Indian heart journal最新文献

{"title":"Early experience with the \"modified jailed balloon technique\" for side branch protection in bifurcation lesions.","authors":"Somyata Somendra, Himanshu Gupta, Yash Paul Sharma","doi":"10.1016/j.ihj.2025.02.011","DOIUrl":"10.1016/j.ihj.2025.02.011","url":null,"abstract":"<p><strong>Objective: </strong>M-JBT is a novel approach to the \"keep-it-open strategy\" for bifurcation lesions where SB anatomy is unsuitable for stenting. We intend to provide insight into a contemporary way through our experience of the M-JBT.</p><p><strong>Methods: </strong>A semi-compliant balloon sized appropriately for the SB diameter is inflated simultaneously with the MB stent balloon during stent deployment, followed by POT of the MB stent and then recrossing the SB.</p><p><strong>Results: </strong>We performed the \"M-JBT\" in 25 cases of bifurcation lesions between September 2023-24, with absolute procedural success in preventing SB occlusion during MB stenting in all 25 lesions. SB occlusion after MB stent POT was seen in one case.</p><p><strong>Conclusion: </strong>This is the first report of clinical experience with the MJBT from the Indian subcontinent. MJBT proves to be a safe and effective approach to the protection of a clinically important SB during MB stenting across it.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to pharmacotherapy for secondary prevention of coronary heart disease: A registry-based prospective study.","authors":"Aradhai Bana, Krishna Kumar Sharma, Soneil Guptha, Rajeev Gupta","doi":"10.1016/j.ihj.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.02.009","url":null,"abstract":"<p><strong>Background and objective: </strong>There is limited data on secondary prevention medications following acute coronary syndrome (ACS) in India. We performed a registry-based study to evaluate adherence to recommended medications following ACS hospitalisation.</p><p><strong>Methods: </strong>Consecutive patients admitted with ACS were recruited. Data on demographics, baseline characteristics, in-hospital interventions, and prescribed secondary prevention therapies (antiplatelets, statins, beta-blockers, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and calcium channel blockers (CCB) at discharge were recorded. 6-months follow-up was conducted to evaluate adherence using validated tools.</p><p><strong>Results: </strong>716 patients were recruited; the mean age was 60.4 ± 11 years, percutaneous coronary angioplasty (PCI) was performed in 714 (99.7 %) and bypass surgery in none. At hospital discharge, the cardioprotective medications were: aspirin 97.3 %, dual antiplatelets 99.7 %, statins 99.7 %, beta-blockers 74.2 %, ACEI/ARB 38.8 % and CCB 10.9 %. Follow-up data were available for 554 patients; 15 (2.1 %) died and 147 (20.5 %) were lost to follow-up. Medication status and change at 6 months was aspirin 83.9 % (-15.9 %); dual antiplatelets 70.2 % (-29.5 %), statins 70.0 % (-29.8 %), beta-blockers 50.4 % (-32.1 %), ACEI/ARB 22.4 % (-42.3 %) and CCB (-36.7 %) (p < 0.05). Use of high-intensity statins declined from 92.0 % to 45.7 % (-50.3 %). At follow-up, good adherence (>80 %) was 42.7 %, low adherence 24.4 % and non-adherence 10.2 %. Patients with government-sponsored insurance had better adherence than privately insured and self-paying.</p><p><strong>Conclusions: </strong>Following acute coronary syndrome and PCI, the adherence to prescribed pharmacotherapy is sub-optimal at 6 months with a decline in various medications of 16-42 %. Strategies to increase adherence to secondary prevention therapies are required.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factor XI and XII inhibitors-Dawn of a new era.","authors":"Chhabi Satpathy, Trinath Kumar Mishra, Anshu Kumar Jha","doi":"10.1016/j.ihj.2025.02.007","DOIUrl":"10.1016/j.ihj.2025.02.007","url":null,"abstract":"<p><p>The history of coagulation cascade dates back to 17th century. The extrinsic and intrinsic pathways were proposed in 1998. Extrinsic pathway includes the tissue factor and stable factor which activates factor X and with help of factor V, this converts prothrombin to thrombin which is stabilised by factor XIII. This helps to seal the bleeding vessel and is a physiological process as there is only \"limited\" production of thrombin which doe not expand beyond the damaged site due to absence of tissue factor. On the other hand intrinsic pathway is activated by polyanions, neutrophilic extracellular traps which are present during infection and inflammation. These activate factor XI which activates factor X with the help of factor IX and VIII and then the common pathway ensues. But newer discoveries have shown that this is a very simplified way of explaining the coagulation system. The researches propose that haemostasis is divided into initiation, amplification and propagation phase. Also, the factor VII-tissue factor complex formed activates factor IX and leads to sustained thrombin production as the amount of thrombin produced by extrinsic pathway alone is not sufficient to form a haemostatic plug. Thrombin also activates factor XI and lead to self perpetuation of intrinsic pathway. All the anticoagulants have an inherent property of bleeding. So the newer factor XI and XII inhibitors focus to inhibit the excessive thrombin production without hampering the physiological haemostasis process. This is supported by the fact that congenital factor XI and XII deficiency does not cause excessive bleeding but increased levels did make patients more vulnerable to thromboembolism. This review shall focus on the various factor XI and XII inhibitors which are in the pipeline.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of fluoroscopic landmarks in IVUS guided zero contrast PCI - A single centre experience.","authors":"Uday B Khanolkar, Pankaj Banotra, Bijay Kumar Mahala, Nitin Kumar Hegde, Blessvin Jino, Devi Prasad Shetty, Parin Chandrakant Sangoi","doi":"10.1016/j.ihj.2025.02.006","DOIUrl":"10.1016/j.ihj.2025.02.006","url":null,"abstract":"<p><strong>Introduction: </strong>Contrast induced nephropathy is third most common cause of renal insufficiency following percutaneous coronary angioplasty (PCI) and patients with preexisting renal dysfunction are even at a higher risk for poor outcomes. With the advent of intravascular imaging, safety and efficacy of angioplasty can be improved significantly in these patients.</p><p><strong>Material and methods: </strong>This observational prospective study included 72 consecutive patients with CKD(eGFR ≤45 ml/min/m²) and established CAD who underwent absolute zero contrast PCI at a single tertiary center.PCI was planned in patients with significant stenosis and indications for revascularization.All Procedures were performed under dry fluoroscopy and IVUS guidance without use of any contrast.Informed consent, clinical,procedural and follow-up data was collected and analysed.</p><p><strong>Results: </strong>Total 72 patients (90 vessels) with median age of 63 years and eGFR (34.1 ml/min/1.73 m²) underwent zero contrast PCI. Procedure was performed by Femoral (45.6 %)and radial (54.4%) route. Total 11 patients (15.3%) underwent left main stenting. Fluoroscopic landmarks such as side-branch wiring (71.1%),floating wire in aorta (22.2 %), calcifications (21.1%), bony landmarks such as ribs or vertebrae (45.5%) and Sternal wires/clips (6.6%) were used in addition to IVUS to enable more accurate placement of stent.Technical and procedural success were achieved in 91.1% and 97.2% of patients.One patient died in hospital due to non-cardiac cause and one patient required hemodialysis.Post procedure at 48 hrs, there was no deterioration of renal function.On 3 months followup, there was no significant major adverse cardiovascular events (MACE).</p><p><strong>Conclusion: </strong>Our study shows that with the help of fluoroscopy landmarks and intravascular imaging, zero contrast PCI can be performed safely with good clinical outcomes in patients at risk of nephropathy.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diastolic duration as a percentage of the cardiac cycle in healthy adults: A pilot study.","authors":"Neeta Bachani, Soorampally Vijay, Aniruddha Vyas, Jaipal Jadwani, Gopikrishna Panicker, Yash Lokhandwala","doi":"10.1016/j.ihj.2025.02.005","DOIUrl":"10.1016/j.ihj.2025.02.005","url":null,"abstract":"<p><strong>Background: </strong>A widely accepted concept in cardiovascular physiology states that diastole constitutes 62.5 % of the cardiac cycle during a typical 0.8-s cycle at 75 beats per minute. However, this has not been confirmed by using modern technology in healthy individuals.</p><p><strong>Objective: </strong>This study aimed to accurately measure diastolic duration as a fraction of the cardiac cycle using echocardiography in healthy adults with structurally normal hearts.</p><p><strong>Methods: </strong>In this prospective study, 200 healthy adults aged over 18 years, with heart rates between 50 and 100 beats per minute, normal ECGs, and structurally normal hearts, were included. Using a modified apical 5-chamber view and pulse wave Doppler at the aortic and mitral valves, researchers measured the RR interval (total cardiac cycle), diastolic duration (from aortic valve closure to mitral valve closure), and systolic duration. Three measurements were taken for each parameter, and the mean was used for analysis.</p><p><strong>Results: </strong>Participants had a mean age of 47.7 years (range 19-79), with an equal gender distribution. The mean RR interval was 799 ± 97 ms. The left ventricular (LV) diastolic duration was 469 ± 76 ms, and the LV systolic duration was 330 ± 42 ms. The ratio of diastolic duration to the total cardiac cycle was 0.58 ± 0.04, slightly higher in males (0.59 ± 0.04) compared to females (0.57 ± 0.04).</p><p><strong>Conclusion: </strong>This study challenges the longstanding teaching that diastole accounts for two-thirds of the cardiac cycle. Instead, diastole represents 58 % of the cycle, highlighting the need to reconsider its role in cardiovascular physiology and clinical applications.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a hub and spoke STEMI Goa project - Initial results, gains and challenges.","authors":"Guruprasad Naik, Amar Prabhudesai, Venkatesh Malali, Michelle Viegas Parab, Joel Quadros, Pankajam Vaidya, Edward D'Mello, Swapnil Arsekar, Radha Valaulikar","doi":"10.1016/j.ihj.2025.02.004","DOIUrl":"10.1016/j.ihj.2025.02.004","url":null,"abstract":"<p><strong>Objectives: </strong>To study the impact of a 'hub and spoke' STEMI management programme on delivery of thrombolysis in the state of Goa.</p><p><strong>Methods: </strong>A prospective observational study was conducted to assess the 'hub and spoke' model STEMI programme in the state of Goa. Data was collected using predesigned proformas filled at Primary Health Centres or District Hospitals which served as the spokes. Primary programme efficacy outcomes studied were the proportion of eligible patients of STEMI receiving thrombolysis and the time to thrombolysis. Secondary outcome assessed was in-hospital mortality.</p><p><strong>Results: </strong>A total of 2050 number of patients were diagnosed with STEMI between November 2019 and March 2022, of which complete data was available for 1325 patients. After ruling out contraindications, delayed presentations or refusal for treatment, 74.3 % of STEMI patients received thrombolysis. The median window period was 130.83 min with an interquartile range (IQR) of 159.63 min. The median time from presentation to recording ECG was 7.9 (IQR = 11.63) minutes and presentation to cloud diagnosis was 11.78 (IQR = 12.96) minutes. The median time from presentation to administering thrombolysis (Door to Needle time) was 18.48 (IQR = 28.85) minutes. Only 0.22 % patients received inappropriate thrombolysis and the in-hospital mortality was 9.4 %.</p><p><strong>Conclusion: </strong>A STEMI programme utilizing the existing manpower and primary health care setup improved 'secondary' level of care to patients by providing thrombolysis to a high percentage of patients in quick time. This may serve as a model to improve the outreach of reperfusion therapy in a resource challenged country like India.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional study on the incidence of prosthetic valve thrombosis and its outcome treated with fibrinolysis in a tertiary care hospital.","authors":"Dhiviya Murugesan, Balasubramanian Sundaram, Nagasundar Gurusamy, Hemanath Ramamurthy, Nisamudeen Kaja Mohideen","doi":"10.1016/j.ihj.2025.02.003","DOIUrl":"10.1016/j.ihj.2025.02.003","url":null,"abstract":"<p><strong>Aims: </strong>To find the incidence, risk factors of Prosthetic Valve Thrombosis (PVT)To study the efficacy, outcome and complications of fibrinolysis in PVT.</p><p><strong>Methods: </strong>Data from 44 consecutive patients admitted with PVT treated with fibrinolytics were assessed, outcomes recorded. Only medically managed PVT were included in this study and Surgical management were not included due to inadequate resources.</p><p><strong>Results: </strong>Out of 44 patients, 28 were female and 16 were male with mean age of 36.5 41 had underwent MVR, 3 had underwent DVR. 42 (92.4 %) had thrombus at mitral valve 2 (4.5 %) were at aortic valve. Visible clot was present in 7 (15.9 %) and absent in 37 (84 %) patients. 7 (15.9 %) had recurrent episode of PVT. At the time of thrombolysis, no patient had major bleeding manifestation. During follow up after thrombolysis, 37 (84 %) were alive and 7 (16 %) expired. The incidence of primary end point i.e successful thrombolysis (as defined as complete response without complications) was seen in 61.3 % patients. The secondary end point i.e. Therapeutic failure/death is recorded in 15.9 % study subjects. Among the vulnerable population, therapeutic Failure/death is seen with 57.1 % sub-therapeutic anticoagulant consumers and 42.8 % patients with poor drug compliance.</p><p><strong>Conclusion: </strong>In conclusion this study sheds light on the complexities and challenges associated with prosthetic valve thrombosis in pregnant patients, patients with sub therapeutic anticoagulation or poor drug consumers. This study underscores the importance of close monitoring, optimal anticoagulation, patient education. This study highlights that fibrinolysis unless contraindicated can be considered as effective especially in developing countries or in centres with limited resources, where multiple factors such as surgical availability, financial cost, high operative mortality are to be weighed before treatment.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory cytokine levels in rheumatic heart disease and their association with use of benzathine penicillin: A case-control pilot study.","authors":"Sanjeev Kumar, Prakash Chand Negi, Sanjeev Asotra, Meenakshi Chandel, Jitender Kumar, Rajeev Merwah, Rajesh Sharma, Ritesh Kumar, Vinay Bhardwaj, Preetam Singh Thakur","doi":"10.1016/j.ihj.2025.01.007","DOIUrl":"10.1016/j.ihj.2025.01.007","url":null,"abstract":"<p><strong>Background: </strong>Valvular inflammation plays an important role in the progression of Rheumatic Heart Disease. We report the association between inflammatory markers and use of Benzathine Penicillin G in patients with Rheumatic mitral valve disease.</p><p><strong>Methods: </strong>The levels of inflammatory cytokines; IL-1β, IL-6, TNF-α and inflammatory marker hs- CRP were measured using ELISA method in 32 patients with RHD receiving Benzathine Penicillin as secondary prophylaxis and 31 patients not receiving secondary prophylaxis, in a case-control study. The severity and type of valvular dysfunction were assessed with echocardiogram.</p><p><strong>Results: </strong>The median level of IL-1β was significantly lower in patients on BPG (0.95 pg/ml vs. 5.47 pg/ml) p < 0.002. The median levels of IL-6, TNF-α and hs-CRP were not significantly different between study groups. The adjusted odds of raised IL-1β were lower in patients on BPG (odds ratio 0.40, 95 % C.I. 0.11, 1.45) p 0.16. There was a trend of inverse association between the use of BPG and mitral stenosis (odds ratio 0.42, 95 % C.I. (0.12, 1.46) p 0.17.</p><p><strong>Conclusion: </strong>Patients with RHD on BPG had lower levels of IL-1β and a trend toward a lower prevalence of mitral stenosis. Role of IL-1β in progression of incompetent to stenotic mitral valve dysfunction needs to be explored in future studies.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Clopidogrel therapy in Acute Coronary Syndrome: Contemporary issues'.","authors":"Satyavir Yadav, Rakesh Yadav","doi":"10.1016/j.ihj.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.02.002","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"A Study of Intracoronary Thrombolytic Agents In High Thrombus Burden Lesions During Primary PCI\".","authors":"Venkata Rs Subrahmanya Sarma, K Gopalakrishna, K Purnachandra Rao, G Somasekahr, P S S Chowdary, P Raghuram, B Dasarath, Manohar Reddy, Ramkishore, Raji Veeramachineni, Y Sasidhar, M Prasad","doi":"10.1016/j.ihj.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.01.008","url":null,"abstract":"<p><strong>Objectives: </strong>High thrombus burden during Primary Percutaneous Coronary Intervention begets poor outcomes; there are several lacunas in the management of those patients.- The purpose of this study is to analyse the long-term outcomes of patients undergoing primary percutaneous coronary intervention with high thrombus burden, treated with intracoronary thrombolysis as an adjunctive therapy.</p><p><strong>Methods: </strong>In this prospective observational study, 108 consecutive primary percutaneous coronary intervention patients with high thrombus burden were stratified into two groups basing on whether they received intracoronary thrombolytic agent before stent implantation. The primary outcome is Net Adverse Clinical Events. Secondary outcomes include Major Adverse Cardiac Events, and all other individual components of the Net Adverse Clinical Events when analysed separately.</p><p><strong>Results: </strong>The primary outcome events occurred in 21 patients (26%) in the Primary stent group (n=80), whereas it occurred in 2 patients (6%) in the primary intra-coronary thrombolysis group (n=28), this study shows that there is no difference in primary endpoints in both groups (26% Vs 7%, p-value - 0.042, Hazard ratio - 2.56; 95% CI - 0.76 - 8.57), however Kaplan-Meier event-free survival curves show that both the curves are well separated apart even at the end of the one year of follow - up.</p><p><strong>Conclusion: </strong>There is no difference in the primary outcome events in both groups, however there was a consistent increase in events in the primary stent group over the one-year follow-up period. These findings suggest the need for a larger randomized clinical trial to confirm and further elucidate these results.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}