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T1 Age 2 13 53-year-old T2 Sex 14 17 man T3 Clinical_event 18 22 came E1 Clinical_event:T3 T4 Nonbiological_location 30 38 hospital R1 MODIFY Arg1:T4 Arg2:E1 T5 Disease_disorder 72 85 heart failure E2 Disease_disorder:T5 T6 Detailed_description 66 71 acute R2 MODIFY Arg1:T6 Arg2:E2 T7 Duration 94 108 2-week history E3 Duration:T7 T8 Sign_symptom 124 138 breathlessness E4 Sign_symptom:T8 T9 Detailed_description 112 123 progressive R3 MODIFY Arg1:T9 Arg2:E4 A1 TREND E4 INC T10 Sign_symptom 175 184 abscesses E5 Sign_symptom:T10 T11 Disease_disorder 196 206 dermatitis E6 Disease_disorder:T11 T12 Detailed_description 189 195 atopic R4 MODIFY Arg1:T12 Arg2:E6 T13 Biological_structure 170 174 skin T14 Frequency 160 169 recurrent R5 MODIFY Arg1:T14 Arg2:E5 R6 MODIFY Arg1:T13 Arg2:E5 T15 History 149 184 history of recurrent skin abscesses T16 History 189 206 atopic dermatitis T17 Clinical_event 221 228 visited E7 Clinical_event:T17 T18 Frequency 211 220 regularly R7 MODIFY Arg1:T18 Arg2:E7 T19 Nonbiological_location 231 244 dermatologist R8 MODIFY Arg1:T19 Arg2:E7 T20 Clinical_event 265 273 arriving E8 Clinical_event:T20 T21 Nonbiological_location 281 289 hospital R9 MODIFY Arg1:T21 Arg2:E8 T22 Sign_symptom 312 316 warm E9 Sign_symptom:T22 T23 Sign_symptom 321 324 dry E10 Sign_symptom:T23 T24 Biological_structure 295 306 extremities R10 MODIFY Arg1:T24 Arg2:E9 R11 MODIFY Arg1:T24 Arg2:E10 T25 Diagnostic_procedure 343 378 New York Heart Association criteria E11 Diagnostic_procedure:T25 T27 Disease_disorder 397 421 congestive heart failure E12 Disease_disorder:T27 T28 Disease_disorder 423 426 CHF E13 Disease_disorder:T28 R13 IDENTICAL Arg1:E13 Arg2:E12 T29 Diagnostic_procedure 432 449 electrocardiogram E14 Diagnostic_procedure:T29 T30 Nonbiological_location 252 260 hospital R14 MODIFY Arg1:T30 Arg2:E7 T26 Lab_value 387 396 class III E15 Lab_value:T26 R12 MODIFY Arg1:E15 Arg2:E11 T31 Sign_symptom 479 493 T-wave changes E16 Sign_symptom:T31 T32 Diagnostic_procedure 522 537 extremity leads E17 Diagnostic_procedure:T32 T33 Diagnostic_procedure 573 593 anterior chest leads E18 Diagnostic_procedure:T33 R15 SUB_PROCEDURE Arg1:E17 Arg2:E14 R16 SUB_PROCEDURE Arg1:E18 Arg2:E14 T34 Detailed_description 467 478 nonspecific T35 Detailed_description 459 466 diffuse R17 MODIFY Arg1:T34 Arg2:E16 R18 MODIFY Arg1:T35 Arg2:E16 T36 Diagnostic_procedure 499 506 voltage E19 Diagnostic_procedure:T36 R19 SUB_PROCEDURE Arg1:E19 Arg2:E17 T37 Lab_value 495 498 low E20 Lab_value:T37 T38 Lab_value 508 513 <5 mm E21 Lab_value:T38 R20 MODIFY Arg1:E21 Arg2:E19 R21 MODIFY Arg1:E20 Arg2:E19 T39 Diagnostic_procedure 547 565 R-wave progression E22 Diagnostic_procedure:T39 R22 SUB_PROCEDURE Arg1:E22 Arg2:E18 T40 Lab_value 542 546 poor E23 Lab_value:T40 R23 MODIFY Arg1:E23 Arg2:E22 T41 Sign_symptom 625 640 premature beats E24 Sign_symptom:T41 T42 Quantitative_concept 595 603 Multiple T43 Frequency 604 612 sporadic T44 Biological_structure 613 624 ventricular R24 MODIFY Arg1:T44 Arg2:E24 R25 MODIFY Arg1:T43 Arg2:E24 R26 MODIFY Arg1:T42 Arg2:E24 T45 Diagnostic_procedure 669 674 x-ray E25 Diagnostic_procedure:T45 T46 Biological_structure 663 668 Chest R27 MODIFY Arg1:T46 Arg2:E25 T47 Disease_disorder 696 712 pleural effusion E26 Disease_disorder:T47 T48 Detailed_description 690 695 right R28 MODIFY Arg1:T48 Arg2:E26 T49 Sign_symptom 723 735 cardiomegaly E27 Sign_symptom:T49 T50 Disease_disorder 743 763 pulmonary congestion E28 Disease_disorder:T50 A2 POLARITY E28 NEG T51 Severity 718 722 mild R29 MODIFY Arg1:T51 Arg2:E27 T52 Diagnostic_procedure 776 787 Blood tests E29 Diagnostic_procedure:T52 T53 Diagnostic_procedure 813 839 B-type natriuretic peptide E30 Diagnostic_procedure:T53 T54 Lab_value 795 812 severely elevated E31 Lab_value:T54 T55 Lab_value 841 850 901 pg/mL E32 Lab_value:T55 R30 MODIFY Arg1:E32 Arg2:E30 R31 MODIFY Arg1:E31 Arg2:E30 T56 Diagnostic_procedure 872 875 IgE E33 Diagnostic_procedure:T56 T57 Lab_value 865 871 raised E34 Lab_value:T57 T58 Lab_value 877 889 12 000 IU/mL E35 Lab_value:T58 R32 MODIFY Arg1:E35 Arg2:E33 R33 MODIFY Arg1:E34 Arg2:E33 T59 Sign_symptom 899 911 eosinophilia E36 Sign_symptom:T59 A3 POLARITY E36 NEG T60 Diagnostic_procedure 913 929 eosinophil count E37 Diagnostic_procedure:T60 T61 Lab_value 933 943 1.62×108/L E38 Lab_value:T61 R34 MODIFY Arg1:E38 Arg2:E37 T62 Diagnostic_procedure 946 966 Biochemical analysis E39 Diagnostic_procedure:T62 T63 Diagnostic_procedure 1001 1020 blood urea nitrogen E40 Diagnostic_procedure:T63 R35 SUB_PROCEDURE Arg1:E30 Arg2:E29 R36 SUB_PROCEDURE Arg1:E33 Arg2:E29 R37 SUB_PROCEDURE Arg1:E37 Arg2:E29 T64 Lab_value 1024 1034 14.3 mg/dL E41 Lab_value:T64 R38 MODIFY Arg1:E41 Arg2:E40 T65 Diagnostic_procedure 1071 1081 creatinine E42 Diagnostic_procedure:T65 R39 SUB_PROCEDURE Arg1:E40 Arg2:E39 T66 Lab_value 1085 1095 0.90 mg/dL E43 Lab_value:T66 R40 MODIFY Arg1:E43 Arg2:E42 T67 Diagnostic_procedure 1113 1131 C-reactive protein E44 Diagnostic_procedure:T67 T68 Diagnostic_procedure 1133 1136 CRP E45 Diagnostic_procedure:T68 R41 IDENTICAL Arg1:E45 Arg2:E44 T69 Lab_value 1141 1150 0.2 mg/dL E46 Lab_value:T69 T70 Diagnostic_procedure 1168 1183 serum amyloid A E47 Diagnostic_procedure:T70 T71 Diagnostic_procedure 1185 1188 SAA E48 Diagnostic_procedure:T71 R42 IDENTICAL Arg1:E48 Arg2:E47 T72 Lab_value 1193 1202 7.0 μg/mL E49 Lab_value:T72 R43 MODIFY Arg1:E49 Arg2:E47 T73 Diagnostic_procedure 1220 1230 troponin T E50 Diagnostic_procedure:T73 T74 Lab_value 1234 1244 0.07 ng/mL E51 Lab_value:T74 R44 MODIFY Arg1:E51 Arg2:E50 T75 Diagnostic_procedure 1258 1276 Immunology testing E52 Diagnostic_procedure:T75 R45 SUB_PROCEDURE Arg1:E42 Arg2:E39 R46 SUB_PROCEDURE Arg1:E44 Arg2:E39 R47 SUB_PROCEDURE Arg1:E47 Arg2:E39 R48 SUB_PROCEDURE Arg1:E50 Arg2:E39 T76 Diagnostic_procedure 1295 1345 perinuclear anti-neutrophil cytoplasmic antibodies E53 Diagnostic_procedure:T76 R49 SUB_PROCEDURE Arg1:E53 Arg2:E52 T77 Lab_value 1286 1294 negative E54 Lab_value:T77 R50 MODIFY Arg1:E54 Arg2:E53 T78 Diagnostic_procedure 1366 1392 myeloperoxidase antibodies E55 Diagnostic_procedure:T78 T79 Lab_value 1350 1362 no elevation E56 Lab_value:T79 R51 MODIFY Arg1:E56 Arg2:E55 T80 Diagnostic_procedure 1414 1421 albumin E57 Diagnostic_procedure:T80 T81 Diagnostic_procedure 1426 1434 globulin E58 Diagnostic_procedure:T81 T82 Detailed_description 1442 1447 serum R52 MODIFY Arg1:T82 Arg2:E58 R53 MODIFY Arg1:T82 Arg2:E57 T83 Lab_value 1452 1458 normal E59 Lab_value:T83 R54 MODIFY Arg1:E59 Arg2:E57 R55 MODIFY Arg1:E59 Arg2:E58 T84 Diagnostic_procedure 1466 1496 protein immuno-electrophoresis E60 Diagnostic_procedure:T84 T85 Detailed_description 1460 1465 Serum R56 MODIFY Arg1:T85 Arg2:E60 T86 Diagnostic_procedure 1512 1521 M-protein E61 Diagnostic_procedure:T86 R57 SUB_PROCEDURE Arg1:E61 Arg2:E60 T87 Lab_value 1497 1511 did not reveal E62 Lab_value:T87 R58 MODIFY Arg1:E62 Arg2:E61 T88 Diagnostic_procedure 1527 1537 urinalysis E63 Diagnostic_procedure:T88 T89 Diagnostic_procedure 1550 1569 Bence-Jones protein E64 Diagnostic_procedure:T89 R59 SUB_PROCEDURE Arg1:E64 Arg2:E63 T90 Lab_value 1547 1549 no E65 Lab_value:T90 R60 MODIFY Arg1:E65 Arg2:E64 T91 Diagnostic_procedure 1585 1601 echocardiography E66 Diagnostic_procedure:T91 T92 Biological_structure 1571 1584 Transthoracic R61 MODIFY Arg1:T92 Arg2:E66 T93 Sign_symptom 1658 1669 hypertrophy E67 Sign_symptom:T93 T94 Biological_structure 1654 1656 LV T95 Biological_structure 1636 1652 left ventricular R62 MODIFY Arg1:T94 Arg2:T95 R63 MODIFY Arg1:T95 Arg2:E67 T96 Severity 1631 1635 mild T97 Detailed_description 1620 1630 concentric R64 MODIFY Arg1:T96 Arg2:E67 R65 MODIFY Arg1:T97 Arg2:E67 T98 Distance 1671 1676 12 mm R66 MODIFY Arg1:T98 Arg2:E67 T99 Sign_symptom 1705 1734 granular sparkling appearance E68 Sign_symptom:T99 A4 POLARITY E68 NEG T100 Disease_disorder 1739 1759 pericardial effusion E69 Disease_disorder:T100 A5 POLARITY E69 NEG T101 Diagnostic_procedure 1771 1788 ejection fraction E70 Diagnostic_procedure:T101 T102 Lab_value 1790 1793 60% E71 Lab_value:T102 R67 MODIFY Arg1:E71 Arg2:E70 T103 Lab_value 1761 1770 preserved E72 Lab_value:T103 R68 MODIFY Arg1:E72 Arg2:E70 T104 Sign_symptom 1810 1821 enlargement E73 Sign_symptom:T104 T105 Biological_structure 1800 1809 bi-atrial R69 MODIFY Arg1:T105 Arg2:E73 T106 Diagnostic_procedure 1834 1854 ventricular chambers E74 Diagnostic_procedure:T106 T107 Lab_value 1827 1833 normal E75 Lab_value:T107 R70 MODIFY Arg1:E75 Arg2:E74 T108 Diagnostic_procedure 1875 1892 diastolic filling E76 Diagnostic_procedure:T108 T109 Biological_structure 1872 1874 LV T110 Detailed_description 1856 1871 Doppler-derived R71 MODIFY Arg1:T110 Arg2:E76 R72 MODIFY Arg1:T109 Arg2:E76 T111 Diagnostic_procedure 2374 2380 biopsy E77 Diagnostic_procedure:T111 T112 Nonbiological_location 2347 2361 dermatologists R73 MODIFY Arg1:T112 Arg2:E77 T113 Sign_symptom 2391 2397 macula E78 Sign_symptom:T113 T114 Color 2386 2390 blue T115 Biological_structure 2405 2418 forehead skin R74 MODIFY Arg1:T115 Arg2:E78 R75 MODIFY Arg1:T114 Arg2:E78 T116 Diagnostic_procedure 2011 2020 E/A ratio E79 Diagnostic_procedure:T116 T117 Lab_value 2024 2027 2.8 E80 Lab_value:T117 T118 Lab_value 2002 2010 elevated E81 Lab_value:T118 R76 MODIFY Arg1:E81 Arg2:E79 R77 MODIFY Arg1:E80 Arg2:E79 T119 Diagnostic_procedure 1948 1984 early filling wave deceleration time E82 Diagnostic_procedure:T119 T120 Biological_structure 1935 1947 trans-mitral R78 MODIFY Arg1:T120 Arg2:E82 T121 Lab_value 1988 1994 160 ms E83 Lab_value:T121 R79 MODIFY Arg1:E83 Arg2:E82 T122 Lab_value 1908 1927 restrictive pattern E84 Lab_value:T122 R80 MODIFY Arg1:E84 Arg2:E76 T123 Diagnostic_procedure 2053 2063 E/e’ ratio E85 Diagnostic_procedure:T123 T124 Lab_value 2067 2071 27.3 E86 Lab_value:T124 T125 Diagnostic_procedure 2091 2110 LV filling pressure E87 Diagnostic_procedure:T125 T126 Lab_value 2082 2090 elevated E88 Lab_value:T126 R81 MODIFY Arg1:E88 Arg2:E87 T127 Lab_value 2040 2049 elevation E89 Lab_value:T127 R82 MODIFY Arg1:E89 Arg2:E85 T128 Date 2115 2120 day 1 E90 Date:T128 T129 Clinical_event 2124 2139 hospitalization E91 Clinical_event:T129 T130 Date 2231 2236 day 3 E92 Date:T130 T131 Clinical_event 2240 2255 hospitalization E93 Clinical_event:T131 T132 Medication 2158 2203 angiotensin-converting enzyme (ACE) inhibitor E94 Medication:T132 T133 Medication 2217 2226 diuretics E95 Medication:T133 T134 Dosage 2208 2216 low-dose R83 MODIFY Arg1:T134 Arg2:E95 T135 Medication 2274 2287 ACE inhibitor E96 Medication:T135 T136 Medication 2292 2300 diuretic E97 Medication:T136 T137 Sign_symptom 2324 2332 symptoms E98 Sign_symptom:T137 A6 POLARITY E98 NEG T138 Date 2423 2428 day 4 E99 Date:T138 T139 Medication 2455 2464 β-blocker E100 Medication:T139 T140 Dosage 2446 2454 low-dose R84 MODIFY Arg1:T140 Arg2:E100 T141 Diagnostic_procedure 2482 2503 endomyocardial biopsy E101 Diagnostic_procedure:T141 T142 Diagnostic_procedure 2505 2508 EMB E102 Diagnostic_procedure:T142 R85 IDENTICAL Arg1:E102 Arg2:E101 T143 Disease_disorder 2608 2619 amyloidosis E103 Disease_disorder:T143 A7 POLARITY E103 UNCERTAIN T144 Biological_structure 2600 2607 cardiac R86 MODIFY Arg1:T144 Arg2:E103 T145 Sign_symptom 2650 2666 amyloid deposits E104 Sign_symptom:T145 A8 POLARITY E104 UNCERTAIN T146 Clinical_event 3787 3798 followed-up E105 Clinical_event:T146 T147 Frequency 3802 3819 6-month intervals R87 MODIFY Arg1:T147 Arg2:E105 T148 Disease_disorder 3867 3870 CHF E106 Disease_disorder:T148 A9 POLARITY E106 NEG #1 AnnotatorNotes E106 congestive heart failure T149 Medication 3689 3698 β-blocker E107 Medication:T149 T150 Clinical_event 3712 3722 discharged E108 Clinical_event:T150 T151 Date 3726 3732 day 10 E109 Date:T151 T152 Disease_disorder 3741 3754 complications E110 Disease_disorder:T152 A10 POLARITY E110 NEG T153 Diagnostic_procedure 3484 3512 immunohistochemical reaction E111 Diagnostic_procedure:T153 T154 Diagnostic_procedure 3516 3538 immunoglobulin λ-chain E112 Diagnostic_procedure:T154 T155 Lab_value 3466 3483 strongly positive E113 Lab_value:T155 R88 MODIFY Arg1:E113 Arg2:E112 R89 SUB_PROCEDURE Arg1:E112 Arg2:E111 T156 Biological_structure 3546 3569 myocardial interstitium R90 MODIFY Arg1:T156 Arg2:E112 T157 Disease_disorder 3628 3642 AL amyloidosis E114 Disease_disorder:T157 #2 AnnotatorNotes E114 immunoglobulin light chain amyloidosis T158 Disease_disorder 3613 3624 amyloidosis E115 Disease_disorder:T158 T159 Detailed_description 3604 3612 systemic R91 MODIFY Arg1:T159 Arg2:E115 T160 Diagnostic_procedure 3233 3256 Histological examinatio E116 Diagnostic_procedure:T160 T161 Disease_disorder 3312 3323 myocarditis E117 Disease_disorder:T161 A11 POLARITY E117 NEG T162 Disease_disorder 3338 3348 granulomas E118 Disease_disorder:T162 A12 POLARITY E118 NEG T163 Detailed_description 3325 3337 eosinophilic R92 MODIFY Arg1:T163 Arg2:E118 T164 Disease_disorder 3353 3367 cardiomyopathy E119 Disease_disorder:T164 A13 POLARITY E119 NEG T165 Detailed_description 3373 3388 iron deposition R93 MODIFY Arg1:T165 Arg2:E119 T166 Biological_structure 3265 3284 myocardial specimen R94 MODIFY Arg1:T166 Arg2:E116 T167 Diagnostic_procedure 2694 2721 right heart catheterization E120 Diagnostic_procedure:T167 T168 Diagnostic_procedure 2723 2726 RHC E121 Diagnostic_procedure:T168 R95 IDENTICAL Arg1:E121 Arg2:E120 T169 Diagnostic_procedure 2733 2753 coronary angiography E122 Diagnostic_procedure:T169 T170 Disease_disorder 2765 2800 obstructive coronary artery disease E123 Disease_disorder:T170 A14 POLARITY E123 NEG T171 Diagnostic_procedure 2829 2832 RHC E124 Diagnostic_procedure:T171 T172 Diagnostic_procedure 2875 2899 Forrester classification E125 Diagnostic_procedure:T172 T173 Lab_value 2843 2857 subset type IV E126 Lab_value:T173 R96 MODIFY Arg1:E126 Arg2:E125 T174 Diagnostic_procedure 2923 2937 pressure curve E127 Diagnostic_procedure:T174 T175 Biological_structure 2905 2922 right ventricular R97 MODIFY Arg1:T175 Arg2:E127 T176 Sign_symptom 2953 2982 dip-and-plateau configuration E128 Sign_symptom:T176 A15 POLARITY E128 NEG T177 Diagnostic_procedure 2989 2995 biopsy E129 Diagnostic_procedure:T177 T178 Biological_structure 2984 2988 Skin R98 MODIFY Arg1:T178 Arg2:E129 T179 Sign_symptom 3005 3019 hyperkeratosis E130 Sign_symptom:T179 T180 Biological_structure 3027 3036 epidermis R99 MODIFY Arg1:T180 Arg2:E130 T181 Sign_symptom 3046 3066 inflammatory changes E131 Sign_symptom:T181 T182 Severity 3041 3045 mild R100 MODIFY Arg1:T182 Arg2:E131 T183 Biological_structure 3082 3088 dermis R101 MODIFY Arg1:T183 Arg2:E131 T184 Sign_symptom 3097 3109 infiltration E132 Sign_symptom:T184 T185 Biological_structure 3113 3124 lymphocytes R102 MODIFY Arg1:T185 Arg2:E132 T186 Diagnostic_procedure 3202 3220 Congo red staining E133 Diagnostic_procedure:T186 T187 Detailed_description 3180 3195 polarized light R103 MODIFY Arg1:T187 Arg2:E133 T188 Lab_value 3161 3174 birefringence E134 Lab_value:T188 T189 Color 3149 3160 apple-green R104 MODIFY Arg1:T189 Arg2:E134 R105 MODIFY Arg1:E134 Arg2:E133 * OVERLAP E1 E2 R106 AFTER Arg1:E2 Arg2:E3 * OVERLAP E3 E4 R107 AFTER Arg1:E4 Arg2:E5 * OVERLAP E5 E6 E7 R108 BEFORE Arg1:E7 Arg2:E8 * OVERLAP E8 E9 E10 E11 E12 E14 E16 E24 E25 E26 E27 E28 E29 E39 E52 E57 E58 E60 E63 E66 E67 E68 E69 E70 E73 E74 E76 E82 E79 E85 E87 R109 SUB_PROCEDURE Arg1:E55 Arg2:E52 R110 MODIFY Arg1:E86 Arg2:E85 R111 BEFORE Arg1:E87 Arg2:E90 * OVERLAP E90 E91 E94 E95 R112 BEFORE Arg1:E95 Arg2:E92 * OVERLAP E92 E93 E96 E97 R113 BEFORE Arg1:E97 Arg2:E98 * OVERLAP E98 E77 E78 R114 BEFORE Arg1:E78 Arg2:E99 * OVERLAP E99 E100 E101 E103 E104 E120 E122 E123 E124 E125 E127 E128 E129 E130 E131 E132 E133 E116 E117 E118 E119 E135 E136 E111 E115 E114 T190 Biological_structure 2540 2564 right ventricular septum R115 MODIFY Arg1:T190 Arg2:E101 T191 Quantitative_concept 2521 2532 3 fragments R116 MODIFY Arg1:T191 Arg2:T190 T192 Diagnostic_procedure 3394 3412 Congo red staining E135 Diagnostic_procedure:T192 T193 Sign_symptom 3422 3438 amyloid deposits E136 Sign_symptom:T193 R117 BEFORE Arg1:E114 Arg2:E107 R118 BEFORE Arg1:E107 Arg2:E108 * OVERLAP E108 E109 E110 R119 BEFORE Arg1:E110 Arg2:E105 * OVERLAP E105 E106