Heart, Lung and Circulation最新文献

{"title":"Transthyretin Cardiac Amyloidosis in Australia and New Zealand–A Multi-Site Snapshot for 2022","authors":"Paul Geenty MBBS ,&nbsp;Nicholas Davidson MBBS ,&nbsp;Natasha Gorrie MBBS ,&nbsp;Nicole Bart DPhil ,&nbsp;Jay Baumwol MBBS ,&nbsp;Timothy Sutton MBChB ,&nbsp;Fiona Kwok MBBS ,&nbsp;James L. Hare PhD ,&nbsp;Kah Yong Peck MBBS ,&nbsp;Dariusz Korczyk MD ,&nbsp;Simon D.J. Gibbs MBBS ,&nbsp;Liza Thomas PhD ,&nbsp;Cardiac Subcommittee of the Australian Amyloidosis Network","doi":"10.1016/j.hlc.2024.05.014","DOIUrl":"10.1016/j.hlc.2024.05.014","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the burden of transthyretin cardiac amyloidosis (ATTR-CA) through a cross- sectional ‘snapshot’ of Australian Amyloidosis Network (AAN) and New Zealand (NZ) specialist amyloidosis clinics.</div></div><div><h3>Design, Setting &amp; Participants</h3><div>A prospective survey was performed of seven AAN/ specialist amyloidosis clinics across Australia and NZ. All centres were invited to contribute data; participating centres provided clinical and demographic data for patients with ATTR-CA reviewed in the 2022 calendar year. Patients with new or previously confirmed ATTR-CA reviewed in the 2022 calendar year were included. Diagnosis was established through a positive cardiac scintigraphy scan in the absence of a monoclonal gammopathy or through a cardiac biopsy staining positive with transthyretin (TTR).</div></div><div><h3>Results</h3><div>A total of 515 patients were reviewed across seven sites. A total of 302/515 (59%) were wild type TTR (ATTRwt), 63/515 (12%) were variant ATTR (ATTRv) and the remaining 150 (29%) had not undergone genetic testing at the time of data collection. A total of 455/515 (88%) patients were male. Compared to ATTRwt, patients with ATTRv had smaller left ventricular (LV) wall thickness (IVSd 14±3 mm vs 16±3mm, p&lt;0.001), and better LV systolic function (LVGLS -15.4±5% vs -11.7±3%, p&lt;0.001). Most patients, 387/515 (75%) were on at least one ATTR specific treatment, including EGCG (157), diflunisal (139), doxycycline (68) and tafamidis (78), acoramidis (33) and gene silencer therapies or monoclonal antibodies (23).</div></div><div><h3>Conclusion</h3><div>A significant number of patients with ATTR-CA are seen in specialist amyloidosis clinics across Australia and NZ. Most patients received specific amyloidosis therapy, thorough enrollment in clinical trials. With increased recognition of amyloidosis and newer therapies becoming available, the volume of patients seen in these clinics is likely to increase.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages 48-57"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency and Cryoablation as Energy Sources in the Cox-Maze Procedure: A Meta-Analysis of Rhythm Outcomes","authors":"Massimo Baudo MD,&nbsp;Fabrizio Rosati MD,&nbsp;Michele D’Alonzo MD,&nbsp;Stefano Benussi MD, PhD,&nbsp;Claudio Muneretto MD,&nbsp;Lorenzo Di Bacco MD","doi":"10.1016/j.hlc.2024.10.014","DOIUrl":"10.1016/j.hlc.2024.10.014","url":null,"abstract":"<div><h3>Aim</h3><div>Cox-maze IV is the most effective surgical procedure for atrial fibrillation (AF) treatment to date; however, few studies have compared the outcomes of the different energy sources applied to achieve transmurality. This study aimed to analyse the impact of the different energy sources on Cox-maze IV results in terms of sinus rhythm restoration.</div></div><div><h3>Method</h3><div>A systematic review and meta-analysis was conducted by including studies reporting rhythm outcomes on biatrial Cox-maze AF ablation with bipolar radio-frequency (BRF), cryoenergy (Cryo), or both (BRF+Cryo). The primary endpoints were the early and late rhythm outcomes of AF ablation using the different energy sources. Late AF recurrences were evaluated through timepoint analysis, and freedom from AF from Kaplan-derived data. Sixty articles including 8,293 patients were selected (3,364 patients Cryo, 1,937 BRF, and 2,992 BRF+Cryo).</div></div><div><h3>Results</h3><div>At 6 months, AF incidence was significantly lower in the Cryo group at 6.73%; it was 25.52% in the BRF and 16.79% in the BRF+Cryo groups (p=0.0112). At the 4-year timepoint, AF incidence was lower in the Cryo group compared with the BRF and BRF+Cryo: 6.14% vs 51.59% vs 16.09%, respectively (p=0.0392). Freedom from AF was 76.7%±2.2%, 60.9%±2.2%, and 66.3%±1.6% for Cryo, BRF, and BRF+Cryo at 4 years, respectively (p&lt;0.001). At meta-regression, mean left atrial diameter was positively associated with higher AF recurrences (OR 1.04, 95% CI 1.01–1.08; p=0.0159).</div></div><div><h3>Conclusion</h3><div>When performing this procedure, cryoablation seems to be associated with improved rhythm outcomes when compared with bipolar radiofrequency ablation.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages 25-33"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Workforce Sustainability Sector Consultation: Recommendations From an Australian Stakeholder Summit","authors":"Celine F. Santiago PhD ,&nbsp;Lauren C. Blekkenhorst PhD ,&nbsp;Meng-Ping Hsu PhD ,&nbsp;Katrina M. Mirabito Colafella PhD ,&nbsp;Anna C. Calkin PhD ,&nbsp;Stephen J. Nicholls PhD, FRACP ,&nbsp;Kerry C. Doyle PSM, OAM ,&nbsp;Jamie I. Vandenberg PhD ,&nbsp;Emma E. Thomas MPH, PhD ,&nbsp;Niamh Chapman BSc, PhD ,&nbsp;all Summit participants","doi":"10.1016/j.hlc.2024.10.012","DOIUrl":"10.1016/j.hlc.2024.10.012","url":null,"abstract":"<div><div>In 2023, a joint National Cardiovascular Workforce Sustainability Summit was convened by the Australian Cardiovascular Alliance (ACvA), the Cardiac Society of Australia and New Zealand, and the National Heart Foundation of Australia, to facilitate a national conversation towards developing a workforce sustainability strategy within the cardiovascular research sector. This initiative stemmed from a previous study conducted by the ACvA which revealed that almost 70% of early and mid-career cardiovascular researchers surveyed had contemplated leaving the sector. Summit attendees reported sector-wide challenges to career progression and retention across three key themes: 1) well-being and career satisfaction, 2) learning and development, and 3) resource allocation. The summit also identified a need for greater collaboration and multidisciplinary approaches to research to foster growth towards a more sustainable sector. Key recommendations from the Summit included: 1) establish metrics to monitor progress towards a more sustainable sector and signpost improvement in workforce sustainability; 2) establish a collective partnership between central bodies for unified advocacy and monitoring of metrics; and 3) develop a collaborative, strategic and targeted approach to guide and facilitate training programs that have been developed by shared sector-wide philosophy.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages 95-101"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral Valve Repair Versus Replacement in Patients Undergoing Concomitant Aortic Valve Replacement","authors":"Yi Zhang MD ,&nbsp;Guangguo Fu MD ,&nbsp;Gang Li MD ,&nbsp;Bohao Jian MD ,&nbsp;Rui Wang MD ,&nbsp;Yang Huang MD ,&nbsp;Tongxin Chu MD ,&nbsp;Zhongkai Wu MD, PhD ,&nbsp;Zhuoming Zhou MD ,&nbsp;Mengya Liang MD, PhD","doi":"10.1016/j.hlc.2024.07.015","DOIUrl":"10.1016/j.hlc.2024.07.015","url":null,"abstract":"<div><h3>Aim</h3><div>Mitral valve repair (MVr) is associated with more favourable long-term outcomes than mitral valve replacement (MVR) in cases of isolated mitral valve disease suitable for repair. However, there is debate regarding whether the superiority of MVr extends to patients with concomitant aortic and mitral valve disease. Therefore, this meta-analysis was conducted to compare the survival benefits between aortic valve replacement (AVR) plus MVr with a double valve replacement (DVR).</div></div><div><h3>Method</h3><div>A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane until 20 October 2022. Studies comparing MVr and MVR in patients undergoing concomitant AVR were included. The primary outcome was long-term survival. The secondary outcomes were early mortality, mitral valve reoperation, and valve-related adverse events.</div></div><div><h3>Results</h3><div>Sixteen studies with a total of 140,638 patients were included in this analysis. Patients undergoing AVR plus MVr exhibited a favourable trend in long-term survival (HR 0.85; 95% CI 0.71–1.03; p=0.10; <em>I</em>²=58%). The reconstructed Kaplan–Meier curve revealed that the long-term survival at 5, 10, and 15 years was higher in the AVR plus MVr (80.95%, 67.63%, and 51.18%, respectively) than in the DVR group (76.62%, 61.36%, 43.21%, respectively). Aortic valve replacement plus MVr had a lower risk of early mortality (RR 0.67; 95% CI 0.58–0.79; p&lt;0.001; <em>I</em>²=77%), thromboembolic events (RR 0.81; 95% CI 0.67–0.98; p=0.03; <em>I</em>²=5%), and haemorrhagic events (RR 0.87; 95% CI 0.78–0.98; p=0.01; <em>I</em>²=59%). Moreover, both groups displayed comparable rates of mitral valve reoperation (HR 1.73; 95% CI 0.86–3.48; p=0.13; <em>I</em>²=60%) and infective endocarditis (RR 1.60; 95% CI 0.65–3.93; p=0.31; <em>I</em>²=0%). However, the rate of reoperation for AVR plus MVr significantly increased in rheumatic heart disease patients (HR 3.30, 95% CI 1.66–6.59; p&lt;0.0001).</div></div><div><h3>Conclusions</h3><div>Compared with DVR, AVR plus MVr was associated with favourable long-term survival, reduced early mortality risk, and a lower incidence of thromboembolic and haemorrhagic events without increasing the risk of mitral valve reoperation or infective endocarditis in unselected patients. However, higher reoperation rates were observed in rheumatic heart disease patients undergoing AVR plus MVr.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages 3-15"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Intensity Interval Training in Adults With Congenital Heart Disease: A Systematic Review","authors":"Lino Sérgio Rocha Conceição PhD ,&nbsp;Naomi Gauthier MD ,&nbsp;Alana Lalucha Andrade Guimarães MSc ,&nbsp;Caroline Oliveira Gois MSc ,&nbsp;Ianne Karollayne Oliveira ,&nbsp;Diego Santos Souza PhD ,&nbsp;Vitor Oliveira Carvalho PhD","doi":"10.1016/j.hlc.2024.09.008","DOIUrl":"10.1016/j.hlc.2024.09.008","url":null,"abstract":"<div><h3>Background &amp; Aim</h3><div>Individuals with congenital heart disease (CHD) have reduced cardiorespiratory fitness which is associated with poor prognosis and quality of life. Evidence shows that exercise is effective in the management of adults with CHD. However, uncertainties remain about the safety and efficacy of high-intensity interval training (HIIT) in these patients. We performed a systematic review to assess the effects of HIIT on aerobic capacity and quality of life in adults with CHD.</div></div><div><h3>Methods</h3><div>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Cochrane Collaboration Handbook.</div></div><div><h3>Results</h3><div>As only three studies fitting the inclusion criteria could be included, with a total of 87 adults with CHD, we identified a major need for more studies assessing the effect of HIIT. Although HIIT appeared to improve peak oxygen uptake, other measures were inconclusive due to limited studies.</div></div><div><h3>Conclusion</h3><div>Available evidence to date suggests that HIIT improves aerobic capacity in adults with CHD with no serious adverse events. However, these data are too limited and are to be viewed with caution, identifying an important need for future studies to determine the direct impact of HIIT and to compare HIIT with other exercise intensity modalities.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages 16-24"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yield of Coronary Assessment in Sustained Monomorphic Ventricular Tachycardia","authors":"Ashwin Bhaskaran MBBS, MSc(Int Med) ,&nbsp;Kasun De Silva B Med, BSc(Med) ,&nbsp;Samual Turnbull BSc ,&nbsp;Wilfred Wong BPharm, MD ,&nbsp;Timothy Campbell BSc, PhD ,&nbsp;Richard G. Bennett MBChB, PhD ,&nbsp;Andrew Ong MBBS, PhD ,&nbsp;Sarah Zaman MBBS, PhD ,&nbsp;Saurabh Kumar BSc(Med), MBBS, PhD","doi":"10.1016/j.hlc.2024.08.009","DOIUrl":"10.1016/j.hlc.2024.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Coronary assessment is frequently conducted in patients with sustained monomorphic ventricular tachycardia (SMVT); however, its yield and subsequent treatment implications remain unclear. This study aimed to determine the prevalence of coronary artery disease (CAD) in patients presenting with SMVT, factors influencing clinician referral for coronary assessment, and clinical outcomes based on revascularisation or medical management of CAD.</div></div><div><h3>Method</h3><div>Consecutive patients presenting with acute SMVT requiring inpatient admission between 2017 and 2022 were identified.</div></div><div><h3>Results</h3><div>A total of 249 individual patients with SMVT were identified, with 140 undergoing coronary assessment. Referral for coronary assessment was driven by chest pain (p&lt;0.001) and increased troponin kinetics (p&lt;0.001). No patient with SMVT had an acute coronary occlusion. Significant CAD was found in 48 (34%) patients, and traditional ischaemic features did not predict significant CAD. Nineteen (40%) patients with significant CAD underwent revascularisation (n=15 percutaneous coronary intervention, n=4 coronary artery bypass grafting). There was no significant difference in time to ventricular tachycardia (VT) recurrence between revascularised and medically managed CAD (hazard ratio 1.670; 95% confidence interval 0.756–3.687; p=0.199). A total of five of six patients who underwent a revascularisation-only strategy (no upfront antiarrhythmic therapy or ablation) had VT recurrence (median time to recurrence 8.9 months).</div></div><div><h3>Conclusions</h3><div>Despite being frequently performed, coronary assessment in SMVT has only modest yield, with no patients having an acute coronary occlusion. Traditional clinical factors of ischaemia did not improve this yield. Revascularisation alone did not improve freedom from VT.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages 40-47"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Modified History of Juvenile Rheumatic Mitral Stenosis Following Percutaneous Transmitral Commissurotomy: Intermediate-Term Outcomes From a Decadal Follow-Up Study","authors":"Arun P. Satheesan DM ,&nbsp;Bharath A. Paraswanath MD, FNB ,&nbsp;Anand P. Subramanian DM ,&nbsp;Maninder Singh Setia MD, PhD, MPH ,&nbsp;Jayranganath Mahimarangaiah DM","doi":"10.1016/j.hlc.2024.08.010","DOIUrl":"10.1016/j.hlc.2024.08.010","url":null,"abstract":"<div><h3>Aim</h3><div>There are few studies that have looked at the long-term outcomes of juvenile mitral stenosis (JMS) following percutaneous transmitral commissurotomy (PTMC). This study sought to analyse the modified history of JMS in children following PTMC.</div></div><div><h3>Method</h3><div>We describe a longitudinal, observational follow-up study of all children and young adults aged &lt;20 years who underwent PTMC at Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India from 2012 to 2021. Children were followed up for progression of mitral stenosis (MS), development of mitral regurgitation (MR), need for repeat interventions (percutaneous or surgical), and mortality.</div></div><div><h3>Results</h3><div>A total of 114 children and adolescents underwent the procedure. The mean age of children in the study was 15.1±2.5 years. After immediate procedural success, there was a tendency towards restenosis with respect to valve areas and transmitral gradients at follow-up. Severe MR after the procedure was noted in 2.6%. Compliance with penicillin prophylaxis was noted in 42.5%. The Kaplan–Meier survival estimate over 10 years showed a mortality rate of 1.98/100 patient-years and a re-intervention rate (re-do PTMC or surgery) of 5.50/100 patient-years. Additional valvular lesions were noted in 13.1% of children during follow-up. Severe symptomatic status at presentation (New York Heart Association class 4) was predictive of mortality, and children aged &lt;15 years often needed re-intervention.</div></div><div><h3>Conclusions</h3><div>With a mortality rate of 6.1% and re-do intervention rate of 15.8% during extended follow-up, JMS has considerable healthcare implications in terms of morbidity and mortality in children and young adults.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages 58-66"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Letter to the Editor Regarding: “Phenotypic Characterisation of Obstructive Sleep Apnoea in Acute Coronary Syndrome”","authors":"Benjamin K. Tong PhD ,&nbsp;Peter A. Cistulli MD, PhD","doi":"10.1016/j.hlc.2024.11.003","DOIUrl":"10.1016/j.hlc.2024.11.003","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages e10-e11"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutting, Ablation, and Reorganisation for Efficient Function and Growth","authors":"Salvatore Pepe PhD, FAHA, FESC, FCSANZ","doi":"10.1016/j.hlc.2024.12.004","DOIUrl":"10.1016/j.hlc.2024.12.004","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages 1-2"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding: “Phenotypic Characterisation of Obstructive Sleep Apnoea in Acute Coronary Syndrome” by Tong et al. Heart Lung Circ. 2024;33(12):1648–58","authors":"Tomoyuki Kawada PhD, MD","doi":"10.1016/j.hlc.2024.11.002","DOIUrl":"10.1016/j.hlc.2024.11.002","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 1","pages":"Pages e8-e9"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}