher":"Texas Heart Institute Journal","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>Locoregional cytokine treatment, or immunoembolization, is an experimental targeted therapy for uveal melanoma metastatic to the liver. Unlike systemic cytokine treatments that have been associated with substantial toxicity, this method of drug delivery appears to be better tolerated. Because this newer therapy is being prescribed more widely, oncologists, interventional radiologists, cardiologists, pulmonologists, critical care specialists, and other providers should become familiar with potential adverse reactions.<\/jats:p>\n        <jats:p>We describe the case of a 67-year-old man who had metastatic uveal melanoma. Before he underwent liver-directed immunoembolization, he had elevated markers of endothelial dysfunction. He died after the rapid onset of acute right ventricular failure from severe pulmonary hypertension with possible superimposed isolated right ventricular takotsubo cardiomyopathy. In discussing this rare case, we focus on the differential diagnosis.<\/jats:p>","DOI":"10.14503\/thij-18-6762","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T23:55:50Z","timestamp":1601510150000},"page":"224-228","source":"Crossref","is-referenced-by-count":1,"title":["Rapid, Fatal Acute Right Ventricular Failure After Locoregional Cytokine Therapy for Uveal Melanoma Liver Metastases"],"prefix":"10.14503","volume":"47","author":[{"given":"Rajiv A.","family":"Kabadi","sequence":"first","affiliation":[{"name":"Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mital","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregary D.","family":"Marhefka","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gautam","family":"George","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bharat","family":"Awsare","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mizue","family":"Terai","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takami","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5628","reference":[{"issue":"8","key":"i1526-6702-47-3-224-b1","series-title":"Expert Opin Investig Drugs","first-page":"993","article-title":"Successes and setbacks of early investigational drugs for melanoma","volume":"24","year":"2015","unstructured":"Orloff\n              M,\n            \n            \n              Valsecchi\n              ME,\n            \n            \n              Sato\n              T.\n            \n          \n          Successes and setbacks of early investigational drugs for melanoma.\n\t\t\t\t\tExpert Opin Investig Drugs2015;24(8):993\u20137."},{"issue":"10","key":"i1526-6702-47-3-224-b2","series-title":"J Cancer Metastasis Treat","first-page":"231","article-title":"Immunological aspect of the liver and metastatic uveal melanoma","volume":"3","year":"2017","unstructured":"Terai\n              M,\n            \n            \n              Mastrangleo\n              MJ,\n            \n            \n              Sato\n              T.\n            \n          \n          Immunological aspect of the liver and metastatic uveal melanoma.\n\t\t\t\t\tJ Cancer Metastasis Treat2017;3(10):231\u201343."},{"issue":"4","key":"i1526-6702-47-3-224-b3","series-title":"J Vasc Interv Radiol","first-page":"523","article-title":"Double-blinded, randomized phase II study using embolization with or without granulocyte-macrophage colony-stimulating factor in uveal melanoma with hepatic metastases","volume":"26","year":"2015","unstructured":"Valsecchi\n              ME,\n            \n            \n              Terai\n              M,\n            \n            \n              Eschelman\n              DJ,\n            \n            \n              Gonsalves\n              CF,\n            \n            \n              Chervoneva\n              I,\n            \n            \n              Shields\n              JA,\n            \n          \n          et al.\n          Double-blinded, randomized phase II study using embolization with or without granulocyte-macrophage colony-stimulating factor in uveal melanoma with hepatic metastases.\n\t\t\t\t\tJ Vasc Interv Radiol2015;26(4):523\u201332.e2."},{"issue":"4","key":"i1526-6702-47-3-224-b4","series-title":"World J Gastroenterol","first-page":"1344","article-title":"Pulmonary embolism after arterial chemoembolization for hepatocellular carcinoma: an autopsy case report","volume":"21","year":"2015","unstructured":"Hatamaru\n              K,\n            \n            \n              Azuma\n              S,\n            \n            \n              Akamatsu\n              T,\n            \n            \n              Seta\n              T,\n            \n            \n              Urai\n              S,\n            \n            \n              Uenoyama\n              Y,\n            \n          \n          et al.\n          Pulmonary embolism after arterial chemoembolization for hepatocellular carcinoma: an autopsy case report.\n\t\t\t\t\tWorld J Gastroenterol2015;21(4):1344\u20138."},{"issue":"1","key":"i1526-6702-47-3-224-b5","series-title":"Target Oncol","first-page":"63","article-title":"Comparison of acute toxicity and mortality after two different dosing regimens of high-dose interleukin-2 for patients with metastatic melanoma","volume":"9","year":"2014","unstructured":"Alwan\n              LM,\n            \n            \n              Grossmann\n              K,\n            \n            \n              Sageser\n              D,\n            \n            \n              Van Atta\n              J,\n            \n            \n              Agarwal\n              N,\n            \n            \n              Gilreath\n              JA.\n            \n          \n          Comparison of acute toxicity and mortality after two different dosing regimens of high-dose interleukin-2 for patients with metastatic melanoma.\n\t\t\t\t\tTarget Oncol2014;9(1):63\u201371."},{"issue":"12","key":"i1526-6702-47-3-224-b6","series-title":"Cancer","first-page":"3212","article-title":"Cardiopulmonary toxicity of treatment with high dose interleukin-2 in 199 consecutive patients with metastatic melanoma or renal cell carcinoma","volume":"74","year":"1994","unstructured":"White\n              RL\n              Jr\n            ,\n\t\t\t\t\t\tSchwartzentruberDJ,GuleriaA,MacFarlaneMP,WhiteDE,TuckerE,RosenbergSA.\n          Cardiopulmonary toxicity of treatment with high dose interleukin-2 in 199 consecutive patients with metastatic melanoma or renal cell carcinoma.\n\t\t\t\t\tCancer1994;74(12):3212\u201322."},{"issue":"7","key":"i1526-6702-47-3-224-b7","series-title":"Crit Care Med","first-page":"1216","article-title":"The clinical picture of severe systemic capillary-leak syndrome episodes requiring ICU admission","volume":"45","year":"2017","unstructured":"Pineton de Chambrun\n              M,\n            \n            \n              Luyt\n              CE,\n            \n            \n              Beloncle\n              F,\n            \n            \n              Gousseff\n              M,\n            \n            \n              Mauhin\n              W,\n            \n            \n              Argaud\n              L,\n            \n          \n          et al.\n          The clinical picture of severe systemic capillary-leak syndrome episodes requiring ICU admission.\n\t\t\t\t\tCrit Care Med2017;45(7):1216\u201323."},{"issue":"3","key":"i1526-6702-47-3-224-b8","series-title":"Hosp Pract","first-page":"23","article-title":"Poor positive predictive value of McConnell's sign on transthoracic echocardiography for the diagnosis of acute pulmonary embolism","volume":"41","year":"2013","unstructured":"Vaid\n              U,\n            \n            \n              Singer\n              E,\n            \n            \n              Marhefka\n              GD,\n            \n            \n              Kraft\n              WK,\n            \n            \n              Baram\n              M.\n            \n          \n          Poor positive predictive value of McConnell's sign on transthoracic echocardiography for the diagnosis of acute pulmonary embolism.\n\t\t\t\t\tHosp Pract2013;41(3):23\u20137."},{"issue":"6","key":"i1526-6702-47-3-224-b9","series-title":"Blood","first-page":"1565","article-title":"Granulocyte-macrophage colony-stimulating factor induces neutrophil adhesion to pulmonary vascular endothelium in vivo: role of beta 2 integrins","volume":"80","year":"1992","unstructured":"Yong\n              KL,\n            \n            \n              Rowles\n              PM,\n            \n            \n              Patterson\n              KG,\n            \n            \n              Linch\n              DC.\n            \n          \n          Granulocyte-macrophage colony-stimulating factor induces neutrophil adhesion to pulmonary vascular endothelium in vivo: role of beta 2 integrins.\n\t\t\t\t\tBlood1992;80(6):1565\u201375."},{"issue":"12","key":"i1526-6702-47-3-224-b10","series-title":"Eur J Clin Invest","first-page":"1342","article-title":"Acute lung injury results from failure of neutrophil de-priming: a new hypothesis","volume":"42","year":"2012","unstructured":"Singh\n              NRP,\n            \n            \n              Johnson\n              A,\n            \n            \n              Peters\n              AM,\n            \n            \n              Babar\n              J,\n            \n            \n              Chilvers\n              ER,\n            \n            \n              Summers\n              C.\n            \n          \n          Acute lung injury results from failure of neutrophil de-priming: a new hypothesis.\n\t\t\t\t\tEur J Clin Invest2012;42(12):1342\u20139."},{"issue":"2","key":"i1526-6702-47-3-224-b11","series-title":"Clin Exp Immunol","first-page":"392","article-title":"Granulocyte-macrophage colony-stimulating factor (GM-CSF) but not granulocyte colony-stimulating factor (G-CSF) induces plasma membrane expression of proteinase 3 (PR3) on neutrophils in vitro","volume":"120","year":"2000","unstructured":"Hellmich\n              B,\n            \n            \n              Csernok\n              E,\n            \n            \n              Trabandt\n              A,\n            \n            \n              Gross\n              WL,\n            \n            \n              Ernst\n              M.\n            \n          \n          Granulocyte-macrophage colony-stimulating factor (GM-CSF) but not granulocyte colony-stimulating factor (G-CSF) induces plasma membrane expression of proteinase 3 (PR3) on neutrophils in vitro.\n\t\t\t\t\tClin Exp Immunol2000;120(2):392\u20138."},{"issue":"1","key":"i1526-6702-47-3-224-b12","series-title":"J Cardiol Cases","first-page":"28","article-title":"Acute myocarditis following high-dose interleukin-2 treatment","volume":"15","year":"2016","unstructured":"Tan\n              MCC,\n            \n            \n              Ortega-Legaspi\n              JM,\n            \n            \n              Cheng\n              SF,\n            \n            \n              Patton\n              KK.\n            \n          \n          Acute myocarditis following high-dose interleukin-2 treatment.\n\t\t\t\t\tJ Cardiol Cases2016;15(1):28\u201331."},{"issue":"3","key":"i1526-6702-47-3-224-b13","series-title":"Acute Card Care","first-page":"102","article-title":"Sepsis-induced myocardial depression and takotsubo syndrome","volume":"16","year":"2014","unstructured":"Y-Hassan\n              S,\n            \n            \n              Settergren\n              M,\n            \n            \n              Henareh\n              L.\n            \n          \n          Sepsis-induced myocardial depression and takotsubo syndrome.\n\t\t\t\t\tAcute Card Care2014;16(3):102\u20139."},{"issue":"6","key":"i1526-6702-47-3-224-b14","series-title":"N Engl J Med","first-page":"539","article-title":"Neurohumoral features of myocardial stunning due to sudden emotional stress","volume":"352","year":"2005","unstructured":"Wittstein\n              IS,\n            \n            \n              Thiemann\n              DR,\n            \n            \n              Lima\n              JAC,\n            \n            \n              Baughman\n              KL,\n            \n            \n              Schulman\n              SP,\n            \n            \n              Gerstenblith\n              G,\n            \n          \n          et al.\n          Neurohumoral features of myocardial stunning due to sudden emotional stress.\n\t\t\t\t\tN Engl J Med2005;352(6):539\u201348."},{"issue":"9","key":"i1526-6702-47-3-224-b15","series-title":"Intensive Care Med","first-page":"1387","article-title":"Catecholamines for inflammatory shock: a Jekyll-and-Hyde conundrum","volume":"42","year":"2016","unstructured":"Andreis\n              DT,\n            \n            \n              Singer\n              M.\n            \n          \n          Catecholamines for inflammatory shock: a Jekyll-and-Hyde conundrum.\n\t\t\t\t\tIntensive Care Med2016;42(9):1387\u201397."},{"issue":"3","key":"i1526-6702-47-3-224-b16","series-title":"J Card Fail","first-page":"206","article-title":"Importance of inflammation and neurohumoral activation in takotsubo cardiomyopathy","volume":"15","year":"2009","unstructured":"Morel\n              O,\n            \n            \n              Sauer\n              F,\n            \n            \n              Imperiale\n              A,\n            \n            \n              Cimarelli\n              S,\n            \n            \n              Blondet\n              C,\n            \n            \n              Jesel\n              L,\n            \n          \n          et al.\n          Importance of inflammation and neurohumoral activation in takotsubo cardiomyopathy.\n\t\t\t\t\tJ Card Fail2009;15(3):206\u201313."},{"issue":"4","key":"i1526-6702-47-3-224-b17","series-title":"J Cardiol","first-page":"247","article-title":"Inflammation in takotsubo cardiomyopathy? Inquiry from \u201cGuidelines for Diagnosis and Treatment of Myocarditis (JCS 2009)\u201d","volume":"63","year":"2014","unstructured":"Kawai\n              S,\n            \n            \n              Shimada\n              T.\n            \n          \n          Inflammation in takotsubo cardiomyopathy? Inquiry from \u201cGuidelines for Diagnosis and Treatment of Myocarditis (JCS 2009)\u201d.\n\t\t\t\t\tJ Cardiol2014;63(4):247\u20139."},{"key":"i1526-6702-47-3-224-b18","series-title":"Int J Cardiol","first-page":"168","article-title":"Takotsubo cardiomyopathy and myopericarditis: unraveling the inflammatory hypothesis","volume":"196","year":"2015","unstructured":"Khalid\n              N,\n            \n            \n              Ahmad\n              SA,\n            \n            \n              Umer\n              A,\n            \n            \n              Chhabra\n              L.\n            \n          \n          Takotsubo cardiomyopathy and myopericarditis: unraveling the inflammatory hypothesis.\n\t\t\t\t\tInt J Cardiol2015;196:168\u20139."},{"issue":"1","key":"i1526-6702-47-3-224-b19","series-title":"Int J Cardiol","first-page":"149","article-title":"Myocarditis and takotsubo syndrome: are they mutually exclusive?","volume":"177","year":"2014","unstructured":"Y-Hassan\n              S.\n            \n          \n          Myocarditis and takotsubo syndrome: are they mutually exclusive?\n          \n            Int J Cardiol\n          \n          2014;177(1):149\u201351."},{"issue":"246","key":"i1526-6702-47-3-224-b20","series-title":"Pol Merkur Lekarski","first-page":"283","article-title":"Isolated right ventricular takotsubo cardiomyopathy: a case report and literature review","volume":"41","year":"2016","unstructured":"Elikowski\n              W,\n            \n            \n              Malek-Elikowska\n              M,\n            \n            \n              Rozanska\n              P,\n            \n            \n              Fertala\n              N,\n            \n            \n              Zawodna\n              M.\n            \n          \n          Isolated right ventricular takotsubo cardiomyopathy: a case report and literature review.\n\t\t\t\t\tPol Merkur Lekarski2016;41(246):283\u20136."},{"issue":"16","key":"i1526-6702-47-3-224-b21","series-title":"J Am Coll Cardiol","first-page":"1751","article-title":"Right ventricular takotsubo cardiomyopathy","volume":"55","year":"2010","unstructured":"Mrdovic\n              I,\n            \n            \n              Kostic\n              J,\n            \n            \n              Perunicic\n              J,\n            \n            \n              Asanin\n              M,\n            \n            \n              Vasiljevic\n              Z,\n            \n            \n              Ostojic\n              M.\n            \n          \n          Right ventricular takotsubo cardiomyopathy.\n\t\t\t\t\tJ Am Coll Cardiol2010;55(16):1751."},{"issue":"7","key":"i1526-6702-47-3-224-b22","series-title":"Clin Res Cardiol","first-page":"617","article-title":"Isolated right ventricular stress-induced (Tako-Tsubo) cardiomyopathy","volume":"100","year":"2011","unstructured":"Burgdorf\n              C,\n            \n            \n              Hunold\n              P,\n            \n            \n              Radke\n              PW,\n            \n            \n              Schunkert\n              H,\n            \n            \n              Kurowski\n              V.\n            \n          \n          Isolated right ventricular stress-induced (Tako-Tsubo) cardiomyopathy.\n\t\t\t\t\tClin Res Cardiol2011;100(7):617\u20139."},{"issue":"14","key":"i1526-6702-47-3-224-b23","series-title":"Eur Heart J","first-page":"1821","article-title":"Isolated right ventricular ballooning syndrome: a new variant of transient cardiomyopathy","volume":"32","year":"2011","unstructured":"St\u00e4hli\n              BE,\n            \n            \n              Ruschitzka\n              F,\n            \n            \n              Enseleit\n              F.\n            \n          \n          Isolated right ventricular ballooning syndrome: a new variant of transient cardiomyopathy.\n\t\t\t\t\tEur Heart J2011;32(14):1821."},{"issue":"1","key":"i1526-6702-47-3-224-b24","series-title":"Exp Ther Med","first-page":"260","article-title":"Takotsubo cardiomyopathy recurrence with left ventricular apical ballooning following isolated right ventricular involvement: a case report","volume":"6","year":"2013","unstructured":"Joe\n              BH,\n            \n            \n              Hwang\n              HJ,\n            \n            \n              Park\n              CB,\n            \n            \n              Jin\n              ES,\n            \n            \n              Sohn\n              IS,\n            \n            \n              Cho\n              JM,\n            \n            \n              Kim\n              CJ.\n            \n          \n          Takotsubo cardiomyopathy recurrence with left ventricular apical ballooning following isolated right ventricular involvement: a case report.\n\t\t\t\t\tExp Ther Med2013;6(1):260\u20132."},{"issue":"8","key":"i1526-6702-47-3-224-b25","series-title":"Echocardiography","first-page":"E240","article-title":"Recurrent right ventricular takotsubo cardiomyopathy in a patient with recurrent aspiration","volume":"31","year":"2014","unstructured":"Chandorkar\n              A,\n            \n            \n              Codolosa\n              JN,\n            \n            \n              Lippmann\n              ML,\n            \n            \n              Pressman\n              GS,\n            \n            \n              Sta Cruz\n              JP\n            .\n\t\t\t\t\t\n          Recurrent right ventricular takotsubo cardiomyopathy in a patient with recurrent aspiration.\n\t\t\t\t\tEchocardiography2014;31(8):E240\u20132."},{"issue":"3","key":"i1526-6702-47-3-224-b26","series-title":"Eur Heart J Cardiovasc Imaging","first-page":"285","article-title":"Isolated right ventricular takotsubo cardiomyopathy","volume":"16","year":"2015","unstructured":"Kagiyama\n              N,\n            \n            \n              Okura\n              H,\n            \n            \n              Kume\n              T,\n            \n            \n              Hayashida\n              A,\n            \n            \n              Yoshida\n              K.\n            \n          \n          Isolated right ventricular takotsubo cardiomyopathy.\n\t\t\t\t\tEur Heart J Cardiovasc Imaging2015;16(3):285."},{"issue":"10 Suppl","key":"i1526-6702-47-3-224-b27","series-title":"J Card Fail","first-page":"S84","article-title":"P24-4 - Cardiac arrest caused by isolated right ventricular takotsubo cardiomyopathy [abstract]","volume":"23","year":"2017","unstructured":"Maeba\n              H,\n            \n            \n              Senoh\n              T,\n            \n            \n              Suwa\n              Y,\n            \n            \n              Miyasaka\n              Y,\n      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Results from CORONA","volume":"16","year":"2014","unstructured":"Nymo\n              SH,\n            \n            \n              Hulthe\n              J,\n            \n            \n              Ueland\n              T,\n            \n            \n              McMurray\n              J,\n            \n            \n              Wikstrand\n              J,\n            \n            \n              Askevold\n              ET,\n            \n          \n          et al.\n          Inflammatory cytokines in chronic heart failure: interleukin-8 is associated with adverse outcome. 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Assoc","first-page":"e005077","article-title":"Inflammatory biomarkers interleukin-6 and C-reactive protein and outcomes in stable coronary heart disease: experiences from the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) Trial","volume":"6","year":"2017","unstructured":"Held\n              C,\n            \n            \n              White\n              HD,\n            \n            \n              Stewart\n              RAH,\n            \n            \n              Budaj\n              A,\n            \n            \n              Cannon\n              CP,\n            \n            \n              Hochman\n              JS,\n            \n          \n          et al.\n          Inflammatory biomarkers interleukin-6 and C-reactive protein and outcomes in stable coronary heart disease: experiences from the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) Trial.\n\t\t\t\t\tJ Am Heart Assoc2017;6(10):e005077."},{"key":"i1526-6702-47-3-224-b32","series-title":"Atherosclerosis","first-page":"28","article-title":"Serum interleukin 6 and 10 levels in takotsubo cardiomyopathy: increased admission levels may predict adverse events at follow-up","volume":"254","year":"2016","unstructured":"Santoro\n              F,\n            \n            \n              Tarantino\n              N,\n            \n            \n              Ferraretti\n              A,\n            \n            \n              Ieva\n              R,\n            \n            \n              Musaico\n              F,\n            \n            \n              Guastafierro\n              F,\n            \n          \n          et al.\n          Serum interleukin 6 and 10 levels in takotsubo cardiomyopathy: increased admission levels may predict adverse events at follow-up.\n\t\t\t\t\tAtherosclerosis2016;254:28\u201334."},{"issue":"4","key":"i1526-6702-47-3-224-b33","series-title":"JACC Heart Fail","first-page":"256","article-title":"Limited added value of circulating inflammatory biomarkers in chronic heart failure","volume":"5","year":"2017","unstructured":"Nymo\n              SH,\n            \n            \n              Aukrust\n              P,\n            \n            \n              Kjekshus\n              J,\n            \n            \n              McMurray\n              JJV,\n            \n            \n              Cleland\n              JGF,\n            \n            \n              Wikstrand\n              J,\n            \n          \n          et al.\n          Limited added value of circulating inflammatory biomarkers in chronic heart failure.\n\t\t\t\t\tJACC Heart Fail2017;5(4):256\u201364."},{"issue":"7","key":"i1526-6702-47-3-224-b34","series-title":"Am J Respir Crit Care Med","first-page":"779","article-title":"Transforming growth factor-\u03b2 induced protein promotes severe vascular inflammatory responses","volume":"189","year":"2014","unstructured":"Bae\n              JS,\n            \n            \n              Lee\n              W,\n            \n            \n              Nam\n              JO,\n            \n            \n              Kim\n              JE,\n            \n            \n              Kim\n              SW,\n            \n            \n              Kim\n              IS.\n            \n          \n          Transforming growth factor-\u03b2 induced protein promotes severe vascular inflammatory responses.\n\t\t\t\t\tAm J Respir Crit Care Med2014;189(7):779\u201386."},{"issue":"10","key":"i1526-6702-47-3-224-b35","series-title":"Eur J Heart Fail","first-page":"1015","article-title":"Long-term prognosis of the transient left ventricular dysfunction syndrome (Tako-Tsubo cardiomyopathy): focus on malignancies","volume":"10","year":"2008","unstructured":"Burgdorf\n              C,\n            \n            \n              Kurowski\n              V,\n        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