Hypertension最新文献

{"title":"Resistant Hypertension Is Not Essential: It Is Primarily Aldosteronism.","authors":"Morris J Brown, William M Drake","doi":"10.1161/HYPERTENSIONAHA.125.26401","DOIUrl":"10.1161/HYPERTENSIONAHA.125.26401","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"e26401"},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149619","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":"Treatment of Primary Aldosteronism.","authors":"Stéfanie Parisien-La Salle, Gregory L Hundemer, Matthew A Nehs, Justine A Barletta, Anand Vaidya","doi":"10.1161/HYPERTENSIONAHA.126.26238","DOIUrl":"10.1161/HYPERTENSIONAHA.126.26238","url":null,"abstract":"<p><p>Primary aldosteronism (PA) is a common cause of hypertension, characterized by renin-independent aldosterone production that drives inappropriate mineralocorticoid receptor activation, sodium retention, volume expansion, and potassium wasting, ultimately resulting in hypertension and adverse cardiorenal outcomes. Management of PA involves therapies that target these pathophysiologic mechanisms to restore homeostasis and reduce risk, which is usually tailored based on patient preference and whether PA is lateralizing or nonlateralizing. For patients with lateralizing PA, surgical adrenalectomy, and to a lesser extent, minimally invasive adrenal or adrenal artery ablation, is highly effective at improving blood pressure control and risk for incident cardiovascular outcomes. However, the vast majority of patients with PA will be treated with medical therapy using steroidal mineralocorticoid receptor antagonists as the cornerstone of therapy, and epithelial sodium channel inhibitors serving as infrequent alternatives. Dietary sodium restriction in PA should be strongly encouraged because it reduces the substrate that fuels PA pathophysiology; dietary sodium restriction can facilitate substantial reductions in blood pressure, especially when combined with mineralocorticoid receptor antagonist therapy. Once initiated, medical therapy should be intensified to achieve 3 objectives in the following order of importance: normalization of blood pressure with the fewest number of antihypertensive agents, normalization of serum potassium when applicable, and increases in renin from baseline as a biomarker of adequate aldosterone blockade.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"e26238"},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432596","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":"Emerging Medical Therapies for Primary Aldosteronism.","authors":"Peeradon Vibhatavata, Adina F Turcu","doi":"10.1161/HYPERTENSIONAHA.126.26229","DOIUrl":"10.1161/HYPERTENSIONAHA.126.26229","url":null,"abstract":"<p><p>Medical therapy for primary aldosteronism has been stagnant for decades, relying on mineralocorticoid receptor antagonists, which block downstream signaling of aldosterone rather than aldosterone production. This approach typically leads to reactive elevation of aldosterone production, and possible implications of its nongenomic effects. In addition, steroidal mineralocorticoid receptor antagonist use is limited by cross-reactivity with other nuclear receptors and concern for hyperkalemia, particularly in kidney insufficiency. These limitations have propelled a rising interest in therapies that suppress aldosterone production. Aldosterone synthase inhibitors directly target aldosterone synthase overexpression and aldosterone excess. This review presents the evolving landscape of primary aldosteronism therapies, including emerging aldosterone synthase inhibitors and nonsteroidal mineralocorticoid receptor antagonists, and it presents a perspective on expected benefits and limitations of these emerging classes.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"e26229"},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146179207","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":"Cardiometabolic Burden in Bilateral Macronodular Adrenal Disease With Primary Aldosteronism.","authors":"Annalisa Panarelli, Marta Araujo-Castro, Livia M Mermejo, Adina F Turcu, Jung Hee Kim, Seung Shin Park, Fabio Bioletto, Mirko Parasiliti-Caprino, Masakatsu Sone, Athina Markou, Troy Puar, Piotr Kmieć, Paolo Mulatero, Norio Wada, Mika Tsuiki, Marga González-Boillos, Noemi Jimenez López, Takashi Yoneda, Filippo Ceccato, Margaret de Castro, Stéphanie Espiard, Takamasa Ichijo, Shoichiro Izawa, Masanori Murakami, Serena Palmieri, Vittoria Favero, Takuyuki Katabami, Henrik Falhammar, Mitsuhide Naruse, Marcus Quinkler, Martin Reincke, Elisabeth Nowak","doi":"10.1161/HYPERTENSIONAHA.125.25507","DOIUrl":"10.1161/HYPERTENSIONAHA.125.25507","url":null,"abstract":"<p><strong>Background: </strong>Bilateral macronodular adrenocortical disease is often linked to autonomous cortisol secretion, but may also present with primary aldosteronism (PA).</p><p><strong>Methods: </strong>This international (Europe, United States, Asia) retrospective cohort study included adults with radiological evidence of bilateral macronodular adrenocortical disease and biochemically confirmed PA. The primary endpoints was major adverse cardiovascular events (MACE); secondary end points included cardiometabolic comorbidities and surgical outcomes per PA surgical outcome criteria.</p><p><strong>Results: </strong>Two hundred forty-nine patients from 41 centers in 12 countries were included (median age, 55 years; 62% male). Median hypertension duration at PA diagnosis was 9.9 years. Among 178 tested, 52% had cortisol cosecretion and 47% isolated PA. At baseline, 56% had metabolic comorbidities, and 16% had ≥1 MACE. Patients with MACE were older, more often male, had longer hypertension duration, and higher diabetes rates. Eighty-nine patients underwent adrenalectomy: 50 without MRA (mineralocorticoid receptor antagonists), 38 with MRA, and 1 with steroidogenesis inhibitors. One hundred twenty-four patients received continued MRA without adrenalectomy or steroidogenesis inhibitors. Adrenal venous sampling showed lateralized PA in 89% of surgical versus 19% of MRA-treated patients (<i>P</i><0.001). Over a median follow-up of 36 (MRA) and 18 months (surgery; <i>P</i>=0.2), MACE occurred in 8% and 6%, respectively (<i>P</i>=1.0). Blood pressure and organ damage were similar, but more MRA-treated patients needed ≥3 antihypertensives (MRA: 48% versus adrenalectomy: 14%; <i>P</i><0.001). Among operated patients, complete clinical and biochemical success was 26% and 71%, respectively.</p><p><strong>Conclusions: </strong>Bilateral macronodular adrenocortical disease with PA carries a high cardiometabolic burden. Early detection and precise subtyping are key to optimizing management and preventing target organ damage.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"e25507"},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511624","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":"Broadening Primary Aldosteronism Screening: Alignment Across Contemporary Guidelines.","authors":"Lily Owei, Heather Wachtel, Jordana B Cohen","doi":"10.1161/HYPERTENSIONAHA.125.26228","DOIUrl":"10.1161/HYPERTENSIONAHA.125.26228","url":null,"abstract":"<p><p>Fewer than 2% of eligible patients are screened for primary aldosteronism, despite evidence that early detection and targeted therapy are associated with lower cardiovascular and kidney morbidity. Recent updates to major hypertension and endocrine guidelines reflect growing recognition that primary aldosteronism is far more prevalent than previously understood and that broader, more practical screening approaches are needed. These recommendations increasingly extend screening beyond resistant hypertension to adults with stage 2 hypertension and even to all individuals with hypertension. They also aim to lower barriers to testing through more flexible guidance on antihypertensive medication management, reaffirm the aldosterone-to-renin ratio as the preferred initial test, and provide more standardized criteria for interpretation. Supporting evidence includes epidemiological data demonstrating a continuum of renin-independent aldosterone production across blood pressure categories, strong associations between untreated primary aldosteronism and adverse cardiovascular and kidney outcomes independent of blood pressure, and favorable cost-effectiveness of screening even in lower-risk groups. Implementation remains the principal challenge, with obstacles spanning patient, clinician, and health system levels. Emerging electronic health record strategies, including electronic phenotyping and integrated clinical decision support, have shown early promise in increasing screening uptake and streamlining diagnostic pathways. Collectively, contemporary guideline updates and implementation innovations represent a shift toward earlier and broader detection of primary aldosteronism, with the potential to reduce preventable cardiorenal disease across the hypertensive population.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"e26228"},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124817","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":"Aldosterone and the Mineralocorticoid Receptor in Atrial Fibrillation.","authors":"Argen Mamazhakypov, Rémi Pyronnet, Achim Lother","doi":"10.1161/HYPERTENSIONAHA.125.26187","DOIUrl":"10.1161/HYPERTENSIONAHA.125.26187","url":null,"abstract":"<p><p>Atrial fibrillation represents the most prevalent cardiac arrhythmia and is associated with substantial morbidity, including an increased risk for stroke and heart failure. The pathophysiology of atrial fibrillation involves electrical and structural remodeling of the atria, often referred to as atrial myopathy, that together increase the risk for arrhythmias. However, a specific approach to target the proarrhythmic substrate of atrial fibrillation is still lacking. Aldosterone and the mineralocorticoid receptor are well-known drivers of cardiac remodeling, and recent clinical and experimental studies indicate that they play a critical role in the pathogenesis of atrial fibrillation. Elevated aldosterone levels, for example, in primary aldosteronism, are associated with a higher risk for atrial fibrillation. Mineralocorticoid receptor antagonists reduce the onset of atrial fibrillation across various patient populations, including patients with hypertension, heart failure, chronic kidney disease, or undergoing cardiac surgery. In patients with preexisting atrial fibrillation, mineralocorticoid receptor antagonists may decrease atrial fibrillation recurrence when added to antiarrhythmic therapies. Experimental studies provide a direct link between aldosterone and atrial remodeling and arrhythmia. Mineralocorticoid receptor activation modulates several key cellular processes involved in atrial inflammation, fibrosis, and arrhythmogenesis, including fibroblast activation, cardiomyocyte dysfunction, and ion channel activity. Here, we review what is currently known about the role of aldosterone and the mineralocorticoid receptor in atrial fibrillation, summarize the mechanistic basis as supported by experimental studies, and discuss the potential of mineralocorticoid receptor antagonists in the prevention and treatment of atrial fibrillation.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"e26187"},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146179144","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":"Correction to: 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.","authors":"Daniel W Jones, Keith C Ferdinand, Sandra J Taler, Heather M Johnson, Daichi Shimbo, Marwah Abdalla, M Martine Altieri, Nisha Bansal, Natalie A Bello, Adam P Bress, Jocelyn Carter, Jordana B Cohen, Karen J Collins, Yvonne Commodore-Mensah, Leslie L Davis, Brent Egan, Sadiya S Khan, Donald M Lloyd-Jones, Bernadette Mazurek Melnyk, Eva A Mistry, Modele O Ogunniyi, Stacey L Schott, Sidney C Smith, Amy W Talbot, Wanpen Vongpatanasin, Karol E Watson, Paul K Whelton, Jeff D Williamson","doi":"10.1161/HYP.0000000000000262","DOIUrl":"https://doi.org/10.1161/HYP.0000000000000262","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"83 5","pages":"e000262"},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689782","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":"From Progress to Plateau: 50-Year Trends in Hypertension Prevalence and Salt Intake in the Finnish Population.","authors":"Annika Santalahti, Anniina Ojanen, Tarja Palosaari, Tuija Jääskeläinen, Niina E Kaartinen, Katri Sääksjärvi, Tiina Laatikainen, Annamari Lundqvist","doi":"10.1161/HYPERTENSIONAHA.125.25982","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.125.25982","url":null,"abstract":"<p><strong>Background: </strong>We examined 50-year time trends in hypertension prevalence and salt intake in Finland to evaluate the impact of public health interventions and inform future strategies for salt reduction and hypertension prevention.</p><p><strong>Methods: </strong>Twelve cross-sectional health examination surveys conducted in Finland between 1972 and 2023 included 77 418 randomly selected adults aged 25 to 64 years, with blood pressure measured in all participants and 24-hour urine samples collected from a subsample of 5035 individuals. Year-to-year changes in the prevalence of hypertension and mean salt intake were assessed using age-adjusted logistic regression, with the previous adjacent survey year as the reference for each year.</p><p><strong>Results: </strong>Hypertension prevalence (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg and current use of antihypertensive medication) declined in men from 1972 to 2002 and in women until 1997, after which reductions slowed, with 2023 rates remaining high (42.6% in men, 31.8% in women). Mean salt intake decreased until the early 2000s (men: from 13.9-9.7 g/d; women: from 11.1-7.6 g/d) but plateaued thereafter, remaining above recommended levels in 2023 (men: 10.3 g/d; women: 7.6 g/d).</p><p><strong>Conclusions: </strong>The previously declining trend in hypertension prevalence in Finland has plateaued over the last 2 decades, coinciding with persistently high salt intake remaining largely unchanged throughout the 21st century. Actions aimed at enhancing hypertension prevention and reducing population salt intake should therefore be reintroduced into Finland's public health discourse.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814574","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":"Sex Differences in Cardiac Remodeling and Dysfunction in Primary Aldosteronism.","authors":"Yu-Ching Chang, Chi-Sheng Hung, Zheng-Wei Chen, Yi-Yao Chang, Chin-Chen Chang, Ching-Chu Lu, Bo-Ching Lee, Jeff Shih-Chieh Chueh, Shuo-Meng Wang, Vin-Cent Wu, Cheng-Hsuan Tsai, Yen-Hung Lin","doi":"10.1161/HYPERTENSIONAHA.125.26213","DOIUrl":"10.1161/HYPERTENSIONAHA.125.26213","url":null,"abstract":"<p><strong>Background: </strong>Sex differences influence cardiovascular risk assessment and management; however, their role in aldosterone-mediated cardiac remodeling in primary aldosteronism remains incompletely understood.</p><p><strong>Methods: </strong>We conducted a retrospective study of 547 patients with primary aldosteronism, including 249 men and 298 women. Clinical and echocardiographic data were collected at baseline and 1 year following aldosterone-targeted therapies.</p><p><strong>Results: </strong>The mean age was 53.8 years in men and 54.6 years in women. At baseline, men had a higher left ventricular mass index (LVMI), whereas women had a higher prevalence of left ventricular (LV) hypertrophy and worse diastolic function, as indicated by a higher ratio of early diastolic transmitral to mitral annular velocity (E/e') and left atrial volume index. In multivariable analyses, plasma aldosterone concentration (PAC) was associated with baseline LVMI in both sexes. Associations between PAC and baseline diastolic indices, including E/e' and left atrial volume index, were observed in men but not in women in sex-stratified models. However, formal interaction testing did not demonstrate significant sex-by- PAC interactions for left atrial volume index, E/e', or LAVI. After 1 year of treatment, LVMI reduction was comparable between sexes. Improvement in E/e' was significantly less pronounced in women. LAVI decreased significantly in men but not in women, although between-sex differences in change were not statistically significant.</p><p><strong>Conclusions: </strong>Sex-specific differences in cardiac remodeling and diastolic function were observed in patients with primary aldosteronism. Despite lower baseline LVMI, women exhibited a more adverse cardiac phenotype, with a higher prevalence of left ventricular hypertrophy and worse diastolic function. Following aldosterone-targeted therapies, structural regression was similar between sexes, whereas diastolic function improved to a lesser extent in women.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"e26213"},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511586","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":"Renal Tubule Cell-Specific <i>Npr1</i> is Essential to Regulate Blood Pressure and Kidney Dysfunction.","authors":"Kandasamy Neelamegam, Chandramohan Ramasamy, Ramachandran Samivel, Shoujin Hao, Nicholas R Ferreri, Zheng Dong, Huijing Xia, Daniel R Kapusta, Kailash N Pandey","doi":"10.1161/HYPERTENSIONAHA.125.25890","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.125.25890","url":null,"abstract":"<p><strong>Background: </strong>Atrial and brain natriuretic peptides activate GC-A/NPRA (guanylyl cyclase-A/natriuretic peptide receptor-A) and regulate blood pressure and electrolyte homeostasis. Renal tubule (RT) dysfunction results in decreased kidney function and increased blood pressure. We determined the sex-specific consequences of RT cell-specific deletion of <i>Npr1</i> (encoding NPRA) on blood pressure and renal hemodynamics.</p><p><strong>Methods: </strong>Mice were generated with inducible RT knockout by breeding lox-flanked (flox/flox: <i>f/f</i>) exons 1 to 2 in <i>Npr1</i> with mice expressing the Pax8-rtTA-LC-1-<i>Cre</i> transgene. Doxycycline-treated RT cell-specific <i>Npr1</i> knockout (<i>Npr1 f/</i>-), heterozygous (HT; <i>Npr1 f/+</i>), and wild-type (<i>Npr1 f/f</i>) male and female mice were used. Proximal tubule, distal tubule, and cortical collecting duct were isolated from RT-<i>Npr1</i> knockout mice and did not express <i>Npr1</i> mRNA or protein.</p><p><strong>Results: </strong>RT cell-specific male knockout and HT mice showed significantly lower glomerular filtration rate, creatinine clearance, and urinary sodium excretion than female mice, compared with wild-type mice. The effect of <i>Npr1</i> deletion was more severe on high-salt diets than their normal-diet counterparts. Loss of <i>Npr1</i> in RT segments significantly increased systolic blood pressure and mean arterial pressure in a sex-specific manner. Mutant male mice showed higher total urinary protein and albumin-creatinine ratios than female mice. On a high-salt diet, male knockout and HT mice showed greater salt sensitivity than female mice.</p><p><strong>Conclusions: </strong>Loss of <i>Npr1</i> along the nephron tubules leads to arterial hypertension and abnormal renal functional hemodynamic changes that are more pronounced in male mice compared with female mice.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770022","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}