{"title":"Prevalence and Outcomes of Fears in Advanced Heart Failure: Differences Across Disease Stages.","authors":"Mats Westas, Semyon Melnikov","doi":"10.1007/s11897-025-00705-0","DOIUrl":"10.1007/s11897-025-00705-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Heart failure (HF) is a complex, multifactorial syndrome resulting from impaired heart function. When medical management of HF is ineffective, mechanical circulatory support with a left-ventricular assist device (LVAD) or heart transplantation are the only options for significantly extending patients' lives. Patients with HF experience various emotional reactions, including fears, which may impact their well-being44444 and disease management. Understanding how fears may differentially influence patients with HF depending on the stage of the disease is thus essential for delivering personalized care.</p><p><strong>Recent findings: </strong>Among patients with advanced HF, disease-related and existential fears were associated with anxiety, depression, sleeplessness, loss of dignity, feelings of abandonment, uncertainty about the future, and restricted physical and social activities. The fears of patients with LVAD can be categorized into device-related, transplant-related, and psychological/emotional fears. Device-related fears involved maintaining the device in optimal condition, transplant-related fears included not surviving until transplantation or not receiving an organ, and psychological/emotional fears related to sexuality and disease progression, correlating with anxiety and depression. The fears experienced by heart transplant recipients fall into three main categories: avoidance, existential, and psychological fears. Avoidance fears lead to lower exercise motivation and higher anxiety, existential fears involved the fear of death leading to poor psychological well-being, and psychological fears included concerns about non-compliance repercussions, hypochondriacal responses, and appearing ungrateful. Each stage of HF disease presents unique fears with distinct implications, emphasizing the need for stage-specific psychological support and interventions. Further studies are required to understand the impact of fears in different stages of HF disease.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"18"},"PeriodicalIF":3.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ravi Patel, Emmanuel Kokori, Gbolahan Olatunji, Faith Adedayo Adejumo, Joan Dumebi Ukah, Adetola Emmanuel Babalola, Andrew Ndakotsu, Israel Charles Abraham, Nicholas Aderinto
{"title":"Therapeutic Potential of GLP-1 Receptor Agonists in Heart Failure with Preserved Ejection Fraction (HFpEF) in Obese Patients.","authors":"Ravi Patel, Emmanuel Kokori, Gbolahan Olatunji, Faith Adedayo Adejumo, Joan Dumebi Ukah, Adetola Emmanuel Babalola, Andrew Ndakotsu, Israel Charles Abraham, Nicholas Aderinto","doi":"10.1007/s11897-025-00704-1","DOIUrl":"https://doi.org/10.1007/s11897-025-00704-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent among individuals with obesity, primarily due to metabolic dysfunction and structural cardiac remodeling. This review explores the emerging therapeutic role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in managing HFpEF in obese populations.</p><p><strong>Recent findings: </strong>Recent clinical trials, including the STEP-HFpEF and SUMMIT studies, have shown that GLP-1 RAs such as semaglutide and tirzepatide significantly reduce body weight (13.3% and 13.9%, respectively), enhance exercise capacity (increases of 21.5m and 26m in 6-minute walk distance), and improve quality of life (19.5 and 16.6-point increases in KCCQ-CSS scores). Additionally, both agents demonstrated marked reductions in systemic inflammation, with C-reactive protein levels decreasing by 38.8% and 43.5%, respectively. GLP-1 RAs represent a promising class of agents targeting the cardiometabolic axis in HFpEF, offering meaningful improvements in functional capacity and symptom burden among obese patients. However, current evidence is limited by short trial durations, lack of population diversity, and insufficient long-term data. Future research should focus on more inclusive cohorts and extended outcomes such as hospitalization rates and cardiovascular events to fully define the long-term safety and efficacy of GLP-1 RAs in HFpEF management.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"17"},"PeriodicalIF":3.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu Fu Ferrari Chen, Alberto Aimo, Vincenzo Castiglione, Olena Chubuchna, Paolo Morfino, Iacopo Fabiani, Gabriele Buda, Michele Emdin, Giuseppe Vergaro
{"title":"Etiological Treatment of Cardiac Amyloidosis: Standard of Care and Future Directions.","authors":"Yu Fu Ferrari Chen, Alberto Aimo, Vincenzo Castiglione, Olena Chubuchna, Paolo Morfino, Iacopo Fabiani, Gabriele Buda, Michele Emdin, Giuseppe Vergaro","doi":"10.1007/s11897-025-00701-4","DOIUrl":"https://doi.org/10.1007/s11897-025-00701-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cardiac amyloidosis (CA) is a condition caused by interstitial infiltration of misfolded proteins structured into amyloid fibrils. Transthyretin (ATTR) and immunoglobulin light chain (AL) amyloidosis represent the most common forms of CA. CA was traditionally perceived as a rare and incurable disease, but diagnostic and therapeutic advances have undermined the conventional paradigm.</p><p><strong>Recent findings: </strong>The standard of care for ATTR-CA include agents capable of selectively stabilizing the precursor protein (e.g., tafamidis), whereas the plasma cell clone is the main target of chemotherapy for AL-CA. For long, tafamidis represented the only drug approved for patients with ATTR-CA. Recent data from ATTRibute-CM led to the approval of acoramidis, whereas patisiran received refusal based on the APOLLO-B trial. Novel CRISPR-Cas9-based drugs (i.e., NTLA-2001) hold great potential in the setting of ATTR-CA. Several hematological regimens are available to treat AL-CA. The main limit of current therapies is their inability to trigger removal of amyloid from tissues. However, the investigation of monoclonal antibodies targeting misfolded ATTR (e.g., PRX004, NI301A) or AL (e.g., birtamimab, anselamimab) has led to encouraging results. Various cutting-edge strategies are being tested for treatment of CA and may change the prognostic landscape of this condition in the next years.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"16"},"PeriodicalIF":3.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hanna Gyllensten, Matilda Cederberg, Sara Alsén, Elin Blanck, Lilas Ali, Andreas Fors, Håkan Hedman, Laura Pirhonen Nørmark, Karl Swedberg, Inger Ekman
{"title":"Person-Centred Care: State-of-the-Art and Future Perspectives.","authors":"Hanna Gyllensten, Matilda Cederberg, Sara Alsén, Elin Blanck, Lilas Ali, Andreas Fors, Håkan Hedman, Laura Pirhonen Nørmark, Karl Swedberg, Inger Ekman","doi":"10.1007/s11897-025-00702-3","DOIUrl":"https://doi.org/10.1007/s11897-025-00702-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Many countries prioritise the implementation of person-centred care. This study examines the progression of research in person-centred care, specifically focusing on using complex interventions within intricate contexts. It aims to explore how previous experiences can inform and shape subsequent projects. The review was based on five studies from our research group, encompassing 1099 patients, resulting in 41 peer-reviewed scientific publications. Most studies focused on patients suffering from chronic heart failure, as well as patients with chronic obstructive pulmonary disease. Additionally, interventions for acute coronary syndrome and common mental disorders were also considered. Analyses included the development of a logical model for person-centred care, an overview of partnership operationalisation, and the establishment of evaluation criteria for the trials. The analyses involved creating a coherent model for person-centred care, examining partnership operationalisation, and establishing trial evaluation criteria.</p><p><strong>Recent findings: </strong>Sequential trials build upon their predecessors and add new elements. The studies conducted by clinicians in usual care and in-house by research staff were complementary, providing a deeper understanding of the efficacy and effectiveness of person-centred care. Initiating, working, and safeguarding a partnership between patient and staff was possible, whether through in-person or remote communication. Evaluations followed modern research standards and incorporated past study insights for a more thorough approach. This study highlights how the cumulative experience from previous research in person-centred care informs the design and analyses of subsequent projects through an iterative learning process, particularly important for complex interventions in various health care contexts.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"15"},"PeriodicalIF":3.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Personalizing Care for Informal Heart Failure Caregivers: Challenges and Practical Implications.","authors":"Emma Säfström, Maria Liljeroos","doi":"10.1007/s11897-025-00703-2","DOIUrl":"10.1007/s11897-025-00703-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize articles describing how to personalize care for heart failure (HF) informal caregivers on the basis of the literature review results. We also describe informal caregivers' preferences and wishes regarding personalized care.</p><p><strong>Recent findings: </strong>Recent interventions to support informal caregivers were delivered face-to-face or online in group or individual sessions. The sessions embraced various elements, including coaching on setting personalized goals and developing problem-solving strategies. The interventions improved a range of variables, such as caregiver burden, quality of life, depression, stress and anxiety. Informal caregivers described personalized care as being in a partnership, clear communication and coordination of care. Several intervention studies reported positive caregiver effects; however, they were small, and sometimes, the interventions were only briefly described. A deeper and more comprehensive understanding of the experiences and needs of informal caregivers is essential before new tailored interventions can be developed.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"14"},"PeriodicalIF":3.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacob Whitman, Elie Kozaily, Erin D Michos, Daniel N Silverman, Marat Fudim, Robert J Mentz, Ryan J Tedford, Vishal N Rao
{"title":"Epicardial Fat in Heart Failure and Preserved Ejection Fraction: Novel Insights and Future Perspectives.","authors":"Jacob Whitman, Elie Kozaily, Erin D Michos, Daniel N Silverman, Marat Fudim, Robert J Mentz, Ryan J Tedford, Vishal N Rao","doi":"10.1007/s11897-025-00700-5","DOIUrl":"10.1007/s11897-025-00700-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cardiovascular effects of obesity may be driven, in part, by the distribution of fat. More recently, epicardial adipose tissue (EAT) has gained recognition as an adverse visceral fat impacting cardiac dysfunction in heart failure with preserved ejection fraction (HFpEF).</p><p><strong>Recent findings: </strong>EAT can be identified and measured using several non-invasive imaging techniques, including transthoracic echocardiography, computed tomography, and cardiac magnetic resonance. The presence of EAT is associated with increased risk of HFpEF and worse clinical outcomes among patients with established HFpEF, independent of total adiposity. EAT may serve a pivotal role in the pathogenesis of HFpEF by worsening volume distribution, enhancing pericardial restraint and ventricular interaction, worsening right ventricular dysfunction, and diminishing exercise tolerance. No large trials have tested the effects of reducing fat in specific areas of the body on cardiovascular outcomes, but some studies that followed people in communities and trials over time have suggested that drug and non-drug treatments that lower EAT could improve the risk factors for heart problems in patients with HFpEF. Further understanding the role that pathogenic fat depots play in HFpEF incidence and progression may provide future therapeutic targets in treating the obese-HFpEF phenotype.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"13"},"PeriodicalIF":3.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aynaz Lotfinaghsh, Adnan Imam, Alexander Pompian, Nathan O Stitziel, Ali Javaheri
{"title":"Clinical Insights from Proteomics in Heart Failure.","authors":"Aynaz Lotfinaghsh, Adnan Imam, Alexander Pompian, Nathan O Stitziel, Ali Javaheri","doi":"10.1007/s11897-025-00698-w","DOIUrl":"10.1007/s11897-025-00698-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>The pathophysiology of heart failure (HF), a complex and heterogenous condition, remains to be fully understood. Troponin and b-type natriuretic peptide are the only biomarkers that are utilized in clinical practice for HF clinical management. Recent advances in proteomics present a powerful tool to identify risk markers and ultimately, potential molecular mechanisms underlying HF pathogenesis. Herein, we explore traditional and novel heart biomarkers, highlighting their potential role in the pathogenesis of HF.</p><p><strong>Recent findings: </strong>Recent proteomic analyses have identified numerous proteins including Galectin-3, sST2, GDF-15, FGF21, Endotrophin, THSB-2, ADAMSTL, SVEP1, and anthracycline that are associated with clinical outcomes in HF. These biomarkers are not presently utilized in HF management but may be useful in the future for prediction of death or HF hospitalization. While traditional biomarkers remain essential, proteomic strategies have revealed additional targets that require further mechanistic exploration. Future research should focus on validating these biomarkers and translating proteomic insights into clinical practice to enhance HF management.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"12"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Izabella Uchmanowicz, Magdalena Lisiak, Katarzyna Lomper, Michał Czapla, Donata Kurpas, Maria Jedrzejczyk, Marta Wleklik
{"title":"State of the Art in Measuring Frailty in Patients With Heart Failure: from Diagnosis to Advanced Heart Failure.","authors":"Izabella Uchmanowicz, Magdalena Lisiak, Katarzyna Lomper, Michał Czapla, Donata Kurpas, Maria Jedrzejczyk, Marta Wleklik","doi":"10.1007/s11897-025-00699-9","DOIUrl":"10.1007/s11897-025-00699-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to present the current state of the art in measuring frailty in patients with heart failure (HF), covering the entire spectrum from diagnosis to advanced stages of the disease. Frailty is a critical factor that significantly impacts outcomes in heart failure, and accurate assessment is essential for guiding treatment and improving prognosis.</p><p><strong>Recent findings: </strong>Frailty is increasingly recognized as a key determinant of morbidity and mortality in HF patients. Various tools are available for assessing frailty, but there is no consensus on the optimal method. The assessment of frailty needs to be multidimensional, incorporating physical, cognitive, and social domains. Early detection of frailty, coupled with personalized interventions, has the potential to improve patient outcomes. Integrating routine frailty assessments into the clinical care of heart failure patients is essential for optimizing treatment. Future research should focus on standardizing frailty assessment tools and integrating innovative technologies, such as artificial intelligence, to enhance the precision and applicability of these assessments in clinical practice.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"11"},"PeriodicalIF":3.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Htet Htet Ei Khin, Joe J Cuthbert, Abhilash Koratala, Giovanni Donato Aquaro, Nicola Riccardo Pugliese, Luna Gargani, Sokratis Stoumpos, John G F Cleland, Pierpaolo Pellicori
{"title":"Imaging of Congestion in Cardio-renal Syndrome.","authors":"Htet Htet Ei Khin, Joe J Cuthbert, Abhilash Koratala, Giovanni Donato Aquaro, Nicola Riccardo Pugliese, Luna Gargani, Sokratis Stoumpos, John G F Cleland, Pierpaolo Pellicori","doi":"10.1007/s11897-025-00695-z","DOIUrl":"10.1007/s11897-025-00695-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Both cardiac and renal dysfunction can lead to water overload - commonly referred to as \"congestion\". Identification of congestion is difficult, especially when clinical signs are subtle.</p><p><strong>Recent findings: </strong>As an extension of an echocardiographic examination, ultrasound can be used to identify intravascular (inferior vena cava diameter dilation, internal jugular vein distension or discontinuous venous renal flow) and tissue congestion (pulmonary B-lines). Combining assessment of cardiac structure, cardiac and renal function and measures of congestion informs the management of heart and kidney disease, which should improve patient outcomes. In this manuscript, we describe imaging techniques to identify and quantify congestion, clarify its origin, and potentially guide the management of patients with cardio-renal syndrome.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"10"},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elias Haj-Yehia, Lars Michel, Raluca I Mincu, Tienush Rassaf, Matthias Totzeck
{"title":"Prevention of cancer-therapy related cardiac dysfunction.","authors":"Elias Haj-Yehia, Lars Michel, Raluca I Mincu, Tienush Rassaf, Matthias Totzeck","doi":"10.1007/s11897-025-00697-x","DOIUrl":"10.1007/s11897-025-00697-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Introduction of modern cancer therapies has led to increased survival of affected patients. With this advantage, the incidence of cancer therapy-related cardiac dysfunction (CTRCD) has increased and reasonable prevention strategies become necessary. This review outlines the major approaches to limit development and progression of CTRCD.</p><p><strong>Recent findings: </strong>A broad range of cancer therapies can provoke CTRCD ranging from mild asymptomatic forms to severe heart failure. Profound cardiological assessment of cardiovascular comorbidities before initiation of cancer therapy allows identification of cancer patients at higher risk developing CTRCD which may also require closer surveillance. Cardioprotective adjustment of cancer therapy and initiation of cardioprotective medication and lifestyle optimization prior to anti-cancer treatment additionally limit the risk of CTRCD. During therapy, regular examination of cancer patients using high-sensitive cardiological diagnostic tools as three-dimensional (3D) echocardiography and global longitudinal strain (GLS) enables early detection of mild forms of CTRCD. This allows appropriate adjustment of cancer therapy and initiation of CTRCD treatment to prevent further progression to severe forms. Cardiological risk stratification before treatment initiation, cardioprotective interventions before and during cancer therapy, along with regular monitoring of treated cancer patients, can help prevent the development of CTRCD. This maintains the antitumor effects of cancer therapy while limiting cardiotoxic side effects resulting in improved quality of life and mortality of affected cancer patients.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"22 1","pages":"9"},"PeriodicalIF":3.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}