Coronary artery disease最新文献

{"title":"Prognostic impact of treatment patterns of in-hospital heart failure on clinical outcomes after myocardial infarction.","authors":"Shogo Okita, Yuichi Saito, Hiroaki Yaginuma, Kazunari Asada, Hiroki Goto, Tatsuro Yamazaki, Osamu Hashimoto, Takanori Sato, Kan Saito, Naoto Mori, Hideki Kitahara, Yoshio Kobayashi","doi":"10.1097/MCA.0000000000001644","DOIUrl":"10.1097/MCA.0000000000001644","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is a common complication after acute myocardial infarction (AMI). However, the prognostic impact of patterns of heart failure management during hospitalization remains unclear.</p><p><strong>Methods: </strong>This multicenter, retrospective study included 2426 patients with AMI undergoing percutaneous coronary intervention. Patients were categorized into three groups: no intravenous (i.v.) heart failure treatment (patients received neither i.v. diuretics nor inotropes/vasopressors), diuretics only (diuretics without inotropes/vasopressors), and inotropes (inotropes/vasopressors with or without diuretics) groups. The primary endpoints included all-cause death during hospitalization and a composite of all-cause death and heart failure rehospitalization after discharge.</p><p><strong>Results: </strong>Overall, 646 patients (26.6%) developed in-hospital heart failure. During hospitalization, the mortality rate was higher in the inotropes group (34.9%), followed by the diuretics only group (5.9%) and the no i.v. heart failure treatment group (2.2%) ( P  < 0.001). During a median follow-up of 535 days, 196 (9.7%) patients developed the primary endpoint after discharge. A composite of all-cause death and heart failure rehospitalization occurred in 6.5% of the no i.v. heart failure treatment group, while those in the diuretics group (21.2%) and inotropes group (24.3%) had a similar risk of the primary endpoint.</p><p><strong>Conclusion: </strong>Heart failure events requiring i.v. treatments during hospitalization were associated with an increased in-hospital mortality, particularly in those treated with inotropes in patients with AMI. Among patients who were discharged alive, however, long-term outcomes did not differ significantly between patients treated with diuretics only and inotropes.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"528-536"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Back to the flow: a comprehensive systematic review and meta-analysis of epinephrine in the treatment of no-reflow.","authors":"Leonardo Dexheimer da Silva, Leonardo Cadorin de Araújo, Eduarda Dexheimer da Silva, Kauã Gabriel Oliveira, Ricardo Fonseca Oliveira Suruagy-Motta, Miguel Rodrigues Moreira, Gabriel Rezende Neves, Carlos Alexandre Farias, Leonardo Galvão de Oliveira Oldra, Pedro Antonio Machado Gomes de Sousa, Pedro Augusto Bento de Sousa, Felipe da Silva Ribeiro, Guilherme Sobreira Spina, Kalgi Modi","doi":"10.1097/MCA.0000000000001632","DOIUrl":"10.1097/MCA.0000000000001632","url":null,"abstract":"<p><strong>Purpose: </strong>The no-reflow phenomenon is defined as inadequate microvascular reperfusion despite successful epicardial coronary recanalization, associated with multiple adverse outcomes, occurring in up to 7% of primary PCI. Its multifactorial pathophysiology includes endothelial injury, distal embolization, and vasospasm. Thus, intracoronary epinephrine has shown promising results due to its vascular regulation. Then, this meta-analysis evaluates the role of epinephrine to treat and prevent the no-reflow phenomenon.</p><p><strong>Methods: </strong>Following Preferred reporting Items for Systematic Reviews and Meta-Analysis standards, we systematically searched MEDLINE, Scopus, Embase, Cochrane, and Web of Science for studies comparing epinephrine with conventional therapy or other drugs. The primary outcome was thrombolysis in myocardial infarction (TIMI) flow. Secondary outcomes included major adverse cardiovascular events (MACE), heart failure, mortality, left ventricular ejection fraction, and myocardial blush grade.</p><p><strong>Results: </strong>Eleven studies (700 epinephrine, 298 control) were included. TIMI flow was assessed using single-arm meta-analyses, stratified into refractory and primary no-reflow. TIMI 3 flow was achieved in 63% of refractory and 86% of primary. Myocardial blush grade 3 was achieved in 47.4% of cases. MACE incidence was 14% in refractory and 18% in primary no-reflow. Compared with conventional treatment, epinephrine reduced MACE risk (risk ratio 0.45; 95% confidence interval: 0.23-0.87; P  = 0.01; I2  = 0%) but showed no difference versus adenosine. Heart failure incidence was 11% in controls and 5% in adenosine, without significant comparative differences.</p><p><strong>Conclusion: </strong>Therefore, intracoronary epinephrine was associated with encouraging but exploratory findings, and the higher success rate in primary no-reflow may reflect earlier intervention and less severe microvascular damage. Its modest advantage over adenosine suggests potential therapeutic value, though evidence remains limited and heterogeneous.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"491-502"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of an artificial intelligence based fractional flow reserve assessment for coronary artery disease.","authors":"Chun-Chin Chang, Song-Po Chen, Ya-Wan Lu, Wei-Ting Sung, Ting-Yung Chang, Ruey-Hsing Chou, Shu-Mei Guo, Po-Hsun Huang","doi":"10.1097/MCA.0000000000001647","DOIUrl":"10.1097/MCA.0000000000001647","url":null,"abstract":"<p><strong>Background: </strong>The implementation of artificial intelligence has been investigated in many aspects of cardiovascular disease.</p><p><strong>Objectives: </strong>To develop deep learning models based on coronary angiograms to detect functionally significant coronary stenoses.</p><p><strong>Methods: </strong>A total of 610 frames from 122 coronary arteries that received pressure wire-based fractional flow reserve (FFR) assessment were analyzed. Deep learning models were developed for the segmentation and classification of coronary stenoses. Both internal and external validation of the deep learning models were performed.</p><p><strong>Results: </strong>The mean FFR value was 0.84 ± 0.08. The artificial intelligence-based FFR was significantly correlated with wire-based FFR with an average correlation coefficient of 0.68 and a mean absolute error of 0.05. The diagnostic performance of artificial intelligence-based FFR versus wire-based FFR was accuracy 87.6%, F1 score = 83.6%, and recall = 81.1%. The artificial intelligence-based FFR showed good discriminative performance with an area under the receiver operating characteristic curve of 86.5% (95% CI: 79.3-93.6).</p><p><strong>Conclusion: </strong>The artificial intelligence-based FFR showed moderate agreement with pressure wire-based FFR and showed promising diagnostic performance in the internal cohort, although reduced performance was observed in external validation, warranting further refinement and multicenter validation.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"553-559"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of serum fibroblast growth factor 21 levels with coronary artery calcification and coronary intervention in patients with chronic total occlusion.","authors":"Cong Wang, Jinghua Liu","doi":"10.1097/MCA.0000000000001636","DOIUrl":"10.1097/MCA.0000000000001636","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between serum fibroblast growth factor 21 (FGF21) levels and the severity of coronary artery calcification (CAC) in patients with chronic total occlusion (CTO), as well as the complexity and outcomes of percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>We enrolled 128 CTO patients who underwent PCI and preprocedural coronary computed tomography angiography, dividing them into severe CAC ( n  = 48) and nonsevere CAC ( n  = 80) groups according to an Agatston score of greater than or equal to 400.</p><p><strong>Results: </strong>Serum FGF21 levels were significantly lower in patients with severe CAC, negatively correlated with CAC scores, and independently associated with severe CAC after multivariable adjustment [odds ratio (OR) per 1-SD increase: 0.481, 95% confidence interval (CI): 0.244-0.947; P  < 0.05]. Patients with low FGF21 levels had significantly higher complexity scores, increased use of guidewires, longer procedural times, and lower procedural success rates (all P  < 0.05). Receiver operating characteristic analysis identified 226.13 pg/ml as the optimal cut-off value of serum FGF21 for predicting procedural success. The area under the curve was 0.664 (95% CI: 0.527-0.802; P  = 0.029).</p><p><strong>Conclusion: </strong>Serum FGF21 levels were negatively correlated with CAC severity and independently predicted severe CAC in patients with CTO. Serum FGF21 was associated with procedural difficulty and had a diagnostic value for procedural success.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"510-517"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term prognostic impact of atrial fibrillation subtypes in unselected patients undergoing coronary angiography.","authors":"Henning Johann Steffen, Tobias Schupp, Mohammad Abumayyaleh, Lasse Kuhn, Philipp Steinke, Jonas Dudda, Marielen Reinhardt, Kathrin Weidner, Jonas Rusnak, Mahboubeh Jannesari, Fabian Siegel, Michael Behnes, Ibrahim Akin","doi":"10.1097/MCA.0000000000001641","DOIUrl":"10.1097/MCA.0000000000001641","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the long-term prognostic impact of atrial fibrillation and its subtypes in an unselected cohort undergoing coronary angiography.</p><p><strong>Background: </strong>Atrial fibrillation is common in patients undergoing coronary angiography and linked to adverse outcomes, but the long-term prognostic impact of atrial fibrillation subtypes, particularly regarding heart failure risk, remains unclear.</p><p><strong>Methods: </strong>Patients undergoing coronary angiography from 2016 to 2022 were stratified by atrial fibrillation status and subtype (paroxysmal, persistent, permanent, new-onset). The primary endpoint was heart failure-related rehospitalization at 36 months. Secondary endpoints included coronary revascularization, acute myocardial infarction (AMI), and in-hospital all-cause mortality.</p><p><strong>Results: </strong>Among 7529 patients, 26.8% had atrial fibrillation (i.e. paroxysmal: 37.7%; persistent: 14.8%, permanent: 16.6%, and new-onset atrial fibrillation: 31.0%). Compared with patients without atrial fibrillation, atrial fibrillation patients were older (median 76 vs. 67 years; P  = 0.001) and had higher rates of heart failure, chronic kidney disease, and acute heart failure. At 36 months, heart failure-related rehospitalization occurred more frequently in atrial fibrillation patients (30.2 vs. 18.4%; P  = 0.001), whereas AMI rates were similar, and coronary revascularization rates were lower. Atrial fibrillation was independently associated with heart failure-related rehospitalization (hazard ratio = 1.246, 95% confidence interval: 1.108-1.400, P  = 0.001), but not with coronary revascularization or AMI. H eart failure rehospitalization increased stepwise across atrial fibrillation subtypes, with the highest in permanent atrial fibrillation (42.5%; P  = 0.001) and progressively lower risk in persistent (34.8%; P  = 0.001), paroxysmal (26.9%; P  = 0.001), and new-onset atrial fibrillation (23.6%; P  = 0.002).</p><p><strong>Conclusion: </strong>Atrial fibrillation independently predicts long-term heart failure-related rehospitalization after coronary angiography, highest in permanent followed by persistent atrial fibrillation.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"518-527"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-aortic balloon support for myocardial infarction with cardiogenic shock: insights from the Swedish Coronary Angiography and Angioplasty Registry.","authors":"Sebastian Völz, Pétur Pétursson, Björn Redfors, Truls Råmunddal, Dimitrios Venetsanos, Antros Louca, Araz Rawshani, Jacob Odenstedt, Inger Valeljung, Oskar Angerås, Dan Ioanes, Anna Myredal, Christian Dworeck, Charlotta Ljungman, Entela Bollano, Giovanna Sarno, Sasha Koul, Tomas Jernberg, Robin Hofmann, Joakim Alfredsson, Ole Fröbert, David Erlinge, Elmir Omerovic","doi":"10.1097/MCA.0000000000001634","DOIUrl":"10.1097/MCA.0000000000001634","url":null,"abstract":"<p><strong>Background: </strong>Cardiogenic shock remains the leading cause of in-hospital death in patients with acute myocardial infarction (MI). The intra-aortic balloon pump (IABP), once widely used, was downgraded in European guidelines after a major randomized trial showed no mortality benefit. This prospective observational study evaluated the impact of IABP on 30-day mortality and in-hospital complications in real-world patients with MI complicated by cardiogenic shock.</p><p><strong>Methods: </strong>Data were obtained from the Swedish Coronary Angiography and Angioplasty Registry, including all percutaneous coronary intervention procedures performed across 31 hospitals in Sweden between 2005 and 2018. A total of 2991 patients with cardiogenic shock were included, of whom 737 (25%) received IABP. To account for baseline differences, instrumental variable analysis was applied using hospital treatment preference as the instrument.</p><p><strong>Results: </strong>At 30 days, 52% of patients had died, and by 1 year, mortality reached 63.2%. In-hospital complications occurred in 13.4% of patients. IABP treatment was not associated with reduced mortality at 30 days [risk reduction: -1.1%, 95% confidence interval (CI): -15.7 to 13.5; P = 0.881] or at 1 year (risk reduction: -0.8%, 95% CI: -23.2 to 0.06; P = 0.258). However, IABP use was associated with a significantly higher risk of in-hospital complications (increase of 26.1%, 95% CI: 15.2-36.8; P < 0.001).</p><p><strong>Conclusion: </strong>IABP did not improve short- or long-term survival in patients with MI-related cardiogenic shock but was linked to increased complications, supporting current guideline recommendations against its routine use.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"503-509"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary computed tomography angiography versus functional testing in a multi-ethnic urban county population.","authors":"Joshua R Colasurdo, Naofumi Yamamoto, April Kinninger, Matthew J Budoff, Sion K Roy","doi":"10.1097/MCA.0000000000001643","DOIUrl":"10.1097/MCA.0000000000001643","url":null,"abstract":"<p><strong>Background: </strong>The greater positive predictive value of coronary computed tomography angiography (CCTA) relative to myocardial perfusion imaging (MPI) and exercise treadmill stress test (ETT) presents the opportunity to optimize resource utilization in identifying coronary artery disease. This study aims to compare the performance of CCTA with functional testing in an understudied, multi-ethnic urban population.</p><p><strong>Methods: </strong>This retrospective observational study evaluated patients at Harbor-UCLA Medical Center (Torrance, California, USA) who were referred for invasive coronary angiography (ICA) following positive CCTA, MPI, or ETT from 2012 to 2022. ICA results were reviewed to ascertain the rate of indication for revascularization following CCTA, MPI, and ETT.</p><p><strong>Results: </strong>A total of 224 patients were included (mean age 58.8 ± 9.6 year, 63% male, and greater than 56% ethnic minority). Of the 67 patients with positive CCTA referred for ICA, 49 (73%) had an indication for revascularization. In comparison, of the 116 patients with positive MPI, only 49 (42%) had an indication for revascularization, and of the 41 patients with positive ETT, only 16 (39%) had an indication for revascularization. The adjusted odds of CCTA correctly predicting indication for revascularization versus MPI were 6.34 (95% confidence interval: 2.70, 14.92; P ≤ 0.001). Similar odds were found comparing CCTA and ETT, with adjusted odds ratio of 5.97 (95% confidence interval: 2.09, 16.99, P  = 0.008).</p><p><strong>Conclusion: </strong>In a multi-ethnic urban population, CCTA provides a greater positive predictive value in the diagnosis of obstructive coronary artery disease than MPI and ETT. These results may help guide the allocation of diagnostic resources in a public, urban hospital.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"537-543"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and design of the Global Heart Attack Treatment Initiative program.","authors":"","doi":"10.1097/MCA.0000000000001604","DOIUrl":"10.1097/MCA.0000000000001604","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"565-570"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical role and regulatory mechanism of KMT2E-AS1 in coronary heart disease.","authors":"Jie Zhang, Yue Bai, Lixin Wang, Yiming Ren, Ya Zhong","doi":"10.1097/MCA.0000000000001646","DOIUrl":"10.1097/MCA.0000000000001646","url":null,"abstract":"<p><strong>Objective: </strong>Coronary heart disease (CHD) is a common cardiovascular disease with high incidence and mortality rates. This study aims to explore the role of KMT2E-AS1 in the progression of CHD and its potential regulatory mechanisms.</p><p><strong>Methods: </strong>The research included 135 CHD patients and 103 healthy volunteers. And CHD patients were categorized into major adverse cardiovascular events (MACE) and non-MACE groups. Differential expression of KMT2E-AS1 in various groups and its diagnostic value were analyzed. Correlation of KMT2E-AS1 expression with myocardial injury markers was investigated. The predictive potential of KMT2E-AS1 for MACE risk was evaluated. The interaction between KMT2E-AS1 and miR-2681-5p was verified, and their effects on human aortic smooth muscle cells (HASMCs) proliferation, inflammation, and oxidative stress response were examined.</p><p><strong>Results: </strong>KMT2E-AS1 is significantly downregulated in the CHD and MACE group. KMT2E-AS1 is significantly negatively correlated with myocardial injury markers, such as Gensini score, creatine kinase-myocardial band, cardiac troponin I, and N-terminal pro-B-type natriuretic peptide. KMT2E-AS1 exhibits favorable diagnostic performance for the occurrence of CHD and serves as an independent protective factor against MACE following surgery. KMT2E-AS1 directly targets and regulates miR-2681-5p. Moreover, KMT2E-AS1 overexpression promotes proliferation, alleviates inflammation, and oxidative stress response in oxidized low-density lipoprotein-induced HASMCs, while miR-2681-5p overexpression counteracts the effects of KMT2E-AS1 overexpression.</p><p><strong>Conclusion: </strong>KMT2E-AS1 is a promising biomarker for predicting CHD occurrence and postoperative MACE risk. KMT2E-AS1 protects HASMCs and inhibits CHD progression by targeting miR-2681-5p.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"544-552"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve-year natural progression of a giant right coronary artery aneurysm.","authors":"Ryoma Oda, Takeshi Kinoshita, Naoki Murata, Yuta Hanawa, Yasuyuki Tsushima, Minoru Tabata","doi":"10.1097/MCA.0000000000001608","DOIUrl":"10.1097/MCA.0000000000001608","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"560-562"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}