Clinical Research in Cardiology最新文献

{"title":"Prospective evaluation of low voltage-guided repeat ablation of atrial fibrillation.","authors":"Dennis Lawin, Christoph Stellbrink, Sophia Schulze Lammers, Alina Hoffmann, Andrej Teren, Thorsten Lawrenz","doi":"10.1007/s00392-025-02695-4","DOIUrl":"https://doi.org/10.1007/s00392-025-02695-4","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) recurrences following pulmonary vein isolation (PVI) remain a substantial challenge.</p><p><strong>Aims: </strong>To evaluate repeat ablation of AF combining PVI with substrate-based left atrial ablation targeting low voltage areas (LVA).</p><p><strong>Methods: </strong>Patients with recurrent AF after prior solely PVI were enrolled. Voltage map was conducted during sinus rhythm. Repeat PVI was performed in case of PV-reconnection. Only if LVA (defined as electrogram amplitudes < 0.5 mV) were present, substrate modification was conducted by creating linear or box lesions. Arrhythmia monitoring was performed for 6 months using a photoplethysmography-based smartphone application.</p><p><strong>Results: </strong>58 patients were analysed (37.9% female, median age 66.0 years [IQR 59.8-72.3]). Reconnection of at least 1 PV was found in 49 patients (84.5%). LVA were found in 31 patients (53.4%). An anterior box lesion was created in 39.7%, anterior linear lesion in 8.6%, posterior box lesion in 17.2%, roof line in 34.5%, and posterior mitral isthmus line in 5.2% of the patients. Patients with LVA were more often female (54.8% vs. 18.5% without LVA; p = 0.0045), were at higher age (71.0 years [IQR 66.0-78.0] vs. 62.0 years [IQR 55.0-66.0] without LVA; p < 0.0001), and had higher left atrial volume indexes (50.0ml/m² [IQR 40.0-61.0] vs. 34.0ml/m² [IQR 28.0-48.0] without LVA; p = 0.0014). Arrhythmia-free survival was 66.7% in patients without LVA and 48.4% in patients with LVA (HR 0.6063; 95% CI:0.2767-1.329; p = 0.2206).</p><p><strong>Conclusion: </strong>PV reconnection and the presence of LVA constitute the main findings of repeat ablations of AF. Repeat PVI combined with a tailored ablation approach individually targeting LVA was effective and safe.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of tricuspid regurgitation in patients with right ventricular pacing.","authors":"Felix Rudolph, Maria Ivannikova, Johanna Bormann, Arseniy Goncharov, Vanessa Sciacca, Johannes Kirchner, Kai P Friedrichs, Tanja K Rudolph, Thomas Fink, Thomas Eitz, Philipp Sommer, Volker Rudolph, Muhammed Gerçek, Christian Sohns","doi":"10.1007/s00392-025-02684-7","DOIUrl":"https://doi.org/10.1007/s00392-025-02684-7","url":null,"abstract":"<p><strong>Objective: </strong>To compare the prevalence and progression of tricuspid regurgitation (TR) after the implantation of right-ventricular pacing cardiac implantable electronic devices (CIEDs) versus biventricular pacing devices.</p><p><strong>Background: </strong>TR in patients with CIEDs is often linked to mechanical interference from leads, but studies show TR can also progress with leadless pacemakers, suggesting a direct effect of pacing.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 549 patients who received a pacemaker (PM), implantable cardioverter defibrillator (ICD), or cardiac resynchronization therapy (CRT) device. Follow-ups were conducted after one year and at least three years with aggregate interrogation and transthoracic echocardiography performed. Patients were categorized into two groups: right-ventricular (RV_all) pacing and biventricular (BiV) pacing.</p><p><strong>Results: </strong>Median age was 68 [57-76] years, with 419 (76.3%) being male. Of these patients, 21.5% received an ICD, 30.4% a PM, and 48.1% a CRT device (RV_all: n = 285; BiV: n = 264). BiV patients had worse left ventricular (LV) function and more pronounced evidence of RV dilatation at baseline. After three years, a relevant TR was more prevalent in the RV paced patients (RV_all: 17.4%; BiV: 9.8%). Also, an increase in TR grade of ≥I° and ≥II° was more frequent in the RV_all group. While tricuspid annular systolic excursion (TAPSE) deteriorated in the RV_all group, it was preserved in the BiV group.</p><p><strong>Conclusions: </strong>RV pacing was associated with a higher prevalence and severity of TR after CIED implantation compared to BiV pacing, but this effect might also be explained by significant differences in the group's clinical characteristics.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in numbers needed to treat and hospital care expenditures of optimized indications for primary prevention implantable cardioverter defibrillators: a scenario analysis.","authors":"M van Barreveld, P F H M van Dessel, E Buskens, L V A Boersma, P P H M Delnoy, A E Tuinenburg, D A M J Theuns, P H van der Voort, G P Kimman, T E Verstraelen, A H Zwinderman, A A M Wilde, M G W Dijkgraaf","doi":"10.1007/s00392-025-02687-4","DOIUrl":"https://doi.org/10.1007/s00392-025-02687-4","url":null,"abstract":"<p><strong>Aim: </strong>A strong need exists to better select patients with reduced left ventricular ejection fraction for primary prevention of sudden cardiac death by ICD implantation. This paper reports on the expected clinical and economic benefits of stricter indication scenarios based on minimum probabilities for patients of experiencing appropriate ICD-therapy and/or maximum risks of dying during the first 2 years following ICD implantation.</p><p><strong>Methods: </strong>Data on clinical events and hospital care expenditures were gathered for patients in the Dutch DO-IT registry. Registry-based prediction models were used to derive individual prior probabilities. Realistic assumptions were made concerning short-term disease courses and related hospital care in absence of ICD implantation. The potential impact of stricter indication scenarios was assessed with changes in numbers needed to treat (NNT) in subpopulations with (NNT-yes) or without (NNT-no) indication for ICD implantation and with changes in the yearly incidence-based national hospital care budget for ICD-based primary prevention.</p><p><strong>Results: </strong>The NNT-yes under the existing guidelines equalled 42. Not indicating ICD implantation if prior probabilities of receiving appropriate therapy within 2-year post-implant are < 5% seems a promising cutoff with an NNT-yes of 33, an NNT-no of 246 and a national annual reduction in hospital expenditures for ICD-based primary prevention of €11 million (16.7%).</p><p><strong>Conclusions: </strong>Stricter indication criteria for primary prevention ICD implantation enable the selection of patient subpopulations with high numbers needed to treat, in which unnecessary harm can be forgone and substantial savings can be accomplished. The scenario analysis facilitates rationing of indication policies for ICD implantations.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of semaglutide on health outcomes and mood in obese heart failure patients: a retrospective analysis.","authors":"Mahmoud Balata, Atsushi Sugiura, Marwa Hassan, Mohamed Rady, Marian Christoph, Karim Ibrahim, Marc Ulrich Becher, Akram Youssef","doi":"10.1007/s00392-025-02694-5","DOIUrl":"https://doi.org/10.1007/s00392-025-02694-5","url":null,"abstract":"<p><strong>Background and objective: </strong>Obesity is common in heart failure (HF), worsening quality of life and depressive symptoms. While semaglutide, a GLP-1 agonist, aids weight loss in obese adults, its impact on health and mood in obese HF patients is unclear. This study evaluated semaglutide's effects on body weight, health status, and mood in obese HF patients over one year.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 122 obese HF patients treated consecutively with semaglutide between January 2019 and August 2023. The primary endpoints were changes in body mass index (BMI), Hospital Anxiety and Depression Scale (HADS) scores, and Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS) from baseline to one year. Secondary endpoints included changes in NYHA functional class and NT-proBNP levels.</p><p><strong>Results: </strong>Semaglutide treatment resulted in a significant weight reduction at one year, with a mean BMI decrease of -2.23 kg/m² (95% CI -2.71 to -1.75; p < 0.001). This weight reduction was consistent across patients with baseline BMI < 35 kg/m² and ≥ 35 kg/m² (p for interaction = 0.26). HADS anxiety scores decreased from a baseline of 5 points (IQR: 2-8) to 3 points (IQR: 1-7; p = 0.037), while HADS depression scores decreased from 6 points (IQR: 3-8) to 3 points (IQR: 1-6; p < 0.001). KCCQ-OSS scores improved from 62 points (IQR: 52-77) at baseline to 82 points (IQR: 55-95; p < 0.001) at one year. These improvements in HADS depression and KCCQ-OSS scores were consistent across all subgroups, including those with baseline LVEF (≥ 50% or < 50%), BMI (≥ 35 kg/m² or < 35 kg/m²), ischemic versus non-ischemic cardiomyopathy, and the presence or absence of diabetes. Additionally, significant improvements in NYHA class and NT-proBNP levels were observed at one year.</p><p><strong>Conclusion: </strong>Semaglutide significantly improves health status and mood in obese heart failure patients, with these improvements strongly correlating with weight loss.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the leak: why should interventional closure of paravalvular leaks deserve more attention?","authors":"Tobias Schupp, Ibrahim Akin","doi":"10.1007/s00392-025-02689-2","DOIUrl":"https://doi.org/10.1007/s00392-025-02689-2","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute and long-term results of interventional treatment of paravalvular leaks after prosthetic valve replacement with plug devices: results from a prospective multicentre registry.","authors":"Hanna Konrad, Nicolas Werner, Taoufik Ouarrak, Joachim Schofer, Edith Lubos, Volker Geist, Holger Eggebrecht, Christian Butter, Thomas Schmitz, Ulrich Schäfer, Burghard Schumacher, Steffen Schneider, Uwe Zeymer, Ralf Zahn","doi":"10.1007/s00392-025-02681-w","DOIUrl":"https://doi.org/10.1007/s00392-025-02681-w","url":null,"abstract":"<p><strong>Background: </strong>Interventional closure of symptomatic paravalvular leaks (PVL) after valve replacement has developed to an attractive treatment option for patients at high operative risk. However, prospective and long-term data are sparse.</p><p><strong>Methods: </strong>We analysed data from a multicentre prospective registry on interventional PVL closure.</p><p><strong>Results: </strong>41 patients with symptomatic PVL were included in the plug registry at nine German hospitals from 2014 until 2020. In total 50 interventions with 67 plug implantations were recorded, 46.3% of procedures were performed for aortic and 53.7% for mitral PVLs. In 82% of patients PVL closure was performed once, in 16% twice and 2% underwent three procedures. Indication for PVL closure was symptomatic heart failure with NYHA class ≥ II (63.4%), haemolysis (4.9%), or NYHA class ≥ II and haemolysis (31.7%). PVL closure was completely successful in 76%, partially successful in 10% and failed in 14%. Acute improvement of one NYHA class was achieved in 56.4% and of two NYHA classes in 15.4%. Postprocedural no residual severe aortic PVL was described and residual severe mitral PVL was seen in 4.8%. Postinterventional complications occurred in 21.9%. In-hospital mortality rate was 4.9%. A follow-up was performed after 30 days, 12 months, 3 and 5 years. Calculated mortality rates were 10.1% at 1-year-, 18.5% at 3-year- and 32.5% at 5-year-follow-up. The estimated rates for mortality and/or reintervention (surgical or interventional) were 25.6% at 1-year, 36.8% at 3-year and 45.1% at 5-year follow-up.</p><p><strong>Conclusions: </strong>The multicentre German Plug-Registry describes a high procedural success rate with clinical improvement in most patients and acceptable long-term outcomes after percutaneous PVL closure.</p><p><strong>Trial registration number: </strong>NCT03179969.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postinterventional surveillance at a dedicated valve unit is safe and reduces intensive care utilization after TAVR.","authors":"B Gonska, M Krohn-Grimberghe, H Kirindi, T Stephan, J Mörike, C Buck, W Rottbauer, D Buckert","doi":"10.1007/s00392-025-02676-7","DOIUrl":"https://doi.org/10.1007/s00392-025-02676-7","url":null,"abstract":"<p><strong>Background: </strong>The postprocedural care pathway after transcatheter aortic valve replacement (TAVR) mostly includes monitoring patients for 24-48 h at an intensive care unit (ICU) or intermediate care unit (routine intensive care monitoring = ICM). To reduce the need for postprocedural intensive care surveillance, our center established a dedicated monitoring unit (valve unit = VU) for pre- and postprocedural care of TAVR patients.</p><p><strong>Methods: </strong>The aim of this prospective case-control study was to evaluate outcomes of patients directly before and after the introduction of the VU. Starting in April 2020 TAVR patients were directly transferred to a VU after the procedure with 24-h telemetric electrocardiogram (ECG) and non-invasive blood pressure monitoring, which was spatially integrated into a general cardiology ward. Patients with hemodynamic or respiratory instability, stroke, delirium, and severe bleeding complications were still directly transferred to the ICU.</p><p><strong>Results: </strong>796 consecutive patients treated with TAVR at our center were included. 592 patients had been treated during ICM and 204 after the establishment of the VU. The overall rate of events was similar before and after the implementation of the valve unit. 182 of 592 ICM patients developed study-specific endpoints (30.7%) compared to 60 of 204 VU patients (29.4%) (P value for difference: 0.87). VU patients showed a trend towards a lower rate of delirium (ICM 3.5% vs VU 1%, p-value 0.06).</p><p><strong>Conclusion: </strong>Introduction of a VU for patient monitoring after TAVR with prespecified criteria for postinterventional ICU surveillance reduced the percentage of postinterventional ICU admissions by 73% without increasing the overall rate of adverse events.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Native QRS duration and outcomes in heart failure with mildly reduced ejection fraction: results from a large-scaled registry.","authors":"Finn Ole Kronberg, Michael Behnes, Marielen Reinhardt, Noah Abel, Alexander Schmitt, Felix Lau, Thomas Bertsch, Henning Johann Steffen, Kathrin Weidner, Mohammad Abumayyaleh, Jürgen Kuschyk, Ibrahim Akin, Tobias Schupp","doi":"10.1007/s00392-025-02683-8","DOIUrl":"https://doi.org/10.1007/s00392-025-02683-8","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in survival following acute coronary syndrome with and without standard modifiable risk factors.","authors":"Vickram Vijay Anand, Jaycie Koh, Tobias Teo, Yip Han Chin, Rishabh Mahesh, Mark Y Chan, Gemma A Figtree, Nicholas W S Chew","doi":"10.1007/s00392-024-02563-7","DOIUrl":"10.1007/s00392-024-02563-7","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis investigates the sex differences in mortality risk between the acute coronary syndrome (ACS) population without standard modifiable risk factors (SMuRF-less) and those with at least one standard modifiable risk factor (SMuRF), and analyses mortality rates between males and females within the SMuRF-less cohort.</p><p><strong>Methods: </strong>The MEDLINE and Embase databases were searched for cohort studies with sex-stratified outcomes for SMuRF-less versus SMuRF patients with ACS till 15 December 2023. The analysis of variables reported in proportions was carried out by utilizing a meta-analysis with a generalized linear mixed model while continuous variables were analyzed by a meta-analysis of means, using an inverse variance method.</p><p><strong>Results: </strong>Eight studies were included in the current paper, with 82,395 SMuRF-less ACS patients and 607,558 SMuRF ACS patients. Excess in-hospital mortality found in SMuRF-less ACS, compared to those with SMuRFs, were only observed in females (RR 1.56, 95%CI 1.08-2.25, p = 0.029), but not in males (RR 1.59, 95%CI 0.90-2.80, p = 0.088). On longer follow-up, the 1- and 2-year post-ACS mortality rates were similar across the SMuRF-less and SMuRF cohorts, for both sexes. The subgroup analysis of SMuRF-less ACS individuals revealed that SMuRF-less females had higher in-hospital (RR 1.52, 95%CI 1.30-1.78, p = 0.002), 1-year (RR 1.51, 95%CI 1.34-1.71, p = 0.005) and 2-year mortality risks (RR 1.40, 95%CI 1.13-1.75, p = 0.016) compared to the SMuRF-less male counterparts.</p><p><strong>Conclusion: </strong>Paradoxical excess mortality in SMuRF-less ACS, compared to those with SMuRFs, was only observed in females. Females without cardiovascular risk factors are at the highest risk of short- and medium-term mortality following ACS.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"681-689"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global longitudinal strain in long-term risk prediction after acute coronary syndrome: an investigation of added prognostic value to ejection fraction.","authors":"Joel Lenell, Bertil Lindahl, David Erlinge, Tomas Jernberg, Jonas Spaak, Tomasz Baron","doi":"10.1007/s00392-024-02439-w","DOIUrl":"10.1007/s00392-024-02439-w","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to investigate the additional value of global longitudinal strain (GLS) on top of left ventricular ejection fraction (LVEF) in long-term risk prediction of combined death and heart failure (HF) re-hospitalization after acute coronary syndrome (ACS).</p><p><strong>Method and results: </strong>This retrospective study included patients admitted with ACS between 2008 and 2014 from the three participating university hospitals. LVEF and GLS were assessed at a core lab from images acquired during the index hospital stay. Their prognostic value was studied with the Cox proportional hazards model (median follow-up 6.2 years). A nested model comparison was performed with C-statistics. A total of 941 patients qualified for multivariable analysis after multiple imputation of missing baseline covariables. The combined outcome was reached in 17.7% of the cases. Both GLS and LVEF were independent predictors of the combined outcome, hazard ratio (HR) 1.068 (95% CI 1.017-1.121) and HR 0.980 (95% CI 0.962-0.998), respectively. The C-statistic increased from 0.742 (95% CI 0.702-0.783) to 0.749 (95% CI 0.709-0.789) (P = 0.693) when GLS entered the model with clinical data and LVEF.</p><p><strong>Conclusion: </strong>GLS emerged as an independent long-term risk predictor of all-cause death and HF re-hospitalization. However, there was no significant incremental predictive value of GLS when LVEF was already known.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"709-718"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}