Journal of Cardiovascular Development and Disease最新文献

{"title":"Echocardiographic Screening for Transcatheter Edge-to-Edge Mitral Valve Repair: Correlation Between Transthoracic and Transesophageal Assessment.","authors":"Michela Bonanni, Fausto Pizzino, Giovanni Benedetti, Rosangela Capasso, Rachele Manzo, Giuseppe Iuliano, Giancarlo Trimarchi, Andreina D'Agostino, Umberto Paradossi, Alessia Gimelli, Sergio Berti, Massimiliano Mariani","doi":"10.3390/jcdd12040149","DOIUrl":"https://doi.org/10.3390/jcdd12040149","url":null,"abstract":"<p><strong>Background: </strong>In patients with significant mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (M-TEER), assessment of mitral valve (MV) anatomy is essential. While transthoracic echocardiography (TTE) is the initial diagnostic tool, transesophageal echocardiography (TOE) provides better anatomical details. The study aims to assess whether TTE is as effective as TOE in selecting patients with severe MR who are eligible for M-TEER.</p><p><strong>Methods: </strong>From January to December 2024, patients with severe MR eligible for TEER were enrolled at the Fondazione Monasterio Heart Hospital, Italy. They underwent a comprehensive TTE and TOE examination. Cardiologists assessed the severity of MR and valve anatomy using specific protocols. Measurements included MV area, MV gradient, posterior leaflet length, fossa ovalis high, presence of fails, clefts, and calcifications. Three levels of anatomic complexity were defined to determine eligibility for TEER.</p><p><strong>Results: </strong>The study includes 40 patients with severe MR. The correlation between TTE and TOE for key parameters was strong, with coefficients ranging from 0.734 to 0.901, indicating high agreement between the two methods. The comparison of categorical features showed high agreement between TTE and TOE in detecting critical MV conditions, with kappa values ranging from 0.717 to 0.930. The agreement for classifying patients as suitable for M-TEER was 87.5%, indicating moderate consistency between the two methods.</p><p><strong>Conclusions: </strong>TTE may be a viable alternative to TOE for assessing MV anatomy and function before M-TEER in MR patients, especially in high-volume centers. While TTE strongly correlated with TOE for most parameters, TOE was superior for some features. Further research is needed to refine the clinical application of TTE and to define patient selection criteria for its use as the primary imaging modality for pre-procedural M-TEER screening.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Support and 10-Year Mortality Following Acute Myocardial Infarction.","authors":"Batya Betesh-Abay, Arthur Shiyovich, Ygal Plakht","doi":"10.3390/jcdd12040147","DOIUrl":"https://doi.org/10.3390/jcdd12040147","url":null,"abstract":"<p><p>This study investigates social support type and long-term mortality following AMI. Demographic and clinical data were collected retrospectively from a tertiary hospital for all patients with AMI (2011-2017). Study groups based on support type were defined: (1) employed partner (served as the reference group); (2) unemployed partner; (3) no partner, family support; (4) institutional or benefit-dependent; and (5) non-kin support (caregiver). Ten-year all-cause mortality risk was assessed and compared between the groups. We identified 2652 AMI patients with recorded support type: mean age 67.6 (SD = 14) years, 66% male; 40% had no partner, followed by those with an unemployed partner (31%). Over the follow-up of (median) 7.6 years, 1471 patients died; significantly higher mortality rates were observed in patients without family support (67.9%) or receiving non-kin support (94.9%). Those with non-kin support were at the highest mortality risk, AdjHR = 2.20, 95% CI: 1.67-2.91, <i>p</i> < 0.001, as compared with the reference group. Subgroup analyses found women below age 75 years, Arab women, and those with higher functional status to be most vulnerable to mortality in the absence of family support. Lack of family support was associated with increased long-term mortality among AMI patients. Assessment of support status among AMI patients is integral for secondary prevention.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiplatelet and Anticoagulation Therapy in Athletes: A Cautious Compromise… If Possible!","authors":"Flavio D'Ascenzi, Guglielmo Leonardo Manfredi, Vincenzo Minasi, Gian Luca Ragazzoni, Luna Cavigli, Alessandro Zorzi, Giulia Elena Mandoli, Maria Concetta Pastore, Marta Focardi, Matteo Cameli, Massimo Fineschi, Serafina Valente","doi":"10.3390/jcdd12040151","DOIUrl":"https://doi.org/10.3390/jcdd12040151","url":null,"abstract":"<p><p>Antiplatelet and anticoagulation therapy are commonly used in the general population and sometimes in athletes experiencing cardiovascular disorders. In these cases, the treatment has to be tailored according to the individual bleeding and thrombotic risk profile, also considering the intrinsic risk of sports activities when advising athletes for eligibility for competitive sports. In athletes, it is necessary to pre-assess the individual bleeding risk, considering not only the personal bleeding risk (usually low in athletes) but also the type of sport the athlete would like to practice, with careful consideration in sports where traumatic collisions are highly likely. Additionally, non-steroidal anti-inflammatory drugs are commonly used among athletes, and antiplatelet therapy may further increase the bleeding risk. Therefore, in selected competitive athletes, the default approach for antithrombotic therapy could be personalized. This review discusses the clinical management challenges of competitive athletes under antithrombotic or antiplatelet therapy, focusing on the intrinsic risks of sports practice and the indications for sports eligibility and disqualification.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Infarction in the Young: Aetiology, Emerging Risk Factors, and the Role of Novel Biomarkers.","authors":"Mithila Zaheen, Patrick Pender, Quan M Dang, Eva Sinha, James J H Chong, Clara K Chow, Sarah Zaman","doi":"10.3390/jcdd12040148","DOIUrl":"https://doi.org/10.3390/jcdd12040148","url":null,"abstract":"<p><p>Despite significant advancements in the primary and secondary prevention of cardiovascular disease, evidence shows a rising incidence of premature coronary artery disease (CAD) and myocardial infarction (MI) in patients aged < 50 years. This increase is linked to the growing prevalence of traditional cardiovascular risk factors among younger people, such as type 2 diabetes, hypertension, obesity, and hyperlipidaemia, which have led to a rise in atherosclerotic CAD. Additionally, emerging research points to the influence of less traditional risk factors, including chronic inflammation, autoimmune diseases, drug use, psychosocial factors, and novel biomarkers in the early onset of CAD. These factors collectively contribute to the rise in premature CAD, highlighting the need for improved prevention strategies and public health efforts focused on younger populations. In this review, we explore the aetiology, risk factor profile, role of novel biomarkers, and how each of these impact outcomes among younger patients with MI.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic Nervous System Control in Male and Female Elite Soccer Players: Importance of Different Training Routines and Perceived Stress.","authors":"Gianluigi Oggionni, Eleonora Pagani, Jacopo Rizzardini, Margherita Rigillo, Luca Giovanelli, Mara Malacarne, Nuno Loureiro, Júlia Machado Ribeiro, Piero Volpi, Massimo Pagani, Daniela Lucini","doi":"10.3390/jcdd12040150","DOIUrl":"https://doi.org/10.3390/jcdd12040150","url":null,"abstract":"<p><p>The assessment of cardiac autonomic regulation (CAR) with non-invasive techniques, such as heart rate variability (HRV), might be of practical interest in elite sports, considering its importance in determining training. We studied 117 soccer players (74 male and 43 female) from three First Division European soccer teams. We used a ranked Autonomic Nervous System Index (ANSI, resulting from the combination of multivariate statistical methodologies applied to HRV-derived indices) to assess CAR. We hypothesized that ANSI might differentiate playing positions, considering goalkeepers, defenders, midfielders, and forwards. We also assessed the perception of somatic symptoms and stress. We observed in male athletes that ANSI was significantly greater in males as compared to females (<i>p</i> < 0.001), being higher in midfielders and defenders (<i>p</i> = 0.035), who usually sustain the greatest external load. Interestingly, this result was not observed in female athletes, who, instead, reported a significantly higher perception of somatic symptoms (<i>p</i> = 0.018) and stress (<i>p</i> = 0.049), the latter being particularly high in midfielders and forwards (<i>p</i> = 0.045). This approach might represent a convenient model to study the effects of long-term physical exercise on CAR in soccer, even to unveil possible differences due to sex, different playing positions characterized by distinct exercise routines, or stress perception.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Hybrid Minimally Invasive Atrial Fibrillation Ablation Procedure Using Unilateral Thoracoscopy and Endocardial Pulsed Field Ablation: An Early Feasibility Study.","authors":"Ivan Eltsov, Luigi Pannone, Domenico Giovanni Della Rocca, Massimiliano Marini, Giacomo Talevi, Andrea Maria Paparella, Pasquale Vergara, Erwin Ströker, Juan Sieira, Gian-Battista Chierchia, Carlo de Asmundis, Mark La Meir","doi":"10.3390/jcdd12040145","DOIUrl":"https://doi.org/10.3390/jcdd12040145","url":null,"abstract":"<p><p>(1) Objective: To examine the efficiency and efficacy of using endovascular mapping and pulsed field ablation in the setting of a hybrid video-assisted thoracoscopic atrial fibrillation (AF) ablation procedure. (2) Methods: Eleven consecutive patients underwent hybrid video-assisted thoracoscopic epicardial ablation and left atrial appendage exclusion followed by endocardial ablation using pulsed field ablation energy. The completeness of epicardial and endocardial lesion sets were assessed using 3D electro-anatomical mapping. (3) Results: Left atrial appendage (LAA) exclusion and durable pulmonary vein isolation (PVI) and posterior wall isolation (PWI) were achieved in all patients. The endovascular part of the necessary lesion set using PFA energy was successful in 100% of the patients. All patients remained in SR during the 12-month follow-up period. (4) Conclusions: Our study confirms the feasibility of using endovascular pulsed field ablation to complete previously performed epicardial lesion sets during the hybrid AF ablation procedures, without extending the procedure time or increasing the risk of complications.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Management of Spontaneous Aortic Thrombus Floating in the Ascending Aorta, from a Single Case Experience to a Literature Review.","authors":"Jacopo Gardellini, Daniele Linardi, Venanzio Di Nicola, Gino Puntel, Giovanni Puppini, Luca Barozzi, Giovanni Battista Luciani","doi":"10.3390/jcdd12040146","DOIUrl":"https://doi.org/10.3390/jcdd12040146","url":null,"abstract":"<p><p>As spontaneous ascending aortic thrombi (AATs) are uncommon in modern clinical practice, despite the application of new technology and the widespread use of contrast-enhanced computer tomography during primary assessments in patients without underlying predisposing conditions, a thrombus floating in the ascending aorta is rarely discovered in a timely manner; moreover, the ascending tract represents an unusual site for thrombus formation. The clinical presentation of AATs is also often in the form of peripheral arterial embolization, which can cause a wide variety of symptoms, from stroke to limb ischemia, and thus delay correct diagnosis. Medical management is a risky strategy, while surgical treatment is usually challenging due to the risk of thrombus dislodgement and difficulties related to prior embolization complication management. In this study, faced with a peculiar case of embolic stroke in an otherwise healthy 71-year-old woman, we analyzed the status of knowledge on spontaneous ascending aortic thrombus treatments and outcomes. A multidisciplinary approach represents the best choice for defining a patient's timing of surgery and ensuring the management of complications. Sequential multistage treatment minimizes further complications and prevents worsening patient outcomes, leading to the best management for every possible clinical presentation. A less invasive surgical approach could lead to complete resolution of the pathology, avoiding further potentially lethal complications, facilitating postoperative management, avoiding delayed treatments, and resulting in better outcomes.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copeptin in Acute Myocardial Infarction: Is There a Role in the Era of High-Sensitivity Troponins?","authors":"Sofia Bezati, Ioannis Ventoulis, Vasiliki Bistola, Christos Verras, Dionysis Matsiras, Effie Polyzogopoulou, John Parissis","doi":"10.3390/jcdd12040144","DOIUrl":"https://doi.org/10.3390/jcdd12040144","url":null,"abstract":"<p><p>The quest for prompt and effective diagnosis of acute myocardial infarction (AMI) has been in the spotlight for decades. Ongoing research focuses on refined biomarker strategies for the early identification and disposition of patients with symptoms suggestive of AMI. Copeptin, a surrogate of the hormone arginine vasopressin, has emerged as a novel biomarker that could potentially aid in the diagnostic approach of patients with chest pain presenting to the emergency department. Observational studies have demonstrated that copeptin is upregulated in patients with AMI, although the exact pathophysiological mechanisms implicated in its release during myocardial ischemia remain unclear. Following these observations, copeptin was proposed as an adjunct to troponin in an effort to augment the diagnostic accuracy of conventional troponin assays. However, after the introduction of high-sensitivity troponin assays, the diagnostic utility of copeptin has been debated. This narrative review aims to elucidate plausible pathophysiological mechanisms involved in copeptin release during myocardial ischemia and to summarize the most recent evidence regarding its diagnostic potential in combination with high-sensitivity troponin assays.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroprotective Strategies in Coronary Artery Disease Interventions.","authors":"Maurish Fatima, Akbar Bazarbaev, Asama Rana, Ruman Khurshid, Victory Effiom, Nyle Khalid Bajwa, Afsheen Nasir, Katherine Candelario, Sair Ahmad Tabraiz, Samantha Colon, Chanseo Lee, Sedem Dankwa, Irbaz Hameed","doi":"10.3390/jcdd12040143","DOIUrl":"https://doi.org/10.3390/jcdd12040143","url":null,"abstract":"<p><p>Neuroprotective strategies in coronary artery interventions are essential due to the rising number of high-risk patients undergoing procedures like coronary artery bypass grafting (CABG), totally endoscopic coronary artery bypass (TECAB), and hybrid revascularization. In this review article, we summarize the neurological complications associated with coronary artery disease intervention and the risk mitigation strategies. CABG carries significant risks, including ischemic stroke, encephalopathy, seizures, and peripheral nerve injuries. Risk factors include advanced age, hypertension, diabetes, and atherosclerosis. Off-pump CABG minimizes stroke risk by avoiding aortic manipulation and CPB. TECAB and hybrid revascularization have fewer reported neurological complications but still pose risks of stroke and cranial nerve injuries. Pharmacological neuroprotection includes agents such as barbiturates, volatile anesthetics, lidocaine, NMDA receptor antagonists, magnesium, nimodipine, corticosteroids, and aprotinin. Deep hypothermic circulatory arrest (DHCA) is reserved for complex aortic cases requiring a bloodless surgical field. Intraoperative strategies involve cerebral perfusion monitoring, embolic protection devices, and therapeutic hypothermia. Preoperative optimization targets risk factors, arrhythmia prevention, and antiplatelet therapy management. Postoperatively, timely antiplatelet administration, glucose control, hemodynamic stabilization, and cognitive monitoring are critical. Comprehensive neuroprotective approaches, spanning pre- to postoperative phases, aim to reduce neurological complications and enhance outcomes in coronary interventions.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural and Antithrombotic Therapy Optimization in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A Narrative Review.","authors":"Domenico Simone Castiello, Federica Buongiorno, Lina Manzi, Viviana Narciso, Imma Forzano, Domenico Florimonte, Luca Sperandeo, Mario Enrico Canonico, Marisa Avvedimento, Roberta Paolillo, Alessandra Spinelli, Stefano Cristiano, Fiorenzo Simonetti, Federica Semplice, Dario D'Alconzo, Donato Maria Vallone, Giuseppe Giugliano, Alessandro Sciahbasi, Plinio Cirillo, Felice Gragnano, Paolo Calabrò, Giovanni Esposito, Giuseppe Gargiulo","doi":"10.3390/jcdd12040142","DOIUrl":"https://doi.org/10.3390/jcdd12040142","url":null,"abstract":"<p><p>In the past decades, percutaneous coronary intervention (PCI) has become the most common modality for myocardial revascularization in patients with coronary artery disease (CAD). Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is essential in all patients undergoing PCI to prevent thrombotic complications. A large proportion of patients undergoing PCI also have concomitant atrial fibrillation (AF), thus requiring an oral anticoagulant (OAC) to prevent ischemic stroke or systemic embolism. However, the association between OAC and DAPT further increases the risk of bleeding. Compared with a triple antithrombotic therapy (TAT), dual antithrombotic therapy (DAT) has shown to reduce bleeding events, but at the cost of higher risk of stent thrombosis. In this field, patients with AF undergoing PCI represent a special population with significant challenges, and several strategies are needed to reduce the risk for bleeding complications. In this review, we will discuss both the procedural and antithrombotic strategies to optimize ischemic and bleeding outcomes in patients with AF undergoing PCI.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}