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BioMed Research International
Volume 2018 (2018), Article ID 4528148, 9 pages
https://doi.org/10.1155/2018/4528148
Review Article

Right Ventricle Remodeling and Function in Scleroderma Patients

University of Medicine and Pharmacy of Târgu Mureș, Gh. Marinescu Street, No. 38, 540139 Tîrgu Mureș, Romania

Correspondence should be addressed to Iolanda Muntean; moc.liamg@naetnum.adnaloi

Received 1 September 2017; Accepted 12 February 2018; Published 20 March 2018

Academic Editor: Shigeru Kotake

Copyright © 2018 Roxana Cucuruzac et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. R. J. Tedford, J. O. Mudd, R. E. Girgis et al., “Right ventricular dysfunction in systemic sclerosis-associated pulmonary arterial hypertension,” Circulation: Heart Failure, vol. 6, no. 5, pp. 953–963, 2013. View at Publisher · View at Google Scholar · View at Scopus
  2. L. Chung, H. W. Farber, R. Benza et al., “Unique Predictors of Mortality in Patients With Pulmonary Arterial Hypertension Associated With Systemic Sclerosis in the REVEAL Registry,” CHEST, vol. 146, no. 6, pp. 1494–1504, 2014. View at Publisher · View at Google Scholar · View at Scopus
  3. T. A. Winstone, D. Assayag, P. G. Wilcox et al., “Predictors of mortality and progression in scleroderma-associated interstitial lung disease: A systematic review,” CHEST, vol. 146, no. 2, pp. 422–436, 2014. View at Publisher · View at Google Scholar · View at Scopus
  4. M. Elhai, C. Meune, M. Boubaya et al., “Mapping and predicting mortality from systemic sclerosis,” Annals of the Rheumatic Diseases, 2017. View at Google Scholar
  5. K. Romanowska-Próchnicka, M. Walczyk, and M. Olesińska, “Recognizing systemic sclerosis: Comparative analysis of various sets of classification criteria,” Reumatología Clínica, vol. 54, no. 6, pp. 296–305, 2016. View at Publisher · View at Google Scholar · View at Scopus
  6. L. I. Sakkas, “New developments in the pathogenesis of systemic sclerosis,” Autoimmunity, vol. 38, no. 2, pp. 113–116, 2005. View at Publisher · View at Google Scholar · View at Scopus
  7. S. Barsotti, C. Stagnaro, A. d'Ascanio, and A. Della Rossa, “One year in review 2016: Systemic sclerosis,” Clinical and Experimental Rheumatology, vol. 34, pp. 3–13, 2016. View at Google Scholar · View at Scopus
  8. A. J. Gilbane, C. P. Denton, and A. M. Holmes, “Scleroderma pathogenesis: A pivotal role for fibroblasts as effector cells,” Arthritis Research & Therapy, vol. 15, no. 3, article no. 215, 2013. View at Publisher · View at Google Scholar · View at Scopus
  9. M. Matucci-Cerinic, B. Kahaleh, and F. M. Wigley, “Review: evidence that systemic sclerosis is a vascular disease,” Arthritis & Rheumatology, vol. 65, no. 8, pp. 1953–1962, 2013. View at Publisher · View at Google Scholar · View at Scopus
  10. S. A. Jimenez, “Role of endothelial to mesenchymal transition in the pathogenesis of the vascular alterations in systemic sclerosis,” ISRN Rheumatology, vol. 2013, Article ID 835948, 15 pages, 2013. View at Publisher · View at Google Scholar
  11. C. Fatini, F. Gensini, E. Sticchi et al., “High prevalence of polymorphisms of angiotensin-converting enzyme (I/D) and endothelial nitric oxide synthase (Glu298Asp) in patients with systemic sclerosis,” American Journal of Medicine, vol. 112, no. 7, pp. 540–544, 2002. View at Publisher · View at Google Scholar · View at Scopus
  12. R. Togǎnel, I. Muntean, C. Duicu, A. Fǎgǎrǎşan, L. Gozar, and C. Bǎnescu, “The role of eNOS and AGT gene polymorphisms in secondary pulmonary arterial hypertension in Romanian children with congenital heart disease,” Revista Romana de Medicina de Laborator, vol. 21, no. 3-4, pp. 267–274, 2013. View at Publisher · View at Google Scholar · View at Scopus
  13. J. Barnes and M. D. Mayes, “Epidemiology of systemic sclerosis: Incidence, prevalence, survival, risk factors, malignancy, and environmental triggers,” Current Opinion in Rheumatology, vol. 24, no. 2, pp. 165–170, 2012. View at Publisher · View at Google Scholar · View at Scopus
  14. A. C. Gelber, R. L. Manno, A. A. Shah et al., “Race and association with disease manifestations and mortality in scleroderma : A 20-year experience at the johns hopkins scleroderma center and review of the literature,” Medicine (United States), vol. 92, no. 4, pp. 191–205, 2013. View at Publisher · View at Google Scholar · View at Scopus
  15. C. Nguyen, A. Bérezné, T. Baubet et al., “Association of gender with clinical expression, quality of life, disability, and depression and anxiety in patients with systemic sclerosis,” PLoS ONE, vol. 6, no. 3, Article ID e17551, 2011. View at Publisher · View at Google Scholar · View at Scopus
  16. J. Le Pavec, M. Humbert, L. Mouthon, and P. M. Hassoun, “Systemic sclerosis-associated pulmonary arterial hypertension,” American Journal of Respiratory and Critical Care Medicine, vol. 181, no. 12, pp. 1285–1293, 2010. View at Publisher · View at Google Scholar · View at Scopus
  17. C. J. Mullin and S. C. Mathai, “New insights into the recognition, classification and management of systemic sclerosis-associated pulmonary hypertension,” Current Opinion in Rheumatology, vol. 29, no. 6, pp. 561–567, 2017. View at Publisher · View at Google Scholar · View at Scopus
  18. G. Lefèvre, L. Dauchet, E. Hachulla et al., “Survival and prognostic factors in systemic sclerosis–associated pulmonary hypertension: a systematic review and meta-analysis,” Arthritis & Rheumatology, vol. 65, no. 9, pp. 2412–2423, 2013. View at Google Scholar
  19. A. Tyndall, “Systemic sclerosis in Europe: first report from the EULAR Scleroderma Trials And Research (EUSTAR) group database,” Annals of the Rheumatic Diseases, vol. 64, no. 7, pp. 1107–1107, 2005. View at Publisher · View at Google Scholar
  20. M. Hinchcliff, A. Fischer, E. Schiopu, and V. D. Steen, “Pulmonary hypertension assessment and recognition of outcomes in scleroderma (PHAROS): Baseline characteristics and description of study population,” The Journal of Rheumatology, vol. 38, no. 10, pp. 2172–2179, 2011. View at Publisher · View at Google Scholar · View at Scopus
  21. G. Simonneau, M. Gatzoulis, and I. Adatia, “Updated clinical classification of pulmonary hypertension,” Journal of the American College of Cardiology, vol. 62, no. 25, supplement, 2013. View at Publisher · View at Google Scholar
  22. M. R. Fisher, S. C. Mathai, H. C. Champion et al., “Clinical differences between idiopathic and scleroderma-related pulmonary hypertension,” Arthritis & Rheumatology, vol. 54, no. 9, pp. 3043–3050, 2006. View at Google Scholar
  23. A. Campo, S. C. Mathai, J. Le Pavec et al., “Hemodynamic predictors of survival in scleroderma-related pulmonary arterial hypertension,” American Journal of Respiratory and Critical Care Medicine, vol. 182, no. 2, pp. 252–260, 2010. View at Publisher · View at Google Scholar · View at Scopus
  24. R. G. Argula, A. Karwa, A. Lauer et al., “Differences in right ventricular functional changes during treatment between systemic sclerosis-associated pulmonary arterial hypertension and idiopathic pulmonary arterial hypertension,” Annals of the American Thoracic Society, vol. 14, no. 5, pp. 682–689, 2017. View at Publisher · View at Google Scholar · View at Scopus
  25. V. McLaughlin, R. N. Channick, H.-A. Ghofrani et al., “Bosentan added to sildenafil therapy in patients with pulmonary arterial hypertension,” European Respiratory Journal, vol. 46, no. 2, pp. 405–413, 2015. View at Publisher · View at Google Scholar · View at Scopus
  26. N. Galiè, M. Humbert, J. L. Vachiery et al., “2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT),” European Heart Journal, vol. 37, no. 1, pp. 67–119, 2016. View at Google Scholar
  27. P. M. Hassoun, “The right ventricle in scleroderma (2013 Grover conference series),” Pulmonary Circulation, vol. 5, no. 1, pp. 3–14, 2015. View at Publisher · View at Google Scholar · View at Scopus
  28. S. C. Mathai, M. Bueso, L. K. Hummers et al., “Disproportionate elevation of N-terminal pro-brain natriuretic peptide in scleroderma-related pulmonary hypertension,” European Respiratory Journal, vol. 35, no. 1, pp. 95–104, 2010. View at Publisher · View at Google Scholar · View at Scopus
  29. M. J. Overbeek, J.-W. Lankhaar, N. Westerhof et al., “Right ventricular contractility in systemic sclerosis-associated and idiopathic pulmonary arterial hypertension,” European Respiratory Journal, vol. 31, no. 6, pp. 1160–1166, 2008. View at Publisher · View at Google Scholar · View at Scopus
  30. W. P. Follansbee, T. R. Miller, E. I. Curtiss et al., “A controlled clinicopathologic study of myocardial fibrosis in systemic sclerosis (scleroderma),” The Journal of Rheumatology, vol. 17, no. 5, pp. 656–662, 1990. View at Google Scholar
  31. C. Meune, O. Vignaux, A. Kahan, and Y. Allanore, “Heart involvement in systemic sclerosis: evolving concept and diagnostic methodologies,” Archives of Cardiovascular Diseases, vol. 103, no. 1, pp. 46–52, 2010. View at Publisher · View at Google Scholar · View at Scopus
  32. F. Fernandes, F. J. A. Ramires, E. Arteaga, B. M. Ianni, E. S. D. O. Bonfá, and C. Mady, “Cardiac remodeling in patients with systemic sclerosis with no signs or symptoms of heart failure: An endomyocardial biopsy study,” Journal of Cardiac Failure, vol. 9, no. 4, pp. 311–317, 2003. View at Publisher · View at Google Scholar · View at Scopus
  33. S. Lambova, “Cardiac manifestations in systemic sclerosis,” World Journal of Cardiology, vol. 6, no. 9, p. 993, 2014. View at Publisher · View at Google Scholar
  34. J. Kjærgaard, “Assessment of right ventricular systolic function by tissue Doppler echocardiography.,” Danish Medical Journal, vol. 59, no. 3, p. B4409, 2012. View at Google Scholar · View at Scopus
  35. E. Pigatto, D. Peluso, E. Zanatta et al., “Evaluation of right ventricular function performed by 3d-echocardiography in scleroderma patients,” Reumatismo, vol. 66, no. 4, pp. 259–263, 2015. View at Publisher · View at Google Scholar · View at Scopus
  36. E. Durmus, M. Sunbul, K. Tigen et al., “Right ventricular and atrial functions in systemic sclerosis patients without pulmonary hypertension: Speckle-tracking echocardiographic study,” Herz, vol. 40, no. 4, pp. 709–715, 2015. View at Publisher · View at Google Scholar · View at Scopus
  37. S. Schattke, F. Knebel, A. Grohmann et al., “Early right ventricular systolic dysfunction in patients with systemic sclerosis without pulmonary hypertension: A Doppler Tissue and Speckle Tracking echocardiography study,” Cardiovascular Ultrasound, vol. 8, no. 1, article no. 3, 2010. View at Publisher · View at Google Scholar · View at Scopus
  38. C. Matias, L. P. D. Isla, M. Vasconcelos et al., “Speckle-tracking-derived strain and strain-rate analysis: A technique for the evaluation of early alterations in right ventricle systolic function in patients with systemic sclerosis and normal pulmonary artery pressure,” Journal of Cardiovascular Medicine, vol. 10, no. 2, pp. 129–134, 2009. View at Publisher · View at Google Scholar · View at Scopus
  39. M. D'Alto, G. Cuomo, E. Romeo et al., “Tissue Doppler imaging in systemic sclerosis: A 3-year longitudinal study,” Seminars in Arthritis and Rheumatism, vol. 43, no. 5, pp. 673–680, 2014. View at Publisher · View at Google Scholar · View at Scopus
  40. P. M. Hassoun, R. T. Zamanian, R. Damico et al., “Ambrisentan and tadalafil up-front combination therapy in scleroderma-associated pulmonary arterial hypertension,” American Journal of Respiratory and Critical Care Medicine, vol. 192, no. 9, pp. 1102–1110, 2015. View at Publisher · View at Google Scholar
  41. G. Kovacs and H. Olschewski, “Borderline pulmonary pressures in scleroderma—a pre-pulmonary arterial hypertension condition?” Arthritis Research & Therapy, vol. 17, no. 1, p. 123, 2015. View at Publisher · View at Google Scholar · View at Scopus
  42. A. D’Andrea, M. D’Alto, M. Di Maio et al., “Right atrial morphology and function in patients with systemic sclerosis compared to healthy controls: a two-dimensional strain study,” Clinical Rheumatology, vol. 35, no. 7, pp. 1733–1742, 2016. View at Publisher · View at Google Scholar · View at Scopus
  43. M. Rubenfire, M. D. Huffman, S. Krishnan, J. R. Seibold, E. Schiopu, and V. V. McLaughlin, “Survival in systemic sclerosis with pulmonary arterial hypertension has not improved in the modern era,” CHEST, vol. 144, no. 4, pp. 1282–1290, 2013. View at Publisher · View at Google Scholar · View at Scopus
  44. M. R. Fisher, S. C. Mathai, H. C. Champion et al., “Clinical differences between idiopathic and scleroderma-related pulmonary hypertension,” Arthritis & Rheumatology, vol. 54, no. 9, pp. 3043–3050, 2006. View at Publisher · View at Google Scholar · View at Scopus
  45. M. J. Overbeek, K. T. B. Mouchaers, H. M. Niessen et al., “Characteristics of interstitial fibrosis and inflammatory cell infiltration in right ventricles of systemic sclerosis-associated pulmonary arterial hypertension,” International Journal of Rheumatology, vol. 2010, Article ID 604615, 2010. View at Publisher · View at Google Scholar · View at Scopus
  46. B. W. Kelemen, S. C. Mathai, R. J. Tedford et al., “Right ventricular remodeling in idiopathic and scleroderma-associated pulmonary arterial hypertension: Two distinct phenotypes,” Pulmonary Circulation, vol. 5, no. 2, pp. 327–334, 2015. View at Publisher · View at Google Scholar · View at Scopus
  47. A. Harrison, N. Hatton, and J. J. Ryan, “The right ventricle under pressure: Evaluating the adaptive and maladaptive changes in the right ventricle in pulmonary arterial hypertension using echocardiography (2013 Grover conference series),” Pulmonary Circulation, vol. 5, no. 1, pp. 29–47, 2015. View at Publisher · View at Google Scholar · View at Scopus
  48. S. Ramjug, N. Hussain, J. Hurdman et al., “Idiopathic and Systemic Sclerosis-Associated Pulmonary Arterial Hypertension: A Comparison of Demographic, Hemodynamic, and MRI Characteristics and Outcomes,” CHEST, vol. 152, no. 1, pp. 92–102, 2017. View at Publisher · View at Google Scholar · View at Scopus
  49. D. Hagger, R. Condliffe, N. Woodhouse et al., “Ventricular mass index correlates with pulmonary artery pressure and predicts survival in suspected systemic sclerosis-associated pulmonary arterial hypertension,” Rheumatology, vol. 48, no. 9, pp. 1137–1142, 2009. View at Publisher · View at Google Scholar · View at Scopus
  50. S. Hsu, B. A. Houston, E. Tampakakis et al., “Right ventricular functional reserve in pulmonary arterial hypertension,” Circulation, vol. 133, no. 24, pp. 2413–2422, 2016. View at Publisher · View at Google Scholar · View at Scopus
  51. G. Kovacs, A. Avian, N. Wutte et al., “Changes in pulmonary exercise haemodynamics in scleroderma: A 4-year prospective study,” European Respiratory Journal, vol. 50, no. 1, Article ID 1601708, 2017. View at Publisher · View at Google Scholar · View at Scopus
  52. E. Hachulla, D. Launay, A. Yaici et al., “Pulmonary arterial hypertension associated with systemic sclerosis in patients with functional class II dyspnoea: mild symptoms but severe outcome.,” Rheumatology, vol. 49, no. 5, pp. 940–944, 2010. View at Publisher · View at Google Scholar · View at Scopus
  53. P. R. Forfia, M. R. Fisher, S. C. Mathai et al., “Tricuspid annular displacement predicts survival in pulmonary hypertension,” American Journal of Respiratory and Critical Care Medicine, vol. 174, no. 9, pp. 1034–1041, 2006. View at Publisher · View at Google Scholar · View at Scopus
  54. S. C. Mathai, C. T. Sibley, P. R. Forfia et al., “Tricuspid annular plane systolic excursion is a robust outcome measure in systemic sclerosis-associated pulmonary arterial hypertension,” The Journal of Rheumatology, vol. 38, no. 11, pp. 2410–2418, 2011. View at Publisher · View at Google Scholar · View at Scopus
  55. C. Tei, “New non-invasive index for combined systolic and diastolic ventricular function,” Journal of Cardiology, vol. 26, no. 2, pp. 135-136, 1995. View at Google Scholar · View at Scopus
  56. S. Frea, M. Capriolo, W. G. Marra et al., “Echo doppler predictors of pulmonary artery hypertension in patients with systemic sclerosis,” Journal of Echocardiography, vol. 28, no. 8, pp. 860–869, 2011. View at Publisher · View at Google Scholar · View at Scopus
  57. H. Blessberger and T. Binder, “Two dimensional speckle tracking echocardiography: Basic principles,” Heart, vol. 96, no. 9, pp. 716–722, 2010. View at Publisher · View at Google Scholar · View at Scopus
  58. M. Mukherjee, S. Chung, V. K. Ton et al., “Unique abnormalities in right ventricular longitudinal strain in systemic sclerosis patients,” Circulation: Cardiovascular Imaging, vol. 9, article e003792, no. 6, 2016. View at Publisher · View at Google Scholar
  59. A. Meris, F. Faletra, C. Conca et al., “Timing and magnitude of regional right ventricular function: A speckle tracking-derived strain study of normal subjects and patients with right ventricular dysfunction,” Journal of the American Society of Echocardiography, vol. 23, no. 8, pp. 823–831, 2010. View at Publisher · View at Google Scholar · View at Scopus
  60. L. G. Rudski, W. W. Lai, J. Afilalo et al., “Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography,” Journal of the American Society of Echocardiography, vol. 23, no. 7, pp. 685–713, 2010. View at Publisher · View at Google Scholar · View at Scopus
  61. I. Muntean, T. Benedek, M. Melinte, C. Suteu, and R. Togãnel, “Deformation pattern and predictive value of right ventricular longitudinal strain in children with pulmonary arterial hypertension,” Cardiovascular Ultrasound, vol. 14, no. 1, article no. 27, 2016. View at Publisher · View at Google Scholar · View at Scopus
  62. V. D. Steen, W. P. Follansbee, C. G. Conte, and T. A. Medsger Jr., “Thallium perfusion defects predict subsequent cardiac dysfunction in patients with systemic sclerosis,” Arthritis & Rheumatology, vol. 39, no. 4, pp. 677–681, 1996. View at Publisher · View at Google Scholar · View at Scopus
  63. C. Meune, Y. Allanore, J.-Y. Devaux et al., “High prevalence of right ventricular systolic dysfunction in early systemic sclerosis,” The Journal of Rheumatology, vol. 31, no. 10, pp. 1941–1945, 2004. View at Google Scholar · View at Scopus
  64. J. Lekakis, M. Mavrikakis, and M. Emmanuel, “Cold-induced coronary Raynaud's phenomenon in patients with systemic sclerosis,” Clinical and Experimental Rheumatology, vol. 16, no. 2, pp. 135–140, 1998. View at Google Scholar
  65. C. Papagoras, K. Achenbach, N. Tsifetaki, S. Tsiouris, A. Fotopoulos, and A. A. Drosos, “Heart involvement in systemic sclerosis: A combined echocardiographic and scintigraphic study,” Clinical Rheumatology, vol. 33, no. 8, pp. 1105–1111, 2014. View at Publisher · View at Google Scholar · View at Scopus
  66. R. C. Hendel, M. R. Patel, C. M. Kramer et al., “ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology,” Journal of the American College of Cardiology, vol. 48, pp. 1475–1497, 2006. View at Google Scholar
  67. J. P. Ridgway, “Cardiovascular magnetic resonance physics for clinicians: Part i,” Journal of Cardiovascular Magnetic Resonance, vol. 12, no. 1, article no. 71, 2010. View at Publisher · View at Google Scholar · View at Scopus
  68. J. D. Biglands, A. Radjenovic, and J. P. Ridgway, “Cardiovascular magnetic resonance physics for clinicians: Part II,” Journal of Cardiovascular Magnetic Resonance, vol. 14, no. 1, article no. 66, 2012. View at Publisher · View at Google Scholar · View at Scopus
  69. A.-L. Hachulla, D. Launay, V. Gaxotte et al., “Cardiac magnetic resonance imaging in systemic sclerosis: A cross-sectional observational study of 52 patients,” Annals of the Rheumatic Diseases, vol. 68, no. 12, pp. 1878–1884, 2009. View at Publisher · View at Google Scholar · View at Scopus
  70. G. E. Tzelepis, N. L. Kelekis, S. C. Plastiras et al., “Pattern and distribution of myocardial fibrosis in systemic sclerosis: A delayed enhanced magnetic resonance imaging study,” Arthritis & Rheumatology, vol. 56, no. 11, pp. 3827–3836, 2007. View at Publisher · View at Google Scholar · View at Scopus
  71. O. Vignaux, Y. Allanore, C. Meune et al., “Evaluation of the effect of nifedipine upon myocardial perfusion and contractility using cardiac magnetic resonance imaging and tissue Doppler echocardiography in systemic sclerosis,” Annals of the Rheumatic Diseases, vol. 64, no. 9, pp. 1268–1273, 2005. View at Publisher · View at Google Scholar · View at Scopus
  72. M. A. Olimulder, J. van Es, and M. A. Galjee, “The importance of cardiac MRI as a diagnostic tool in viral myocarditis-induced cardiomyopathy,” Netherlands Heart Journal, vol. 17, no. 12, pp. 481–486, 2009. View at Publisher · View at Google Scholar
  73. B. Heydari, M. Jerosch-Herold, and R. Y. Kwong, “Assessment of Myocardial Ischemia with Cardiovascular Magnetic Resonance,” Progress in Cardiovascular Diseases, vol. 54, no. 3, pp. 191–203, 2011. View at Publisher · View at Google Scholar · View at Scopus
  74. G. P. Bezante, D. Rollando, M. Sessarego et al., “Cardiac magnetic resonance imaging detects subclinical right ventricular impairment in systemic sclerosis,” The Journal of Rheumatology, vol. 34, pp. 2431–2437, 2007. View at Google Scholar
  75. Y. Allanore, C. Meune, O. Vignaux, S. Weber, P. Legmann, and A. Kahan, “Bosentan increases myocardial perfusion and function in systemic sclerosis: A magnetic resonance imaging and Tissue-Doppler echography study,” The Journal of Rheumatology, vol. 33, no. 12, pp. 2464–2469, 2006. View at Google Scholar · View at Scopus