Europace最新文献

{"title":"Non-linear associations between blood pressure and clinical outcomes in atrial fibrillation: a systematic review and dose-response meta-analysis.","authors":"Elnaz Shahmohamadi, Alessandra Pina, Adrian D Elliott, Jonathan P Ariyaratnam, Melissa E Middeldorp, Prashanthan Sanders","doi":"10.1093/europace/euag223","DOIUrl":"10.1093/europace/euag223","url":null,"abstract":"<p><strong>Aims: </strong>Hypertension carries the highest attributable risk for atrial fibrillation (AF) and strongly influences clinical outcomes such as stroke and death; however, the optimal blood pressure targets in individuals with AF remain poorly defined. We aimed to characterize the dose-response relationship between systolic blood pressure (SBP) and diastolic blood pressure (DBP) and ischaemic stroke, all-cause mortality, and intracranial haemorrhage.</p><p><strong>Methods and results: </strong>We systematically searched MEDLINE, Embase, and Scopus for studies reporting outcomes in AF stratified by SBP and DBP. A two-stage dose-response meta-analysis used restricted cubic splines to model non-linearity, with within-study correlation handled by the Greenland-Longnecker method. Twenty-three studies (17 cohorts; n = 476 750) were included. SBP demonstrated a U-shaped association with all-cause mortality, with the lowest risk at 134 mmHg (relative risks (RR) 0.92, 0.86-0.98 vs. 120 mmHg). DBP exhibited a J-shaped association, with the lowest risk at 83 mmHg (RR 0.99, 0.97-1.02). In contrast to mortality, the risks of ischaemic stroke, intracranial haemorrhage, and stroke or systemic embolism rose progressively with SBP, with a steepening gradient. At 140 vs. 120 mmHg, the RR was 1.51 for intracranial haemorrhage against 1.08 for ischaemic stroke, reaching 1.99 vs. 1.14 at 150 mmHg.</p><p><strong>Conclusion: </strong>SBP exhibits a U-shaped relationship with all-cause mortality in patients with AF, balancing against a monotonic increase in ischaemic stroke and intracranial haemorrhage at higher pressures. A pragmatic target SBP of 120-130 mmHg with DBP kept above ∼75-80 mmHg, appears to optimize the balance between stroke prevention, bleeding risk, and survival.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcome measures for atrial fibrillation: a systematic review and evaluation of psychometric properties of symptom severity measures.","authors":"Jael-Joy Ogendo, Angeliki Darma, Miroslav Mihajlovic, Elena Arbelo, Deirdre A Lane","doi":"10.1093/europace/euag252","DOIUrl":"10.1093/europace/euag252","url":null,"abstract":"<p><strong>Aims: </strong>Collection of patient-reported outcomes (PROs) is advocated for benchmarking atrial fibrillation (AF) care; however, concerns over the robustness of patient-reported outcome measures (PROMs) limit their use in clinical practice. This systematic review identified PROMs used to evaluate health-related quality of life, physical, emotional, and cognitive function, symptom severity, exercise tolerance, and ability to work and appraised the measurement properties of symptom severity PROMs.</p><p><strong>Methods and results: </strong>Six bibliographic databases were searched from inception until 11 January 2025. Full-text publications in all languages investigating ≥1 measurement property of PROMs in AF patients aged ≥18 years were eligible. The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) recommendations appraised and synthesized measurement properties and risk of bias of symptom severity PROMs (PROSPERO ID: CRD42024523340). A total of 709 eligible publications identified 101 PROMs; six symptom severity PROMs (AFSymp, AFS/B, AFSS, ASTA, AF6, and SCL) underwent psychometric property evaluation. ASTA, AFSymp, and SCL indicated evidence of sufficient content validity and at least low-quality evidence for sufficient internal consistency. ASTA was the most validated PROM and exhibited the greatest level of certainty in evidence quality across assessed psychometric properties. COSMIN assessments revealed critical gaps in responsiveness and cross-cultural validity.</p><p><strong>Conclusion: </strong>ASTA emerged as the most robust symptom severity PROM. Further validation of PROMs identified for other PROs by COSMIN guidelines is recommended prior to their routine integration in AF care, and future studies should address responsiveness, interpretability, feasibility, and cross-cultural validity to ensure PROMs reliably reflect patients' experiences and detect meaningful clinical changes across diverse populations.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of extravascular cardioverter defibrillator implantation: feasibility without general anaesthesia.","authors":"Mauro Biffi, Hans Römers, Andrea Quaranta, Antonio Nicolò Izzo, Carmine Verde, Alberto Spadotto, Jippe Balt, Andrea Angeletti, Cristian Martignani, Igor Diemberger, Matteo Ziacchi, Lucas V A Boersma","doi":"10.1093/europace/euag217","DOIUrl":"10.1093/europace/euag217","url":null,"abstract":"<p><strong>Aims: </strong>Extravascular implantable cardioverter-defibrillator (EV-ICD) is a novel non-transvenous system delivering defibrillation shocks and anti-tachycardia pacing through a substernal lead. Despite proven efficacy, implantation has traditionally required general anaesthesia and cardiothoracic surgical backup, limiting widespread adoption.</p><p><strong>Objectives: </strong>To evaluate feasibility, safety, and workflow efficiency of EV-ICD implantation under cardiologist-directed sedation without anaesthesiology support.</p><p><strong>Methods and results: </strong>Prospective observational study including 115 consecutive patients undergoing EV-ICD implantation across two European centres. Three procedural settings were explored sequentially: general anaesthesia (GA, n = 46), analgosedation without anaesthesiology supervision (AS, n = 28) and regional block with limited sedation (RBS, n = 41). The primary endpoint was successful implantation without conversion to respiratory or circulatory support. Secondary endpoints included procedure duration, procedure-related complications, and device performance at follow-up. Overall implantation success was 97% (112/115) in a predominantly young population (50 ± 17 years; 70% male). All procedures performed without anaesthesiology supervision were completed without conversion to GA or emergency support, with comparable complication rates across groups. RBS was associated with a 27-minute reduction in procedural duration vs. GA (P < 0.001) and earlier mobilization (97% ambulating within 3 h vs. 65% after 6 h with GA; P < 0.001). Over a median follow-up of 20 [10-30] months, appropriate ICD therapy was delivered in 13% of patients with 100% arrhythmia termination. Inappropriate therapy occurred in 8.9%, predominantly during the early learning phase.</p><p><strong>Conclusion: </strong>EV-ICD implantation can be safely and effectively performed under cardiologist-directed sedation without anaesthesiology supervision, achieving a fully electrophysiology-driven workflow. Procedural simplification substantially reduces resource utilization and may facilitate broader adoption of this technology.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond one-size-fits-all: personalized selection of contemporary implantable cardioverter-defibrillator therapies.","authors":"Matteo Ziacchi, Giuseppe Boriani, Mauro Biffi","doi":"10.1093/europace/euag200","DOIUrl":"10.1093/europace/euag200","url":null,"abstract":"<p><p>Since the first human implantation in 1980, implantable cardioverter-defibrillators (ICDs) have transformed the prevention of sudden cardiac death. Today, multiple ICD platforms are available, each with distinct strengths and limitations, making individualized device selection essential to optimize outcomes and minimize complications. The transvenous ICD remains the most established technology, offering reliable defibrillation, antitachycardia pacing (ATP), and pacing support, but is limited by lead-related complications and infection risk. The subcutaneous ICD avoids intravascular leads and is particularly attractive in younger patients and those at high risk of infection, although it lacks ATP and has shorter device longevity. The extravascular ICD is an emerging alternative designed to combine the advantages of both systems by providing ATP and shock therapy without intravascular leads, though implantation is more complex and long-term evidence remains limited. Given these differences, ICD selection should be guided by patient-specific clinical characteristics rather than a one-size-fits-all approach. Key determinants include pacing indication, prior lead failure, infection risk, body mass index, age, and arrhythmic substrate. The proposed clinical pathway offers a practical framework to support tailored ICD selection by integrating these variables into a structured decision-making process. Such an individualized approach may improve patient outcomes, reduce device-related complications, and enhance the appropriate adoption of contemporary ICD technologies.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Differential effects of semaglutide and colchicine on atrial remodeling in rats with reduced ejection fraction after myocardial infarction.","authors":"","doi":"10.1093/europace/euag279","DOIUrl":"10.1093/europace/euag279","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 10","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved patient value after implementing same day discharge for patients undergoing pulmonary vein isolation.","authors":"Stacey R Slingerland, Mileen R D van de Kar, Jasper Vermeer, Gijs J van Steenbergen, Daniela N Schulz, Dennis van Veghel, Lukas Dekker","doi":"10.1093/europace/euag155","DOIUrl":"10.1093/europace/euag155","url":null,"abstract":"<p><strong>Aims: </strong>Pulmonary vein isolation (PVI) is an effective intervention to treat atrial fibrillation, which is increasingly prevalent. Same-day discharge (SDD) is a strategic approach to limit procedure-related costs. This study aimed to compare healthcare utilization, costs, and clinical outcomes before and after implementation of an SDD protocol.</p><p><strong>Methods and results: </strong>This retrospective study included 2987 patients undergoing PVI between 1 January 2016 and 1 April 2021. Baseline characteristics, pre-, peri-, and post-procedure healthcare utilization and clinical outcomes were compared before (cohort A; n = 1379) and after (Cohort B; n = 1608) implementation of the SDD protocol using bivariate and multivariate analyses. show that cohort B vs. cohort A had lower all-cause 90-day mortality (0% vs. 0.3%, P = 0.031), no differences in re-ablation < 1 year (P = 0.286), as well as in complications: bleedings (P = 0.177), tamponade < 30 days (P = 0.157), phrenic nerve injury (P = 0.984), thromboembolic complication < 72 h (P = 0.212), or vascular complications (P = 0.290). In terms of healthcare utilization and costs, cohort B had significantly less peri-procedure hospital admission costs (€721.52 vs. €1011.78, P < 0.001) and less total peri- and post-procedure costs (€840.37 vs. €1152.94, P < 0.001). Adjusted for all baseline characteristics, the post-implementation cohort showed on average €315 lower total costs per patient.</p><p><strong>Conclusion: </strong>The implementation of the SDD protocol was associated with comparable complication rates while significantly reducing both peri- and post-procedure healthcare utilization and costs, thereby enhancing patient value. This indicates a potential margin for further cost reductions and increased efficiency.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 10","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Edoxaban antithrombotic therapy in diabetic patients with atrial fibrillation and stable coronary artery disease: the EPIC-CAD trial.","authors":"Seunghan Lee, Min Soo Cho, Do-Yoon Kang, Jung-Min Ahn, Jung-Bok Lee, Han-Su Park, Soo Yeon An, Seong-Bong Wee, Kyeong-Won Seo, Yong-Seog Oh, Chang Hoon Lee, Eue-Keun Choi, Ji Hyun Lee, Chang Hee Kwon, Gyung-Min Park, Hyung Oh Choi, Kyoung-Ha Park, Kyoung-Min Park, Jongmin Hwang, Ki-Dong Yoo, Young-Rak Cho, Ji Hyun Kim, Ki Won Hwang, Eun Sun Jin, Osung Kwon, Ki-Hun Kim, Seung-Jung Park, Gi-Byoung Nam, Duk-Woo Park","doi":"10.1093/europace/euag247","DOIUrl":"10.1093/europace/euag247","url":null,"abstract":"<p><strong>Aims: </strong>The appropriate antithrombotic regimen for diabetic patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) who are at high atherothrombotic risk remains uncertain. We evaluated whether the effects of different antithrombotic strategies differ according to diabetes status.</p><p><strong>Methods and results: </strong>The EPIC-CAD (Edoxaban versus Edoxaban with Antiplatelet Agent in Patients with Atrial Fibrillation and Chronic Stable Coronary Artery Disease) was a randomized trial comparing edoxaban monotherapy with dual antithrombotic therapy (edoxaban plus a single antiplatelet agent) in patients with AF and stable CAD. The primary outcome was a composite of death from any cause, myocardial infarction, stroke, systemic embolism, unplanned urgent revascularization, and major or clinically relevant non-major bleeding at 12 months. Among 1040 randomized patients, 421 (40.5%) had diabetes. There were no differences in the incidence of the primary outcome between diabetic and non-diabetic patients [9.7% vs. 11.6%; hazard ratio (HR) 0.82; 95% confidence interval (CI) 0.56-1.20; P = 0.30]. The incidence of the primary outcome at 12 months was significantly lower with edoxaban monotherapy than with dual antithrombotic therapy in both diabetic (6.3% vs. 13.7%; HR 0.44; 95% CI 0.23-0.83; P = 0.01) and non-diabetic patients (6.7% vs. 16.3%; HR 0.39; 95% CI 0.23-0.65; P < 0.001), with no significant interaction between diabetic status and randomized treatment strategy (P for interaction = 0.78).</p><p><strong>Conclusion: </strong>The risk of primary outcome was similar between diabetic and non-diabetic patients with AF and CAD. Irrespective of diabetes status, edoxaban monotherapy led to a lower risk of a primary outcome at 12 months than dual antithrombotic therapy.</p><p><strong>Clinical trial registration: </strong>EPIC-CAD ClinicalTrials.gov number: NCT03718559.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LifeRhythms: The continuous commitment of the European Heart Rhythm Association in the field of arrhythmias and electrophysiology.","authors":"Giuseppe Boriani, Helmut Puererfellner, Haran Burri, Davide A Mei","doi":"10.1093/europace/euag285","DOIUrl":"10.1093/europace/euag285","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sphingomyelin as a key negative mediator in atrial fibrillation via lipid profiling analysis and functional identification.","authors":"Linlin Wang, Anqi Shi, Daixin Yu, Zhengmeng Jiang, Qianqian Chen, Xiaoxuan Yu, Cheng Qu, An Pan","doi":"10.1093/europace/euag270","DOIUrl":"10.1093/europace/euag270","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation (AF) has emerged as one of the most prevalent cardiac arrhythmias globally, with its incidence continuously rising, thereby elevating it to a major public health concern. The heart is known for its high lipid content, and disorders or abnormalities in lipid metabolism are frequently associated with cardiovascular diseases. This study aimed to investigate the regulatory roles of lipids in AF.</p><p><strong>Methods and results: </strong>Using tree-based ensemble learning-assisted lipidomics, sphingomyelin was identified as a key differential metabolite and found to be significantly reduced in AF patients. Exogenous supplementation of sphingomyelin significantly attenuated acetylcholine-CaCl2-induced and angiotensin II-induced AF, fibrosis, and inflammation in mice. Furthermore, decreased sphingomyelin levels were attributed to increased activity of sphingomyelin phosphodiesterases (SMPDs) under AF conditions. Mechanistically, RNA-Seq analysis demonstrated that sphingomyelin inhibits AF-induced activation of the Rap1 signalling pathway, a finding corroborated by overexpression and knockdown of RAP1 in vivo.</p><p><strong>Conclusion: </strong>Together, these findings highlight the therapeutic potential of sphingomyelin and SMPD inhibitors in mitigating AF through inhibition of the Rap1 signalling pathway, thereby establishing the targeting of sphingomyelin metabolism as a viable and novel treatment strategy for AF.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive assessment of left atrial activation using lead V8 during Bachmann bundle pacing.","authors":"Simon Mulier, Arno Fennema, Johan van Koll, Masih Mafi-Rad, Vidal Essebag, Atul Verma, Dominik Linz, Justin Luermans, Kevin Vernooy, Jacqueline Joza","doi":"10.1093/europace/euag276","DOIUrl":"10.1093/europace/euag276","url":null,"abstract":"<p><strong>Aims: </strong>Bachmann bundle pacing (BBP) improves atrial synchrony by advancing LA activation, but quantifying inter-atrial synchronization remains challenging. This study evaluated whether lead V8 reflects posterolateral LA activation time and whether lead V8 can be used to assess the effect of BBP on LA activation.</p><p><strong>Methods and results: </strong>Consecutive patients undergoing an electrophysiology study and ablation (Cohort 1) or BBP lead implantation (Cohort 2) were prospectively enrolled. Surface ECGs were recorded with the V5 electrode repositioned to the V8 location (2 cm below the inferior left scapula). LA activation was determined using the steepest negative downslope of the P-wave (NDAT-P-V8). Iso-V8 was defined as the time from P-wave onset to first positive deflection in lead V8. In Cohort 1, a coronary sinus (CS) catheter invasively determined activation timing at the posterolateral LA (mitral isthmus region). In Cohort 2, NDAT-P-V8 and iso-V8 were used to assess the effect of BBP on LA activation. In Cohort 1 (n = 50), NDAT-P-V8 strongly correlated with the latest CS activation (r = 0.94, P < 0.001). In Cohort 2 (n = 50), lead V8 facilitated intra-procedural assessment of LA activation. IAB was corrected in 20/23 (87%), accompanied by shortening of NDAT-P-V8 (from 120 ± 25 ms to 82 ± 17 ms, P < 0.001) and iso-V8 (from 51 ± 22 ms to 18 ± 17 ms, P < 0.001), consistent with earlier LA activation.</p><p><strong>Conclusion: </strong>NDAT-P-V8 closely reflects the invasively determined timing of the posterolateral LA activation and provides a simple non-invasive marker to assess the effect of BBP on LA activation. Lead V8 may therefore help to assess and optimize atrial activation with BBP.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149059456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}