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Nisha Parikh, MD

TitleAssistant Professor
InstitutionUniversity of California San Francisco
DepartmentMedicine
Address555 Mission Bay Blvd South
San Francisco CA 94158
Phone415-514-0992
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    Collapse Biography 
    Collapse Education and Training
    UC Berkeley, Berkeley, CABA05/1995Molecular and Cellular Biology- Immunology
    UC Berkeley, Berkeley, CAMPH05/1997Epidemiology and Biostatistics
    New York Medical College, Valhalla, NYMD06/2002Medicine
    Tufts New England Medical Center, Boston, MA06/2005Internal Medicine Residency
    Framingham Heart Study/ Boston University School of Medicine, Boston, MA06/2007Cardiovascular Epidemiology
    Harvard Beth-Israel Deaconess Medical Center, Boston, MA06/2010Cardiology

    Collapse Overview 
    Collapse Overview
    Clinical Interests: Dr. Parikh is a noninvasive cardiologist. She sees both men and women in her clinical practice, emphasizing primary and secondary cardiovascular disease prevention. She also has an interest in women's cardiovascular diseases across the lifespan; including cardiovascular disease in pregnancy and the post-partum period.

    Research Interests: Dr. Parikh is a trained cardiovascular epidemiologist and population scientist. She demonstrated in the Multi-Ethnic Study of Atherosclerosis that the hemodynamic changes of pregnancy may not revert back to normal, may be cumulative across successive pregnancies, and can lead to left ventricular remodeling on cardiac MRI in mid-life. Along with a research team at the Framingham Heart Study, she developed a risk score for incident hypertension and this work was cited in the recent version of the US hypertension guidelines. She has added to the scientific knowledge base demonstrating which specific reproductive factors are predictors of cardiovascular disease using data from the NIH sponsored Women's Health Initiative Study and has leveraged data from the Swedish Population Registers. Her work has been supported by grants from the American Heart Association, the NIH/National Heart Lung and Blood Institute and the UCSF Preterm Birth Initiative.

    Other interests: Dr. Parikh is the inaugural co-Chair of the UCSF Women in Cardiology Council. This group promotes the recruitment and professional development of women in cardiology and encompasses 28 faculty at the three UCSF campuses. She has been an active volunteer for the American Heart Association (AHA) for over ten years. She currently serves on the AHA Board of Directors for the Bay Area and on the AHA Leadership Committee of the Epidemiology and Prevention Council (national level).


    Collapse Research 
    Collapse Research Activities and Funding
    Pregnancy complications, future cardiovascular disease risk factors and cardiovas
    NIH/NHLBI R21HL115398Aug 15, 2013 - Apr 30, 2015
    Role: Principal Investigator
    Reproductive Risk Stratification and Coronary Heart Disease: The Women’s Health Initiative (WHI)
    American Heart Association 13CRP17350002Jul 1, 2013 - Jun 30, 2016
    Role: Principal Investigator
    Reproductive Factors and Maternal Cardiovascular Disease
    NIH/NHLBI F32HL096390Jul 1, 2009 - Jun 30, 2010
    Role: Principal Investigator

    Collapse ORNG Applications 
    Collapse Featured Publications
    Collapse In The News
    Collapse Featured Presentations

    Collapse Bibliographic 
    Collapse Publications
    Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
    List All   |   Timeline
    1. Parikh NI, Kapphahn K, Hedlin H, Olgin JE, Allison MA, Magnani JW, Ryckman KR, Waring ME, Perez MV, Howard BV. Effects of reproductive period duration and number of pregnancies on midlife ECG indices: a secondary analysis from the Women's Health Initiative Clinical Trial. BMJ Open. 2018 Aug 17; 8(8):e019129. PMID: 30121588.
      View in: PubMed
    2. Sardana M, Lessard D, Tsao CW, Parikh NI, Barton BA, Nah G, Thomas RC, Cheng S, Schiller NB, Aragam JR, Mitchell GF, Vaze A, Benjamin EJ, Vasan RS, McManus DD. Association of Left Atrial Function Index with Atrial Fibrillation and Cardiovascular Disease: The Framingham Offspring Study. J Am Heart Assoc. 2018 Mar 30; 7(7). PMID: 29602764.
      View in: PubMed
    3. Parikh NI, Hall PS. Reply: Hormone Status Correlates With Incidence of Heart Failure. J Am Coll Cardiol. 2017 Oct 31; 70(18):2313. PMID: 29073965.
      View in: PubMed
    4. Sardana M, Nah G, Tsao CW, Ogunsua AA, Vittinghoff E, Thomas RC, Cheng S, Vaze A, Aragam JR, Mitchell GF, Benjamin EJ, Vasan RS, Aurigemma GP, Schiller NB, McManus DD, Parikh NI. Clinical and Echocardiographic Correlates of Left Atrial Function Index: The Framingham Offspring Study. J Am Soc Echocardiogr. 2017 Sep; 30(9):904-912.e2. PMID: 28735892.
      View in: PubMed
    5. Parikh NI, Gonzalez J. Preeclampsia and Hypertension: Courting a Long While: Time to Make It Official. JAMA Intern Med. 2017 Jul 01; 177(7):917-918. PMID: 28444352.
      View in: PubMed
    6. Heidecker B, Spencer RM, Hayes V, Hall S, Parikh N, Stock EO, Redberg R. High Prevalence and Clinical/Sociodemographic Correlates of Miscarriages Among Flight Attendants. Am J Med. 2017 Dec; 130(12):1397-1401. PMID: 28624541.
      View in: PubMed
    7. Hall PS, Nah G, Howard BV, Lewis CE, Allison MA, Sarto GE, Waring ME, Jacobson LT, Manson JE, Klein L, Parikh NI. Reproductive Factors and Incidence of Heart Failure Hospitalization in the Women's Health Initiative. J Am Coll Cardiol. 2017 May 23; 69(20):2517-2526. PMID: 28521890.
      View in: PubMed
    8. Sanghavi M, Parikh NI. Harnessing the Power of Pregnancy and Pregnancy-Related Events to Predict Cardiovascular Disease in Women. Circulation. 2017 Feb 07; 135(6):590-592. PMID: 28153994.
      View in: PubMed
    9. Parikh NI, Norberg M, Ingelsson E, Cnattingius S, Vasan RS, Domellöf M, Jansson JH, Edstedt Bonamy AK. Association of Pregnancy Complications and Characteristics With Future Risk of Elevated Blood Pressure: The Västerbotten Intervention Program. Hypertension. 2017 03; 69(3):475-483. PMID: 28137991.
      View in: PubMed
    10. LeBlanc ES, Kapphahn K, Hedlin H, Desai M, Parikh NI, Liu S, Parker DR, Anderson M, Aroda V, Sullivan S, Woods NF, Waring ME, Lewis CE, Stefanick M. Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: findings from the Women's Health Initiative. Menopause. 2017 Jan; 24(1):64-72. PMID: 27465714.
      View in: PubMed
    11. Sardana M, Ogunsua AA, Spring M, Shaikh A, Asamoah O, Stokken G, Browning C, Ennis C, Donahue JK, Rosenthal LS, Floyd KC, Aurigemma GP, Parikh NI, McManus DD. Association of Left Atrial Function Index With Late Atrial Fibrillation Recurrence after Catheter Ablation. J Cardiovasc Electrophysiol. 2016 Dec; 27(12):1411-1419. PMID: 27569695.
      View in: PubMed
    12. Elajami TK, Giuseffi J, Avila MD, Hovnanians N, Mukamal KJ, Parikh N, Welty FK. Parity, coronary heart disease and mortality in the old order Amish. Atherosclerosis. 2016 Nov; 254:14-19. PMID: 27680773.
      View in: PubMed
    13. Parikh NI, Jeppson RP, Berger JS, Eaton CB, Kroenke CH, LeBlanc ES, Lewis CE, Loucks EB, Parker DR, Rillamas-Sun E, Ryckman KK, Waring ME, Schenken RS, Johnson KC, Edstedt-Bonamy AK, Allison MA, Howard BV. Reproductive Risk Factors and Coronary Heart Disease in the Women's Health Initiative Observational Study. Circulation. 2016 May 31; 133(22):2149-58. PMID: 27143682; PMCID: PMC4889516 [Available on 05/31/17].
    14. Rodriguez F, Stefanick ML, Greenland P, Soliman EZ, Manson JE, Parikh N, Martin LW, Larson JC, Hlatky M, Nassir R, Cené CW, Rodriguez BL, Albert C, Perez MV. Racial and ethnic differences in atrial fibrillation risk factors and predictors in women: Findings from the Women's Health Initiative. Am Heart J. 2016 Jun; 176:70-7. PMID: 27264222.
      View in: PubMed
    15. Chow D, Young R, Valcour N, Kronmal RA, Lum CJ, Parikh NI, Tracy RP, Budoff M, Shikuma CM. HIV and coronary artery calcium score: comparison of the Hawaii Aging with HIV Cardiovascular Study and Multi-Ethnic Study of Atherosclerosis (MESA) cohorts. HIV Clin Trials. 2015 08; 16(4):130-8. PMID: 26038953.
      View in: PubMed
    16. Sanghavi M, Kulinski J, Ayers CR, Nelson D, Stewart R, Parikh N, de Lemos JA, Khera A. Association between number of live births and markers of subclinical atherosclerosis: The Dallas Heart Study. Eur J Prev Cardiol. 2016 Mar; 23(4):391-9. PMID: 25691547; PMCID: PMC4827778 [Available on 03/01/17].
    17. Munger AM, Chow DC, Playford MP, Parikh NI, Gangcuangco LM, Nakamoto BK, Kallianpur KJ, Ndhlovu LC, Shikuma CM, Mehta NN. Characterization of lipid composition and high-density lipoprotein function in HIV-infected individuals on stable antiretroviral regimens. AIDS Res Hum Retroviruses. 2015 Feb; 31(2):221-8. PMID: 25416403; PMCID: PMC4313425.
    18. Parikh NI, Gerschenson M, Bennett K, Gangcuangco LM, Lopez MS, Mehta NN, Playford MP, Nakamoto BK, Seto TB, Chow DC, Shikuma CM. Lipoprotein concentration, particle number, size and cholesterol efflux capacity are associated with mitochondrial oxidative stress and function in an HIV positive cohort. Atherosclerosis. 2015 Mar; 239(1):50-4. PMID: 25574857.
      View in: PubMed
    19. Parker DR, Lu B, Sands-Lincoln M, Kroenke CH, Lee CC, O'Sullivan M, Park HL, Parikh N, Schenken RS, Eaton CB. Risk of cardiovascular disease among postmenopausal women with prior pregnancy loss: the women's health initiative. Ann Fam Med. 2014 Jul; 12(4):302-9. PMID: 25024237; PMCID: PMC4096466.
    20. Ryckman KK, Rillamas-Sun E, Spracklen CN, Wallace RB, Garcia L, Tylavsky FA, Howard BV, Liu S, Song Y, LeBlanc ES, White MV, Parikh NI, Robinson JG. Ethnic differences in the relationship between birth weight and type 2 diabetes mellitus in postmenopausal women. Diabetes Metab. 2014 Nov; 40(5):379-85. PMID: 24751988; PMCID: PMC4638122.
    21. Shikuma CM, Chow DC, Gangcuangco LM, Zhang G, Keating SM, Norris PJ, Seto TB, Parikh N, Kallianpur KJ, Nakamoto BK, Nagamine LS, Ndhlovu LC, Barbour JD. Monocytes expand with immune dysregulation and is associated with insulin resistance in older individuals with chronic HIV. PLoS One. 2014; 9(2):e90330. PMID: 24587328; PMCID: PMC3937368.
    22. Li D, Le Pape MA, Parikh NI, Chen WX, Dye TD. Assessing differential expression in two-color microarrays: a resampling-based empirical Bayes approach. PLoS One. 2013; 8(11):e80099. PMID: 24312198; PMCID: PMC3842292.
    23. Barbour JD, Jalbert EC, Chow DC, Gangcuangco LM, Norris PJ, Keating SM, Heitman J, Nagamine L, Seto T, Ndhlovu LC, Nakamoto BK, Hodis HN, Parikh NI, Shikuma CM. Reduced CD14 expression on classical monocytes and vascular endothelial adhesion markers independently associate with carotid artery intima media thickness in chronically HIV-1 infected adults on virologically suppressive anti-retroviral therapy. Atherosclerosis. 2014 Jan; 232(1):52-8. PMID: 24401216.
      View in: PubMed
    24. Nakamoto BK, Shikuma CM, Ogata-Arakaki D, Umaki T, Neuwelt EA, Shiramizu BT, Chow DC, Parikh NI, Kallianpur KJ, Hamilton BE. Feasibility and potential role of ferumoxytol-enhanced neuroimaging in HIV-associated neurocognitive disorder. J Neurovirol. 2013 Dec; 19(6):601-5. PMID: 24129909; PMCID: PMC3947641.
    25. Chua Chiaco JM, Parikh NI, Fergusson DJ. The jugular venous pressure revisited. Cleve Clin J Med. 2013 Oct; 80(10):638-44. PMID: 24085809; PMCID: PMC4865399.
    26. Jalbert E, Crawford TQ, D'Antoni ML, Keating SM, Norris PJ, Nakamoto BK, Seto T, Parikh NI, Shikuma CM, Ndhlovu LC, Barbour JD. IL-1? enriched monocytes mount massive IL-6 responses to common inflammatory triggers among chronically HIV-1 infected adults on stable anti-retroviral therapy at risk for cardiovascular disease. PLoS One. 2013; 8(9):e75500. PMID: 24086545; PMCID: PMC3783392.
    27. Shikuma CM, Barbour JD, Ndhlovu LC, Keating SM, Norris PJ, Budoff M, Parikh N, Seto T, Gangcuangco LM, Ogata-Arakaki D, Chow D. Plasma monocyte chemoattractant protein-1 and tumor necrosis factor-a levels predict the presence of coronary artery calcium in HIV-infected individuals independent of traditional cardiovascular risk factors. AIDS Res Hum Retroviruses. 2014 Feb; 30(2):142-6. PMID: 23984974; PMCID: PMC3910454.
    28. Chow D, Nakamoto B, So E, Parikh N, Souza S, Kallianpur K, Shikuma C. Rates of autonomic dysfunction in HIV patients receiving antiretroviral therapy. J Neurovirol. 2013 Oct; 19(5):511-2. PMID: 24018903; PMCID: PMC4314100.
    29. Tongma C, Shikuma CM, Nakamoto BK, Kallianpur KJ, Umaki TM, Barbour JD, Ndhlovu L, Parikh NI, Chow DC. Albuminuria as a marker of cardiovascular risk in HIV-infected individuals receiving stable antiretroviral therapy. Hawaii J Med Public Health. 2013 Sep; 72(9 Suppl 4):34-8. PMID: 24052917; PMCID: PMC3764546.
    30. Won S, Hong RA, Shohet RV, Seto TB, Parikh NI. Methamphetamine-associated cardiomyopathy. Clin Cardiol. 2013 Dec; 36(12):737-42. PMID: 24037954; PMCID: PMC4319790.
    31. Ryckman KK, Borowski KS, Parikh NI, Saftlas AF. Pregnancy Complications and the Risk of Metabolic Syndrome for the Offspring. Curr Cardiovasc Risk Rep. 2013 Jun; 7(3):217-223. PMID: 23997844.
      View in: PubMed
    32. Edstedt-Bonamy A-K, Parikh NI.. Current Cardiovascular Risk Reports. Eds. Robinson JF and Levy D. Predicting Women’s Future Cardiovascular Health from Pregnancy Complications. 2013; 7(3):173-82.
    33. Lin C, Grandinetti A, Shikuma C, Souza S, Parikh N, Nakamoto B, Kallianpur KJ, Chow D. The effects of extended release niacin on lipoprotein sub-particle concentrations in HIV-infected patients. Hawaii J Med Public Health. 2013 Apr; 72(4):123-7. PMID: 23795312; PMCID: PMC3689507.
    34. Carty CL, Spencer KL, Setiawan VW, Fernandez-Rhodes L, Malinowski J, Buyske S, Young A, Jorgensen NW, Cheng I, Carlson CS, Brown-Gentry K, Goodloe R, Park A, Parikh NI, Henderson B, Le Marchand L, Wactawski-Wende J, Fornage M, Matise TC, Hindorff LA, Arnold AM, Haiman CA, Franceschini N, Peters U, Crawford DC. Replication of genetic loci for ages at menarche and menopause in the multi-ethnic Population Architecture using Genomics and Epidemiology (PAGE) study. Hum Reprod. 2013 Jun; 28(6):1695-706. PMID: 23508249; PMCID: PMC3657124.
    35. Parikh NI, Honeycutt EF, Roe MT, Neely M, Rosenthal EJ, Mittleman MA, Carrozza JP, Ho KK. Left and codominant coronary artery circulations are associated with higher in-hospital mortality among patients undergoing percutaneous coronary intervention for acute coronary syndromes: report From the National Cardiovascular Database Cath Percutaneous Coronary Intervention (CathPCI) Registry. Circ Cardiovasc Qual Outcomes. 2012 Nov; 5(6):775-82. PMID: 23110791.
      View in: PubMed
    36. Chow D, Kocher M, Shikuma C, Parikh N, Grandinetti A, Nakamoto B, Seto T, Low P. Effects of antiretroviral therapy on autonomic function in early HIV infection: a preliminary report. Int J Med Sci. 2012; 9(5):397-405. PMID: 22859899; PMCID: PMC3410283.
    37. Chow D, Thomas BS, Liang CY, Souza SC, Nakamoto BK, Parikh NI, Shikuma C. Role of the veterans aging cohort study index in assessing total atherosclerotic burden. Clin Infect Dis. 2012 Sep; 55(5):750-1; author reply 751-2. PMID: 22670040; PMCID: PMC3732044.
    38. Parikh NI, Lloyd-Jones DM, Ning H, Ouyang P, Polak JF, Lima JA, Bluemke D, Mittleman MA. Association of number of live births with left ventricular structure and function. The Multi-Ethnic Study of Atherosclerosis (MESA). Am Heart J. 2012 Mar; 163(3):470-6. PMID: 22424019; PMCID: PMC3656723.
    39. Parikh NI, Cnattingius S, Mittleman MA, Ludvigsson JF, Ingelsson E. Subfertility and risk of later life maternal cardiovascular disease. Hum Reprod. 2012 Feb; 27(2):568-75. PMID: 22131387; PMCID: PMC3283089.
    40. Bonamy AK, Parikh NI, Cnattingius S, Ludvigsson JF, Ingelsson E. Birth characteristics and subsequent risks of maternal cardiovascular disease: effects of gestational age and fetal growth. Circulation. 2011 Dec 20; 124(25):2839-46. PMID: 22124377.
      View in: PubMed
    41. Parikh NI. Sex differences in the risk of cardiovascular disease. BMJ. 2011 Sep 06; 343:d5526. PMID: 21896609.
      View in: PubMed
    42. Parikh NI, Cnattingius S, Dickman PW, Mittleman MA, Ludvigsson JF, Ingelsson E. Parity and risk of later-life maternal cardiovascular disease. Am Heart J. 2010 Feb; 159(2):215-221.e6. PMID: 20152219.
      View in: PubMed
    43. Parikh NI, Hwang SJ, Ingelsson E, Benjamin EJ, Fox CS, Vasan RS, Murabito JM. Breastfeeding in infancy and adult cardiovascular disease risk factors. Am J Med. 2009 Jul; 122(7):656-63.e1. PMID: 19559168; PMCID: PMC2704490.
    44. Parikh NI, Keyes MJ, Larson MG, Pou KM, Hamburg NM, Vita JA, O'Donnell CJ, Vasan RS, Mitchell GF, Hoffmann U, Fox CS, Benjamin EJ. Visceral and subcutaneous adiposity and brachial artery vasodilator function. Obesity (Silver Spring). 2009 Nov; 17(11):2054-9. PMID: 19282819.
      View in: PubMed
    45. Parikh NI, Gona P, Larson MG, Fox CS, Benjamin EJ, Murabito JM, O'Donnell CJ, Vasan RS, Levy D. Long-term trends in myocardial infarction incidence and case fatality in the National Heart, Lung, and Blood Institute's Framingham Heart study. Circulation. 2009 Mar 10; 119(9):1203-10. PMID: 19237656.
      View in: PubMed
    46. Velagaleti RS, Pencina MJ, Murabito JM, Wang TJ, Parikh NI, D'Agostino RB, Levy D, Kannel WB, Vasan RS. Long-term trends in the incidence of heart failure after myocardial infarction. Circulation. 2008 Nov 11; 118(20):2057-62. PMID: 18955667; PMCID: PMC2729712.
    47. Parikh NI, Hwang SJ, Yang Q, Larson MG, Guo CY, Robins SJ, Sutherland P, Benjamin EJ, Levy D, Fox CS. Clinical correlates and heritability of cystatin C (from the Framingham Offspring Study). Am J Cardiol. 2008 Nov 01; 102(9):1194-8. PMID: 18940290; PMCID: PMC2709776.
    48. Parikh NI, Hwang SJ, Larson MG, Hoffmann U, Levy D, Meigs JB, O'Donnell CJ, Fox CS. Indexes of kidney function and coronary artery and abdominal aortic calcium (from the Framingham Offspring Study). Am J Cardiol. 2008 Aug 15; 102(4):440-3. PMID: 18678302; PMCID: PMC2709777.
    49. Parikh NI, Hwang SJ, Larson MG, Levy D, Fox CS. Chronic kidney disease as a predictor of cardiovascular disease (from the Framingham Heart Study). Am J Cardiol. 2008 Jul 01; 102(1):47-53. PMID: 18572034; PMCID: PMC2517213.
    50. Foster MC, Hwang SJ, Larson MG, Lichtman JH, Parikh NI, Vasan RS, Levy D, Fox CS. Overweight, obesity, and the development of stage 3 CKD: the Framingham Heart Study. Am J Kidney Dis. 2008 Jul; 52(1):39-48. PMID: 18440684; PMCID: PMC2531220.
    51. Parikh NI, Pencina MJ, Wang TJ, Benjamin EJ, Lanier KJ, Levy D, D'Agostino RB, Kannel WB, Vasan RS. A risk score for predicting near-term incidence of hypertension: the Framingham Heart Study. Ann Intern Med. 2008 Jan 15; 148(2):102-10. PMID: 18195335.
      View in: PubMed
    52. Parikh NI, Vasan RS. Assessing the clinical utility of biomarkers in medicine. Biomark Med. 2007 Oct; 1(3):419-36. PMID: 20477384.
      View in: PubMed
    53. Parikh NI, Gona P, Larson MG, Wang TJ, Newton-Cheh C, Levy D, Benjamin EJ, Kannel WB, Vasan RS. Plasma renin and risk of cardiovascular disease and mortality: the Framingham Heart Study. Eur Heart J. 2007 Nov; 28(21):2644-52. PMID: 17895253.
      View in: PubMed
    54. Parikh NI, Hwang SJ, Larson MG, Cupples LA, Fox CS, Manders ES, Murabito JM, Massaro JM, Hoffmann U, O'Donnell CJ. Parental occurrence of premature cardiovascular disease predicts increased coronary artery and abdominal aortic calcification in the Framingham Offspring and Third Generation cohorts. Circulation. 2007 Sep 25; 116(13):1473-81. PMID: 17785619.
      View in: PubMed
    55. Foster MC, Hwang SJ, Larson MG, Parikh NI, Meigs JB, Vasan RS, Wang TJ, Levy D, Fox CS. Cross-classification of microalbuminuria and reduced glomerular filtration rate: associations between cardiovascular disease risk factors and clinical outcomes. Arch Intern Med. 2007 Jul 09; 167(13):1386-92. PMID: 17620532.
      View in: PubMed
    56. Parikh NI, Pencina MJ, Wang TJ, Lanier KJ, Fox CS, D'Agostino RB, Vasan RS. Increasing trends in incidence of overweight and obesity over 5 decades. Am J Med. 2007 Mar; 120(3):242-50. PMID: 17349447.
      View in: PubMed
    57. Parikh NI, Hwang SJ, Larson MG, Meigs JB, Levy D, Fox CS. Cardiovascular disease risk factors in chronic kidney disease: overall burden and rates of treatment and control. Arch Intern Med. 2006 Sep 25; 166(17):1884-91. PMID: 17000946.
      View in: PubMed
    58. Kuvin J, Parikh N, Salomon R, Tischler A, Daoust P, Arshanskiy Y, Coyner K, Carpino P, Pandian NG, Kimmelstiel C, Foote C, Erban J, Rastegar H. Images in cardiovascular medicine. Primary lymphoma of the heart. Circulation. 2005 Jul 05; 112(1):e5-6. PMID: 15998689.
      View in: PubMed