Circulation: Cardiovascular Interventions最新文献

{"title":"Optical Coherence Tomography Versus Angiography Alone to Guide PCI for Complex Lesions: A Meta-Analysis of Randomized Controlled Trials.","authors":"Chidubem Ezenna, Mrinal Murali Krishna, Meghna Joseph, Sammudeen Ibrahim, Vinicius Pereira, Ancy Jenil-Franco, Michael G Nanna, Sripal Bangalore, Andrew M Goldsweig","doi":"10.1161/CIRCINTERVENTIONS.125.015141","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015141","url":null,"abstract":"<p><strong>Background: </strong>Optical coherence tomography (OCT) provides high-resolution intracoronary imaging. However, whether the addition of OCT to angiography to guide percutaneous coronary intervention (PCI) of complex lesions affects clinical outcomes is debated.</p><p><strong>Methods: </strong>A systematic search for randomized controlled trials was conducted using PubMed, Scopus, and Cochrane databases through September 2024. End points included major adverse cardiovascular events, cardiac death, myocardial infarction, periprocedural myocardial infarction, all-cause mortality, stent thrombosis (definite or probable), and target-vessel revascularization. The random-effects model was used to generate risk ratios (RRs) and 95% CIs.</p><p><strong>Results: </strong>A literature search identified 4 randomized controlled trials including 5603 patients with a median follow-up of 2 years. Compared with PCI guided by angiography alone, OCT-guided PCI was associated with lower major adverse cardiovascular events (RR, 0.68 [95% CI, 0.55-0.84]; <i>P</i><0.001), cardiac death (RR, 0.43 [95% CI, 0.24-0.76]; <i>P</i>=0.003), myocardial infarction (RR, 0.75 [95% CI, 0.59-0.96]; <i>P</i>=0.02), all-cause mortality (RR, 0.58 [95% CI, 0.38-0.87]; <i>P</i>=0.009, and stent thrombosis (RR, 0.49 [95% CI, 0.26-0.90]; <i>P</i>=0.02). There was a trend toward lower target-vessel revascularization (RR, 0.67 [95% CI, 0.44-1.03]; <i>P</i>=0.07) and lower periprocedural myocardial infarction (RR, 0.79 [95% CI, 0.59-1.06]; <i>P</i>=0.11) with OCT guidance compared with angiography alone.</p><p><strong>Conclusions: </strong>The addition of OCT guidance to PCI of complex lesions resulted in better clinical outcomes than angiography guidance alone. Updated guidelines should strengthen recommendations supporting the use of OCT guidance for complex PCI.</p><p><strong>Registration: </strong>URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42024603847.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015141"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751419","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":"Exploring the Economic Impact of Cardiac Damage in Aortic Valve Replacement Patients: A Real-World Data Analysis.","authors":"Bhavanadhar Penta, Gilbert H L Tang","doi":"10.1161/CIRCINTERVENTIONS.125.015358","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015358","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015358"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978117","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":"Letter by Peled et al Regarding Article, \"Intravascular Imaging as a Performance Measure for Percutaneous Coronary Intervention\".","authors":"Harry Peled, Nhu Quyen Dau","doi":"10.1161/CIRCINTERVENTIONS.125.015335","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015335","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015335"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062763","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":"Efficacy of the Glucagon-Like Peptide-1 Agonist Exenatide in Patients Undergoing CABG or Aortic Valve Replacement: A Randomized Double-Blind Clinical Trial.","authors":"Jesper Kjaergaard, Christian Holdflod Møller, Sebastian Wiberg, Astrid Duus Mikkelsen, Hasse Møller-Sørensen, Hanne Berg Ravn, Jesper Ravn, Peter Skov Olsen, Dan E Høfsten, Søren Boesgaard, Lars Køber, Jens Christian Nilsson, Christian Hassager","doi":"10.1161/CIRCINTERVENTIONS.124.014961","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014961","url":null,"abstract":"<p><strong>Background: </strong>GLP-1 (glucagon-like peptide-1) agonists have been proven beneficial in reducing the risk of and injury associated with several cardiovascular diseases. The efficacy in cardiopulmonary bypass-assisted cardiac surgery is unknown. This trial aimed to investigate the efficacy of an infusion of the GLP-1 agonist exenatide during and after open-heart surgery in reducing the risk of death and major organ failure.</p><p><strong>Methods: </strong>Randomized, double-blinded, 2-by-2 factorial design, single-center clinical trial, also including liberal (FiO₂ of 100%) or restrictive (FiO₂ of 50%) oxygenation during and after bypass. The present article presents the results of the exenatide intervention. We included adult patients undergoing elective cardiopulmonary bypass-assisted coronary artery bypass grafting or aortic valve replacement. Patients were predominantly low risk. The intervention was an infusion of 17.4 µg of exenatide or placebo during cardiopulmonary bypass and the first hour after weaning thereof. The main outcome was time to a composite end point consisting of death, stroke, renal failure requiring dialysis, or new/worsening heart failure during follow-up. Secondary end points included occurrence of prespecified adverse events.</p><p><strong>Results: </strong>A total of 1389 patients were included in the analyses. Within a follow-up period of a median of 5.9 years (min-max; 2.5-8.3 years), 170 (24%) patients in the exenatide group and 165 (24%) patients experienced a primary end point. We found no difference in time to the first event between patients randomized to FiO₂ 50% versus FiO₂ 100% (hazard ratio, 1.0 [95% CI, 0.83-1.3]; <i>P</i>=0.80). We found no significant difference in rates of adverse events between the 2 groups.</p><p><strong>Conclusions: </strong>Exenatide during cardiopulmonary bypass and weaning thereof did not significantly reduce the incidence of death, stroke, renal failure, or new/worsening heart failure in patients undergoing coronary artery bypass grafting and aortic valve replacement.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02673931.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014961"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966082","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":"Transapical Beating-Heart Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy: Lessons Learned After the Learning Curve Period.","authors":"Jing Fang, Yue Chen, Yani Liu, Rui Li, Ying Zhu, Wei Zhou, Lin Cheng, Qunhui Wang, Juan Shi, Yupeng Wei, Yilei Ma, Eduard Quintana, Juan B Grau, Song Wan, Xiang Wei","doi":"10.1161/CIRCINTERVENTIONS.124.015044","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.015044","url":null,"abstract":"<p><strong>Background: </strong>The transapical beating-heart septal myectomy (TA-BSM) procedure was developed to enhance efficiency and reduce surgical trauma compared with conventional septal myectomy in treating obstructive hypertrophic cardiomyopathy. The current study aimed to delineate a refined TA-BSM surgical technique and summarize the midterm outcomes of the cohort immediately after the learning curve period.</p><p><strong>Methods: </strong>Employing a beating-heart myectomy device and guided by real-time transesophageal echocardiography, TA-BSM was conducted through a left mini-thoracotomy. Multiple tailored resections were performed on the beating heart to optimize hemodynamics and morphology. The primary outcome was procedural success, defined by resting/provoked left ventricular outflow tract gradient <30/50 mm Hg and mitral regurgitation ≤grade 2+ (of 4+) at 3- to 6-month follow-up.</p><p><strong>Results: </strong>Between January 2023 and January 2024, 418 patients with heterogeneous anatomic presentations of obstructive hypertrophic cardiomyopathy underwent TA-BSM. The maximal left ventricular outflow tract gradient decreased from a median of 85 (interquartile range, 65-114) mm Hg preoperatively to 19 (interquartile range, 12-28) mm Hg at 3- to 6-month follow-up. Mitral regurgitation improved with 98.8% of patients achieving ≤grade 2+ upon follow-up, versus 47.7% preoperatively. Overall, procedural success was achieved in 91.1% of the patients. Major adverse events included left ventricular apical tear (n=3, 0.7%), iatrogenic mitral valve injury (n=3, 0.7%), permanent pacemaker implantation (n=10, 2.4%), and transient ischemic stroke (n=2, 0.5%). All affected patients recovered uneventfully. The 30-day mortality was 0.2% (n=1). The estimated 1-year survival was 98.7% (95% CI, 97.6%-99.9%) over a median follow-up of 310 (interquartile range, 207-408) days.</p><p><strong>Conclusions: </strong>With real-time echocardiographic guidance, the individualized TA-BSM approach can effectively and safely achieve adequate and precise resections of septal myocardium. The technique's midterm results further confirmed its therapeutic advantages, potentially broadening the applicability of surgical septal reduction in obstructive hypertrophic cardiomyopathy treatment.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT05332691.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015044"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955203","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":"Effect of Red Blood Cell Transfusion Strategy on Clinical Outcomes Among Patients With Acute Myocardial Infarction Undergoing Revascularization: A Prespecified Analysis of the MINT Trial.","authors":"Sunil V Rao, Maria Mori Brooks, Helen E A D'Agostino, P Gabriel Steg, Tabassome Simon, Herbert D Aronow, Andrew M Goldsweig, Shahbaz Malik, Caroline Alsweiler, Kalon K L Ho, Payam Dehghani, Adriano Caixeta, Ata R Quraishi, Simon Robinson, Jay H Traverse, Omar Siddiqi, Dean A Fergusson, Brian J Potter, Joshua Schulman-Marcus, Friederike K Keating, Jeffrey L Carson","doi":"10.1161/CIRCINTERVENTIONS.125.015249","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015249","url":null,"abstract":"<p><strong>Background: </strong>The MINT trial (Myocardial Ischemia and Transfusion; N=3504) randomized patients with acute myocardial infarction (MI) and hemoglobin ≤10 g/dL to liberal (maintain hemoglobin ≥10 g/dL) or restrictive (maintain hemoglobin ≥8 g/dL) red blood cell transfusion. The results suggested a benefit on 30-day death or MI with a liberal transfusion strategy. The effect of transfusion in patients with acute MI undergoing revascularization is unclear.</p><p><strong>Methods: </strong>In this prespecified analysis of the MINT trial, patients who underwent revascularization (n=1002) before randomization but during index hospitalization were compared with those who did not (n=2442). The primary outcome was 30-day death or MI; secondary outcomes included 30-day death, recurrent MI, the composite of death, recurrent MI, ischemia-driven unscheduled revascularization, or readmission for ischemic cardiac diagnosis, heart failure, and cardiac death. Multivariable log-binomial regression was used to determine the relative risks of the primary and secondary outcomes by transfusion strategy for revascularized and nonrevascularized patients with interaction terms.</p><p><strong>Results: </strong>Patients undergoing revascularization were younger, more often female, and had fewer comorbidities than those who did not. There was no significant interaction between revascularization and assigned transfusion strategy for any outcome except cardiac death. Compared with liberal transfusion, restrictive transfusion increased the risk of 30-day cardiac death among nonrevascularized patients (relative risk, 2.45 [1.58-3.81]) but not among revascularized patients (relative risk, 0.97 [0.59,-1.60]; interaction <i>P</i>=0.006).</p><p><strong>Conclusions: </strong>In this analysis of the MINT trial, revascularization did not alter the effect of the randomized transfusion strategy on 30-day death or MI. The hypothesis-generating finding that a restrictive transfusion strategy was associated with an increased risk of cardiac death among patients with anemia and acute MI who do not undergo revascularization requires confirmation.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02981407.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015249"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751418","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":"Periprocedural Myocardial Injury Using CKMB Following Elective PCI: Incidence and Associations With Long-Term Mortality.","authors":"Nina Talmor, Claire Graves, Sam Kozloff, Vincent J Major, Yuhe Xia, Binita Shah, Anvar Babaev, Louai Razzouk, Sunil V Rao, Michael J Attubato, Frederick Feit, James Slater, Nathaniel R Smilowitz","doi":"10.1161/CIRCINTERVENTIONS.124.014934","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014934","url":null,"abstract":"<p><strong>Background: </strong>Myocardial injury detected after percutaneous coronary intervention (PCI) is associated with increased mortality. Predictors of post-PCI myocardial injury are not well established. The long-term prognostic relevance of post-PCI myocardial injury remains uncertain.</p><p><strong>Methods: </strong>Consecutive adults aged ≥18 years with stable ischemic heart disease who underwent elective PCI at NYU Langone Health between 2011 and 2020 were included in a retrospective, observational study. Patients with acute myocardial infarction or creatinine kinase myocardial band (CKMB) or troponin concentrations >99% of the upper reference limit before PCI were excluded. All patients had routine measurement of CKMB concentrations at 1 and 3 hours post-PCI. Post-PCI myocardial injury was defined as a peak CKMB concentration >99% upper reference limit. Linear regression models were used to identify clinical factors associated with post-PCI myocardial injury. Cox proportional hazard models were generated to evaluate relationships between post-PCI myocardial injury and all-cause mortality at long-term follow-up.</p><p><strong>Results: </strong>Among 10 807 patients undergoing elective PCI, the median age was 67 years (interquartile range, 15.6), and 24.9% were of female sex. Post-PCI myocardial injury occurred in 1813 (16.8%) patients. Myocardial injury was less common among female than male patients (14.1% versus 17.7%, <i>P</i><0.001). Older age, longer lesion lengths, multivessel PCI, severe coronary calcification, and thrombectomy device use were independently associated with post-PCI myocardial injury with CKMB levels ≥99% upper reference limit. Over 46 071 patient-years of follow-up (mean 4.3 years), 472 patients died (4.4%). A greater proportion of patients with versus without post-PCI myocardial injury died during follow-up (7.9% versus 3.6%, <i>P</i><0.001). After adjustment for demographics and clinical covariates, post-PCI myocardial injury was associated with an excess hazard for long-term mortality (hazard ratio, 1.46 [95% CI, 1.20-1.78]).</p><p><strong>Conclusions: </strong>Myocardial injury defined by elevated CKMB early after PCI is common and associated with all-cause, long-term mortality. More complex coronary anatomy is predictive of post-PCI myocardial injury.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014934"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751421","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":"Navigating the Crossroads of Transfusion and Revascularization Strategies in Myocardial Infarction: Is There a Turning Point?","authors":"Katherine J Kunkel, David E Kandzari","doi":"10.1161/CIRCINTERVENTIONS.125.015422","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015422","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015422"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993293","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":"Comparing the Efficacy of Sirolimus and Paclitaxel-Eluting Balloon Catheters in the Treatment of Coronary In-Stent Restenosis: A Prospective Randomized Study (TIS 2 Study).","authors":"Leos Pleva, Pavel Kukla, Tomas Kovarnik, Jana Zapletalova","doi":"10.1161/CIRCINTERVENTIONS.124.014677","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014677","url":null,"abstract":"<p><strong>Background: </strong>Current therapy for in-stent restenosis (ISR) is based on drug-eluting stents (DES) or drug-eluting balloon catheters. This prospective randomized study compared the efficacy of a novel sirolimus-eluting balloon (SEB) catheter to that of a paclitaxel-eluting balloon (PEB) catheter for the treatment of bare-metal stent (BMS-ISR) or DES-ISR.</p><p><strong>Methods: </strong>A total of 145 patients with 158 BMS or DES-ISR lesions were randomly assigned to the treatment with either SEB or PEB. The in-segment late lumen loss at 12 months, the 12-month incidence of binary ISR, and major adverse cardiac events (cardiac death, nonfatal acute myocardial infarction, or target lesion revascularization) were compared between groups.</p><p><strong>Results: </strong>The noninferiority of SEB compared with PEB in the treatment of BMS/DES-ISR with respect to late lumen loss was not demonstrated (Δlate lumen loss, -0.024 mm [95% CI, -0.277 to 0.229]; for a noninferiority margin of 0.20 mm), except in the post hoc subanalysis for the BMS-ISR group (-0.203 mm [95% CI, -0.584 to 0.178]). No significant differences in the incidence of repeated binary ISR (31.6% versus 30.4%, <i>P</i>=0.906) or 12-month major adverse cardiac events (31% for both; <i>P</i>>0.999) between the SEB and PEB groups were observed.</p><p><strong>Conclusions: </strong>The noninferiority of SEB relative to PEB in the treatment of BMS/DES-ISR with respect to late lumen loss was not confirmed.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03667313.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014677"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763202","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":"Response by Stein and Doll to Letter Regarding Article, \"Intravascular Imaging as a Performance Measure for Percutaneous Coronary Intervention\".","authors":"Elliot J Stein, Jacob A Doll","doi":"10.1161/CIRCINTERVENTIONS.125.015351","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015351","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015351"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993199","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}