Francesca Nesta Delling, MD, MPH
Associate Professor
Medicine
School of Medicine

CLINICAL

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Dr Delling is a cardiologist with advanced training in echocardiography and cardiac magnetic resonance imaging (MRI) and the Medical Director of the Echocardiography Laboratory at UCSF. She completed internal medicine residency at Boston University Medical Center and cardiovascular and cardiac imaging fellowships at Beth Israel Deaconess Medical Center and Massachusetts General Hospital. Her clinical interests include valvular heart disease (with a focus on mitral valve prolapse), primary and secondary cardiomyopathies and sudden cardiac death related to valvular disease.

RESEARCH Dr Delling's research has focused on mitral valve disease and the combined use of echocardiography, cardiac MRI, and molecular genetics as tools to better understand disease mechanisms and progression. She is currently an NIH-funded investigator (previously supported by the American Heart Association) with collaborators at the Framingham Heart Study and the Leducq MITRAL Network in Europe. Attended coursework essential for her research endeavors includes a Master in Public Health (Harvard T.H. Chan School of Public Health).

Awards

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• Samuel A. Levine Young Clinical Investigator Award finalist, American Heart Association, 2004

Education & Training

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• M.P.H. Public Health Harvard T.H. Chan School of Public Health 2016
• Fellow Cardiovascular Medicine Beth Israel Deaconess Medical Center 2010
• Resident Medicine Boston University Medical Center 2007
• Fellow Echocardiography Cardiac Ultrasound Laboratory, Massachusetts General Hospital 2004
• M.D. Medicine Universita' di Brescia School of Medicine 1998

Interests

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• sudden cardiac death
• cardiomyopathy
• aortic valve disease
• tricuspid valve disease
• mitral valve prolapse
• Mitral regurgitation

Websites

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• Faculty Spotlight (ucsfhealthcardiology.ucsf.edu)
• Clinical Profile at UCSF Medical Center (ucsfhealth.org)

Grants and Projects

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• Prospective sudden cardiac death risk stratification using CMR and echocardiography machine learning in mitral valve prolapse, NIH, 2020-2025
• Sudden cardiac death in mitral valve prolapse: a genotype-phenotype study, NIH, 2018-2020
• Genetic Determinants and Progression of Mitral Valve Prolapse, NIH, 2014-2018

Publications (69)

Top publication keywords:
Diagnosis, Computer-AssistedAtrial RemodelingHeart Valve DiseasesMitral Valve ProlapseFibrosisDeath, Sudden, CardiacMitral Valve InsufficiencyCardiac Imaging TechniquesDefibrillators, ImplantableVentricular Premature ComplexesPedigreeMitral ValveEchocardiographyMagnetic Resonance Imaging, CineAtrial Function, Left

• Multimodality Imaging of Arrhythmic Risk in Mitral Valve Prolapse.
  Circulation. Cardiovascular imaging 2025 Cristin L, Tastet L, Shah DJ, Miller MA, Delling FN
• Characteristics of Patients With the Arrhythmogenic Mitral Valve Prolapse Syndrome and Sudden Cardiac Arrest and Sustained Ventricular Arrhythmias.
  Circulation. Arrhythmia and electrophysiology 2025 Chakrabarti A, Giudicessi JR, Ezzeddine FM, Delling FN, Dixit S, Lee YJ, Muser D, Magnani S, Van Wijngaarden A, Ajmone Marsan N, Miller MA, Gandhi J, Trivieri MG, Font J, Martins R, McCaffrey JA, …
• Inheritance of Imaging Parameters of Arrhythmic Risk in Mitral Valve Prolapse: A Pedigree Study.
  Circulation. Cardiovascular imaging 2025 Cristin L, Dixit S, Bibby D, Tang JJ, Fang Q, Tastet L, Rich AH, Jhawar R, Nagata Y, Higuchi S, Levine RA, Hsia HH, Tseng ZH, Schiller NB, Delling FN
• Interstitial fibrosis and arrhythmic mitral valve prolapse: Unraveling sex-based differences.
  Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 2024 Tastet L, Dixit S, Jhawar R, Nguyen T, Al-Akchar M, Bibby D, Arya F, Cristin L, Anwar S, Higuchi S, Hsia H, Lee YJ, Delling FN
• Smoking Cessation and Incident Atrial Fibrillation in a Longitudinal Cohort.
  JACC. Clinical electrophysiology 2024 Teraoka JT, Tang JJ, Delling FN, Vittinghoff E, Marcus GM

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• Ethnic Differences in Atrial Fibrillation in the United Kingdom
  JACC: Advances 2024 Frimodt-Møller EK, Tang JJ, Biering-Sørensen T, Delling FN, Jackson LR, Marcus GM.
• Primary Atriopathy in Mitral Valve Prolapse: Echocardiographic Evidence and Clinical Implications.
  Circulation. Cardiovascular imaging 2024 Tastet L, Lim LJ, Bibby D, Hu G, Cristin L, Rich AH, Jhawar R, Fang Q, Arya F, Delling FN
• Mitral Annular Disjunction: An Under-Recognized Entity in Pediatrics.
  JACC. Case reports 2024 Alfares FA, Sohn JH, Lee YJ, Farrell R, Delling FN, Avasarala K, Moon-Grady AJ, Anwar S, Austin KM
• Clinical Improvement With Transcatheter Edge-to-Edge Tricuspid Repair Irrespective of Right Atrial Pressure.
  JACC. Advances 2024 Ya'Qoub L, Caughron H, Qasim A, Tolstrop K, Delling FN, Watt C, Nguyen T, Deuse T, Beygui RE, Mahadevan VS
• Mechanical Dispersion Discriminates Between Arrhythmic and Nonarrhythmic Sudden Death: From the POST SCD Study.
  JACC. Clinical electrophysiology 2024 Tastet L, Ramakrishna S, Lim LJ, Bibby D, Olgin JE, Connolly AJ, Moffatt E, Tseng ZH, Delling FN
• Left ventricular fibrosis in arrhythmic mitral valve prolapse: quantification and comparison of semi-automated techniques assessed by cardiac magnetic resonance.
  The international journal of cardiovascular imaging 2023 Cecere A, Cipriani A, De Lazzari M, Graziano F, Brunetti G, De Conti G, Motta R, Ravagnin A, Lorenzoni G, Gregori D, Basso C, Tona F, Lee YJ, Delling FN, Iliceto S, Marra MP
• Cannabis use and incident atrial fibrillation in a longitudinal cohort.
  Heart rhythm 2023 Teraoka JT, Tang JJ, Delling FN, Vittinghoff E, Marcus GM
• Risk Factors for Sudden Cardiac Arrest and Ventricular Arrhythmias in Arrhythmogenic Mitral Valve Prolapse Syndrome
  medRxiv 2023 Chakrabarti A, Giudicessi JR, Ezzeddine FM, Delling FN, Dixit S, Lee YJ, Muser D, Magnani S, Van Wijngaarden A, Ajmone Marsan N, Miller MA, Gandhi J, Trivieri M, Font J, Martins R, McCaffrey JA, …
• Identifying Mitral Valve Prolapse at Risk for Arrhythmias and Fibrosis From Electrocardiograms Using Deep Learning.
  JACC. Advances 2023 Tison GH, Abreau S, Barrios J, Lim LJ, Yang M, Crudo V, Shah DJ, Nguyen T, Hu G, Dixit S, Nah G, Arya F, Bibby D, Lee Y, Delling FN
• Stroke in mitral valve prolapse: risk factors and left atrial function in cryptogenic versus non-cryptogenic ischemic subtypes.
  Frontiers in neurology 2023 Calicchio F, Lim LJ, Cross D, Bibby D, Fang Q, Meisel K, Schiller NB, Delling FN
• Abnormal Mechanics Relate to Myocardial Fibrosis and Ventricular Arrhythmias in Patients With Mitral Valve Prolapse.
  Circulation. Cardiovascular imaging 2023 Nagata Y, Bertrand PB, Baliyan V, Kochav J, Kagan RD, Ujka K, Alfraidi H, van Kampen A, Morningstar JE, Dal-Bianco JP, Melnitchouk S, Holmvang G, Borger MA, Moore R, Hua L, Sultana R, Calle PV, Yum B,…
• Research Opportunities in the Treatment of Mitral Valve Prolapse: JACC Expert Panel.
  Journal of the American College of Cardiology 2022 Delling FN, Noseworthy PA, Adams DH, Basso C, Borger M, Bouatia-Naji N, Elmariah S, Evans F, Gerstenfeld E, Hung J, Le Tourneau T, Lewis J, Miller MA, Norris RA, Padala M, Perazzolo-Marra M, Shah DJ, …
• Valvular disease burden in the modern era of percutaneous and surgical interventions: the UK Biobank.
  Open heart 2022 Tung M, Nah G, Tang J, Marcus G, Delling FN
• Genome-wide association study reveals novel genetic loci: a new polygenic risk score for mitral valve prolapse.
  European heart journal 2022 Roselli C, Yu M, Nauffal V, Georges A, Yang Q, Love K, Weng LC, Delling FN, Maurya SR, Schrölkamp M, Tfelt-Hansen J, Hagège A, Jeunemaitre X, Debette S, Amouyel P, Guan W, Muehlschlegel JD, Body SC, …
• Sex Differences and Similarities in Valvular Heart Disease.
  Circulation research 2022 DesJardin JT, Chikwe J, Hahn RT, Hung JW, Delling FN
• Coffee Consumption and Incident Tachyarrhythmias: Reported Behavior, Mendelian Randomization, and Their Interactions.
  JAMA internal medicine 2021 Kim EJ, Hoffmann TJ, Nah G, Vittinghoff E, Delling F, Marcus GM
• Antemortem and Post-Mortem Characteristics of Lethal Mitral Valve Prolapse Among All Countywide Sudden Deaths.
  JACC. Clinical electrophysiology 2021 Delling FN, Aung S, Vittinghoff E, Dave S, Lim LJ, Olgin JE, Connolly A, Moffatt E, Tseng ZH
• Cardiac Imaging for Risk Assessment of Malignant Ventricular Arrhythmias in Patients With Mitral Valve Prolapse.
  Frontiers in cardiovascular medicine 2021 Tayal B, Delling FN, Malahfji M, Shah DJ
• Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.
  Circulation 2021 Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson …
• Characteristics and Significance of Tricuspid Valve Prolapse in a Large Multidecade Echocardiographic Study.
  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 2020 Lorinsky MK, Belanger MJ, Shen C, Markson LJ, Delling FN, Manning WJ, Strom JB
• Long-term outcomes of ablation for ventricular arrhythmias in mitral valve prolapse.
  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2020 Marano PJ, Lim LJ, Sanchez JM, Alvi R, Nah G, Badhwar N, Gerstenfeld EP, Tseng ZH, Marcus GM, Delling FN
• Artificial Intelligence in Cardiovascular Imaging.
  Methodist DeBakey cardiovascular journal 2020 Lim LJ, Tison GH, Delling FN
• Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association.
  Circulation 2020 Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL,…
• Automated and Interpretable Patient ECG Profiles for Disease Detection, Tracking, and Discovery.
  Circulation. Cardiovascular quality and outcomes 2019 Tison GH, Zhang J, Delling FN, Deo RC
• Primary cilia defects causing mitral valve prolapse.
  Science translational medicine 2019 Toomer KA, Yu M, Fulmer D, Guo L, Moore KS, Moore R, Drayton KD, Glover J, Peterson N, Ramos-Ortiz S, Drohan A, Catching BJ, Stairley R, Wessels A, Lipschutz JH, Delling FN, Jeunemaitre X, Dina C, …
• Does cannabis legalisation change healthcare utilisation? A population-based study using the healthcare cost and utilisation project in Colorado, USA.
  BMJ open 2019 Delling FN, Vittinghoff E, Dewland TA, Pletcher MJ, Olgin JE, Nah G, Aschbacher K, Fang CD, Lee ES, Fan SM, Kazi DS, Marcus GM
• Genome-Wide Association Study-Driven Gene-Set Analyses, Genetic, and Functional Follow-Up Suggest GLIS1 as a Susceptibility Gene for Mitral Valve Prolapse.
  Circulation. Genomic and precision medicine 2019 Yu M, Georges A, Tucker NR, Kyryachenko S, Toomer K, Schott JJ, Delling FN, Fernandez-Friera L, Solis J, Ellinor PT, Levine RA, Slaugenhaupt SA, Hagège AA, Dina C, Jeunemaitre X, Milan DJ, Norris RA, …
• Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association.
  Circulation 2019 Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, …
• Left ventricular mechanical dispersion predicts arrhythmic risk in mitral valve prolapse.
  Heart (British Cardiac Society) 2019 Ermakov S, Gulhar R, Lim L, Bibby D, Fang Q, Nah G, Abraham TP, Schiller NB, Delling FN
• New insights into mitral valve dystrophy: a Filamin-A genotype-phenotype and outcome study.
  European heart journal 2018 Le Tourneau T, Le Scouarnec S, Cueff C, Bernstein D, Aalberts JJJ, Lecointe S, Mérot J, Bernstein JA, Oomen T, Dina C, Karakachoff M, Desal H, Al Habash O, Delling FN, Capoulade R, Suurmeijer AJH, …
• Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association.
  Circulation 2018 Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, …
• Incidental Statin Use and the Risk of Stroke or Transient Ischemic Attack after Radiotherapy for Head and Neck Cancer.
  Journal of stroke 2018 Addison D, Lawler PR, Emami H, Janjua SA, Staziaki PV, Hallett TR, Hennessy O, Lee H, Szilveszter B, Lu M, Mousavi N, Nayor MG, Delling FN, Romero JM, Wirth LJ, Chan AW, Hoffmann U, Neilan TG
• Mitral Valve Prolapse: Multimodality Imaging and Genetic Insights.
  Progress in cardiovascular diseases 2017 Parwani P, Avierinos JF, Levine RA, Delling FN
• Heritability of Mitral Regurgitation: Observations From the Framingham Heart Study and Swedish Population.
  Circulation. Cardiovascular genetics 2017 Delling FN, Li X, Li S, Yang Q, Xanthakis V, Martinsson A, Andell P, Lehman BT, Osypiuk EW, Stantchev P, Zöller B, Benjamin EJ, Sundquist K, Vasan RS, Smith JG
• Clinical performance of high-resolution late gadolinium enhancement imaging with compressed sensing.
  Journal of magnetic resonance imaging : JMRI 2017 Basha TA, Akçakaya M, Liew C, Tsao CW, Delling FN, Addae G, Ngo L, Manning WJ, Nezafat R
• Relationship between native papillary muscle T1 time and severity of functional mitral regurgitation in patients with non-ischemic dilated cardiomyopathy.
  Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 2016 Kato S, Nakamori S, Roujol S, Delling FN, Akhtari S, Jang J, Basha T, Berg S, Kissinger KV, Goddu B, Manning WJ, Nezafat R
• Diffuse myocardial fibrosis in patients with mitral valve prolapse and ventricular arrhythmia.
  Heart (British Cardiac Society) 2016 Bui AH, Roujol S, Foppa M, Kissinger KV, Goddu B, Hauser TH, Zimetbaum PJ, Ngo LH, Manning WJ, Nezafat R, Delling FN
• Evolution of Mitral Valve Prolapse: Insights From the Framingham Heart Study.
  Circulation 2016 Delling FN, Rong J, Larson MG, Lehman B, Fuller D, Osypiuk E, Stantchev P, Hackman B, Manning WJ, Benjamin EJ, Levine RA, Vasan RS
• Tricuspid Regurgitation and Mortality in Patients With Transvenous Permanent Pacemaker Leads.
  The American journal of cardiology 2016 Delling FN, Hassan ZK, Piatkowski G, Tsao CW, Rajabali A, Markson LJ, Zimetbaum PJ, Manning WJ, Chang JD, Mukamal KJ
• Mitral valve disease--morphology and mechanisms.
  Nature reviews. Cardiology 2015 Levine RA, Hagége AA, Judge DP, Padala M, Dal-Bianco JP, Aikawa E, Beaudoin J, Bischoff J, Bouatia-Naji N, Bruneval P, Butcher JT, Carpentier A, Chaput M, Chester AH, Clusel C, Delling FN, Dietz HC, …
• Response to Letter Regarding Article, "Familial Clustering of Mitral Valve Prolapse in the Community".
  Circulation 2015 Delling FN, Rong J, Larson MG, Lehman B, Osypiuk E, Stantchev P, Slaugenhaupt SA, Benjamin EJ, Levine RA, Vasan RS
• Left Ventricular Ejection Index as a Marker of Early Myocardial Dysfunction in Primary Mitral Regurgitation: Novel or Old in Disguise?
  Circulation. Cardiovascular imaging 2015 Delling FN
• Genetic association analyses highlight biological pathways underlying mitral valve prolapse.
  Nature genetics 2015 Dina C, Bouatia-Naji N, Tucker N, Delling FN, Toomer K, Durst R, Perrocheau M, Fernandez-Friera L, Solis J, PROMESA investigators, Le Tourneau T, Chen MH, Probst V, Bosse Y, Pibarot P, Zelenika D, …
• Mutations in DCHS1 cause mitral valve prolapse.
  Nature 2015 Durst R, Sauls K, Peal DS, deVlaming A, Toomer K, Leyne M, Salani M, Talkowski ME, Brand H, Perrocheau M, Simpson C, Jett C, Stone MR, Charles F, Chiang C, Lynch SN, Bouatia-Naji N, Delling FN, Freed …
• Assessment of mitral valve disease: a review of imaging modalities.
  Current treatment options in cardiovascular medicine 2015 Motiwala SR, Delling FN
• Mitral valve prolapse and glaucoma: a 'floppy' perception?
  Heart (British Cardiac Society) 2015 Delling FN, Vasan RS
• Familial clustering of mitral valve prolapse in the community.
  Circulation 2014 Delling FN, Rong J, Larson MG, Lehman B, Osypiuk E, Stantchev P, Slaugenhaupt SA, Benjamin EJ, Levine RA, Vasan RS
• Epidemiology and pathophysiology of mitral valve prolapse: new insights into disease progression, genetics, and molecular basis.
  Circulation 2014 Delling FN, Vasan RS
• Mild expression of mitral valve prolapse in the Framingham offspring: expanding the phenotypic spectrum.
  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 2013 Delling FN, Gona P, Larson MG, Lehman B, Manning WJ, Levine RA, Benjamin EJ, Vasan RS
• Intermediate-signal-intensity late gadolinium enhancement predicts ventricular tachyarrhythmias in patients with hypertrophic cardiomyopathy.
  Circulation. Cardiovascular imaging 2011 Appelbaum E, Maron BJ, Adabag S, Hauser TH, Lesser JR, Haas TS, Riley AB, Harrigan CJ, Delling FN, Udelson JE, Gibson CM, Manning WJ, Maron MS
• CMR predictors of mitral regurgitation in mitral valve prolapse.
  JACC. Cardiovascular imaging 2010 Delling FN, Kang LL, Yeon SB, Kissinger KV, Goddu B, Manning WJ, Han Y
• Mitral regurgitation augments post-myocardial infarction remodeling failure of hypertrophic compensation.
  Journal of the American College of Cardiology 2008 Beeri R, Yosefy C, Guerrero JL, Nesta F, Abedat S, Chaput M, del Monte F, Handschumacher MD, Stroud R, Sullivan S, Pugatsch T, Gilon D, Vlahakes GJ, Spinale FG, Hajjar RJ, Levine RA
• Frequency and mechanism of persistent systolic anterior motion and mitral regurgitation after septal ablation in obstructive hypertrophic cardiomyopathy.
  The American journal of cardiology 2007 Delling FN, Sanborn DY, Levine RA, Picard MH, Fifer MA, Palacios IF, Lowry PA, Vlahakes GJ, Vaturi M, Hung J
• A framework for the analysis of acoustical cardiac signals.
  IEEE transactions on bio-medical engineering 2007 Syed Z, Leeds D, Curtis D, Nesta F, Levine RA, Guttag J
• Software enhanced learning of cardiac auscultation.
  Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2006 Syed Z, Curtis D, Guttag J, Nesta F, Levine RA
• New locus for autosomal dominant mitral valve prolapse on chromosome 13: clinical insights from genetic studies.
  Circulation 2005 Nesta F, Leyne M, Yosefy C, Simpson C, Dai D, Marshall JE, Hung J, Slaugenhaupt SA, Levine RA
• Usefulness of three-dimensionally guided assessment of mitral stenosis using matrix-array ultrasound.
  The American journal of cardiology 2005 Sebag IA, Morgan JG, Handschumacher MD, Marshall JE, Nesta F, Hung J, Picard MH, Levine RA
• Case records of the Massachusetts General Hospital. Case 15-2005. An 80-year-old man with shortness of breath, edema, and proteinuria.
  The New England journal of medicine 2005 Dember LM, Shepard JA, Nesta F, Stone JR
• Leaflet concavity: a rapid visual clue to the presence and mechanism of functional mitral regurgitation.
  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 2003 Nesta F, Otsuji Y, Handschumacher MD, Messas E, Leavitt M, Carpentier A, Levine RA, Hung J
• A locus for autosomal dominant mitral valve prolapse on chromosome 11p15.4.
  American journal of human genetics 2003 Freed LA, Acierno JS, Dai D, Leyne M, Marshall JE, Nesta F, Levine RA, Slaugenhaupt SA
• Impact of tissue harmonic imaging in patients with distorted left ventricles: improvement in accuracy and reproducibility of visual, manual and automated echocardiographic assessment of left ventricular ejection fraction.
  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 2003 Mele D, Campana M, Sclavo M, Seveso G, Aschieri D, Nesta F, D'Aiello I, Ferrari R, Levine RA
• A semiautomated objective technique for applying the proximal isovelocity surface area method to quantitate mitral regurgitation: Clinical studies with the digital flow map.
  American heart journal 2001 Mele D, Schwammenthal E, Torp H, Nesta F, Pedini I, Vandervoort P, Alboni P, Levine RA
• Endothelial dysfunction during heart failure: effects of Carvedilol
  Heart Failure Reviews 1999 Ferrari R, Agnoletti L, Ceconi C, Curello S, Nesta F, Manfredini R.
• Metabolic derangement in ischemic heart disease and its therapeutic control.
  The American journal of cardiology 1998 Ferrari R, Pepi P, Ferrari F, Nesta F, Benigno M, Visioli O