European Heart Journal: Case Reports最新文献

{"title":"Clinical application of multi-detector computed tomography coronary angiography and global longitudinal strain for diagnosis of multi-vessel coronary artery spasm: case reports.","authors":"Sangyong Jo, Kyung Hee Lim, Moo Hyun Kim, Eun-Ju Kang, Jinwoo Jeong","doi":"10.1093/ehjcr/ytaf401","DOIUrl":"10.1093/ehjcr/ytaf401","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis of epicardial coronary artery spasm, which is considered the cause of vasospastic angina, can be achieved through the coronary angiography (CAG) with a pharmacologic provocation test. However, this procedure is thought to have a potential risk of complications. Although multi-detector computed tomography coronary angiography (MDCTA) is proposed as the alternative test for the diagnosis of spastic coronary artery, myocardial ischaemia does not always coincide with coronary artery stenosis. MDCTA combined with echocardiographic left ventricular global longitudinal strain (LV GLS) is an innovative non-invasive diagnostic method expected to detect multivessel coronary artery spasm in patients with vasospastic angina.</p><p><strong>Case summary: </strong>We report two cases of vasospastic angina caused by multivessel coronary artery spasm, which were confirmed using MDCTA and echocardiographic LV GLS.</p><p><strong>Discussion: </strong>In patients with suspected vasospastic angina, MDCTA and echocardiographic LV GLS during spontaneous attacks could be used to document the coronary artery vasospasm and associated myocardial ischaemia. These non-invasive diagnostic techniques could be considered a new alternative for patients with suspected vasospastic angina who exhibit certain characteristics, such as nitrate-responsive and resting chest pain and no history of significant coronary atherosclerosis. This approach may be particularly useful when these patients present to the emergency department during a spontaneous vasospasm.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 9","pages":"ytaf401"},"PeriodicalIF":0.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112192","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":"Dietary lifestyle changes unexpectedly causing digoxin intoxication with cardiogenic shock: a grand round case report.","authors":"Anna M Gerritsma, Quint A J Hagdorn, Timon H Geurkink, Jan G Groothuis, Clara E E van Ofwegen-Hanekamp, Jurjen S Lagas","doi":"10.1093/ehjcr/ytaf352","DOIUrl":"10.1093/ehjcr/ytaf352","url":null,"abstract":"<p><strong>Background: </strong>Digoxin is primarily used for atrial arrhythmias and known for its narrow therapeutic index. It is predominantly excreted renally and has a long half-life and large volume of distribution, requiring personalized dosing. Due to its narrow therapeutic index, only modestly elevated plasma levels may already cause digoxin toxicity, including gastro-intestinal, ocular, neuropsychiatric, and cardiac complications.</p><p><strong>Case summary: </strong>A 66-year-old Caucasian male, with a history of heart failure with preserved ejection fraction and permanent atrial fibrillation, treated with digoxin 0.25 mg daily and metoprolol succinate 200 mg daily presented to the emergency room. He was in cardiogenic shock due to bradycardia resulting from third-degree AV block with varying escape rhythm (minimum of 20 b.p.m.). A temporary external pacemaker lead was placed. Elevated digoxin serum levels (3.2-3.4 µg/L, toxicity threshold > 2.0 µg/L) and hyperkalaemia were found. To reverse digoxin toxicity, digoxin-specific antibody fragments (digoxin-Fabs) were administered and complete recovery of AV-conduction was observed. Interestingly, the patient recently drastically altered his diet and completely abandoned from massive cola and beer intake.</p><p><strong>Discussion: </strong>The cause of this intoxication is probably multifactorial, including reduced renal digoxin excretion, co-medication, and most likely changes in diet. We hypothesize that this dietary change not only led to substantial weight loss but also resulted in an increase of intragastric pH, thereby significantly enhancing digoxin uptake. This case underscores the importance of considering digoxin-Fabs treatment based on several factors including clinical presentation and digoxin serum levels. Furthermore, it highlights the importance of regular lifestyle anamnesis and renal function assessment to reassess digoxin dosage.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf352"},"PeriodicalIF":0.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947576","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":"Ventricular fibrillation due to coronary vasospasm triggered by hyperventilation in a patient with panic disorder: case report.","authors":"Shota Takimoto, Shinichiro Masuda, Shuzou Tanimoto, Nobuhiko Ogata, Takaaki Isshiki","doi":"10.1093/ehjcr/ytaf383","DOIUrl":"10.1093/ehjcr/ytaf383","url":null,"abstract":"<p><strong>Background: </strong>Panic attacks can trigger hyperventilation, which has been associated with the induction of coronary vasospasm. The resulting vasospasm may cause myocardial ischaemia and trigger life-threatening arrhythmias. Patients with panic disorders experiencing hyperventilation sometimes present with symptoms similar to those of acute coronary syndrome, making it difficult to determine their origin.</p><p><strong>Case summary: </strong>A 37-year-old man with a history of panic disorder was transported to our institute after he experienced hyperventilation during a panic attack and developed chest pain and a subsequent loss of consciousness. During transportation, ventricular fibrillation was observed on electrocardiography, and sinus rhythm was successfully restored with defibrillation. Suspecting hyperventilation-induced coronary vasospasm, a hyperventilation test was performed, which induced 90% coronary spasm accompanied by chest pain. An acetylcholine (ACh) provocation test revealed total occlusion of the left main bifurcation, with significant ischaemic ST-T elevation. Medication with a calcium channel blocker (nifedipine 40 mg per day), nitrate (isosorbide dinitrate 40 mg per day), and statin (rosuvastatin 20 mg per day) was initiated. Three months later, a repeat ACh provocation test performed to assess response to the medications revealed 90% stenosis with ischaemic ST-T changes and chest discomfort. Subsequently, a subcutaneous cardioverter defibrillator was implanted to address refractory vasospastic angina.</p><p><strong>Discussion: </strong>Herein, ventricular fibrillation was likely caused by coronary spasm induced by hyperventilation during the panic attack. Regarding the management of patients with panic disorder who present with chest pain, clinicians should carefully assess the symptoms and consider hyperventilation-induced coronary spasm as a differential diagnosis.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 9","pages":"ytaf383"},"PeriodicalIF":0.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947205","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":"A case report of fulminant eosinophilic myo-pericarditis related to checkpoint inhibitors complicated by acute heart failure and cardiac tamponade.","authors":"Yaqub Betz, Selveras Zayed, Francesco Moroni, Robin LeGallo, Antonio Abbate","doi":"10.1093/ehjcr/ytaf400","DOIUrl":"10.1093/ehjcr/ytaf400","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but are associated with various adverse effects, including myocarditis, with mortality rates up to 50%. We report a case of fatal ICI-related fulminant eosinophilic myo-pericarditis complicated by tamponade in a 69-year-old man with metastatic lung adenocarcinoma.</p><p><strong>Case summary: </strong>Two weeks after receiving one dose of pembrolizumab, the patient presented with sudden chest pain and dyspnoea. Examination revealed tachycardia, hypotension, and hypoxia. Electrocardiogram showed a new right bundle branch block and ST depressions in the precordial leads with an elevated troponin I of 49.69 ng/mL. Echocardiogram demonstrated globally reduced function and pericardial effusion, suggesting impending tamponade. Despite aggressive resuscitative efforts, the patient rapidly decompensated and ultimately went into cardiac arrest and passed away. Autopsy was performed with pathology demonstrating necrotizing eosinophilic myocarditis related to ICIs. Other potential causes of eosinophilic myocarditis, such as drug hypersensitivity, were felt less likely given lack of drugs associated with eosinophilic myocarditis. Eosinophilic granulomatosis with polyangiitis and hypereosinophilic syndrome were also less likely based on American College of Rheumatology criteria as well as the absence of peripheral eosinophilia.</p><p><strong>Discussion: </strong>This case emphasizes the need for awareness of eosinophilic myo-pericarditis as a potential complication of ICI therapy. It underscores the value of early endomyocardial biopsy in unstable patients with suspected acute myocarditis, 'fast-tracking' treatment initiation. It also highlights the rapid progression of cardiac complications in ICI-related myocarditis and the potential for tamponade, emphasizing the low threshold for consideration of myocarditis and treatment in patients initiating or receiving ICIs.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf400"},"PeriodicalIF":0.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947517","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":"Rescue of acute ST-elevation myocardial infarction secondary to traumatic coronary artery rupture: a case report.","authors":"Guangfeng Sun, Shan Huang, Huiyuan Kang, Bin Wang","doi":"10.1093/ehjcr/ytaf402","DOIUrl":"10.1093/ehjcr/ytaf402","url":null,"abstract":"<p><strong>Background: </strong>Trauma-related acute myocardial infarction represents a complex and high-risk condition in the emergency department, necessitating a range of sophisticated treatment strategies. Failure to provide timely and accurate intervention significantly increases the risk of short-term mortality.</p><p><strong>Case summary: </strong>We present the case of a 36-year-old male who was admitted to local hospital following a penetrating chest trauma. Relevant diagnostic evaluations revealed haemopneumothorax and shock. Following initial stabilization measures, the patient was urgently transferred to our institution due to haemopericardium, which was initially suspected to be secondary to traumatic aortic dissection. However, the admission electrocardiogram clearly demonstrated concurrent anterior and high lateral wall myocardial infarction. Coronary angiography revealed occlusion of the left anterior descending (LAD) artery. We attempted interventional therapy on the LAD to restore blood flow. However, intraoperative findings revealed complete rupture of the LAD. The patient was transferred to the cardiac surgery department for emergency coronary artery bypass grafting (CABG). The foreign body was successfully retrieved, and the CABG was completed without complications. The patient gradually recovered under short-term ECMO support and was discharged successfully. Follow-up assessments indicate a favourable recovery.</p><p><strong>Discussion: </strong>The mechanism underlying traumatic myocardial infarction is complex and variable. Given that emergency physicians and cardiologists often lack extensive experience in such cases, they should exercise caution, conduct a thorough assessment, and meticulously plan each step of diagnosis and treatment.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 9","pages":"ytaf402"},"PeriodicalIF":0.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999983","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":"'Whisper from the mitral valve': delayed diagnosis of traumatic mitral valve regurgitation in an elderly farmer-a case report.","authors":"Shinnosuke Tsukamoto, Kensuke Matsumoto, Tomohiro Hayashi, Akitaka Yamada, Satoru Kawasaki","doi":"10.1093/ehjcr/ytaf399","DOIUrl":"10.1093/ehjcr/ytaf399","url":null,"abstract":"<p><strong>Background: </strong>Traumatic mitral regurgitation (MR) is an exceptionally rare complication associated with blunt chest trauma, particularly following relatively low-impact injuries. In the critical and chaotic settings of polytrauma, its diagnosis is often delayed and can easily be overlooked. This oversight can lead to progressive haemodynamic deterioration and, ultimately, fatal outcomes.</p><p><strong>Case summary: </strong>A 73-year-old man sustained blunt chest trauma after falling ∼2.5 m from a truck bed. Initial assessment revealed a left haemopneumothorax and multiple rib fractures, with no audible heart murmur or signs of haemodynamic compromise. A chest drain was inserted, and he was discharged after conservative management. However, 3 weeks post-injury, a Grade III systolic regurgitant murmur was newly detected. Transthoracic and transoesophageal echocardiography revealed severe eccentric MR due to posterior mitral valve prolapse caused by chordal rupture. Intraoperative inspection confirmed a P2 chordal rupture with myxomatous degeneration. The patient underwent successful mitral valve repair and had an uneventful postoperative recovery.</p><p><strong>Discussion: </strong>This case highlights that traumatic MR, though extremely rare, can occur even after relatively minor trauma in elderly individuals, potentially due to underlying degenerative changes. Clinical signs of acute MR can be obscured by coexisting injuries, and auscultatory findings may only become apparent after these conditions have been treated. While echocardiography is crucial for identifying traumatic valvular dysfunction, its effectiveness can be limited by various factors associated with polytrauma. Therefore, a high index of suspicion is essential to prevent overlooking this potentially life-threatening complication in cases of blunt chest trauma.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 9","pages":"ytaf399"},"PeriodicalIF":0.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991863","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":"Life-threatening pulmonary artery rupture during transcatheter tricuspid valve-in-ring implantation: case report and management strategies.","authors":"Kadir Sadikoglu, Dilara Pay, Serkan Aslan, Gamze Babur Guler, Mehmet Erturk","doi":"10.1093/ehjcr/ytaf351","DOIUrl":"10.1093/ehjcr/ytaf351","url":null,"abstract":"<p><strong>Background: </strong>This case report highlights pulmonary artery rupture as a rare but severe complication during transcatheter valve-in-ring implantation (TVIRI). The case offers practical preventive strategies to enhance procedural safety in high-risk patients undergoing TVIRI.</p><p><strong>Case summary: </strong>A 54-year-old female patient presented with severe tricuspid regurgitation due to annuloplasty ring failure. The TVIRI was complicated by pulmonary artery rupture, resulting in massive haemoptysis and haemodynamic collapse. The bleeding was successfully controlled by prompt management with balloon tamponade and selective embolization using an Amplatzer Vascular Plug 4.</p><p><strong>Discussion: </strong>This case demonstrates the potential for life-threatening complications during TVIRI and highlights the importance of careful procedural planning, multidisciplinary collaboration, and prompt intervention to ensure patient safety.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf351"},"PeriodicalIF":0.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130248","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":"Comprehensive improvement in cardiac function following myosin inhibition after the ineffectiveness of myectomy and alcohol septal ablation: a case report.","authors":"Aleksandar Aleksandrov, Wilhelm Haverkamp, Adrian Constantin Borges, Thomas Zöller, Fabian Knebel","doi":"10.1093/ehjcr/ytaf365","DOIUrl":"10.1093/ehjcr/ytaf365","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy affects approximately 1 in 500 adults and is often associated with left ventricular outflow tract obstruction. Despite guideline-directed medical therapy and septal reduction procedures, a significant number of patients remain symptomatic. Recently, cardiac myosin inhibitors such as mavacamten have emerged as promising therapeutic options. By directly targeting the underlying hypercontractility, mavacamten can reduce left ventricular outflow tract gradients and improve functional capacity.</p><p><strong>Case summary: </strong>This report highlights the effects of myosin inhibition in a 72-year-old male patient with symptomatic hypertrophic obstructive cardiomyopathy. The patient was refractory to standard medical as well as interventional therapies (myectomy and septal ablation). Initiation of mavacamten therapy led to marked clinical improvement, including increased exercise capacity and weight loss due to improved physical activity. Echocardiography revealed regression of septal wall thickness, reduction of the left ventricular outflow tract gradient, and improvement of diastolic function. Furthermore, electrocardiogram changes consistent with hypertrophyincluding voltage criteria and T wave inversions-resolved completely. The cardiac biomarkers have normalized.</p><p><strong>Discussion: </strong>Myosin inhibition has the potency to reverse multiple pathophysiological mechanisms in hypertrophic obstructive cardiomyopathy-even in patients with advanced age and with long-standing, resistant, and symptomatic disease. The treatment effects could be observed rapidly.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf365"},"PeriodicalIF":0.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872073","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":"Unintended coronary biopsy following successful management of rotational atherectomy burr entrapment using the Ping-Pong technique: images in cardiology.","authors":"Dimitrios Siamkouris, Marc Schloesser, Elmar Offers, Stergios Tzikas","doi":"10.1093/ehjcr/ytaf374","DOIUrl":"10.1093/ehjcr/ytaf374","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf374"},"PeriodicalIF":0.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947592","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":"Pericardial tamponade in pregnancy due to undiagnosed systemic lupus erythematosus: a case report.","authors":"Barbara Wichert-Schmitt, Rainer Hintenberger, Hermann Blessberger, Patrick Stelzl, Clemens Steinwender","doi":"10.1093/ehjcr/ytaf388","DOIUrl":"10.1093/ehjcr/ytaf388","url":null,"abstract":"<p><strong>Background: </strong>Pericardial tamponade during pregnancy is rare. Diagnosis of pericardial effusion can easily be made by echocardiography. Thorough clinical assessment, laboratory testing and advanced cardiac imaging are necessary to identify the underlying cause of pericardial effusion and rule out other causes of chest pain. Most diagnostic tests and therapeutic measures are safe during pregnancy. Systemic lupus erythematosus can be diagnosed by integrating clinical features and serologic testing. Certain autoantibodies increase the risk for adverse pregnancy events and multi-disciplinary team care is essential for a favourable pregnancy outcome.</p><p><strong>Case summary: </strong>A 37-year-old previously healthy woman presented with chest pain at 24 weeks gestational age. Echocardiography revealed a large pericardial effusion, which quickly progressed to pericardial tamponade. The woman required urgent thoracoscopic pericardial drainage as the gravid uterus impaired subcostal or apical access for pericardiocentesis. The surgery was performed without complications. Serologic testing was positive for antinuclear antibodies. Rheumatology assessment revealed further clinical features of systemic lupus erythematosus, which established the diagnosis. After initiation of treatment with hydroxychloroquine and prednisone the chest pain resolved and pericardial effusion did not recur. The twin fetuses were monitored regularly by the obstetrical team and no adverse pregnancy events occurred.</p><p><strong>Conclusion: </strong>Cardiologists may be the first to detect pericardial effusion as a clinical feature of rheumatologic disease. Multi-disciplinary team care leads to good pregnancy outcomes for mother and child.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 9","pages":"ytaf388"},"PeriodicalIF":0.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947654","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}