Clinical Research in Cardiology最新文献

{"title":"Publisher Correction: Association between exposure to air pollution and arterial stiffness in participants with and without atherosclerotic cardiovascular disease.","authors":"Haoyu Zhang, Jinghao Sun, Yinghua Zhang, Keling Xiao, Yang Wang, Jin Si, Yan Li, Lijie Sun, Ting Zhao, Ming Yi, Xi Chu, Jing Li","doi":"10.1007/s00392-024-02521-3","DOIUrl":"10.1007/s00392-024-02521-3","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1236"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281483","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":"Subclinical left ventricular dysfunction in rheumatoid arthritis: findings from the prospective Porto-RA cohort.","authors":"André Alexandre, David Sá-Couto, Mariana Brandão, Sofia Cabral, Tomás Fonseca, Rita Quelhas Costa, António Marinho, Carlos Vasconcelos, Betânia Ferreira, João Pedro Ferreira, Patrícia Rodrigues","doi":"10.1007/s00392-024-02548-6","DOIUrl":"10.1007/s00392-024-02548-6","url":null,"abstract":"<p><strong>Aim: </strong>Patients with rheumatoid arthritis (RA) have an increased risk of cardiac dysfunction and heart failure (HF) due to a pro-inflammatory state. Detecting cardiac dysfunction in RA is challenging as these patients often present preserved ejection fraction (EF) but may have subclinical ventricular dysfunction. Echocardiographic strain analysis is a promising tool for early detection of subclinical left ventricular systolic dysfunction (LVSD). This study assesses the prognostic role of strain analysis in RA.</p><p><strong>Methods and results: </strong>Prospective study of 277 RA patients without known heart disease and preserved EF, categorized by left ventricular global longitudinal strain (GLS): normal GLS (≤ - 18%) vs. subclinical LVSD (> - 18%). Primary outcome was a composite of myocardial infarction, HF hospitalization, stroke, or cardiovascular death (MACE). Mean age was 57 years, 79% female. Although mean GLS was within normal (- 20 ± 3%), subclinical LVSD was observed in 24% of patients (n = 67) and was positively correlated with older age (OR 1.54 per 10 years; p < 0.001) and comorbid conditions, such as dyslipidemia (OR 2.27; p = 0.004), obesity (OR 2.29; p = 0.015), and chronic kidney disease (OR 8.39; p = 0.012). Subclinical LVSD was independently associated with a 3.9-fold higher risk of MACE (p = 0.003) and a 3.4-fold higher risk of HF hospitalization/cardiovascular death (p = 0.041). A GLS threshold of > - 18.5% provided optimal sensitivity (78%) and specificity (74%) in identifying patients at elevated MACE risk (AUC = 0.78; p < 0.001).</p><p><strong>Conclusion: </strong>Subclinical LVSD, identified by reduced GLS, was strongly associated with adverse cardiovascular events in RA. Whether these findings have therapeutic implications is worth exploring in clinical trials.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1191-1203"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342939","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}

{"title":"A 39-year-old women with newly diagnosed ALCAPA syndrome during pregnancy.","authors":"Lukas Stolz, Juliane J Schneider, Magda Haum, Heidi Estner, Jörg Hausleiter, Steffen Massberg, Manuela Thienel","doi":"10.1007/s00392-025-02597-5","DOIUrl":"10.1007/s00392-025-02597-5","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1232-1235"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058230","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}

{"title":"Myocarditis incidence and hospital mortality from 2007 to 2022: insights from a nationwide registry.","authors":"Felix A Rottmann, Christian Glück, Klaus Kaier, Xavier Bemtgen, Alexander Supady, Constantin von Zur Mühlen, Dirk Westermann, Tobias Wengenmayer, Dawid L Staudacher","doi":"10.1007/s00392-024-02494-3","DOIUrl":"10.1007/s00392-024-02494-3","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the burden of disease of myocarditis in Germany and identify similarities and differences in myocarditis with or without COVID-19.</p><p><strong>Methods: </strong>All patients hospitalized with myocarditis in Germany were included in this nationwide retrospective analysis. Data were retrieved from the Federal Statistical Office of Germany (DESTATIS) for the years from 2007 to 2022. The primary endpoint was hospital mortality.</p><p><strong>Results: </strong>A total of 88,159 patients hospitalized with myocarditis were analyzed. Annual cases increased from 5100 in 2007 to 6593 in 2022 (p < 0.001 for trend) with higher incidence during winter months. Incidence per 100,000 inhabitants was 6.2 in 2007 rising to 7.8 in 2022 (p < 0.001 for trend). Hospital mortality remained constant at an average of 2.44% (p = 0.164 for trend). From 2020 to 2022, 1547/16,229 (9.53%) patients were hospitalized with both, myocarditis and COVID-19 (incidence 0.62/100,000 inhabitants and 180/100,000 hospitalizations with COVID-19). These patients differed significantly in most patient characteristics and had a higher rate of hospital mortality compared to myocarditis without COVID-19 (12.54% vs. 2.26%, respectively, p < 0.001).</p><p><strong>Conclusions: </strong>Myocarditis hospitalizations were slowly rising over the past 16 years with hospital mortality remaining unchanged. Incidence of hospitalizations with combined myocarditis and COVID-19 was low, but hospital mortality was high.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1156-1163"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055151","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}

{"title":"Appointment as Editor-in-Chief of Clinical Research in Cardiology-goals and vision.","authors":"Ulrich Laufs","doi":"10.1007/s00392-025-02721-5","DOIUrl":"10.1007/s00392-025-02721-5","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1096-1097"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728445","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}

{"title":"Cardiac disease in patients with vasculitis.","authors":"Leonhard Binzenhöfer, Katharina Strauß, Linus Seifert, Inas Saleh, Marie Scherzer, Julia Höpler, Didzis Gailis, Christina Gebhard, Julia Lichtnekert, Fabian Ullrich, Delila Singh, Torben Sonneck, Matthias Thaler, Sebastian Zimmer, Steffen Massberg, Holger Thiele, Valentin Sebastian Schäfer, Georg Nickenig, Michael Czihal, Hendrik Schulze-Koops, Enzo Lüsebrink","doi":"10.1007/s00392-025-02728-y","DOIUrl":"10.1007/s00392-025-02728-y","url":null,"abstract":"<p><strong>Background: </strong>Cardiac involvement has been described in many forms of vasculitides and is associated with worse outcomes. However, data on the incidence of structural and arrhythmic heart disease is limited.</p><p><strong>Methods: </strong>For this single-center study, we recruited 191 patients with giant-cell arteritis (GCA, n = 109), Takayasu arteritis (TAK, n = 26), polyarteritis nodosa (PAN, n = 3), granulomatosis with polyangiitis (GPA, n = 38), or eosinophilic granulomatosis with polyangiitis (EGPA, n = 15) between August 2023 and January 2025. The primary study endpoint was the incidence of structural or arrhythmic heart disease after the diagnosis of vasculitis.</p><p><strong>Results: </strong>The demographic characteristics of patients diagnosed with vasculitis differed significantly between those with GCA, TAK, PAN, GPA, and EGPA. Arterial hypertension and dyslipidemia at baseline were more prevalent among patients with GCA, while chest pain and signs of congestion were more frequently reported by patients with EGPA. No significant difference between the five main subgroups were found regarding the incidence of documented arrhythmic diseases. Cardiac imaging was performed using echocardiography in 70% of the overall cohort and cardiac magnetic resonance (CMR) in 11%. CMR detected left ventricular systolic dysfunction and myocardial fibrosis in 33% and 40% of EGPA patients, respectively. All four cases of acute myocardial infarction occurred in patients with GCA. Among 19 GCA patients who underwent coronary angiography, 21.1% underwent percutaneous coronary intervention. In the EGPA group, coronary angiography was performed in 46.7% of patients, but none required percutaneous intervention. A substantial proportion of patients was treated with acetylsalicylic acid (50.3%), beta-blockers (41.9%), or ACE-inhibitors/AT1-receptor antagonists (60.2%).</p><p><strong>Conclusion: </strong>Severe cardiac complications occurred rarely, although cardiovascular risk factors, structural abnormalities, and arrhythmias affected a substantial proportion of patients with vasculitis, highlighting the potential benefit of systematic screening and multidisciplinary management.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":"114 9","pages":"1216-1231"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945383","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}

{"title":"Inflammation, Lp(a) and cardiovascular mortality: results from the LURIC study.","authors":"Stephanie Wissel, Hubert Scharnagl, Marcus E Kleber, Graciela Delgado, Angela Moissl, Bernhard Krämer, Winfried März","doi":"10.1007/s00392-025-02609-4","DOIUrl":"10.1007/s00392-025-02609-4","url":null,"abstract":"<p><strong>Objective: </strong>Lipoprotein(a) [Lp(a)] concentrations have been associated with cardiovascular risk. Recent studies suggested an interaction between systemic inflammation assessed via high-sensitivity C-reactive protein (hsCRP) and Lp(a). This study aimed to evaluate whether Lp(a), hsCRP, and interleukin-6 (IL-6) levels are associated with cardiovascular mortality in a German hospital-based cohort.</p><p><strong>Methods: </strong>Data were drawn from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, including 3,316 patients undergoing coronary angiography. Lp(a) was measured by immunoturbidimetry and categorized into three strata (< 50 mg/dL, n = 2668; 50-100 mg/dL, n = 482; > 100 mg/dL, n = 163). HsCRP was measured by immunonephelometry and categorized by intervals (1st < 1 mg/L, 2nd 1-2 mg/L and 3rd interval > 2 mg/L). IL-6 was measured by ELISA and categorized into two groups (1st < 3.2 ng/L, 2nd ≥ 3.2 ng/L). The primary outcome was cardiovascular disease (CVD) mortality, analyzed using Cox proportional hazards models and logistic regression.</p><p><strong>Results: </strong>Participants were predominantly male, with a mean age of 62.6 years. Extremely high Lp(a) (> 100 mg/dL) was associated with increased cardiovascular mortality (HR 1.5, 95% CI 1.06-2.12) compared to Lp(a) < 50 mg/dl. Both hsCRP (> 2 mg/L, HR 1.39, 95% CI 1.08-1.79 third vs. first interval) and more so IL-6 (HR 1.92, 95% CI 1.64-2.23, upper vs. lower half), were independently associated with higher CVD mortality. While hsCRP did not increase the Lp(a)-CVD mortality in stratified analysis, high IL-6 conferred an increased risk at Lp(a) levels > 100 mg/dL (HR 1.25, 95% CI 1.09-1.44).</p><p><strong>Conclusion: </strong>HsCRP and IL-6 are associated with cardiovascular mortality. Markedly elevated Lp(a) is associated with an increased risk of cardiovascular mortality in the context of high systemic inflammation. Anti-inflammatory treatments may provide additional therapeutic benefits for individuals with high Lp(a).</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1204-1215"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255029","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":"Determinants and reference values of the 6-min walk distance in the general population-results of the population-based STAAB cohort study.","authors":"Caroline Morbach, Nicola Moser, Vladimir Cejka, Michael Stach, Floran Sahiti, Fabian Kerwagen, Stefan Frantz, Rüdiger Pryss, Götz Gelbrich, Peter U Heuschmann, Stefan Störk","doi":"10.1007/s00392-023-02373-3","DOIUrl":"10.1007/s00392-023-02373-3","url":null,"abstract":"<p><strong>Aims: </strong>The 6-min walk test is an inexpensive, safe, and easy tool to assess functional capacity in patients with cardiopulmonary diseases including heart failure (HF). There is a lack of reference values, which are a prerequisite for the interpretation of test results in patients. Furthermore, determinants independent of the respective disease need to be considered when interpreting the 6-min walk distance (6MWD).</p><p><strong>Methods: </strong>The prospective Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigates a representative sample of residents of the City of Würzburg, Germany, aged 30 to 79 years, without a history of HF. Participants underwent detailed clinical and echocardiographic phenotyping as well as a standardized assessment of the 6MWD using a 15-m hallway.</p><p><strong>Results: </strong>In a sample of 2762 participants (51% women, mean age 58 ± 11 years), we identified age and height, but not sex, as determinants of the 6MWD. While a worse metabolic profile showed a negative association with the 6MWD, a better systolic and diastolic function showed a positive association with 6MWD. From a subgroup of 681 individuals without any cardiovascular risk factors (60% women, mean age 52 ± 10 years), we computed age- and height-specific reference percentiles.</p><p><strong>Conclusion: </strong>In a representative sample of the general population free from HF, we identified determinants of the 6MWD implying objective physical fitness associated with metabolic health as well as with cardiac structure and function. Furthermore, we derived reference percentiles applicable when using a 15-m hallway.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1098-1108"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485313","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}

{"title":"Cardiovascular magnetic resonance reveals myocardial involvement in patients with active stage of inflammatory bowel disease.","authors":"Maximilian Fenski, Endri Abazi, Jan Gröschel, Thomas Hadler, Diane Kappelmayer, Frank Kolligs, Claudia Prieto, Rene Botnar, Karl-Philipp Kunze, Jeanette Schulz-Menger","doi":"10.1007/s00392-024-02503-5","DOIUrl":"10.1007/s00392-024-02503-5","url":null,"abstract":"<p><strong>Background: </strong>Active inflammatory bowel disease (A-IBD) but not remission (R-IBD) has been associated with an increased risk of cardiovascular death and hospitalization for heart failure.</p><p><strong>Objectives: </strong>Using cardiovascular magnetic resonance (CMR), this study aims to assess adverse myocardial remodeling in patients with IBD in correlation with disease activity.</p><p><strong>Methods: </strong>Forty-four IBD patients without cardiovascular disease (24 female, median-age: 39.5 years, 26 A-IBD, 18 R-IBD) and 44 matched healthy volunteers (HV) were prospectively enrolled. The disease stage was determined by endoscopic and patient-reported criteria. Participants underwent CMR for cardiac phenotyping: cine imaging and strain analysis were performed to assess ventricular function. T1 mapping, extracellular volume and late-gadolinium enhanced images were obtained to assess focal and diffuse myocardial fibrosis. Simultaneous T1 and T2 elevation (T1 > 1049.3 ms, T2 > 54 ms) was considered to indicate a myocardial segment was inflamed.</p><p><strong>Results: </strong>16/44 (16.4%) IBD patients described dyspnea on exertion and 10/44 (22.7%) reported chest pain. A-IBD patients showed impaired ventricular function, indicated by reduced global circumferential and radial strain despite preserved left-ventricular ejection fraction. 16% of all IBD patients had focal fibrosis in a non-ischemic pattern. A-IDB patients had increased markers of diffuse left ventricular fibrosis (T1-values: A-IBD: 1022.0 ± 34.83 ms, R-IBD: 1010.10 ± 32.88 ms, HV: 990.61 ± 29.35 ms, p < .01). Significantly more participants with A-IDB (8/26, 30.8%) had at least one inflamed myocardial segment than patients in remission (0/18) and HV (1/44, 2.3%, p < .01). Markers of diffuse fibrosis correlated with disease activity.</p><p><strong>Conclusion: </strong>This study, using CMR, provides evidence of myocardial involvement and patterns of adverse left ventricular remodeling in patients with IBD.</p><p><strong>Clinical trial registration: </strong>ISRCTN30941346.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1164-1175"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888709","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}

{"title":"Cardiovascular complications during delivery hospitalizations in inflammatory bowel disease patients.","authors":"Chengu Niu, Jing Zhang, Kaiwen Zhu, George Agbakoba, Karin Dunnigan, Patrick I Okolo","doi":"10.1007/s00392-024-02476-5","DOIUrl":"10.1007/s00392-024-02476-5","url":null,"abstract":"<p><strong>Background: </strong>The relationship between inflammatory bowel disease (IBD) and cardiovascular outcomes among pregnant women has yet to be thoroughly investigated. Our aim is to assess the odds of cardiovascular disease and cardiac arrhythmias during hospital admissions for delivery and identify contributing factors associated with cardiovascular complications in pregnant women with IBD.</p><p><strong>Methods: </strong>We performed a retrospective analysis of data from the National Inpatient Sample, obtained from delivery admissions of pregnant women with and without IBD, identified via International Classification of Diseases codes, from 2009 to 2019. Using a regression model, we compared the odds of cardiovascular complications between these two groups, adjusting for traditional cardiovascular risk factors as confounding variables.</p><p><strong>Results: </strong>Our study included 71,361 pregnancies with IBD and 41,117,443 pregnancies without this condition. The incidence of IBD in pregnancy rose near three-fold increase over the decade. In comparison to pregnancies without IBD, those involving pregnant patients with IBD exhibited an increased likelihood of encountering cardiovascular complications, with an adjusted odds ratio (AOR) of 1.37 (95% CI, 1.29-1.46). This heightened risk encompasses a range of conditions, including peripartum cardiomyopathy (AOR, 9.45; 95% CI, 3.86-23.15), cardiac arrhythmias (AOR, 2.03; 95% CI, 1.59-2.60), and hypertensive disorders of pregnancy (AOR, 1.51; 95% CI, 1.37-1.66), notably preeclampsia, eclampsia, and the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome). Pregnancies with IBD were also associated with three-fold higher odds of venous thromboembolism (AOR, 3.91; 95% CI, 1.45-10.48).</p><p><strong>Conclusions: </strong>Pregnant patients with IBD had an increased odds of cardiovascular complications during delivery admissions, independent of traditional cardiovascular risk factors. Further research is needed to elucidate the underlying mechanisms and develop targeted prevention strategies for this high-risk population.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1145-1155"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491162","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}