Journal of Cardiovascular Electrophysiology最新文献

{"title":"Utility of Cardiopulmonary Exercise Testing in Assessing Beta-Blocker Efficacy in LQTS: Moving Away From One-Size-Fits-All.","authors":"Iqbal El Assaad, Alison K Heilbronner, Kenneth Zahka, Benjamin Hammond, Akash Patel, Peter F Aziz","doi":"10.1111/jce.70001","DOIUrl":"https://doi.org/10.1111/jce.70001","url":null,"abstract":"<p><strong>Background: </strong>Currently, there is no specific standard to assess beta blocker efficacy in long QT syndrome (LQTS).</p><p><strong>Objective: </strong>To describe our institutional experience with utilizing cardiopulmonary exercise testing (CPET) to assess for chronotropic suppression and to compare frequency of life-threatening events (LTEs) on intentional \"submaximal\" treatment to those on maximal treatment.</p><p><strong>Methods: </strong>We queried our Inherited Arrhythmia Registry and identified patients with LQTS who were on \"submaximal\" beta blocker doses (nadolol < 0.75-mg/kg/day & propranolol < 2 mg/kg/day) with at least 6 months follow up. Adequate beta blockade effect was defined as at least 15% decrease from maximal HR.</p><p><strong>Results: </strong>The study included 127 LQTS patients: 47% on maximal therapy, 43% on submaximal therapy, and 10% not receiving treatment. Thirty three percent of patients were on submaximal therapy due to side effects, none in patients less than 10 years of age. Baseline characteristics were similar between the groups. There was no significant difference in LTEs between maximal and submaximal therapy (8% vs. 5.4%, p = 0.72). During CPET, patients on maximal therapy were more likely to exhibit adequate chronotropic suppression (60% vs. 40%, p = 0.01). None of the patients on submaximal therapy with adequate chronotropic effect experienced LTEs during follow-up.</p><p><strong>Conclusions: </strong>Adequate chronotropic suppression was achieved with \"submaximal\" beta blocker dose in 40%. Despite similar baseline risk profiles, LTEs were not significantly different in patients with submaximal versus maximal therapy. CPET may be a useful modality to devise an individualized treatment plan, especially in those who cannot tolerate the recommended guideline directed dose.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isoproterenol for Unmasking Dormant Conduction and Non-Pulmonary Vein Triggers During Atrial Fibrillation Ablation: Prospective Multicenter Study.","authors":"Saumil R Oza, Daniela Hincapie, Manasvi Gupta, Allyson L Varley, Christopher Thorne, Joshua R Silverstein, Mohamed Gabr, Amit J Thosani, Andres F Miranda-Arboleda, Jose Osorio, Alejandro Velasco, Mohammad-Ali Jazayeri, Matthew C Sackett, Alexandru Costea, Anthony Moretta, Richard Kuk, Jose M Silva, Benjamin D'Souza, William Belden, Mark D Metzl, Matthew Quin, Kent E Morris, Jorge E Romero, Nathaniel A Steiger, William Sauer, Paul C Zei","doi":"10.1111/jce.70007","DOIUrl":"https://doi.org/10.1111/jce.70007","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein (PV) reconnection and the onset of non-PV triggers are frequently the cause of atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA). The effectiveness of using isoproterenol for unmasking dormant conduction and non-PV-triggers during AF RFCA and its effect on improving procedural and clinical outcomes is still controversial.</p><p><strong>Objective: </strong>To evaluate the effectiveness of isoproterenol for unmasking dormant conduction and non-PV triggers during RFCA for paroxysmal AF (PAF) and its effects on procedural and long-term clinical outcomes.</p><p><strong>Methods: </strong>In this prospective multicenter cohort from the REAL-AF registry, patients who underwent RFCA for PAF with and without isoproterenol administration from January 2018 to May 2023 were included. The primary efficacy outcome was freedom from all-atrial arrhythmia at 12-month follow-up. Secondary outcomes included procedural and long-term clinical outcomes, and procedure-related complications.</p><p><strong>Results: </strong>A total of 1102 patients were included (isoproterenol = 325 vs. control = 777) (mean age 66.73 ± 10.19 years; 53.05% male). There were no differences in baseline characteristics between the groups. Dormant conduction/non-PV triggers with isoproterenol were observed in 10.2% of the patients. Isoproterenol administration was associated with increased procedural times (109 (83-137.5) vs. 96 (74-122), p = 0.002), and decreased rates of first-pass PV isolation (74.84% vs. 80.14%, p = 0.007). There were no differences in freedom from all-atrial arrhythmias (HR 0.87, 95% CI [0.61-1.24], p = 0.4) or long-term clinical outcomes at 12 months of follow-up between the groups.</p><p><strong>Conclusion: </strong>In patients undergoing RFCA for PAF, the use of isoproterenol was associated with increased procedural times and more extensive ablation, without improved clinical outcomes at 12-month follow-up.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Limitations of Temporary Sinus Rhythm Restoration in Enhancing Catheter Ablation Outcomes for Longstanding Persistent Atrial Fibrillation.","authors":"Zainab Haider Khan, Qura-Tul-Ain, Jananiebarathy Amaranathan, Muneeb Khawar","doi":"10.1111/jce.70012","DOIUrl":"https://doi.org/10.1111/jce.70012","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and Safety of Intramyocardial Needle Ablation for Refractory Ventricular Tachycardia and Premature Ventricular Complexes: A Systematic Review and Meta-Analysis.","authors":"Kartik Gupta, Muhammad Ahmad Qureshi, Bharat Rawlley, Vardhmaan Jain, Atul Verma, Konstantinos C Siontis, Abhishekh Deskhmukh, Arfaat Khan, Mohamad Raad","doi":"10.1111/jce.70000","DOIUrl":"https://doi.org/10.1111/jce.70000","url":null,"abstract":"<p><strong>Introduction: </strong>Intramyocardial needle ablation is a novel technique for treating refractory ventricular tachycardia (VT) and premature ventricular complexes (PVC). However, studies defining the effectiveness and safety of this procedure are limited. This meta-analysis aims to evaluate the safety and effectiveness of needle ablation for VT and PVC refractory to standard ablation.</p><p><strong>Methods: </strong>Embase, Ovid (includes Medline), and ClinicalTrials.gov were searched from inception to December 31, 2024. Human studies on needle ablation for recurrent VT and PVC were included. Primary outcome was immediate effectiveness (no immediate post-procedural inducible VT or PVC). Secondary outcomes were long-term effectiveness (no clinical VT or PVC at 6 months) and safety (composite measure of peri- and post-procedural complications).</p><p><strong>Results: </strong>A total of five studies including 180 patients (140 VT; 40 PVC) were analyzed. Mean ages ranged from 54 to 66 years. Among 129 patients with VT, immediate effectiveness was 75% (95% CI, 54-92; I² 80%), and cumulative freedom from clinical VT dropped to 43% at 6 months (95% CI, 35-52; I² 0%). Among 40 patients with PVC, immediate effectiveness was 82% (95% CI, 67-94; I² 0%), and long-term effectiveness was 76% (95% CI, 61-90; I² 0%). Safety outcomes were reported in 19% of patients (95% CI, 13-27; I² 0%) and 10% of patients (95% CI 1, 23; I² 0%) in the VT and PVC arm, respectively. Death related to ablation was report in 7 patients (5.0%) only in the VT studies.</p><p><strong>Conclusion: </strong>Intramyocardial needle ablation is an emerging alternative approach for refractory VT and PVC ablation, showing cautious but promising results and safety profiles. Prospective studies and an international registry could provide valuable insights needed for optimal patient selection and protocol refinement.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural Outcomes and Conduction System Capture Pattern Maintenance With the Tendril STS™ 2088TC Lead and CPS Locator™ 3D Delivery System: A Comparative Analysis With Lumenless Lead System.","authors":"Ayodeji Dina, Karina Demchuk, Ioannis Koulouridis, Roop Dutta, Vybhav Jetty, Adhiraj Bhattacharya, Danylo Zorin, Artem Astsaturov, Kristen Hagenah, Ibrahim Elgabry, Kathleen Ebersol, Alena Goldman, Shaw Natan, John V Wylie, Michael V Orlov","doi":"10.1111/jce.70003","DOIUrl":"https://doi.org/10.1111/jce.70003","url":null,"abstract":"<p><strong>Introduction: </strong>Left bundle branch area pacing (LBBAP) is typically performed using the lumenless (LLL) Medtronic SelectSecure^TM Model 3830 pacing lead. Stylet-driven leads (SDL) for LBBAP were recently introduced.</p><p><strong>Objective: </strong>To compare the Abbott Tendril STS^TM 2088TC SDL and CPS Locator^TM 3D delivery system to the Medtronic LLL and delivery system acutely and chronically.</p><p><strong>Methods: </strong>Fifty consecutive patients who received SDL using the CPS Locator^TM 3D delivery system for standard pacing indications were included in this study. A comparison was made with 229 LLL patients from a retrospective database, evaluating baseline characteristics, procedural outcomes, lead and system performance, and follow-up data.</p><p><strong>Results: </strong>LBBAP was successful in 84% of SDL and 79% of LLL patients (p = 0.55), with no significant differences in procedural characteristics or complications. Minor pacing differences were noted. CPS Locator^TM 3D performed similarly to C315His® delivery system with a trend for less lead placement attempts. Conduction system capture (CSC) pattern at implant did not differ between both groups. CSC maintenance was similar between SDL and LLL. However, follow-up QRS duration was significantly longer in SDL group (154 ms vs. 129 ms, p = 0.004), suggesting a possibility of CSC loss in some patients.</p><p><strong>Conclusion: </strong>SDL is a viable alternative to LLL, demonstrating comparable acute and midterm pacing parameters. CPS Locator^TM 3D delivery system showed comparable performance and an excellent safety profile. Acute CSC with SDL and LLL is similar, but its long-term maintenance will require further study.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Based Differences in Symptomatology in the First Month Following Atrial Fibrillation Catheter Ablation.","authors":"Mark T Mills, Gregory Y H Lip, Vishal Luther, Dhiraj Gupta","doi":"10.1111/jce.70009","DOIUrl":"https://doi.org/10.1111/jce.70009","url":null,"abstract":"<p><strong>Background: </strong>Differences in baseline characteristics and clinical outcomes exist between female and male patients with atrial fibrillation (AF).</p><p><strong>Objective: </strong>To assess sex-specific symptoms within 1 month of AF catheter ablation.</p><p><strong>Methods: </strong>Patients undergoing AF ablation between 2000 and 2024 were identified from 57 healthcare organizations using a global federated research network. Female and male patients were 1:1 propensity score matched (PSM) based on baseline characteristics. Symptoms within a month of ablation were identified using ICD-10 codes and classified into major systems: cardiac (chest pain, palpitations), respiratory (dyspnea, cough), gastrointestinal (nausea, vomiting, heartburn, dysphagia, bloating, diarrhea, constipation, anorexia), neurological (headache, visual disturbance, speech disturbance, dizziness) and urological (urinary retention and dysuria).</p><p><strong>Results: </strong>After PSM, 69 244 patients were included (34 622 in each group). Female patients had a higher incidence of cardiac (female, 8.9% vs. male, 6.1%; p < 0.001), respiratory (7.9% vs. 6.1%; p < 0.001), gastrointestinal (3.4% vs. 2.2%; p < 0.001) and neurological symptoms (3.1% vs. 2.5%; p < 0.001) compared with male patients. Urological symptoms were more common in male patients (1.6% vs. 0.9%; p < 0.001) due to a higher incidence of urinary retention (1.1% vs. 0.3%; p < 0.001). All individual symptom components of cardiac, respiratory, gastrointestinal and neurological composites were more common in female patients, except from heartburn (0.1% vs. 0.1%; p = 0.49), bloating (0.2% vs. 0.2%; p > 0.99), anorexia (0.1% vs. 0.1%; p = 0.79), and speech disturbance (0.2% vs. 0.2%; p = 0.51) which were similar between sexes.</p><p><strong>Conclusion: </strong>Compared with male patients, female patients experience higher rates of cardiac, respiratory, gastrointestinal, and neurological symptoms within 1 month of AF ablation.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinetics and Disappearance of QRS Transition in Patients Undergoing Left Bundle Branch Pacing - A Novel Method for Classifying Microdislodgement.","authors":"Márk Gémesi, Balázs Polgár, Zoltán Gingl, István Marczell, Előd János Zsigmond, Letícia Chityil-Papp, Péter Bógyi, Gábor Zoltán Duray","doi":"10.1111/jce.16779","DOIUrl":"https://doi.org/10.1111/jce.16779","url":null,"abstract":"<p><strong>Introduction: </strong>QRS transition during the threshold test is the gold standard for confirming direct capture of the Conduction System in patients with left bundle branch pacing (LBBP). Still, we have limited data on the kinetics of QRS transition over time. Microdislodgement is a known complication of left bundle branch area pacing (LBBAP); however, its true incidence depends on the thoroughness of follow-up. We aimed to evaluate the kinetics and disappearance of QRS transition in patients undergoing LBBP, assess the diagnostic yield of QRS transition at various time points, and characterize microdislodgement.</p><p><strong>Methods: </strong>This prospective study included patients who underwent successful LBBP procedures at a tertiary center between January 2022 and February 2024. Based on the kinetics of QRS transition during intraoperative, postoperative, and follow-up threshold tests, microdislodgement was assessed.</p><p><strong>Results: </strong>LBB capture was confirmed in 118 of 155 LBBAP patients (76.1%), which defined our LBBP population. Intraoperative QRS transition was observed in 86.4%, which decreased significantly postoperatively (47.0%) and at follow-up (33.0%)-in 92.0% of LBBP patients' capture of LBB remained, while microdislodgement occurred only in 5.0% of LBBP cases.</p><p><strong>Conclusion: </strong>This study evaluates QRS transition kinetics in LBBAP patients, showing significant intraoperative detectability in patients with direct capture of LBB that decreases postoperatively and at first follow-up. Our classification of microdislodgement aids in understanding its impact on pacing outcomes.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessory Pathway Antegrade Electrophysiologic Features Among Wolff-Parkinson-White Patients: The Risk in Relation to the Location.","authors":"Salah Atta, Mohamed Aboelhassan, Mohamed Khairy Ibraheem, Salma Taha","doi":"10.1111/jce.70008","DOIUrl":"https://doi.org/10.1111/jce.70008","url":null,"abstract":"<p><strong>Background: </strong>Wolff-Parkinson-White (WPW) syndrome is a disorder characterized by presence of an accessory pathway (AP) which predisposes patients to tachyarrhythmia and sudden death. The aim of this study was to evaluate the prevalence of high-risk electrophysiologic AP features among WPW patients referred for electrophysiological study (EPS) and to explore whether the AP location can predict the high-risk nature of the AP.</p><p><strong>Methods: </strong>This descriptive observational study was carried out on 70 patients with WPW subjected to invasive EPS. All patients were subjected to determination of AP anterograde conduction properties [AP effective refractory period (APERP) and shortest pre-excited RR interval (SPERRI)], mapping for localization, and ablation attempts of the AP.</p><p><strong>Results: </strong>Twenty-five patients (35.7%) had an AP antegrade refractory period (APERP) ≤ 240 ms. The shortest RR interval during pre-excited AF (SPERRI) was ≤ 250 ms in 17 patients. Thirty-two APs (45.7%) were classified as high-risk AP (having APERP ≤ 240 ms and/or SPERRI ≤ 250 ms). Radiofrequency ablation was successful in 59/63 patients (93.7%). The mean APERP was significantly lower in postero-septal than anteroseptal and mid-septal APs (p < 0.003), and in left sided than right sided APs (p value = 0.001). Left non-septal APs (specially the left lateral APs) were significantly associated with the presence of high-risk than low-risk parameters. Septal APs (anterior, mid, and posterior) were significantly associated with the presence of low-risk than high-risk parameters.</p><p><strong>Conclusions: </strong>High-risk AP features as determined by the antegrade conduction properties are common among WPW patients. AP location may hold significance in predicting the presence of those high-risk electrophysiologic features.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover Image, Volume 36, Issue 7","authors":"Ming-Jen Kuo,&nbsp;Chin-Yu Lin,&nbsp;Jin-Long Huang,&nbsp;Yenn-Jiang Lin,&nbsp;Yu-Cheng Hsieh,&nbsp;Shih-Lin Chang,&nbsp;Li-Wei Lo,&nbsp;Yu-Feng Hu,&nbsp;Fa-Po Chung,&nbsp;Cheng-Hung Li,&nbsp;Ting-Yung Chang,&nbsp;Ling Kuo,&nbsp;Cheng-I. Wu,&nbsp;Chih-Min Liu,&nbsp;Shin-Huei Liu,&nbsp;Yu-Shan Huang,&nbsp;Shih-Ann Chen","doi":"10.1111/jce.70017","DOIUrl":"https://doi.org/10.1111/jce.70017","url":null,"abstract":"<p>The cover image is based on the article <i>Electrocardiographic characteristics of ventricular arrhythmias originating from high right ventricular outflow tract and pulmonary artery</i> by Chin-Yu Lin et al., https://doi.org/10.1111/jce.16714\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four Different Responses to Premature Atrial Conductions During Narrow Complex Tachycardia.","authors":"Sona Huseynova, Ozcan Ozeke, Ilke Erbay, Can Ozkan, Idriz Merovci, Meryem Kara, Elif Hande Ozcan Cetin, Duygu Kocyiğit Burunkaya, Ahmet Korkmaz, Firat Ozcan, Serkan Cay, Dursun Aras, Serkan Topaloglu","doi":"10.1111/jce.70005","DOIUrl":"https://doi.org/10.1111/jce.70005","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}