Arterial hypertension and chronic heart failure with preserved ejection fraction (literature review)
https://doi.org/10.18705/1607-419X-2025-2514
EDN: GOLMOF
Abstract
The review presents literature data on the role of arterial hypertension in the development of heart failure with preserved ejection fraction (HFpEF) and considers the underlying pathogenetic mechanisms with the focus on left ventricular hypertrophy. It also discusses diagnostic issues, including the use of speckle tracking echocardiography for evaluating global and regional myocardial function based on analysis of left atrial deformation. Special attention is given to the pre-stage of HF and its diagnosis, as well as the role of left atrial function and left atrial deformation index. The early detection of HF pre-stage has both clinical and prognostic significance, and requires intensive preventive measures to slow the progression from HF pre-stage to HFpEF.
About the Authors
L. I. Gapon
Tyumen Cardiology Research Center, Tomsk National Medical Research Center
Russian Federation
Russian Federation
Lyudmila I. Gapon, MD, PhD, DSc, Professor, Honored Scientist of the Russian Federation, Head, Arterial Hypertension and Coronary Heart Disease Department,
111 Melnikaite street, Tyumen, 625026
E. P. Samoilova
Tyumen Cardiology Research Center, Tomsk National Medical Research Center
Russian Federation
Russian Federation
Elena P Samoilova, MD, PhD, Research Scientist, Arterial Hypertension and Coronary Heart Disease Department,
111 Melnikaite street, Tyumen, 625026
References
1. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC Eur Heart J. 2021;42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368
2. Borlaug BA, Sharma K, Shah SJ, Ho JE. Heart failure with preserved ejection fraction: JACC scientific statement. J Am Coll Cardiol. 2023;81(18):1810–1834. https://doi.org/10.1016/j.jacc.2023.01.049
3. GalyavichAS, Tereshchenko SN, Uskach TM, Ageev FT, Aronov DM, Arutyunov GP, et al. Clinical practice guidelines for chronic heart failure. Russian Journal of Cardiology. 2024;29(11):6162. (In Russ.) https://doi.org/10.15829/1560-4071-2024-6162
4. Kim Mi-Na, Park Seong-Mi. Heart failure with preserved ejection fraction: insights from recent clinical researches. Korean J Intern Med. 2020;35:514–534. https://doi.org/10.3904/kjim.2020.104
5. Jasinska-Piadlo A, Campbell P. Management of patients with heart failure and preserved ejection fraction. Heart. 2023;109(11):874– 883. https://doi.org/10.1136/heartjnl-2022-321097
6. Tah S, Valderrama M, Afzal M, Iqbal J, Farooq A, Lak MA, et al. Heart failure with preserved ejection fraction: an evolving understanding. Cureus. 2023;15(9): e46152. https://doi.org/10.7759/cureus.46152
7. Conrad N, Judge A, Tran J. Mohseni H, Hedgecott D, Cre spillo AP, et al. Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. Lancet. 2018;391(10120):572–580. https://doi.org/10.1016/S0140-6736(17)32520-5
8. Khan MS, Shahid I, Bennis A, Rakisheva A, Metra M, Butler J. Global epidemiology of heart failure. Nat Rev Cardiol. 2024;21(10):717–734. https://doi.org/10.1038/s41569-024-01046-6
9. Boytsov SA, Luk’yanov MM, Yakushin SS, Martsevich SYu, Vorobyov AN, Zagrebelny AV, et al. Cardiovascular disease registry (RECVAZA): diagnostic, concomitant cardiovascular pathology, comorbidities and treatment in the real outpatient-polyclinic practice. Cardiovascular Therapy and Prevention. 2014;13(6):44–50. (In Russ.) https://doi.org/10.15829/1728-8800-2014-6-3-8
10. Shlyakhto EV, Belenkov YuN, Boytsov SA, Villevalde SV, Galyavich AS, Glezer MG, et al. Interim analysis of a prospective observational multicenter registry study of patients with chronic heart failure in the Russian Federation “PRIORITET-CHF”: initial characteristics and treatment of the first included patients. Russian Journal of Cardiology. 2023;28(10):5593. (In Russ.) https://doi.org/10.15829/1560-4071-2023-5593
11. Grassi G, Drager LF. Sympathetic overactivity, hypertension and cardiovascular disease: state of the art. Curr Med Res Opin. 2024;40(sup1):5–13. https://doi.org/10.1080/03007995.2024.2305248
12. Grassi G, Dell’Oro R, Quarti-Trevano F, Vanoli J, Oparil S. Sympathetic neural mechanisms in hypertension: recent insights. Curr Hypertens Rep. 2023;25(10):263–270. https://doi.org/10.1007/s11906-023-01254-4
13. Pugliese NR, Masi S, Taddei S. The renin-angiotensin-aldosterone system: a crossroad from arterial hypertension to heart failure. Heart Fail Rev. 2020;25(1):31–42. https://doi.org/10.1007/s10741-019-09855-5
14. Chang JW, Ramchandra R. The sympathetic nervous system in heart failure with preserved ejection fraction. Heart Fail Rev. 2025;30(1):209–218. https://doi.org/10.1007/s10741-024-10456-0
15. Tsutsui H, Albert N, Coats AJS, Anker SD, Bayes-Genis A, Butler J. Natriuretic peptides: role in the diagnosis and management of heart failure: a scientific statement from the heart failure association of the European Society of Cardiology, Heart Failure Society of American and Japanese Heart Failure Society. Eur J Heart Fail. 2023;25(5):616–631. https://doi.org/10.1002/ejhf.2848
16. Vinnakota S, Chen HH. The Importance of natriuretic peptides in cardiometabolic diseases. J Endocr Soc. 2020;4(6):bvaa052. https://doi.org/10.1210/jendso/bvaa052
17. Bayes-Genis A, Morant-Talamante N, Lupon J. Neprilysin and natriuretic peptide regulation in heart failure. Curr Heart Fail Rep. 2016;13:151–157. https://doi.org/10.1007/s11897-016-0292-x
18. Xiao L, Harrison DG. Inflammation in hypertension. Can J Cardiol. 2020;36:635–647. https://doi.org/10.1016/j.cjca.2020.01.013
19. Zhang Z, Zhao L, Zhou X, Meng X, Zhou X. Role of inflammation, immunity, and oxidative stress in hypertension: new insights and potential therapeutic targets. Front Immunol. 2023;13:1098725. https://doi.org/10.3389/fimmu.2022.1098725
20. Rizzoni D, De Ciuceis C, Szczepaniak P, Paradis P, Schiffrin EL, Guzik TJ. Immune system and microvascular remodeling in humans. Hypertension. 2022;79(4):691–705. https://doi.org/10.1161/HYPERTENSIONAHA.121.17955
21. Adamczak DM., Oduah M-T, Kiebalo T, Nartowicz S, Bęben M, Pochylski M, et al. Heart failure with preserved ejection fraction — a concise review. Current Cardiology Reports. 2020;22(9):82. https://doi.org/10.1007/s11886-020-01349-3
22. Buziashvili YuI, Asymbekova EU, Tugeeva EF, Rakhimov AZ, Shahnazaryan LS, Akildzhonov FR. Molecular mechanisms of inflammation in the development of heart failure: a review. Consilium Medicum. 2023;25(10):679–684. (In Russ.) https://doi.org/10.26442/20751753.2023.10.202433
23. Leache L, Gutiérrez–Valencia M, Finizola RM, Infante E, Finizola B, Pardo J. Pharmacotherapy for hypertensioninduced left ventricular hypertrophy. Cochrane Database Syst Rev. 2021;10(10):CD012039. https://doi.org/10.1002/14651858.CD012039.pub3
24. Chun KH, Kang SM. Blood pressure and heart failure: focused on treatment. Clin Hypertens. 2024;30(1):15. https://doi.org/10.1186/s40885-024-00271-y
25. Lorell BH, Carabello BA. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation. 2000;102(4):470–479. https://doi.org/10.1161/01.cir.102.4.470
26. Takei Y, Tomiyama H, Higashi Y, Yamashina A, Chikamori T. Association between endothelial dysfunction and left ventricular diastolic stiffness-subanalysis of the Flow-Mediated Dilation Japan (FMD-J) study. Circ J. 2023;87(9):1203–1211. https://doi.org/10.1253/circj.CJ-22-0810
27. Budzyń M, Gryszczyńka B, Boruczkowski M, KaczmarekM, Begier-Krasińska B, Osińska A, et al. The potential role of circulating endothelial cells and endothelial progenitor cells in the prediction of left ventricular hypertrophy in hypertensive patients. Front Physiol. 2019;10:1005. https://doi.org/10.3389/fphys.2019.01005
28. Zan Y, Wang J, Wang W, Scamurra RW, Lin G. Inflammatory cytokines and their correlations with different left ventricular geometries and functions in PHT patients. Echocardiography. 2022;39(12):1589–1600. https://doi.org/10.1111/echo.15495
29. Cui T, Wang J, Shui W, Markman HJ. The relationship of interleukin 6 and C-reactive protein with left ventricular geometry and function in patients with obstructive sleep apnea syndrome and pre-hypertension. Echocardiography. 2022;39(2):286–293. https://doi.org/10.1111/echo.15305
30. Song W, Zhang C, Tang J, Li Y, Jiao T, Lin X, et al. Hypersensitive C-reactive protein as a potential indicator for predicting left ventricular hypertrophy in elderly community-dwelling patients with hypertension. BMC Cardiovasc Disord. 2023;23(1):480. https://doi.org/10.1186/s12872-023-03509-z
31. Pavlova OS, Yasiukaits NV, Barbuk OA, Denisevich TL, Zatoloka NV, Russkikh II, et al. Association of inflammatory and hematological indices with left ventricular hypertrophy in hypertensive patients. Arterial’naya Gipertenziya = Arterial Hypertension. 2024;30(1):108–120. (In Russ.) https://doi.org/10.18705/1607-419X-2024-2405
32. Zeng X, Yang Y. Molecular mechanisms underlying vascular remodeling in hypertension. Rev Cardiovasc Med. 2024;25(2):72. https://doi.org/10.31083/j.rcm2502072
33. Bombelli M, Vanoli J, Facchetti R, Maloberti A, Cuspidi C, Grassi G, et al. Impact of the increase in left ventricular mass on the risk of long-term cardiovascular mortality: a prospective cohort study. Hypertension. 2023;80(6):1321–1330. https://doi.org/10.1161/HYPERTENSIONAHA.122.19988
34. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368
35. Ageev FT, Ovchinnikov AG. Diastolic heart failure: 20 years later. Сurrent issues of pathogenesis, diagnosis and treatment of heart failure with preserved LVEF. Kardiologiia. 2023;63(3):3–12. (In Russ.) https://doi.org/10.18087/cardio.2023.3.n2376
36. Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018;138(9):861–870. https://doi.org/10.1161/CIRCULATIONAHA.118.034646
37. Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E, et al. How to diagnose heart failure with preserved ejection fraction: the HFA–PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European Heart Journal. 2019;40(40):3297–3317. https://doi.org/10.1093/eurheartj/ehz641
38. Inoue K, Obokata M. Clinical utility of the left atrial strain analysis. J Echocardiogr. 2025;23(3):145–155. https://doi.org/10.1007/s12574-025-00695-x
39. Reddy YNV, Obokata M, Egbe A, Yang JH, Pislaru S, Lin G, et al. Left atrial strain and compliance in the diagnostic evaluation of heart failure with preserved ejection fraction. Eur J Heart Fail. 2019;21:891–900. https://doi.org/10.1002/ejhf.1464
40. Lundberg A, Johnson J, Hage C, Bäck M, Merkely B, Venkateshvaran A, et al. Left atrial strain improves estimation of filling pressures in heart failure: a simultaneous echocardiographic and invasive haemodynamic study. Clin Res Cardiol. 2019;108(6):703– 715. https://doi.org/10.1007/s00392-018-1399-8
41. Obokata M, Reddy YNV, Borlaug BA. Diastolic dysfunction and heart failure with preserved ejection fraction: understanding mechanisms by using noninvasive methods. JACC: Cardiovascular Imaging. 2020;13(1):245–257. https://doi.org/10.1016/j.jcmg.2018.12.034
42. Ye Z, Miranda WR, Yeung DF, Kane GC, Oh JK. Left atrial strain in evaluation of heart failure with preserved ejection fraction. J Am Soc Echocardiogr. 2020;33(12):1490–1499. https://doi.org/10.1016/j.echo.2020.07.020
43. Morris DA, Belyavskiy E, Aravind-Kumar R, Kropf M, Frydas A, Braunauer K, et al. Potential usefulness and clinical relevance of adding left atrial strain to left atrial volume index in the detection of left ventricular diastolic dysfunction. JACC: Cardiovascular Imaging. 2018;11:1405–1415. https://doi.org/10.1016/j. jcmg.2017.07.029
44. Mazur ES, Mazur VV, Bazhenov ND, Nilova OV, Nikolaeva TO. Left atrial strain in assessing heart failure with preserved ejection fraction in hypertensive patients. Russian Journal of Cardiology. 2022;27(8):5099. (In Russ.) https://doi.org/10.15829/1560-4071-2022-5099
45. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277–314. https://doi.org/10.1016/j.echo.2016.01.011
46. Kalinin AO, Alekhin MN, Bahs G, Kalnins A, Shipachov PN. Assessment of the state of atrial myocardium by two-dimensional grey-scale deformation in patients with arterial hypertension and mild left ventricular hypertrophy. Kardiologiia. 2010;50(8):13–20. (In Russ.)
47. Alekhin MN, Kalinin AO. Left ventricular diastolic function: value of left atrial global longitudinal strain. Ultrasound & Functional Diagnostics. 2020;(3):91–104. (In Russ.) https://doi.org/10.24835/1607-0771-2020-3-91-104
48. Pathan F, D’Elia N, Nolan MT, Marwick TH, Negishi K. Normal ranges of left atrial strain by speckle-tracking echocardiography: a systematic review and meta-analysis. J Am Soc Echocardiogr. 2017;30(1):59–70.e8. https://doi.org/10.1016/j.echo.2016.09.007
49. Miranda-Aquino T, Hernandez-del RJE, Perez-Topete SE, González-Padilla C, Lomelí-Sánchez ÓS, del Cid-Porras C, et al. Impact of the diastolic dysfunction in the left atrial strain in patients with ischemic heart disease. A cross-sectional study. Cardiovasc Metab Sci. 2021;32(4):170–178. https://doi.org/10.35366/102767
50. Perutsky DN, Obrezan AG, Osipova OA, Zarudsky AA. Left atrial function in patients with heart failure. Cardiovascular Therapy and Prevention. 2022;21(6):3265. (In Russ.) https://doi.org/10.15829/1728-8800-2022-3265
51. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology / American Heart Association joint committee on clinical practice guidelines. Circulation. 2022;145(18):e895-e1032. https://doi.org/10.1161/CIR.0000000000001063
52. Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. J Heart Lung Transplant. 2002;21(2):189–203. https://doi.org/10.1016/s1053-2498(01)00776-8
53. Drapkina OM, Boytsov SA, Ageev FT, Blankova ZN, Dzhioeva ON, Drozdova LY, et al. Outpatient follow-up of patients with chronic heart failure by a general practitioner in primary health care. Guidelines. Primary Health Care (Russian Federation). 2025;2(1):53–114. (In Russ.) https://doi.org/10.15829/3034-4123-2025-39
54. Dong G. Development and challenges of pre-heart failure with preserved ejection fraction. Rev Cardiovasc Med. 2023;24(9):274. https://doi.org/10.31083/j.rcm2409274
55. Plitt GD, Spring JT, Moulton MJ, Agrawal DK. Mechanisms, diagnosis, and treatment of heart failure with preserved ejection fraction and diastolic dysfunction. Expert Review of Cardiovascular Therapy. 2018;16:579–589. https://doi.org/10.1080/14779072.2018.1497485
56. Bayes-Genis A, Bisbal F, Núñez J, Santas E, Lupón J, Rossignol P, et al. Transitioning from preclinical to clinical heart failure with preserved ejection fraction: a mechanistic approach. J Clin Med. 2020;9(4):1110. https://doi.org/10.3390/jcm9041110
57. Bisbal F, Baranchuk A, Braunwald E, Bayés de Luna A, Bayés-Genís A. Atrial failure as a clinical entity: JACC review topic of the week. JACC. 2020;75(2):222–232. https://doi.org/10.1016/j.jacc.2019.11.013
58. He X, Yang X, Guo P, Ran H. Evaluation of left atrial function in patients with hypertensive heart disease and preserved ejection fraction using real-time, three-dimensional speckle tracking imaging. Kardiologiia. 2025;65(8):63–70. (In Russ.) https://doi.org/10.18087/cardio.2025.8.n2856
59. Habibi M, Chahal H, Opdahl A, Gjesdal O, Helle-Valle TM, Heckbert SR, et al. Association of CMR-measured LA function with heart failure development: Results from the MESA study. JACC Cardiovasc Imaging. 2014;7(6):570–579. https://doi.org/10.1016/j.jcmg.2014.01.016
60. Ammar KA, Jacobsen SJ, Mahoney DW, Kors JA, Redfield MM, Burnett JC Jr, et al. Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology / American Heart Association heart failure staging criteria in the community. Circulation. 2007;115(12):1563–1570. https://doi.org/10.1161/CIRCULATIONAHA.106.666818
61. Meng W, Yang H, Ren Z, Wu J, Zheng Y, Zhao S, et al. Prognosis of early-stage HFpEF in the community-dwelling elderly: The Northern Shanghai Study. ESC Heart Fail. 2025;12(1):229– 238. https://doi.org/10.1002/ehf2.15060
62. Zheng P-P, Yao S-M, Guo D, Cui L-l, Miao G-B, Dong W, et al. Prevalence and prognostic value of heart failure stages: an elderly inpatient based cohort study. Front Med. 2021;8:639453. https://doi.org/10.3389/fmed.2021.639453
63. Shlyakhto EV. Classification of heart failure: focus on prevention. Russian Journal of Cardiology. 2023;28(1):5351. (In Russ.) https://doi.org/10.15829/1560-4071-2023-5351
64. Anwar AM. Incremental diagnostic and prognostic utility of left atrial deformation in heart failure using speckle tracking echocardiography. Heart Fail Rev. 2024;29(3):713–727. https://doi.org/10.1007/s10741-024-10392-z
65. Ovchinnikov AG, Ageev FT, Alekhin MN, Belenkov YuN, Vasyuk YuA, Galyavich AS, et al. The role of diastolic transthoracic stress echocardiography with incremental workload in the evaluation of heart failure with preserved ejection fraction: indications, methodology, interpretation. Expert consensus developed under the auspices of the National Medical Research Center of Cardiology, Society of Experts in Heart Failure (SEHF), and Russian Association of Experts in Ultrasound Diagnosis in Medicine (REUDM). Kardiologiia. 2020;60(12):48–63. (In Russ.) https://doi.org/10.18087/cardio.2020.12.n1219
66. Thomas L, Muraru D, Popescu BA, Sitges M, Rosca M, Pedrizzetti G, et al. Evaluation of left atrial size and function: relevance for clinical practice. J Am Soc Echocardiogr. 2020;33:934– 952. https://doi.org/10.1016/j.echo.2020.03.021
67. Freed BH, Daruwalla V, Cheng JY, Aguilar FG, Beussink L, Choi A, et al. Prognostic utility and clinical significance of cardiac mechanics in heart failure with preserved ejection fraction: importance of left atrial strain. Circ Cardiovasc Imaging. 2016;9(3):e003754. https://doi.org/10.1161/CIRCIMAGING.115.003754
68. Hieda M, Sarma S, Hearon CM, Jr, Dias KA, Martinez J, Samels M, et al. Increased myocardial stiffness in patients with highrisk left ventricular hypertrophy: the hallmark of stage-b heart failure with preserved ejection fraction. Circulation. 2020;141(2):115-123. https://doi.org/10.1161/CIRCULATIONAHA.119.040332
69. Cameli M, Lisi M, Mondillo S, Padeletti M, Ballo P, Tsioulpas C, et al. Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure. Cardiovasc Ultrasound. 2010;8(1):14. https://doi.org/10.1186/1476-7120-8-14
70. Morris DA, Takeuchi M, Krisper M, Köhncke C, Bekfani T, Carstensen T, et al. Normal values and clinical relevance of left atrial myocardial function analysed by speckle-tracking echocardiography: multicentre study. Eur Heart J Cardiovasc Imaging. 2015;16(4):364–372. https://doi.org/10.1093/ehjci/jeu219
71. Singh A, Medvedofsky D, Mediratta A, Balaney B, Kruse E, Ciszek B, et al. Peak left atrial strain as a single measure for the non-invasive assessment of left ventricular filling pressures. Int J Cardiovasc Imaging. 2019;35(1):23–32. https://doi.org/10.1007/s10554-018-1425-y
72. Inoue K, Khan FH, Remme EW, Ohte N, García-Izquierdo E, Chetrit M, et al. Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure. Eur Heart J Cardiovasc Imaging. 2021;23(1):61–70. https://doi.org/10.1093/ehjci/jeaa415
73. Ovchinnikov AG, Potekhina AV, Filatova AYu, Svirida ON, Shogenova MKh, Sobolevskaya MS, et al. The role of the left atrium in the pathogenesis of heart failure with preserved ejection fraction. Kardiologiia. 2024;64(11):132–147. (In Russ.) https://doi.org/10.18087/cardio.2024.11.n2799
74. Coats AJS, Heymans S, Farmakis D, Anker SD, Backs J, Bauersachs J, et al. Atrial disease and heart failure: the common soil hypothesis proposed by the Heart Failure Association of the European Society of Cardiology. Eur Heart J. 2022;43(17):1635. https://doi.org/10.1093/eurheartj/ehac124
75. Ovchinnikov AG, Potekhina AV, Borisov AA, Ibragimova NM, Yushchyuk EN Masenko VP, et al. The contribution of left atrial dysfunction to exercise intolerance in early heart failure with preserved left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging. 2020;21(Suppl 1):jez320. https://doi.org/10.1093/ehjci/jez320
76. Bayes-Genis A, Pascual-Figal D, Núñez J. The pre-HFpEF stage: a new entity that requires proper phenotyping for better management. Eur J Prev Cardiol. 2021;28(9):935–936. https://doi.org/10.1177/2047487320902326
Review
For citations:
Gapon L.I., Samoilova E.P. Arterial hypertension and chronic heart failure with preserved ejection fraction (literature review). "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2025;31(6):483-496. (In Russ.) https://doi.org/10.18705/1607-419X-2025-2514. EDN: GOLMOF
Views:
308
JATS XML
Email this article 