Journal of Cardiovascular Echography最新文献

{"title":"Unmasking Eosinophilic Myocarditis: Importance of Multimodality Imaging and Histological Confirmation in a Challenging Case.","authors":"Simone Luciani, Umberto Ianni, Antonio Dello Russo, Vito Maurizio Parato, Fabio Vagnarelli","doi":"10.4103/jcecho.jcecho_35_26","DOIUrl":"10.4103/jcecho.jcecho_35_26","url":null,"abstract":"<p><p>Eosinophilic myocarditis (EM) is a rare entity, characterized by a heterogeneous clinical presentation, ranging from acute heart failure to acute coronary syndrome, and associated with severe complications. Herein, we describe the case of a 78-year-old woman who presented to the ED with chest pain, elevated cardiac biomarkers, T-wave inversion on the electrocardiogram, left ventricular systolic dysfunction, and intraventricular thrombus (confirmed by contrast echo). Coronary angiography revealed the absence of obstructive coronary artery disease. Cardiac magnetic resonance (CMR) demonstrated the findings consistent with myocarditis. Due to concomitant hypereosinophilia, an endomyocardial biopsy (EB) was performed, revealing eosinophilic infiltrates. A diagnosis of EM was therefore established, and treatment with corticosteroids and anti-interleukin-5 monoclonal antibodies was initiated. This case report highlights the importance of early diagnosis of EM, a potentially elusive condition with misleading clinical features. In cases of suspected EM, CMR and, when feasible, EB are crucial to establish the diagnosis and guide appropriate therapy.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 4","pages":"476-480"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subpulmonic Stenosis due to Systolic Anterior Motion of Elongated Papillary Muscle with Basal Chordal Attachment in a Patient with Congenitally Corrected Transposition of the Great Arteries.","authors":"Homa Ghaderian, Sahar Asl-Fallah, Ali Hosseinsabet","doi":"10.4103/jcecho.jcecho_113_25","DOIUrl":"10.4103/jcecho.jcecho_113_25","url":null,"abstract":"<p><p>One of the complex congenital cardiac diseases is congenitally corrected transposition of the great arteries (cc-TGA). The most important feature of this anomaly is atrioventricular and ventriculo-arterial discordance. Several pathologies, such as subpulmonary obstruction, can accompany this anomaly. Several etiologies can cause subpulmonary obstruction. Echocardiography serves as an initial imaging method in assessing patients with this condition and in detecting accompanying anomalies. Here, we present a man with cc-TGA, accompanied by severe subpulmonic stenosis resulting from anterior systolic motion of an elongated papillary muscle with basal chordal attachment.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 2","pages":"178-181"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care Cardiac Ultrasound in Coronavirus Disease 2019: Indications and Potentials.","authors":"Rim J El-Annan, Dalia Safi, Mariam Arabi","doi":"10.4103/jcecho.jcecho_173_25","DOIUrl":"10.4103/jcecho.jcecho_173_25","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19) strained health systems worldwide and underscored the need for rapid, safe, and efficient bedside imaging. This narrative review synthesizes forty studies, largely from the United States and Europe, on the role of point-of-care ultrasound (POCUS) in the care of patients with COVID-19, with emphasis on cardiology. Compared with full transthoracic echocardiography and computed tomography, POCUS is faster, less costly, and free of ionizing radiation. Several reports document a reduction in staff exposure time by up to seventy-one percent, lowering infection risk and conserving personal protective equipment. In critically ill patients, POCUS frequently identifies right ventricular dysfunction and pulmonary abnormalities, including vertical reverberation artifacts and subpleural consolidations, which support timely clinical decisions; some series observed management changes in as many as seventy percent of cases. Limitations include operator dependence, variable image quality, and a restricted field of view that can necessitate complementary imaging. Overall, POCUS shows strong promise as an integral element of COVID-19 pathways and routine cardiovascular care. Broader training, competency assessment, and standardized protocols are needed to ensure consistent, high-quality implementation at the bedside.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 2","pages":"101-110"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Data on Left Atrial Strain by Echocardiography in Patients with Heart Failure and Preserved Ejection Fraction.","authors":"Sara Afshar, Reza Khademi, Amirhossein Mirzaei, Hoorak Poorzand, Maryam Karimi Teymouri, Vafa Baradaran Rahimi","doi":"10.4103/jcecho.jcecho_157_25","DOIUrl":"10.4103/jcecho.jcecho_157_25","url":null,"abstract":"<p><strong>Background: </strong>This study confronts the diagnostic challenge of identifying diastolic heart failure (HF) in patients with normal systolic function in the early stages of HF.</p><p><strong>Materials and methods: </strong>The study evaluated patients with HF symptoms, excluding those with evidence of increased ventricular filling pressure. All patients underwent stress echocardiography and were categorized into two groups: Heart failure with preserved ejection fraction (HFpEF) (elevated left ventricular end-diastolic pressure) and those with normal left ventricle filling pressure. Echocardiography measured left atrial (LA) strain in three phases.</p><p><strong>Results: </strong>Among the 64 patients, 47 exhibited Grade 1 diastolic dysfunction (DD), and 17 had Grade 2 dysfunction (HFpEF). Echocardiographic factors, including the peak jet velocity of tricuspid regurgitation (TR) exercise, A during rest, E/E' during rest and exercise, LA volume, LA volume index, LA vol index/S1 + S2 + S3, LA vol index/Strain 1, and LA stiffness (E/E'/Strain 1) were significantly lower in Grade 1 diastolic HF than in Grade 2 patients. In contrast, E during rest and exercise, E' during exercise, Strain 1, Strain 2, Strain 3, S1 + S2 + S3, and LVEDD/body surface area were significantly higher in Grade 1 diastolic HF than in Grade 2 patients. In receiver-operating characteristic curve analysis, LA vol index/S1 + S2 + S3, LA vol index/S1, Strain 1, S1 + S2 + S3, and E/E'/Strain 1 showed the potential clinical applicability in diagnosing diastolic HF.</p><p><strong>Conclusion: </strong>Alterations in atrial strain could potentially serve as an early indicator for diagnosing DD. Atrial stiffness with a cutoff of 1.25 can distinguish Grade 2 HF from Grade 1 with high sensitivity and specificity. However, more investigations in this field are warranted.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 2","pages":"164-170"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Study on Effects of Sacubitril-Valsartan on Left Ventricular Ejection Fraction, Myocardial Biomarker, and Myocardial Remodeling in Patients with Heart Failure with Reduced Ejection Fraction.","authors":"Rishabh Gaba, Deepak Agrawal, Rakesh Kumar Meena, Manish Pabri, Jay Kumar Sharma","doi":"10.4103/jcecho.jcecho_159_25","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_159_25","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular ejection fraction (LVEF) is widely used to assess cardiac function but primarily reflects volumetric changes rather than intrinsic myocardial mechanics. Sacubitril/Valsartan, an angiotensin receptor-neprilysin inhibitor, has demonstrated significant benefits in heart failure with reduced ejection fraction (HFrEF). However, its effect on LVEF and left ventricular (LV) torsional dynamics remains insufficiently explored.</p><p><strong>Materials and methods: </strong>This prospective study enrolled 100 patients with HFrEF. Baseline evaluation included clinical history, physical examination, and laboratory parameters (body mass index, blood pressure, renal function, lipid profile, and electrolytes). Echocardiographic assessment - conventional and speckle-tracking - was performed at baseline, 3 months, and 6 months to measure LVEF, LV rotation, and torsion.</p><p><strong>Results: </strong>Participants had a mean age of 51.5 years, and 30% had diabetes. At baseline, the median LVEF was 35.5%, which improved to 40.6% at 6 months (interquartile range (IQR) =5.1; <i>P</i> < 0.01), indicating significant reverse remodeling. The LV end-diastolic index decreased from 57.5 to 52.1 (IQR = 5.4; <i>P</i> < 0.01), and the end-systolic index (LVESi) decreased from 39.0 to 34.4 (IQR = 4.6; <i>P</i> < 0.01). LV mass showed an IQR of 27 (246.9-273.9). N-terminal pro B-type natriuretic peptide levels demonstrated a marked reduction, with an IQR of 1442.4 (1030.6-2473). These findings collectively reflect significant structural and functional improvement over the 6-month follow-up.</p><p><strong>Conclusion: </strong>Sacubitril/Valsartan therapy improves LVEF and LV structural dynamics in HFrEF patients, supporting its role as a superior alternative to enalapril. These findings align with evidence of approximately 20% relative risk reduction in sudden cardiac death and heart failure-related mortality among patients with an ejection fraction <40% and elevated natriuretic peptides.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"287-294"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Presyncope to Recovery: Echocardiography-guided Transcatheter Aortic Valve Implantation for Severe Bicuspid Aortic Stenosis.","authors":"S Fildzah Dini Atikah, Achmad Lefi, Ovin Nada Saputri, Dian Paramita Kartikasari, Ratih Rahmanyati Pasah, Irawati Hajar Kikuko, Yudi Her Oktaviono","doi":"10.4103/jcecho.jcecho_27_26","DOIUrl":"10.4103/jcecho.jcecho_27_26","url":null,"abstract":"<p><p>Bicuspid aortic valve (AV) is the most common congenital cardiac valvular anomaly and often progresses to severe calcific aortic stenosis (AS). Although surgical AV replacement has been the conventional treatment, transcatheter AV implantation (TAVI) is emerging as a viable alternative, especially in patients with high surgical risk or complex anatomy. This case report demonstrates the crucial role of echocardiography in the management of TAVI in a patient with bicuspid AS. A 66-year-old male with a 3-year history of palpitations and recurrent presyncope underwent a comprehensive evaluation for suspected AV disease. Transthoracic echocardiography (TTE) revealed severe bicuspid AS with preserved left ventricular function. Coronary angiography and computed tomography angiography were performed for anatomical and procedural assessment, confirming suitability for TAVI. The procedure was conducted through a transfemoral approach using a 24-mm self-expanding bioprosthetic valve under echocardiographic guidance. TEE provided real-time imaging during valve deployment, while serial TTE was used for postprocedural and follow-up evaluations at 1 and 6 months to assess valve function and complications. This case underscores the central role of echocardiography in the comprehensive management of TAVI for bicuspid AS, from patient selection and intraprocedural guidance to postimplantation monitoring, ultimately optimizing clinical outcomes.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 4","pages":"472-475"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant Dynamic Left Ventricular Outflow Tract Obstruction and Severe Aortic Stenosis a Case Report and a Literature Review.","authors":"Tommaso Crovetto, Fabio Vagnarelli, Vito Maurizio Parato, Alessandro Barbarossa","doi":"10.4103/jcecho.jcecho_95_25","DOIUrl":"10.4103/jcecho.jcecho_95_25","url":null,"abstract":"<p><p>We report the case of a 77-year-old woman presenting with a hypertrophic cardiomyopathy phenotype characterized by hemodynamically significant dynamic left ventricular outflow tract obstruction (LVOTO) due to mitral systolic anterior motion (SAM), in association with aortic stenosis (AS). The clinical presentation included an episode of syncope, followed by progressive exertional dyspnea. Initial transthoracic echocardiography revealed marked septal hypertrophy, a calcified aortic valve with elevated transvalvular gradients, and SAM-induced dynamic LVOTO. Sarcomeric hypertrophic cardiomyopathy (HCM) and its phenocopies were subsequently excluded from the study. Transesophageal echocardiography confirmed the coexistence of severe AS and SAM. Given the complexity of the patient's cardiac condition and the presence of a \"porcelain aorta,\" both surgical and transcatheter aortic valve replacement were deemed high risk. We discuss the diagnostic and therapeutic challenges of this \"double-threat\" scenario - severe aortic stenosis combined with dynamic LVOTO - and review the relevant literature regarding its hemodynamic implications, imaging strategies, and management approaches, including the concept of the \"suicide left ventricle\".</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 2","pages":"190-198"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Serum Chemerin Levels with Coronary Plaque Burden Assessed by Intravascular Ultrasound in Patients with Chronic Coronary Syndrome.","authors":"Mohamed Fahmy Elnoamany, Nouran Ahmed Raafat Mohamed Gaballa, Fatma Elzahraa Abdelmoniem Zein","doi":"10.4103/jcecho.jcecho_133_25","DOIUrl":"10.4103/jcecho.jcecho_133_25","url":null,"abstract":"<p><strong>Background: </strong>Chemerin has emerged as a proinflammatory adipokine implicated in atherosclerotic processes. Yet, its connection with coronary plaque burden in the setting of chronic coronary syndrome (CCS) has not been comprehensively studied. This study aims to examine the association between serum chemerin concentrations and intravascular ultrasound (IVUS)-based assessment of coronary plaque burden in CCS cases.</p><p><strong>Patients and methods: </strong>This prospective case-control investigation included 80 cases undergoing elective coronary angiography - 50 with <i>de novo</i> atherosclerotic lesions (cases) and 30 with angiographically normal coronaries (controls). Serum chemerin was measured by enzyme-linked immunosorbent assay. Assessment of plaque burden was performed with IVUS, whereas angiographic severity was evaluated by applying the Gensini, SYNTAX, and severity scoring systems.</p><p><strong>Results: </strong>Cases exhibited substantially elevated serum chemerin levels relative to controls (median: 346.6 vs. 93 ng/mL; <i>P</i> < 0.001). The mean plaque burden assessed by IVUS was 72 ± 16%. Chemerin concentrations were positively correlated with the severity score (<i>r</i> = 0.63, <i>P</i> < 0.001), Gensini score (<i>r</i> = 0.48, <i>P</i> = 0.001), and IVUS-derived plaque burden (<i>r</i> = 0.71, <i>P</i> < 0.001). Receiver-operating characteristic analysis demonstrated excellent diagnostic accuracy for chemerin in identifying CCS (area under the curve = 0.948; sensitivity 90%, specificity 100% at a cutoff >155 ng/mL). In multivariate analysis, chemerin was the strongest independent predictor of CCS (odds ratio = 1.047; 95% confidence interval: 1.019-1.075; <i>P</i> = 0.001) and plaque burden (β = 0.096; <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Serum chemerin is a valuable noninvasive biomarker for identifying cases with high-risk atherosclerotic disease; however, no long-term follow-up data were available in this study.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 2","pages":"156-163"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"West Nile Virus as a Trigger for Cardiovascular Diseases: A Meta-summary of Case Reports.","authors":"Alfredo Mauriello, Adriana Correra, Giulia Zumbo, Francesco Giallauria, Alfredo Caturano, Pierpaolo Di Micco, Antonello D'andrea, Alberto Enrico Maraolo, Vincenzo Russo","doi":"10.4103/jcecho.jcecho_141_25","DOIUrl":"10.4103/jcecho.jcecho_141_25","url":null,"abstract":"<p><strong>Background: </strong>West Nile virus (WNV) has recently been described as a possible trigger of cardiovascular diseases (CVDs). There is little data in the literature about this association.</p><p><strong>Subjects and methods: </strong>In the present meta-summary, eight case reports describing patients who experienced CVDs following a WNV infection were included. Patient characteristics, triggers, and type of syncope were collected.</p><p><strong>Results: </strong>A total of eight patients with a median age of 67.29 (interquartile range: 53-70) years were evaluated; 87.5% were male. Seventy-five percent of patients had an altered mental status. Left ventricular ejection fraction was impaired in five patients (62.5%). Four of eight patients (50%) had arrhythmias, with 3 of them having a normal ejection fraction. Sudden cardiac death was reported in one patient (12.5%).</p><p><strong>Conclusions: </strong>CVDs due to WNV have been associated with myocarditis and arrhythmias, among elderly patients, males, and those with neurological impairment.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 1","pages":"33-37"},"PeriodicalIF":1.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Challenges of Diagnosing Arrhythmogenic Cardiomyopathy.","authors":"Leonardo Brugiatelli, Carla Lofiego, Irene Capodaglio, Fabio Vagnarelli","doi":"10.4103/jcecho.jcecho_136_25","DOIUrl":"10.4103/jcecho.jcecho_136_25","url":null,"abstract":"<p><p>This case report describes a 55-year-old asymptomatic woman with persistent T-wave inversion who was initially suspected of having arrhythmogenic cardiomyopathy (ACM) based on cardiac magnetic resonance findings of epicardial lipomatosis and a dyskinetic right ventricular segment. Advanced CMR with T1 mapping later reclassified the dyskinetic segment as a benign anatomical variant-a \"butterfly apex\"-and confirmed isolated epicardial fat without myocardial infiltration. Over long-term follow-up, no arrhythmias or structural progression occurred. The case highlights the critical role of multimodal imaging in differentiating ACM from benign anatomical mimics, thereby preventing misdiagnosis and unnecessary intervention.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 1","pages":"66-69"},"PeriodicalIF":1.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}