Heart rhythm最新文献

{"title":"Variations in workflow affecting cost of pulsed field ablation for atrial fibrillation","authors":"Auroa Badin MD, FHRS, Sreedhar R. Billakanty MD, FHRS, David M. Nemer MD, FHRS, Ankur N. Shah MD, FHRS, Jaret D. Tyler MD, FHRS, Eugene Y. Fu MD, FHRS, Nagesh Chopra MD, FHRS, Anish K. Amin MD, FHRS","doi":"10.1016/j.hrthm.2024.09.015","DOIUrl":"10.1016/j.hrthm.2024.09.015","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages 1622-1623"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence age prediction using electrocardiogram data: Exploring biological age differences","authors":"Shaun Evans MD ,&nbsp;Sarah A. Howson MD ,&nbsp;Andrew E.C. Booth MD ,&nbsp;Elnaz Shahmohamadi MD, MPH ,&nbsp;Matthew Lim MBBS ,&nbsp;Stephen Bacchi MBBS, PhD ,&nbsp;Ross L. Roberts-Thomson MBBS, PhD ,&nbsp;Melissa E. Middeldorp PhD ,&nbsp;Mehrdad Emami MD, PhD ,&nbsp;Peter J. Psaltis MBBS, PhD ,&nbsp;Prashanthan Sanders MBBS, PhD, FHRS","doi":"10.1016/j.hrthm.2024.09.046","DOIUrl":"10.1016/j.hrthm.2024.09.046","url":null,"abstract":"<div><h3>Background</h3><div>Biological age can be predicted using artificial intelligence (AI) trained on electrocardiograms (ECGs), which is prognostic for mortality and cardiovascular events.</div></div><div><h3>Objective</h3><div>We developed an AI model to predict age from an ECG and compared baseline characteristics to identify determinants of advanced biological age.</div></div><div><h3>Methods</h3><div>An AI model was trained on ECGs from cardiology inpatients aged 20–90 years. AI analysis used a convolutional neural network with data divided in an 80:20 ratio (development/internal validation), with external validation undertaken using data from the UK Biobank. Performance and subgroup comparison measures included correlation, difference, and mean absolute difference.</div></div><div><h3>Results</h3><div>A total of 63,246 patients with 353,704 total ECGs were included. In internal validation, the correlation coefficient was 0.72, with a mean absolute difference between chronological age and AI-predicted age of 9.1 years. The same model performed similarly in external validation. In patients aged 20–29 years, AI-ECG–predicted biological age was greater than chronological age by a mean of 14.3 ± 0.2 years. In patients aged 80–89 years, biological age was lower by a mean of 10.5 ± 0.1 years. Women were biologically younger than men by a mean of 10.7 months (<em>P</em> = .023), and patients with a single ECG were biologically 1.0 years younger than those with multiple ECGs (<em>P</em> &lt; .0001).</div></div><div><h3>Conclusion</h3><div>There are significant between-group differences in AI-ECG–predicted biological age for patient subgroups. Biological age was greater than chronological age in young hospitalized patients and lower than chronological age in older hospitalized patients. Women and patients with a single ECG recorded were biologically younger than men and patients with multiple recorded ECGs.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages 1492-1497"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of chronic kidney disease and kidney failure with replacement therapy with procedural and long-term outcomes after first-generation Watchman device: Insights from the NCDR LAAO Registry","authors":"Muhammad Bilal Munir MD ,&nbsp;Zhen Tan MS ,&nbsp;Patrick H. Pun MD ,&nbsp;Yongfei Wang MS ,&nbsp;Anwar Tandar MD ,&nbsp;Douglas Darden MD ,&nbsp;Jonathan C. Hsu MD ,&nbsp;Daniel J. Friedman MD ,&nbsp;Jeptha Curtis MD ,&nbsp;James V. Freeman MD, MPH, MS","doi":"10.1016/j.hrthm.2024.10.071","DOIUrl":"10.1016/j.hrthm.2024.10.071","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease (CKD) and kidney failure with replacement therapy (KFRT) are prevalent in patients with atrial fibrillation (AF).</div></div><div><h3>Objective</h3><div>The purpose of this study was to analyze procedural and long-term outcomes in AF patients with underlying CKD and KFRT after left atrial appendage occlusion (LAAO) device implantation.</div></div><div><h3>Methods</h3><div>Data were extracted from the National Cardiovascular Data Registry LAAO Registry from January 2017 to December 2019 and linked to Centers for Medicare &amp; Medicaid Services billing claims. Patients were stratified into 3 groups: no CKD, CKD, and KFRT. Multivariate analyses were used to assess the associations of CKD and KFRT with procedural and long-term outcomes, respectively.</div></div><div><h3>Results</h3><div>A total of 59,190 patients were enrolled in our study. CKD and KFRT were found to be independently associated with any complication from the procedure (odds ratio [OR] 1.149, 95% confidence interval [CI] 1.058–1.;247 and OR 2.163, 95% CI 1.763–2.652) and in-hospital death (OR 1.603, 95% CI 1.054–2.437; and OR 5.488, 95% CI 2.686–11.213). At 1 year, CKD and KFRT were associated with a higher risk of any major adverse event (hazard ratio [HR] 1.402, 95% CI 1.333–1.474; and HR 2.506, 95% CI 2.236–2.809) and death (HR 1.662, 95% CI 1.553–1.779; and HR 3.422, 95% CI 2.989–3.919), but no difference in the competing risk of stroke (HR 0.972, 95% CI 0.819–1.152; and HR 0.794, 95% CI 0.434–1.451).</div></div><div><h3>Conclusion</h3><div>CKD and KFRT were associated with higher rates of procedural complications and 1-year adverse events and death, but no difference in the 1-year rate of stroke.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages 1443-1451"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramyocardial fibrofatty deposits in ischemic sudden cardiac death","authors":"Henrik Appel MD ,&nbsp;Lasse Pakanen MD, PhD ,&nbsp;Anne Ahtikoski MD, PhD ,&nbsp;Lauri Holmström MD, PhD ,&nbsp;Risto Kerkelä MD, PhD ,&nbsp;Heikki Huikuri MD, PhD ,&nbsp;Cristina Basso MD ,&nbsp;Robert J. Myeburg MD ,&nbsp;Riitta Kaarteenaho MD, PhD ,&nbsp;M. Juhani Junttila MD, PhD","doi":"10.1016/j.hrthm.2024.11.004","DOIUrl":"10.1016/j.hrthm.2024.11.004","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages 1462-1463"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HRS/ACC scientific statement: Guiding principles on same-day discharge for intracardiac catheter ablation procedures","authors":"Amit J. Shanker MD, FACC, FHRS (Co-Chair) ,&nbsp;Samuel O. Jones MD, MPH, FACC, FHRS (Co-Chair) ,&nbsp;James C. Blankenship MD, MACC, MHCM, MSCAI ,&nbsp;Jim W. Cheung MD, FACC, FHRS ,&nbsp;Ijeoma A. Ekeruo MD, FACC, FHRS ,&nbsp;Jodie L. Hurwitz MD, FACC, FHRS ,&nbsp;Christopher F. Liu MD, FACC, FHRS ,&nbsp;Faisal M. Merchant MD, FACC, FHRS ,&nbsp;Wilber W. Su MD, FACC, FHRS ,&nbsp;Paul D. Varosy MD, FACC, FHRS","doi":"10.1016/j.hrthm.2025.02.029","DOIUrl":"10.1016/j.hrthm.2025.02.029","url":null,"abstract":"<div><div>Percutaneous catheter ablation in interventional cardiac electrophysiology has evolved over the past several decades. Technologic advances and evolving procedural strategies have improved procedural efficiencies, increased success rates, and lowered complication rates. These advances have increased the ability to treat more patients successfully; however, limitations to access have grown. Access challenges (exacerbated during the COVID-19 public health emergency) and economic pressures have driven a shift in practice trends to reduce hospitalization duration and optimize resource utilization. A same-day discharge (SDD) strategy has increasingly been used to address these challenges. Incorporating a SDD strategy has recently been supported by global clinical studies (demonstrating proof of concept) and real-world evidence/United States Centers for Medicare &amp; Medicaid Services claims data (characterizing a low incidence of complications and need for readmission/emergency department visits). This document analyzes available global clinical data and real-world evidence examining the impact of a cardiac ablation SDD strategy on patient safety, patient access, operational efficiencies, and health care expenditures. Recommended best practices will also be characterized built on the foundation of a shared decision-making strategy that optimizes patient safety, comfort, and procedural outcomes. As clinical flow paradigms evolve with alternate sites of care (ie, ambulatory surgery centers), real-world registries to track outcomes should inform future decision-making.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages e1-e12"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top stories in cardiac arrest","authors":"Anna G. Rosenblatt MD,&nbsp;Mark S. Link MD, FHRS","doi":"10.1016/j.hrthm.2025.03.1951","DOIUrl":"10.1016/j.hrthm.2025.03.1951","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages 1624-1625"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactions of contact force, impedance, and power during repeated atrial arrhythmia ablation after previous atrial fibrillation ablation","authors":"Fares-Alexander Alken MD ,&nbsp;Katharina Scherschel PhD ,&nbsp;Ernan Zhu MD ,&nbsp;Bahram Wafaisade MD ,&nbsp;Ann-Kathrin Kahle MD ,&nbsp;Christian Meyer MD, MA, FESC, FEHRA, FHRS","doi":"10.1016/j.hrthm.2024.09.026","DOIUrl":"10.1016/j.hrthm.2024.09.026","url":null,"abstract":"<div><h3>Background</h3><div>Acutely effective repeated radiofrequency catheter ablation (RFCA) after previous atrial fibrillation ablation depends on several parameters including local impedance (LI), contact force (CF), and power.</div></div><div><h3>Objective</h3><div>We aimed to investigate the relationship of LI, CF, and power to the LI drop in a repeated atrial RFCA environment.</div></div><div><h3>Methods</h3><div>Consecutive patients undergoing repeated atrial RFCA were studied. High-quality local electrograms were analyzed for morphology changes indicating effective RFCA and associated LI dynamics. The influence of baseline LI, mean CF, and power on the LI drop was analyzed. Investigated power levels included ≤25 W, 30 W, and ≥40 W.</div></div><div><h3>Results</h3><div>A total of 1390 RFCA points from 48 patients (48% female; median age, 70 years) were analyzed. Of 309 analyzed electrograms, 40.5% showed effective RFCA morphology changes with an elevated median LI drop (effective, 19.7 Ω; partially effective, 14.1 Ω; <em>P</em> &lt; .001). CF showed the highest correlation to the LI drop within high baseline LI and when applying ≥40 W (low baseline LI, <em>R</em> = 0.39; intermediate, <em>R</em> = 0.66; high, <em>R</em> = 0.72). Within low baseline LI regions, CF levels showed a lower correlation to the LI drop (≤25 W, <em>R</em> = 0.30; 30 W, <em>R</em> = 0.35; ≥40 W, <em>R</em> = 0.39). A mean CF ≥10 g resulted in elevated LI drops with higher power compared with lower power within all baseline LI tertiles (<em>P</em> &lt; .001 each).</div></div><div><h3>Conclusion</h3><div>Within high baseline LI regions, CF plays a greater role for the maximum LI drop when higher power is chosen. A mean CF ≥10 g ensures elevated LI drops with increasing power levels.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages 1411-1420"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in epicardial adipose tissue volume before and after cryoballoon ablation in patients with atrial fibrillation: Supporting the “AF begets EAT” theory","authors":"Kazuki Shimojo MD,&nbsp;Itsuro Morishima MD, PhD,&nbsp;Yasuhiro Morita MD,&nbsp;Yasunori Kanzaki MD,&nbsp;Naoki Watanabe MD, PhD,&nbsp;Naoki Yoshioka MD, PhD,&nbsp;Naoki Shibata MD, PhD,&nbsp;Yoshihito Arao MD, PhD,&nbsp;Takuma Ohi MD,&nbsp;Hiroki Goto MD,&nbsp;Hoshito Karasawa MD,&nbsp;Yuta Nakagawa MD,&nbsp;Yuki Kawasaki MD,&nbsp;Tatsuki Yoshie MD","doi":"10.1016/j.hrthm.2024.09.054","DOIUrl":"10.1016/j.hrthm.2024.09.054","url":null,"abstract":"<div><h3>Background</h3><div>Epicardial adipose tissue (EAT) is closely associated with atrial fibrillation (AF), suggesting that it may be one of the causes of AF progression. However, it is unclear whether AF affects EAT.</div></div><div><h3>Objective</h3><div>This study aimed to demonstrate that sinus rhythm restoration reduces EAT volume (EATV) through left atrial reverse remodeling (LARR).</div></div><div><h3>Methods</h3><div>We analyzed data from 247 patients who underwent cryoballoon ablation for AF. EATV was assessed by contrast-enhanced computed tomography with a 3-dimensional analysis workstation, evaluating EATV surrounding the entire heart (Total-EATV) and left atrium (LA-EATV) at baseline and 6 months after cryoballoon ablation.</div></div><div><h3>Results</h3><div>At 6 months, all patients but one with persistent AF were in sinus rhythm. Total-EATV and LA-EATV were both significantly decreased in patients with persistent AF (n = 33; Total-EATV: 148.8 ± 53.3 mL to 142.9 ± 53.5 mL [<em>P</em> = .01]; LA-EATV: 26.8 ± 11.3 mL to 25.2 ± 10.7 mL [<em>P</em> = .01]). No changes were observed in patients with paroxysmal AF (n = 214). Persistent AF was more strongly associated with LARR than paroxysmal AF (odds ratio, 2.34; 95% confidence interval, 1.01–5.44; <em>P</em> = .05). LARR showed an independent correlation with both Total-EATV and LA-EATV reduction (odds ratio, 1.78 [<em>P</em> = .04] and 2.80 [<em>P</em> &lt; .001], respectively).</div></div><div><h3>Conclusion</h3><div>These findings suggest a novel “AF begets EAT” theory, complementing the previously accepted role of EAT as a cause of AF and supporting the “AF begets AF” mechanism.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages 1421-1428"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The expanding genetic, mechanistic, and phenotype scope of CACNA1C-mediated disease","authors":"Andrew P. Landstrom MD, PhD, FHRS ,&nbsp;Susan P. Etheridge MD, FHRS, CEPS-P","doi":"10.1016/j.hrthm.2025.03.1991","DOIUrl":"10.1016/j.hrthm.2025.03.1991","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages 1626-1627"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesion delivery and scar formation in catheter ablation for atrial fibrillation: The DECAAF II trial","authors":"Nazem Akoum MD ,&nbsp;Mario Mekhael MD ,&nbsp;Felipe Bisbal MD ,&nbsp;Oussama Wazni MD ,&nbsp;Christopher McGann MD ,&nbsp;Hyejung Lee MS ,&nbsp;Tyler Bardsley MS ,&nbsp;Tom Greene PhD ,&nbsp;J. Michael Dean MD ,&nbsp;Lilas Dagher MD ,&nbsp;Eugene Kholmovski PhD ,&nbsp;Moussa Mansour MD ,&nbsp;Francis Marchlinski MD ,&nbsp;David Wilber MD ,&nbsp;Gerhard Hindricks MD ,&nbsp;Christian Mahnkopf MD ,&nbsp;Darryl Wells MD ,&nbsp;Pierre Jaïs MD ,&nbsp;Prashanthan Sanders MD ,&nbsp;Johannes Brachmann MD ,&nbsp;Nassir Marrouche MD","doi":"10.1016/j.hrthm.2024.08.062","DOIUrl":"10.1016/j.hrthm.2024.08.062","url":null,"abstract":"<div><h3>Background</h3><div>The Efficacy of Delayed Enhancement MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation of Atrial Fibrillation randomized trial showed no difference in atrial fibrillation (AF) recurrence with additional delayed enhancement magnetic resonance imaging (DE-MRI) fibrosis-targeted ablation to pulmonary vein isolation (PVI) in persistent AF.</div></div><div><h3>Objective</h3><div>We evaluated the effect of lesion delivery on ablation-induced scarring and AF recurrence.</div></div><div><h3>Methods</h3><div>Lesions delivered, targeting fibrotic and nonfibrotic areas identified from preablation DE-MRI, were studied in relation to ablation-induced scarring on 3-month DE-MRI, including their association with arrhythmia recurrence.</div></div><div><h3>Results</h3><div>A total of 593 patients treated with radiofrequency were analyzed: 293 (49.4%) underwent PVI and 300 (50.6%) underwent additional fibrosis-guided ablation. Lesion analysis showed that 80.9% in the MRI fibrosis-guided group vs 16.5% in the PVI group (<em>P</em> &lt; .001) had ≥40% of baseline fibrosis targeted. MRI assessment of ablation-induced scar showed that 44.8% of fibrosis-guided ablation and 15.5% of PVI had ≥40% of their fibrosis covered by scar (<em>P</em> &lt; .001), demonstrating significant attenuation from lesions delivered to scar formed. In the overall population, fibrosis coverage with scar was not associated with recurrence (hazard ratio [HR] 0.90; 95% confidence interval [CI] 0.80–1.01; <em>P</em> = .08 per 20% increase). In patients with baseline fibrosis &lt; 20%, fibrosis coverage with scar was associated with lower recurrence than PVI (HR 0.85; 95% CI 0.73–0.97; <em>P</em> = .03), whereas the association was not significant when baseline fibrosis ≥ 20% (HR 0.97; 95% CI 0.80–1.17; <em>P</em> = .77). Significant center variation was observed in fibrosis targeting and coverage with scarring.</div></div><div><h3>Conclusion</h3><div>Radiofrequency ablation lesions do not uniformly result in scar formation. A post hoc analysis suggests reduced arrhythmia recurrence when ablation-induced scarring covers fibrotic regions in patients with low baseline fibrosis.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 6","pages":"Pages 1384-1393"},"PeriodicalIF":5.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}