Europace最新文献

{"title":"First-in-human trial of atrial fibrillation ablation using real-time tissue optical assessment to predict pulsed field lesion durability.","authors":"Raphael P Martins, Giorgi Papiashvili, Askar Sabirov, Sherzod Sabirov, David Herranz, Christophe Bailleul, Atul Verma","doi":"10.1093/europace/euaf009","DOIUrl":"10.1093/europace/euaf009","url":null,"abstract":"<p><strong>Aims: </strong>Loss of bipolar electrograms immediately after pulsed field ablation (PFA) makes lesion durability assessment challenging.</p><p><strong>Objective: </strong>The aim of this trial (NCT06700226) was to evaluate a novel ablation system that can optically predict lesion durability by detecting structural changes in the tissue during ablation.</p><p><strong>Methods and results: </strong>Patients with paroxysmal atrial fibrillation underwent pulmonary vein isolation (PVI) using PFA (AblaView®, MedLumics). Using polarization-sensitive optical coherence reflectometry (PS-OCR), reflective characteristics of myocardial tissue and visualization of real-time contrast between healthy tissue and ablated tissue using a drop in tissue birefringence (BiR) was assessed. Wide antral PVI was performed using single point irrigated PFA (unipolar, 1800V, 3 trains, 21 s). Remapping was performed at 3 months. Primary efficacy outcome was the ability of PS-OCR to predict lesion durability at 3-month remapping. Serious adverse events were recorded. Ten patients were included. In total, 38/40 PVs could be isolated with the system. The mean drop of BiR was 17.3 ± 11.5%. Dragging across the ablation lines showed a persistent drop in BiR. During the remap procedures (8/10 patients ablated only with PFA), 12 PVs (37.5%) were found to be electrically reconnected. The mean loss of BiR during all PFA for durable lesions was 20.9%, while only 10.1% BiR loss was observed during the index ablation for reconnected areas (P < 0.001). None of the points with ≥17% loss of birefringence was found to be reconnected.</p><p><strong>Conclusion: </strong>This first-in-human study supports the use of real-time drop in tissue BiR for lesion assessment and durability during PFA delivery, and its procedural safety.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002531","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":"Improving atrial fibrillation or flutter detection and management by smartphone-based photoplethysmography rhythm monitoring following cardiac surgery: a pragmatic randomized trial.","authors":"Henri Gruwez, Nicolas De Melio, Paulien Vermunicht, Leen Van Langenhoven, Lien Desteghe, Marie Lamberigts, Dieter Nuyens, Hugo Van Herendael, Inez Rodrigus, Christiaan Van Kerrebroeck, Pieter Vandervoort, Hein Heidbuchel, Laurent Pison, Filip Rega, Peter Haemers","doi":"10.1093/europace/euaf015","DOIUrl":"10.1093/europace/euaf015","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation (AF) and atrial flutter (AFL) after cardiac surgery are common and associated with adverse outcomes. The increased risk related to AF or AFL may extend beyond discharge. This study aims to determine whether photoplethysmography (PPG)-based smartphone monitoring to detect AF or AFL after hospital discharge following cardiac surgery improves AF management.</p><p><strong>Methods and results: </strong>The intervention group performed 1 min rhythm checks three times daily using a smartphone-based PPG application during 6 weeks after hospitalization for cardiac surgery. The primary outcome involved AF management interventions by independent physicians, including initiation of oral anticoagulation (OAC), direct cardioversion, and up-titration or initiation of antiarrhythmic drugs. The study included 450 patients [mean (SD) age, 64.1 (9.2) years; 96 women (21.3%); 130 patients with AF history (28.9%); median (IQR) CHA2DS2-VASc score, 2 (1-3)], of whom 238 were randomized to PPG-based monitoring and 212 to usual care. AF/AFL was detected with PPG or electrocardiography in 44 patients (18.5%) in the monitoring group and 4 patients (1.9%) in the usual care group (OR 11.8; 95% CI, 4.2-33.3; P < 0.001); these were new detections in, respectively, 22 patients (9.2%) and 1 patient (0.5%) (OR 21.3; 95% CI, 2.9-166.7; P = 0.003). AF management interventions occurred in 24 patients (10.1%) in the monitoring group compared to 5 patients (2.4%) in the usual care group [odds ratio (OR), 5.1; 95% CI, 1.8-14.4; P = 0.002].</p><p><strong>Conclusion: </strong>In unselected patients discharged home following cardiac surgery, PPG-based smartphone monitoring revealed significantly more AF/AFL which led to significantly more optimization of AF management.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002547","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":"Left atrial intramyocardial fat at pulmonary vein reconnection sites during atrial fibrillation redo ablation.","authors":"Federico Landra, Andrea Saglietto, Giulio Falasconi, Diego Penela, David Soto-Iglesias, Emanuele Curti, Bruno Tonello, Lucio Teresi, Dario Turturiello, Paula Franco-Ocaña, Carlo Gigante, Chiara Valeriano, Claudio Capobianco, Pietro Francia, José Alderete, Daniel Viveros, Aldo Francisco Bellido, Fatima Zaraket, Julio Martí-Almor, Matteo Cameli, Antonio Berruezo","doi":"10.1093/europace/euaf038","DOIUrl":"10.1093/europace/euaf038","url":null,"abstract":"<p><strong>Aims: </strong>Electrical reconnections between pulmonary veins (PVs) and the left atrium (LA) are frequently responsible for atrial fibrillation (AF) recurrences after pulmonary vein isolation (PVI). Multidetector computed tomography (MDCT)-derived images can be post-processed to detect intramyocardial fat (inFAT) by signal radiodensity thresholding. The role of inFAT on PV-LA reconnections remains unknown. The aim of this study was to analyse the relationship between inFAT localization at pre-procedural MDCT-derived inFAT maps from first AF ablation and PV-LA reconnections in patients with AF recurrence undergoing redo ablation.</p><p><strong>Methods and results: </strong>We included 45 consecutive patients who underwent AF redo ablation presenting at least one PV-LA reconnection. First AF ablation pre-procedural MDCT-derived data were post-processed with ADAS 3D™ to create 3D LA inFAT maps, which were loaded into CARTO3 navigation system and merged with the electroanatomical map for reconnection site analysis. In 103 out of 156 (66.0%), PV-LA reconnection points inFAT was identified in the 6 mm diameter tag point depicted in the navigation system. When dividing the PVI line into standardized segments, those identified as containing PV-LA reconnection points (i.e. reconnection segments) exhibited significantly higher total inFAT volumes compared with non-reconnection segments (8.05 ± 6.56 vs. 5.40 ± 5.18 μL, P < 0.001). Additionally, reconnection segments showed greater volumes of inFAT components, specifically dense inFAT (0.06 ± 0.06 vs. 0.03 ± 0.04 μL, P < 0.001) and fat-myocardial admixture (7.98 ± 6.52 vs. 5.37 ± 5.16 μL, P < 0.001).</p><p><strong>Conclusion: </strong>Intramyocardial fat is co-localized with two-thirds of PV-LA reconnection points in patients undergoing AF redo ablation. Reconnection segments exhibit significantly higher inFAT volumes compared to non-reconnection segments. This proof-of-concept study suggests that inFAT may play a role in PV-LA electrical reconnections following PVI.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457375","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":"Ventricular tachycardia functional substrate targeting: a standalone strategy for all?","authors":"Antonio Berruezo, Giulio Falasconi, Diego Penela","doi":"10.1093/europace/euaf004","DOIUrl":"10.1093/europace/euaf004","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 2","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482508","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":"Repeat Procedures After Pulsed Field Ablation for Atrial Fibrillation: MANIFEST-REDO Study.","authors":"Daniel Scherr, Mohit K Turagam, Philippe Maury, Yuri Blaauw, Pepijn van der Voort, Petr Neuzil, Tobias Reichlin, Andreas Metzner, Johan Vijgen, Josef Kautzner, Serge Boveda, Ante Anic, Jim Hansen, Martin Manninger, Philipp Sommer, Frederic Anselme, Stephan Willems, Thomas Deneke, Roland Tilz, Daniel Steven, Reza Wakili, Pierre Jais, Moritoshi Funasako, Thomas Arentz, Anne Rollin, Bart A Mulder, Alexandre Ouss, Jan Petru, Thomas Kueffer, Marc D Lemoine, Pieter Koopman, Petr Peichl, Raquel Adelino, Zrinka Jurisic, Martin Ruwald, Anna-Sophie Eberl, Christian Sohns, Arnaud Savoure, Karin Nentwich, Melanie Gunawardene, Christian-Hendrik Heeger, Arian Sultan, Jan-Eric Bohnen, Jana Kupusovic, Nicolas Derval, Heiko Lehrmann, Emmanuel Ekanem, Vivek Y Reddy","doi":"10.1093/europace/euaf012","DOIUrl":"10.1093/europace/euaf012","url":null,"abstract":"<p><strong>Background: </strong>Initial clinical studies of pulsed field ablation (PFA) to treat atrial fibrillation (AF) indicated a >90% durability rate of pulmonary vein isolation (PVI). However, these studies were largely conducted in single centers and involved a limited number of operators. The electrophysiological findings and outcomes in patients undergoing repeat ablation after an initial PF ablation for AF are incompletely understood.</p><p><strong>Methods: </strong>In the MANIFEST-REDO study, we investigated patients who underwent repeat ablation due to clinical recurrence - AF or atrial tachycardia (AT) - following first-ever PVI with a pentaspline PFA catheter (Farawave; Boston Scientific Inc).</p><p><strong>Results: </strong>At 22 centers, 427 patients (age 64±11 years; 37% female) were included. Of note, the recurrent arrhythmia leading to the repeat ablation was paroxysmal AF (51%), persistent AF (30%), or AT (19%). At the repeat procedure, the PV reconnection rates were: 30% (LSPV), 28% (LIPV), 33% (RSPV) and 32% (RIPV). In 45% of patients all PVs were durably isolated at the beginning of the repeat procedure, with the previous use of any imaging or mapping modality being univariately associated with durable PVI. After a post-redo follow-up period of 284 [90-366] days, the primary effectiveness endpoint (freedom from documented AF/AT lasting ≥30s after 3-month blanking without class I/III antiarrhythmic drugs or symptoms) was achieved in 65% of patients, with significant differences between groups (PAF 65% vs. PersAF 56% vs. AT 76%; p=0.04). Persistent AF as recurrent arrhythmia after the initial PFA ablation predicted AT/AF recurrence after repeat ablation (HR 1.241 (95% CI 1.534-1.005 CI); p=0.045). The procedural complication rate was 2.8%.</p><p><strong>Conclusion: </strong>In repeat procedures for AF/AT performed after an index procedure with PFA for AF, PV reconnections are not uncommon. Repeat procedures can be performed safely and with an acceptable subsequent success rate.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002609","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":"Socioeconomic position and sudden cardiac death: A Danish nationwide study.","authors":"Toke Stahl Jacobsen, Tobias Skjelbred, Lars Køber, Bo Gregers Winkel, Thomas Hadberg Lynge, Jacob Tfelt-Hansen","doi":"10.1093/europace/euaf001","DOIUrl":"https://doi.org/10.1093/europace/euaf001","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to examine differences in incidence rates of all-cause mortality (ACM) and sudden cardiac death (SCD) in persons of differing socioeconomic position (SEP).</p><p><strong>Methods: </strong>All deaths in Denmark from 01-01-2010 to 31-12-2010 (1 year) were included. Autopsy reports, death certificates, discharge summaries and nationwide health registries were reviewed to identify cases of SCD. SEP was measured as either household income or highest achieved educational level and analysed separately. Hazard rates were calculated using univariate and multivariable Cox regression model adjusting for age, sex, and selected comorbidities.</p><p><strong>Results: </strong>A total of 53452 deaths were included of which 6820 were classified as SCDs. Incidence rates of ACM and SCD increased with age and were higher in the lower SEP groups. The greatest difference in SCD incidence was found between the low and high education level groups with an incidence rate ratio of 5.1 (95% CI 3.8-6.8). The hazard ratios for ACM and SCD were significantly higher for low SEP groups independently of comorbidities. Compared with the highest income group, the low-income group had adjusted hazard ratios of ACM and SCD that were 2.17 (2.01-2.34) and 1.72 (1.67-1.76) respectively.</p><p><strong>Conclusion: </strong>We observed an inverse association between both income and education level and the risk of ACM and SCD in the general population, which persisted independently of baseline comorbidities. Our results indicate a need for further research into the mechanisms behind socioeconomic disparities in healthcare and targeted preventative strategies.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002610","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":"Etiology and hemodynamic patterns of orthostatic hypotension in a tertiary syncope unit.","authors":"Madeleine Johansson, Boriana S Gagaouzova, Ineke A van Rossum, Roland D Thijs, Viktor Hamrefors, J Gert van Dijk, Artur Fedorowski","doi":"10.1093/europace/euaf017","DOIUrl":"https://doi.org/10.1093/europace/euaf017","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic hypotension (OH) is an important differential diagnosis in unexplained syncope. Neurogenic OH (nOH) has been postulated to differ from non-neurogenic OH (non-nOH), yet pathophysiological differences are largely unexplored. We aimed to investigate etiology and tilt table test (TTT)-induced hemodynamic responses in symptomatic OH patients.</p><p><strong>Methods: </strong>We performed a retrospective study analyzing patients referred for unexplained syncope or highly symptomatic orthostatic intolerance with TTT-verified classical OH (cOH). Medical records were analyzed for the presumptive etiology of cOH. Fifty-two patients (mean age 73±9 years, 46% women) with good quality TTT recordings were divided into three groups on clinical grounds: nOH, non-nOH, and mixed OH. The log-ratio (LR) method was applied to compare the decrease in mean arterial pressure (MAPLR) and corresponding contributions of heart rate (HRLR), stroke volume (SVLR) and total peripheral resistance (TPRLR) during the upright phase of TTT.</p><p><strong>Results: </strong>The prevalence of cOH was 12 (23%) nOH, 14 (27%) non-nOH and 26 (50%) mixed OH. No difference in MAPLR was observed among the three groups during the 4th upright minute of TTT (nOH: -0.10±0.04 vs. non-nOH: -0.07±0.05 and vs. mixed OH: -0.06±0.05, p=0.10). The contributions of HRLR, SVLR and TPRLR to the drop in MAPLR did not differ between groups (all p>0.05).</p><p><strong>Conclusions: </strong>One-half of highly symptomatic OH patients had mixed OH, whereas one-quarter had either pure neurogenic, or non-neurogenic OH, respectively. Different forms of OH were indifferentiable based on hemodynamic responses during TTT, questioning the clinical utility of such classification. Larger studies are needed to confirm these findings.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002514","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":"EP Europace: The Journey Continues, Looking Ahead to 2025 and Beyond Greetings from the New Editor-in-Chief.","authors":"Giuseppe Boriani","doi":"10.1093/europace/euaf006","DOIUrl":"https://doi.org/10.1093/europace/euaf006","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946899","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":"Stereotactic cardiac radiotherapy for refractory ventricular tachycardia in structural heart disease patients: a systematic review.","authors":"Amulya Gupta, Zeeshan Sattar, Nourhan Chaaban, Sagar Ranka, Cameron Carlson, Farhad Sami, Clifford G Robinson, Phillip S Cuculich, Seth H Sheldon, Madhu Reddy, David Akhavan, Amit Noheria","doi":"10.1093/europace/euae305","DOIUrl":"10.1093/europace/euae305","url":null,"abstract":"<p><strong>Aims: </strong>Among patients with structural heart disease with ventricular tachycardia (VT) refractory to medical therapy and catheter ablation, cardiac stereotactic body radiotherapy (SBRT) is a paradigm-changing treatment option. This study aims to assess the efficacy of cardiac SBRT in refractory VT by comparing the rates of VT episodes, anti-tachycardia pacing (ATP) therapies, and implantable cardioverter-defibrillator (ICD) shocks post-SBRT with pre-SBRT.</p><p><strong>Methods and results: </strong>We performed a comprehensive literature search and included all clinical studies reporting outcomes on cardiac SBRT for VT. Treatment efficacy was evaluated as random-effects pooled rate-ratios of VT episodes, ATP therapies and ICD shocks post-SBRT (after 6-week blanking) and pre-SBRT, with patients serving as their own controls. Post-SBRT overall survival was assessed using Kaplan-Meier method. We included 23 studies published 2017-24 reporting on 225 patients who received cardiac SBRT, with median follow-up 5.8-28 months. There was significant heterogeneity among the studies for all three efficacy endpoints (P < 0.00001). The random-effects pooled rate-ratios of VT episodes, ATP therapies and ICD shocks post- vs. pre-SBRT were 0.10 (95% CI 0.06, 0.16), 0.09 (0.05, 0.15), and 0.09 (0.05, 0.17), respectively (all P < 0.00001). The most common reported complications included pericardial (8.0%, including 0.9% late oesophagogastro-pericardial fistula) and pulmonary (5.8%). There was no change in left ventricular ejection fraction post-SBRT (P = 0.3) but some studies reported an increase in mitral regurgitation. The combined 3-, 12-, and 24-month overall patient survival was 0.86 (0.80, 0.90), 0.72 (0.65, 0.78), and 0.57 (0.47, 0.67), respectively.</p><p><strong>Conclusion: </strong>Among patients with refractory VT in context of structural heart disease, VT burden and ICD shocks are dramatically reduced following cardiac SBRT. The overall mortality in this population with heart failure and refractory VT receiving palliative cardiac SBRT remains high.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881717","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":"Use of single-chamber atrial pacemakers post-DANPACE: an analysis using national data.","authors":"Paul A Scott, Ian J Wright, Daniel I Bromage, Chris Plummer, Mark de Belder, Mark Dayer, Francis D Murgatroyd","doi":"10.1093/europace/euae290","DOIUrl":"10.1093/europace/euae290","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 1","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051990","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}