Intramural coronary arterial course

This study tests whether a home monitoring program can reduce complications and deaths in infants who had heart surgery. Parents will measure their child's heart rate, oxygen levels, and weight at home and send the data daily via a secure app. The program includes alerts for worr…

This study tests whether taking a daily fiber and magnesium supplement (WellBiome) for 6-8 weeks before heart surgery can improve recovery. Researchers will compare ICU time, complications, and hospital stay between 80 patients who get the supplement or a placebo. The goal is to …

This large phase 3 trial is testing whether adding vicadrostat to the existing drug empagliflozin can reduce the risk of heart problems in adults with type 2 diabetes, high blood pressure, and heart disease. About 11,800 participants will take either the combination or a placebo …

This study looks at the long-term safety of the drug pelacarsen in people with high lipoprotein(a) and heart disease. About 5,700 participants who finished a previous pelacarsen trial will receive the drug and be monitored for side effects and heart events. The goal is to see if …

This study is testing a digital app called VIRTUES that provides educational resources and treatment recommendations for heart conditions like atrial fibrillation and heart failure. Researchers will enroll 2000 patients across 11 modules to see if the app is easy to use and helps…

This phase 3 trial is testing whether adding baxdrostat to the standard drug dapagliflozin can better prevent heart failure and cardiovascular death in people with type 2 diabetes who already have heart disease and high blood pressure. About 11,300 participants will receive eithe…

This study looks at two different ways to use a heart-lung machine (ECMO) during high-risk heart procedures. One method sets up the machine just in case it's needed, while the other uses it from the start. The goal is to see which approach leads to fewer serious problems like dea…

This study tests whether a special activity score, calculated from heart rate data, can help people who have completed cardiac rehab stick to exercise guidelines. About 318 participants will wear a smartwatch for 4 months and do an exercise test at the end. Researchers will compa…

This study compares two methods for closing the breastbone after open-heart surgery: rigid plate fixation (using a metal plate and screws) versus traditional wire cerclage (using stainless steel wires). The trial will enroll 250 adults at high risk for wound complications, such a…

This study tests whether text messages can help people who have finished cardiac rehab keep up healthy habits like weight management, physical activity, and taking medications. Researchers will enroll 400 people from groups often left out of heart research. The study compares dif…

This study tests a new device called the Elevate™ heart pump in 290 people who need high-risk angioplasty (a procedure to open blocked heart arteries). The pump helps keep blood flowing during the procedure. The goal is to see if it is safer and works better than current methods.…

This study tests a device called Efferon LPS that filters harmful substances from the blood during and after heart surgery. The goal is to see if it can reduce the risk of multiple organ failure, a serious complication. Researchers will enroll 60 adults having heart surgery with …

This study tests whether genetic testing can help veterans at high risk for heart disease start and stick with statin medications. About 410 veterans aged 40-75 with diabetes or heart disease who are not currently taking statins will receive either a genetic report on their stati…

This study tests a new method called decrement evoked potential (DeEP) mapping to guide catheter ablation for ventricular tachycardia (VT) in people with structural heart disease. VT is a fast, dangerous heart rhythm that can cause sudden cardiac arrest. The standard ablation pro…

This study tests whether adding digital coaching to home-based cardiac rehabilitation helps veterans complete more rehab sessions and improve their heart health. 150 veterans with heart disease will be randomly assigned to standard home rehab or home rehab plus a private social m…

This study aims to see if using tiny cameras inside the heart's arteries during stent placement leads to better outcomes for people with complex coronary artery disease. About 11,000 adults in the Netherlands who need a stent for severe blockages will be included. The goal is to …

This study looks at whether people at moderate risk for heart problems should continue or stop taking aspirin before a colonoscopy. About 2,500 participants will be randomly assigned to take either aspirin or a placebo for a few days around the procedure. The goal is to see which…

This study tests a noninvasive radiation treatment (SBRT) for people with ventricular tachycardia, a dangerous heart rhythm that can cause sudden death. The 12 participants have structural heart disease and have not been helped by standard treatments like drugs or catheter ablati…

This registry is following 10,000 people who receive the BioFreedom Ultra stent, a device coated with the drug biolimus A9 to keep heart arteries open. The goal is to see how well the stent works in real-world patients, not just in controlled trials. Researchers will track proble…

This study compares a single dose of targeted radiation (SBRT) to the standard catheter ablation procedure for reducing dangerous heart rhythms in people with advanced heart disease. Sixty participants will be randomly assigned to one of the two treatments. The main goal is to se…

This study tests a program that uses an AI chatbot, health coach, and home monitoring devices to help 300 adults with heart disease, diabetes, or kidney disease manage their conditions. The goal is to see if this approach reduces hospital visits, complications, and deaths over 6 …

This study tests a program called CVD-FIT for African American adults who struggle to afford food and are at risk for heart disease. Participants get monthly income support, weekly incentives to buy healthy food, and phone-based education on heart health. The goal is to see if th…

This study looks at whether using a temporary mechanical heart pump during a high-risk heart procedure (PCI) can improve safety and outcomes. About 98 adults with weak hearts and complex blockages will be randomly assigned to receive the pump or standard care. The goal is to see …

This study is testing whether giving air conditioners and a $100 electricity subsidy to older adults in Boston neighborhoods can reduce heat stress, heat strain, and related health problems. One hundred participants aged 55-95 who don't have AC will be randomly assigned to receiv…

This study tests whether bempedoic acid, a cholesterol-lowering drug, can reduce artery inflammation and improve heart health in people with HIV. About 121 adults aged 40 and older with well-controlled HIV and at least one heart disease risk factor will receive either the drug or…

This study looks at whether SGLT2 inhibitors (drugs like empagliflozin and dapagliflozin, typically used for diabetes) can prevent acute kidney injury caused by contrast dye used in heart X-rays and stent procedures. Researchers will review records of 4,000 patients who had these…

This study tests whether the drug Entresto (sacubitril-valsartan) can improve heart structure and function in adults with congenital heart disease. 45 participants will take either Entresto or a placebo for 52 weeks. Researchers will measure heart changes, blood markers, and qual…

This study is developing a computer program that can analyze heart sounds recorded with a digital stethoscope to tell if a newborn's heart is healthy or not. Researchers will record heart sounds from 1,000 babies under 30 days old and use those recordings to train and test the pr…

This study is testing a special mattress that can measure heart rate, breathing, temperature, and body position without touching the patient. It is designed for people with heart disease who are in the hospital. The goal is to see if this wireless system works as well as standard…

This study tests a new technology called IVUS-FFR that uses ultrasound images from inside heart arteries to quickly check if a blockage is serious enough to need a stent. Unlike the current standard test, it doesn't require an extra pressure wire or medication that can cause disc…

This study is testing a new non-invasive vest that uses 128 electrodes to map the heart's electrical activity in people with congenital heart disease. The goal is to see if this method can accurately identify areas causing abnormal heart rhythms without needing invasive procedure…

About 13 in 1,000 children are born with heart disease, but current tools struggle to measure how well the heart fills with blood. This study tests a new, ultrafast ultrasound technique that captures images at a very high rate to measure heart stiffness and blood flow. Researcher…

This study checks if a quick, non-invasive finger test (QuantaFlo HD) can detect early signs of heart dysfunction. Researchers will compare the finger test results with standard heart ultrasound measurements in 600 adults who have risk factors like high blood pressure or diabetes…

This study is testing whether a machine learning algorithm can accurately detect heart murmurs that point to structural heart disease. Researchers will record heart sounds from 125 adults using two different digital stethoscopes and compare the algorithm's findings to standard ec…

This study tests a smartphone app designed to help people prepare for heart surgery through exercise, nutrition tips, and telehealth check-ins. About 40 adults awaiting surgery will either use the app or receive standard care. Researchers want to see if the app is easy to use, ac…

This study tests a 6-session program called BE-FIT that helps cardiac rehabilitation patients reduce anxiety about exercise. The program uses gradual exposure to feared sensations, prevents safety behaviors, and uses activity monitors for feedback. Researchers will enroll 146 adu…

This study tests two different stitch materials (PDS and Vicryl) for closing groin incisions after planned vascular surgery. About 259 adults will be randomly assigned to one stitch type or the other. The goal is to see which material leads to fewer wound problems.

This study tests whether giving a set of nerve blocks (injections of numbing medicine) right after anesthesia but before surgery can reduce pain and the need for opioid painkillers after coronary artery bypass grafting. 56 adults scheduled for elective bypass surgery will be rand…

This study tests whether live, group exercise sessions delivered via video chat can improve fitness in teens (ages 12-19) with certain types of congenital heart disease. 74 participants will either join the remote exercise program or receive standard exercise handouts. The main g…

This study tests whether a daily movement program led by a kinesiologist can reduce frailty in 60 hospitalized heart patients. Frailty makes people weaker and more likely to have longer hospital stays or be readmitted. The program encourages simple activities like standing, walki…

This study tests a methadone-based recovery plan to improve pain control and reduce opioid use in children after heart surgery. About 500 children aged 3 to 18 will be randomly assigned to either the new methadone plan or standard care. The goal is to see if the new approach lowe…

This study tests whether adding a program that targets sleep and stress (called RESST) to standard cardiac rehabilitation helps heart patients recover better. About 200 adults with heart conditions who also have poor sleep or high stress will take part. Researchers will measure s…

This study tests whether a specific nerve block, called the serratus posterior superior intercostal plane block, can reduce pain and opioid use after minimally invasive heart bypass surgery. Sixty adults undergoing this surgery will be randomly assigned to receive either the nerv…

This study tests a web-based app called IAMABLE that provides evidence-based rehabilitation strategies for people with chronic conditions like heart disease, arthritis, or neurological disorders. Fifty adults aged 45 to 75 will use the app for 4 months to set goals and learn abou…

This study tests whether a nerve block called a parasternal plane block can better control pain during heart surgery in children aged 6 months to 7 years. The block is given after anesthesia and uses a numbing medicine (bupivacaine). Researchers will measure pain using a special …

This study tests whether a type of talk therapy called Behavioral Activation, delivered via home-based telehealth, can improve social functioning and mood in veterans recently discharged from the hospital for a heart condition. About 132 veterans with depression will receive eith…

This study tests whether giving a nerve block (stellate ganglion block) before coronary artery bypass grafting (CABG) can reduce the chance of developing atrial fibrillation, a common irregular heartbeat after surgery. About 60 adults having CABG will be randomly assigned to rece…

This study compares a women-only cardiac rehabilitation program to the standard mixed-gender program for women with heart disease. Sixty women aged 40-80 will attend 36 sessions over 12 weeks, with extra women-focused education. Researchers will measure attendance, completion rat…

This study tests a program called One-Mind One-Heart that combines mindfulness and behavior change skills to help older adults with HIV reduce stress and improve heart health. The program includes text messages and covers topics like physical activity, diet, and substance use. Th…

This study tests whether a standardized, step-by-step protocol for giving blood thinner injections (low-molecular-weight heparin) can reduce bruising and pain in heart patients. About 180 patients in cardiac care units will be randomly assigned to receive injections either by the…

This registry study will enroll 200,000 high-risk cardiac patients to see how well an AI platform called Willem can detect heart problems from standard ECGs. The AI's readings will be compared to expert cardiologist diagnoses, but the AI results won't be shared with doctors, so p…

This study aims to learn more about how diseases related to blood clots, the immune system, and blood vessels start and change over time. Researchers will enroll up to 1,000 people aged 5 and older, including those with these conditions, their healthy relatives, and healthy volun…

This registry tracks 2,000 adults with congenital heart disease who are on the waiting list for a heart or heart-lung transplant. The goal is to understand why some patients get worse or die while waiting, while others improve enough to be removed from the list. By collecting dat…

This study follows 450 babies born with serious heart defects to find early signs of developmental delays by 6 months of age. Researchers want to understand why over half of these children face learning, thinking, or behavior challenges later in life. The goal is to identify risk…

This study aims to learn more about heart and blood vessel diseases by observing people who have them or are at risk. Researchers will collect samples and perform tests like imaging and stress tests on up to 5,000 participants, including healthy volunteers and relatives of affect…

This study creates a large database of about 12,000 people with and without heart disease. Researchers collect medical information and blood samples to analyze factors that influence heart conditions like coronary artery disease, heart failure, and stroke. The goal is to better u…

This study tests two improvements for heart catheterization done through a small artery in the wrist. First, it checks if a special patch can stop bleeding faster. Second, it sees if using ultrasound to guide the needle makes the procedure more successful. About 480 adults needin…

This study looks at medical records of 1,000 older heart patients in Russia to see if they were prescribed potentially harmful medications during the COVID-19 pandemic. Researchers will use a medical database to count how often these risky prescriptions happened and check for dan…

This study is creating a large collection of blood, urine, stool, and heart tissue samples from 10,000 people with and without heart or metabolic conditions. The goal is to store these samples along with medical information to speed up future research into what causes these disea…

This study is observing 20,000 people undergoing routine heart or blood vessel procedures through the wrist (radial or ulnar artery). Researchers will track complications like artery blockage, spasm, and bleeding. The goal is to gather real-world data to improve safety and succes…

This study is testing whether simple nutritional checks before heart surgery can predict how well patients recover. Researchers will give 250 patients questionnaires, blood and urine tests, and measure grip strength and body composition. They will then see if these measures are l…

This study is collecting medical data and biological samples from people with genetic conditions affecting the heart and blood vessels, their relatives, and healthy volunteers. The goal is to better understand these diseases, improve diagnosis, and lay the groundwork for future t…

This study aims to collect DNA samples and medical information from 2,000 people with heterotaxy (a condition where organs are arranged abnormally) and related heart defects, along with their family members. Researchers hope to identify the genetic causes of these conditions, whi…

This study looks at whether people with type 2 diabetes, COPD, or heart disease who join a health program in Halsnaes Municipality improve their physical function and well-being. About 194 adults will be tracked before and after the program using tests and questionnaires. The goa…

This study looks at how people with ME/CFS (chronic fatigue syndrome) and people with heart conditions feel after a bike exercise test. Researchers want to see if the type and timing of symptoms after exercise are different between the two groups. 80 adults will take part, and th…

This study follows 300 people who had hospital-acquired pneumonia to see how it affects their heart and lungs over 18 months. Researchers will take blood samples, swabs, and perform heart and lung tests to understand the link between pneumonia and later cardiovascular problems li…

This study is testing a comprehensive MRI scan to see if it can better diagnose different heart conditions. Researchers will scan 2,000 adults with suspected or confirmed heart disease. The goal is to create a standard imaging method that improves early detection and risk predict…

This study is testing whether artificial intelligence can predict if someone will develop one of five common diseases: diabetes, heart disease, breast cancer, back pain, or arthritis. Researchers will collect health data from 1,000 adults aged 30 to 60, including medical records,…

This study looks at 174 mothers whose babies were diagnosed with serious heart defects before birth. Researchers will track the mothers' mental health from the third trimester until the baby is one year old, and then test the babies' brain development. The goal is to understand i…

This observational study will enroll 10,000 adults who are already scheduled for a cardiac CT scan. Researchers will use artificial intelligence to analyze the scans, looking for subtle signs of dangerous plaque that might predict future heart attacks. Participants will also give…

This study uses advanced heart MRI to see how bariatric surgery and cardiac rehabilitation change the heart's structure and function. Researchers will scan 150 adults before and 6-12 months after these metabolic treatments. The goal is to understand how the heart adapts to these …

This study will use a new type of cardiac MRI to look at the heart's microscopic structure in 1,000 people—both healthy volunteers and those with various heart conditions. The goal is to see if this advanced imaging can detect early signs of heart damage better than standard test…

This registry is following 5,000 adults in Switzerland who were born with heart defects. The goal is to collect data on their long-term health, including complications and treatments. By tracking these patients over time, researchers hope to better understand the challenges they …

This study uses small pieces of heart tissue removed during necessary surgery in children with congenital heart disease. Researchers want to understand how calcium controls heart cell contraction and how infant heart cells differ from adult ones. They also aim to improve lab-grow…

This study is building a huge database of up to 800,000 Korean patients with heart or brain vascular disease. By tracking their health over many years, researchers hope to understand the unique patterns and risk factors in this population. The goal is to create a platform that ca…

This study is creating a large biobank of blood, DNA, plasma, and tissue samples from 15,000 people with and without heart and aortic diseases. Researchers will use this information to better understand conditions like aortic aneurysm, heart failure, and bicuspid aortic valve. Th…

This study aims to develop better MRI methods for imaging the heart and brain, and to describe heart diseases using these new techniques. It will also investigate whether gadolinium, a common MRI contrast agent, stays in the body long after use. Up to 5,000 healthy volunteers and…

This study tests whether a machine-learning model can predict serious heart events in children admitted to the hospital. The model alerts doctors when a child may need a palliative care consultation. Researchers will compare outcomes before and after the model is used, involving …

This study will use advanced heart MRI scans on up to 100,000 people with known or suspected heart disease. The goal is to learn how these scans can help doctors better understand, diagnose, and treat different heart conditions. Researchers will track participants' health over ti…

This study looks at how aging inside our cells might make heart arteries more prone to dangerous plaques. Researchers will measure DNA damage and other aging markers in 300 adults with different types of chest pain or heart attacks. The goal is to find better ways to predict who …

This study looks at infants having heart surgery, where the thymus gland is often fully removed to access the heart. The thymus helps build the immune system early in life. Researchers want to see if removing only part of the thymus keeps the immune system stronger and reduces in…

This study creates a large collection of blood, tissue, and medical information from up to 5,000 people with or at risk for pediatric heart disease. Researchers will use these samples to better understand the disease and find new ways to diagnose or treat it in the future. Partic…

This study follows 10,000 children with congenital heart disease who need surgery for non-heart issues. Researchers want to learn what complications occur and how hospitals use resources. The goal is to create better risk predictions and improve care for these patients.

This study measures how hard children with conditions like neuromuscular disease, scoliosis, or heart problems work to breathe. Researchers use a thin tube placed through the nose into the esophagus to measure breathing muscle strength and effort. The goal is to better understand…

This registry is collecting information from 8,000 people undergoing heart or chest surgery. The goal is to see how factors before and during surgery relate to serious complications like death, shock, or infection. By analyzing this data, researchers hope to find ways to improve …

This study is testing a tool called B-COMPASS that uses a 22-question survey to predict whether people will follow their prescribed treatments. Researchers will enroll 3100 adults with cardiovascular, endocrine, immune, nerve, cancer, or rare diseases across Europe. The goal is t…

This study is testing whether giving probiotics after heart surgery can improve recovery by changing the bacteria in the gut. Researchers will measure certain chemicals in the blood that come from gut bacteria. The trial involves 30 adults scheduled for heart surgery, who will re…

This study looks at how the brain, nerves, and blood vessels interact in 80 adults having heart surgery. Researchers will measure brain activity, blood flow, and heart reflexes to better understand the link between heart disease and depression. The goal is to develop new tools fo…

This study follows 30,000 adults with coronary artery disease to see how different risk factors affect their long-term survival. Researchers will track deaths from any cause and from heart problems specifically. The goal is to better understand what influences outcomes in real-wo…

This study collects blood samples from 1500 adults at risk for heart disease to discover new biomarkers that can predict future heart attacks, strokes, or blocked leg arteries. Participants are seen at a specialized prevention center and provide samples and health data at the sta…

This study uses special MRI scans to look at how the heart and muscles work together during exercise in children with heart disease or those who have had a heart transplant. Researchers want to learn more about what affects fitness in these kids. About 20 children aged 10 to 18 w…

This study examines whether special pacemakers can effectively treat a common type of fast heart rhythm (atrial tachycardia) in people born with heart defects. Researchers will review medical records from up to 300 patients over 10 years to see if the pacemaker reduces the need f…

This study tests whether a single PET tracer (FDG) can measure both blood flow and sugar use in the heart, instead of needing two separate tracers. Researchers will compare results from FDG with a dedicated flow tracer in 60 healthy adults and people with heart disease. The goal …

This study looks at whether a structured physical activity program can improve thinking and learning in children who had heart surgery. Researchers will compare these children to those having other surgeries and healthy kids. The goal is to see if exercise helps with memory, atte…

This study looks at how well the heart works during exercise compared to at rest in people with congenital heart disease. Researchers will use a special test during a routine heart catheterization to measure blood flow and pressures. The goal is to find out if exercise can uncove…

This study tests a program called Heart-to-Heart, where community health workers help low-income patients make informed choices about cardiac rehab after a heart event. About 50 adults from Johns Hopkins Hospital will take part. The goal is to see if the program is practical and …

This study looks at how changes in preoperative care affect anxiety in 100 children with congenital heart disease who need surgery or catheterization. Researchers will measure stress levels using questionnaires and scales, and also get feedback from parents and care teams. The go…

This study will enroll 5,000 adults with chronic heart conditions like heart failure, high blood pressure, or aortic stenosis. Participants will wear a Prolaio digital health patch that monitors heart rate, breathing, and other vital signs. The goal is to observe how these condit…

This international registry is tracking 400 adults with congenital heart disease who are taking SGLT2 inhibitors, a type of diabetes medication that also benefits the heart. Researchers want to see how these drugs are being prescribed, how well they are tolerated, and whether the…

This study tests whether a wrist-worn device can help monitor pregnant women with congenital heart disease. Researchers will track heart rhythms and other data from 50 participants to see if the wearable can detect early signs of trouble. The goal is to improve care and reduce th…

This study is reviewing medical records from 5,000 heart and blood vessel surgery patients to find factors that influence recovery and survival. Researchers are looking at data from 2001 to 2013 to identify what leads to complications or death after surgery. The goal is to improv…

This study looks at whether a special heart ultrasound measurement, called global longitudinal strain (GLS), can predict if a person will have trouble coming off the heart-lung machine during heart surgery. About 213 adults having planned heart surgery will have their hearts meas…

This study aims to understand why people with tetralogy of Fallot and other congenital heart diseases experience shortness of breath, palpitations, and changes in heart structure. Researchers will use remote heart rhythm monitors and imaging to track 300 participants over two yea…

This study collects small heart tissue samples from 400 adults undergoing heart procedures. Researchers will analyze these samples to find new markers that could help diagnose heart diseases earlier and better understand how the heart works in health and disease. The goal is to i…

This study uses a special eye scan called OCTA to measure the density of tiny blood vessels in the retina. Researchers will compare results from 64 people—half with cardiovascular disease and half healthy—to see if the scan can reliably detect vessel changes linked to heart probl…

This study is testing whether adding genetic and imaging information to standard risk assessments can better predict heart disease in 30,000 healthy Italian adults aged 40-80. Participants will have their risk calculated using traditional methods and then again with the added dat…

This study is testing a virtual patient navigation program for 260 English, Chinese, or Spanish speakers with breast cancer or heart disease. The goal is to see if a phone-based portal can help underserved people get the support they need, even though it won't fully replace in-pe…

This study follows over 10,000 Moroccan adults for 10 years after a heart screening. Researchers will track heart attacks, strokes, and heart-related deaths to build a risk score tailored to the Moroccan population. The goal is to better predict and prevent heart disease in Moroc…

This trial tests whether using a wrist artery access point closer to the hand (distal radial) is safer than the usual wrist access for complex heart procedures like opening blocked arteries. About 708 adults with stable or unstable heart conditions will be randomly assigned to on…

This study is building a biobank of blood and tissue samples from 500 patients undergoing cardiac surgery. Researchers will analyze these samples to better understand the causes and progression of heart disease. The goal is to improve future diagnosis and treatment, but no new th…

This study tracks 150 adults in cardiac rehab to see if men and women differ in how much they move during and up to 6 months after the program. Participants wear activity trackers and complete fitness tests at three visits over 10 months. The goal is to understand barriers to sta…

This study is looking at a new blood marker called sST2 to see if it can better detect heart failure in children after congenital heart surgery. Researchers will measure sST2 levels in 225 children under 18 during and after surgery, and at a follow-up 9-12 months later. They will…

This study aims to see if voice recordings from a smartphone can help detect heart disease. Researchers will collect voice samples and health data from up to 1 million adults using the Mayo Clinic app. No treatment is given; the goal is to gather information for future AI tools.

This study looks at whether using a 3D-printed model of a child's heart helps surgeons plan a procedure to place a mechanical pump (VAD) in children with congenital heart disease and heart failure. About 36 children weighing over 3 kilograms will take part. The goal is to see if …

This study tests whether artificial intelligence can evaluate how well surgeons perform a key step in heart bypass surgery. Researchers will compare AI scores to those from human experts. The trial involves 284 patients undergoing bypass grafting and aims to see if AI can reliabl…

This study is testing whether a smartwatch, combined with artificial intelligence and remote doctor check-ins, can help detect heart issues like atrial fibrillation and unstable angina earlier than usual. Researchers at the University of Sao Paulo will enroll 520 adults with hear…

This study is observing 900 adults in Greece who have both chronic obstructive pulmonary disease (COPD) and at least one heart condition. Researchers will track their health for two years, recording lung flare-ups, heart complications, hospital visits, and quality of life. The go…