Circulation: Cardiovascular Interventions最新文献

{"title":"Trans-Collateral Retrograde Perforation of the RVOT in Pulmonary Atresia/Ventricular Septal Defect: A Feasible Catheter-Based Approach.","authors":"Sherien Abdelsalam, Osama Abdelaziz, Hosam Ibrahim, Ahmed Youssef, Eslam Abdulsalam, Nourhanne El-Farargy, Amr Abdallah, Amir Lashin, Gaser Abdelmohsen","doi":"10.1161/CIRCINTERVENTIONS.125.016002","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016002","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary atresia with ventricular septal defect is a rare and complex congenital heart disease. In cases where pulmonary blood flow is supplied exclusively by major aortopulmonary collateral arteries, traditional surgical interventions may be challenging or delayed, especially in resource-limited settings. This study evaluated the feasibility, safety, and outcomes of the right ventricular outflow tract perforation through the retrograde trans-collateral approach in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries dependent pulmonary circulation.</p><p><strong>Methods: </strong>The study cohort comprised 10 patients with pulmonary atresia and ventricular septal defect who underwent attempted retrograde trans-collateral right ventricular outflow tract perforation via major aortopulmonary collateral arteries from October 2021 to February 2025, including 1 unsuccessful procedure.</p><p><strong>Results: </strong>The median age at intervention was 4.1 years, and the median weight was 17 kg. Post-procedure, systemic oxygen saturation increased significantly (<i>P</i><0.01). Follow-up imaging demonstrated substantial growth of the pulmonary arteries following retrograde trans-collateral right ventricular outflow tract recanalization, with significant improvements in both right and left pulmonary artery <i>Z</i> scores (<i>P</i><0.01) and a significant increase in the Nakata index from a median of 49 to 111.7 mm²/m² (<i>P</i><0.01).</p><p><strong>Conclusions: </strong>Retrograde trans-collateral right ventricular outflow tract perforation is a feasible and safe catheter-based strategy for selected patients with pulmonary atresia with ventricular septal defect, promoting central pulmonary artery growth and serving as a bridge to future surgical repair.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016002"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Validation of the MIRACLE₂ Score for Early Neurological Stratification After Out-of-Hospital Cardiac-Arrest: The GLOBAL-MIRACLE Registry.","authors":"Muhamad Abd Razak, George Vamvakas, Michael McGarvey, Samuel McGrath, Krishnaraj Rathod, Ahmed Elamin, Zhihong Yao, Peter Kordis, Rupert Simpson, Uzma Sajjad, Zaid Iskandar, Mandy Fish, Garry Hamilton, Piotr Pałczyński, Szymon Tuchacz, Arka Das, Salaheldin Agamy, Sundeep Kalra, Abdul Mozid, Rafal Dworakowski, Mariusz Sieminksi, Julian Yeoh, Satpal Arri, Thomas W Johnson, Nick Curzen, Marko Noc, Clare Appleby, Paul Rees, Thomas R Keeble, Ajay M Shah, Philip MacCarthy, Jonathan Byrne, Daniel Stahl, Nilesh Pareek","doi":"10.1161/CIRCINTERVENTIONS.125.015918","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015918","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to prospectively validate the MIRACLE₂ score in the GLOBAL-MIRACLE registry, a multicenter, international, prospective registry of patients admitted with resuscitated out-of-hospital cardiac arrest of presumed cardiac cause.</p><p><strong>Methods: </strong>From January 1, 2022 to May 31, 2023, 770 patients were recruited from 11 centers across 5 countries. The primary end point was poor neurological outcome (Cerebral Performance Category 3-5) at hospital discharge. Model discrimination was assessed by the area under the receiver operating characteristic curve. We compared the discriminatory performance of the MIRACLE₂ score against Cardiac Arrest Hospital Prognosis, out-of-hospital cardiac arrest, Target Temperature Management, NULL-PLEASE, C-GRAPH, and rCAST.</p><p><strong>Results: </strong>The primary end point occurred in 395 (51.2%) patients. The MIRACLE₂ score had an area under the curve of 0.861 (95% CI, 0.835-0.887). A MIRACLE₂ score ≤2 had a negative predictive value of 87.8%, while a score of ≥7 had a positive predictive value of 98.3%. The MIRACLE₂ score had equal performance to the TTM risk tool (<i>P</i>=0.12) but better discriminatory performance than other risk tools (<i>P</i><0.0001). The MIRACLE₂ score showed good performance in those with ST-segment-elevation myocardial infarction (0.851 [95% CI, 0.816-0.886]) and without ST-segment-elevation myocardial infarction (0.873 [95% CI, 0.834-0.912]) and in those with cardiogenic shock (0.832 [95% CI, 0.789-0.875]) and without cardiogenic shock (0.853 [95% CI, 0.810-0.895]).</p><p><strong>Conclusions: </strong>The MIRACLE₂ score is a practical risk tool that shows excellent discrimination performance for poor neurological outcome after presumed cardiac cause out-of-hospital cardiac arrest, including based on hemodynamic status and admission 12-lead ECG. Early stratification of out-of-hospital cardiac arrest patients using the MIRACLE₂ score should be evaluated in future randomized controlled trials.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015918"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Efficacy of Rotational Atherectomy for Calcified Nodules With Contralateral Calcification: Insights From a Multicenter Intravascular Ultrasound Imaging Study.","authors":"Naoya Yabumoto, Masashi Fujino, Eri Kiyoshige, Hiroki Sugane, Hayato Hosoda, Satoshi Kitahara, Yusuke Fujino, Kentaro Mitsui, Kota Murai, Takamasa Iwai, Kenichiro Sawada, Hideo Matama, Satoshi Honda, Kazuhiro Nakao, Shuichi Yoneda, Kensuke Takagi, Yasuhide Asaumi, Soshiro Ogata, Kunihiro Nishimura, Kazuya Kawai, Kenichi Tsujita, Teruo Noguchi, Yu Kataoka","doi":"10.1161/CIRCINTERVENTIONS.125.015932","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015932","url":null,"abstract":"<p><strong>Background: </strong>Calcified nodules (CNs) represent a high-risk coronary lesion phenotype associated with target lesion revascularization (TLR). Although rotational atherectomy (RA) is an established treatment for calcified lesions, its benefit for CNs remains unclear. This study aimed to evaluate the impact of RA on TLR and to identify specific morphological features on intravascular ultrasound that may influence its therapeutic effect for CNs.</p><p><strong>Methods: </strong>In a substudy of the U-SCAN registry (Coronary Intravascular Ultrasound for Calcified Nodule), 348 patients with CNs identified by intravascular ultrasound who underwent percutaneous coronary intervention were analyzed. We excluded patients with in-stent restenosis, use of alternative debulking devices, failed device passage without RA, and poor image quality. The final analysis included 209 patients, stratified by RA use. Multivariable Cox proportional hazards models were used to identify predictors of TLR and assess treatment interactions across subgroups.</p><p><strong>Results: </strong>Among 209 patients, 79 patients (37.8%) underwent RA. During a median follow-up of 2.1 years (interquartile range, 0.4-4.9), TLR was required in 20 of 79 patients (25.3%) in the RA group and 41 of 130 patients (31.5%) in the non-RA group. After adjustment, RA independently predicted reduced TLR (hazard ratio, 0.34 [95% CI, 0.19-0.62], <i>P</i><0.001). In addition, intravascular ultrasound-derived calcification features, including greater lumen area stenosis, longer CN length, smaller final minimum lumen area, and adjacent circumferential calcification, were significantly associated with TLR. Notably, the benefit of RA on TLR was pronounced in patients with contralateral calcification (8.6% versus 51.6%, <i>P</i><0.001). In contrast, without this feature, the TLR rate was higher in the RA group (38.6% versus 25.3%, <i>P</i>=0.11), resulting in a statistically significant interaction (<i>P</i>_interaction<0.001).</p><p><strong>Conclusions: </strong>In patients with CNs, RA was associated with a reduced long-term risk of TLR. The presence of contralateral calcification identifies a subgroup deriving substantial benefit, supporting a more selective, morphology-guided approach to treatment.</p><p><strong>Registration: </strong>URL: https://jrct.mhlw.go.jp/; Unique identifier: jRCT1050240037.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015932"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing Complications of Mechanical Circulatory Support Devices: The Clue for Improved Outcomes?","authors":"Uwe Zeymer, Dirk Westermann, Holger Thiele","doi":"10.1161/CIRCINTERVENTIONS.125.016174","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016174","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016174"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Pulmonary Valve Implantation With the Alterra Adaptive Prestent and SAPIEN 3 Transcatheter Heart Valve: 3-Year Pooled Outcomes of the ALTERRA Trials.","authors":"Alejandro J Torres, V Vivian Dimas, Shabana Shahanavaz, David Balzer, Gareth Morgan, D Scott Lim, Aimee K Armstrong, Darren Berman, Vasilis Babaliaros, Dennis Kim, Matthew J Gillespie, Robert Sommer, Jamil Aboulhosn, Thomas K Jones, Vaikom S Mahadevan, Gary Stapleton, Ying Ma, Girish Shirali, Anitha Parthiban, Philipp Blanke, Jonathon Leipsic, Evan Zahn","doi":"10.1161/CIRCINTERVENTIONS.125.015873","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015873","url":null,"abstract":"<p><strong>Background: </strong>The Alterra Adaptive Prestent provides a landing zone for implantation of the 29 mm SAPIEN 3 transcatheter heart valve (THV) in patients with a dysfunctional right ventricular outflow tract (RVOT) to treat pulmonary regurgitation (PR). Here, we report 3-year outcomes from a pooled analysis of patients who underwent Alterra/SAPIEN 3 THV implantation enrolled in the ALTERRA pivotal trial, Continued Access Protocol, and Pulmonic Delivery System Registry.</p><p><strong>Methods: </strong>This multicenter, prospective trial enrolled patients with moderate or greater PR and RVOT/pulmonary valve anatomy suitable for implantation. The nonhierarchical composite end point of THV dysfunction was examined at 6 months: RVOT/pulmonary valve reintervention, moderate or greater PR, and mean RVOT/pulmonary valve gradient ≥35 mm Hg. Individual components of the composite, as well as additional clinical and echocardiographic outcomes were examined up to 3 years.</p><p><strong>Results: </strong>The Alterra/SAPIEN 3 THV system was implanted in 118 patients at 14 sites. At 6 months, THV dysfunction was 3.5% (4/113). At 3 years, 97.3% of patients in the valve implant population had freedom from reintervention, 100% of patients had a mean RVOT/pulmonary valve gradients <35 mm Hg, and 93.3% of patients had mild or lesser total PR. The Kaplan-Meier estimate of all-cause mortality was 3.5% at 3 years. There were no cases of coronary artery compression, hemopericardium, or endocarditis.</p><p><strong>Conclusions: </strong>This analysis reports the longest follow-up in the largest cohort of patients from the ALTERRA trials. The Alterra Adaptive Prestent with the SAPIEN 3 THV system has shown excellent procedural outcomes and is effective in reducing PR at 3-year follow-up.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03130777.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015873"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reno-Protective Effects of SGLT2 Inhibitors in Patients With Diabetes Undergoing Percutaneous Coronary Intervention: Insights From the BMC2 Registry.","authors":"S Nabeel Hyder, Milan Seth, David E Hamilton, Heidi Stoute, Edouard Daher, Joseph Chattahi, Bashar Samman, Vishal Gupta, Carlo Briguori, Michael Rudnick, Devraj Sukul, Hitinder S Gurm","doi":"10.1161/CIRCINTERVENTIONS.125.015645","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015645","url":null,"abstract":"<p><strong>Background: </strong>Chronic therapy with sodium-glucose cotransporter 2 inhibitors (SGLT2i) is associated with long-term reno-protective benefits. There are limited data on the benefits of these agents against the risk of contrast-associated acute kidney injury (CA-AKI).</p><p><strong>Methods: </strong>The retrospective study population included all patients with diabetes enrolled in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium Percutaneous Coronary Intervention registry, a clinical registry of all percutaneous coronary intervention (PCI) cases at nonfederal hospitals in the state of Michigan. Included patients underwent PCI between January 2022 and September 2023. Patients on dialysis and those without post-PCI serum creatinine measurements were excluded. SGLT2i users were compared with nonusers with respect to CA-AKI outcomes, defined as an increase in serum creatinine of ≥0.5 mg/dL following PCI. Outcomes were evaluated in a risk-adjusted, propensity-matched analysis.</p><p><strong>Results: </strong>Among 13 804 patients with diabetes who underwent PCI, CA-AKI occurred in 3.8% (82/2186) of SGLT2i users versus 5.2% (602/11 618) of nonusers (odds ratio, 0.71; <i>P</i>=0.004). In propensity-matched, risk-adjusted analysis, the pre-PCI use of SGLT2i correlated with a lower incidence of CA-AKI (3.69% versus 4.68%; adjusted odds ratio, 0.72; <i>P</i>=0.027). The protective effect of SGLT2i was preserved among higher-risk subgroups.</p><p><strong>Conclusions: </strong>Among patients with diabetes who underwent PCI, preprocedural use of SGLT2i correlated with a lower risk of CA-AKI.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015645"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expecting the Unexpected: Insights and Uncertainties From the ALTERRA Trial 3-Year Results.","authors":"Q Joyce Han, Doff B McElhinney, Ada C Stefanescu Schmidt","doi":"10.1161/CIRCINTERVENTIONS.126.016575","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016575","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016575"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Microvascular Function and Ambulatory Capacity in Peripheral Artery Disease.","authors":"Alexander E Sullivan, Adam Behroozian, Crystal Coolbaugh, Emily Shardelow, Emily K Smith, Quinn S Wells, Daniel G Clair, Aaron W Aday, C Louis Garrard, John A Curci, Tara A Holder, Joey V Barnett, Matthew S Freiberg, Rachelle L Crescenzi, Denis J Wakeham, Christopher M Hearon, Manus J Donahue, Joshua A Beckman","doi":"10.1161/HCV.0000000000000100","DOIUrl":"https://doi.org/10.1161/HCV.0000000000000100","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":"19 4","pages":"e000100"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PCI Versus Conservative Management Before TAVR in Patients With Significant Coronary Artery Disease: A Nationwide Instrumental Variable Analysis.","authors":"Antros Louca, Petur Petursson, Joakim Sundström, Henrik Hagström, Andreas Rück, Stefan James, Sasha Koul, Kristofer Skoglund, Mohammed Mohammed, Anders Jeppsson, Dan Ioanes, Sebastian Völz, Anna Myredal, Oskar Angerås, Araz Rawshani, Truls Råmunddal","doi":"10.1161/CIRCINTERVENTIONS.125.016337","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016337","url":null,"abstract":"<p><strong>Background: </strong>The optimal management of coronary artery disease in patients undergoing transcatheter aortic valve replacement (TAVR) remains unclear, and evidence supporting routine percutaneous coronary intervention (PCI) beforehand is limited. This study aimed to evaluate whether PCI before TAVR provides clinical benefit compared with conservative management in patients with significant coronary artery disease, using nationwide Swedish registry data.</p><p><strong>Methods: </strong>This observational study included 2578 Swedish patients with significant coronary artery disease (≥50% angiographic stenosis or physiologically significant lesions) who underwent TAVR between 2008 and 2023. 1182 underwent PCI before TAVR, and 1396 were managed conservatively. The primary outcome was a composite of all-cause mortality, myocardial infarction, and urgent revascularization. Secondary outcomes included the individual components, cardiovascular mortality, any revascularization, stroke, and bleeding. The primary analysis used an instrumental variable approach based on each region's quarterly PCI treatment preference to account for confounding.</p><p><strong>Results: </strong>PCI was not associated with a significant difference in the primary composite outcome (instrumental variable-adjusted hazard ratio, 0.98 [95% CI, 0.85-1.14]; <i>P</i>=0.80) or in all-cause mortality, myocardial infarction, cardiovascular death, stroke, or urgent revascularization. PCI was, however, associated with a lower risk of any revascularization (adjusted hazard ratio, 0.46 [95% CI, 0.30-0.72]; adjusted <i>P</i>=0.002) and a higher risk of bleeding (instrumental variable-adjusted odds ratio, 1.59 [95% CI, 1.23-2.04]; adjusted <i>P</i>=0.002).</p><p><strong>Conclusions: </strong>In this nationwide cohort, PCI before TAVR did not improve survival or reduce urgent revascularization but did reduce nonurgent revascularization at the cost of increased bleeding. Decisions should be individualized, balancing ischemic and bleeding risks and considering anticipated coronary access after TAVR.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016337"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It's a MIRACLE! Taking the Guesswork Out of Postcardiac Arrest Care.","authors":"Dion Stub, Riley Batchelor, Ziad Nehme","doi":"10.1161/CIRCINTERVENTIONS.126.016674","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016674","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016674"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}