Journal of Cardiovascular Development and Disease最新文献

{"title":"Pathophysiology of Maternal Obesity and Hypertension in Pregnancy.","authors":"Joana Lourenço, Luís Guedes-Martins","doi":"10.3390/jcdd12030091","DOIUrl":"10.3390/jcdd12030091","url":null,"abstract":"<p><p>Obesity is one of the biggest health problems in the 21st century and the leading health disorder amongst women of fertile age. Maternal obesity is associated with several adverse maternal and fetal outcomes. In this group of women, the risk for the development of hypertensive disorders of pregnancy (HDPs), such as gestational hypertension (GH) and pre-eclampsia (PE), is increased. In fact, there is a linear association between an increase in pre-pregnancy body mass index (BMI) and PE. Excessive weight gain during pregnancy is also related to the development of PE and GH. The role of obesity in the pathophysiology of HDP is complex and is most likely due to an interaction between several factors that cause a state of poor maternal cardiometabolic health. Adipokines seem to have a central role in HDP development, especially for PE. Hypoadiponectinemia, hyperleptinemia, insulin resistance (IR), and a proinflammatory state are metabolic disturbances related to PE pathogenesis, contributing to its development by inducing a state of maternal endothelial dysfunction. Hypertriglyceridemia is suggested to also be a part of the disease mechanisms of HDP. Therefore, this review seeks to explore the scientific literature to assess the complications of maternal obesity and its association with the development of HDP.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709872","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":"Incidence and Risk Factors for Developing Type 2 Diabetes Mellitus After Acute Myocardial Infarction-A Long-Term Follow-Up.","authors":"Tamara Yakubov, Muhammad Abu Tailakh, Arthur Shiyovich, Harel Gilutz, Ygal Plakht","doi":"10.3390/jcdd12030089","DOIUrl":"10.3390/jcdd12030089","url":null,"abstract":"<p><p>Acute myocardial infarction (AMI) and type 2 diabetes mellitus (T2DM) share common risk factors. To evaluate the long-term incidence and predictors of new-onset T2DM (NODM) among post-AMI adults, we conducted a retrospective analysis of AMI survivors hospitalized between 2002 and 2017. Eligible patients were followed for up to 16 years to identify NODM, stratified by demographic and clinical characteristics. Among 5147 individuals (74.2% males, mean age 64.6 ± 14.9 years) without pre-existing T2DM, 23.4% developed NODM (cumulative incidence: 0.541). Key risk factors included an age of 50-60 years, a minority ethnicity (Arabs), smoking, metabolic syndrome (MetS), hemoglobin A1C (HbA1C) ≥ 5.7%, and cardiovascular comorbidities. A total score (TS), integrating these factors, revealed a linear association with the NODM risk: each 1-point increase corresponded to a 1.2-fold rise (95% CI 1.191-1.276, <i>p</i> < 0.001). HbA1C ≥ 6% on the \"Pre-DM sub-scale\" conferred a 2.8-fold risk (<i>p</i> < 0.001), while other risk factors also independently predicted NODM. In conclusion, post-AMI patients with multiple cardiovascular risk factors, particularly middle-aged individuals, Arab individuals, and those with HbA1C ≥ 6% or MetS, are at a heightened risk of NODM. Early identification and targeted interventions may mitigate this risk.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709688","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":"Common Risk Factors for Atrial Fibrillation After Transcatheter Aortic Valve Implantation: A Systematic Review from 2009 to 2024.","authors":"John Fernando Montenegro-Palacios, Sinthia Vidal-Cañas, Nelson Eduardo Murillo-Benítez, Jhon Quintana-Ospina, Carlos Andrés Cardona-Murillo, Yamil Liscano","doi":"10.3390/jcdd12030090","DOIUrl":"10.3390/jcdd12030090","url":null,"abstract":"<p><p>Transcatheter Aortic Valve Implantation (TAVI) is an effective treatment for severe aortic stenosis in high-risk patients; however, atrial fibrillation (AF) is a common complication associated with the procedure. New-Onset Atrial Fibrillation (NOAF) after TAVI is linked to increased mortality and additional complications. This study aimed to evaluate the incidence of NOAF following TAVI and identify risk factors associated with mortality and the development of thromboembolic events. A systematic review of 18 studies was conducted using databases such as MEDLINE/PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, Google Scholar, Wiley Online Library, SciELO, and Redalyc. No language restrictions were applied, and the search covered studies from 2009 to 2024. The follow-up period ranged from 48 h to 730 days, with a mean of 180 days. Early monitoring and management of AF are essential in patients undergoing TAVI. The incidence of NOAF ranged up to 29.04%, meaning about 29 out of every 100 patients were affected. AF rates varied between 7.2% and 37%, with an average of around 20. Standardizing anticoagulation strategies is important to reduce complications. Randomized studies are needed to evaluate the relationship between AF and post-TAVI mortality and to determine whether AF is a marker of higher risk or an independent factor in these patients.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709890","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":"Oral Anticoagulation Choice and Dosage in Very Elderly Patients with Atrial Fibrillation.","authors":"Martha Zergioti, Melina Kyriakou, Andreas S Papazoglou, Anastasios Kartas, Dimitrios V Moysidis, Athanasios Samaras, Efstratios Karagiannidis, Vasileios Kamperidis, Antonios Ziakas, George Giannakoulas","doi":"10.3390/jcdd12030086","DOIUrl":"10.3390/jcdd12030086","url":null,"abstract":"<p><strong>Background: </strong>Selecting the optimal oral anticoagulation (OAC) therapy for elderly patients with atrial fibrillation (AF) remains challenging. Our real-world study investigates clinical factors guiding OAC prescription patterns and compares outcomes between full- and reduced-dose direct-acting oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) in this demographic.</p><p><strong>Methods: </strong>This post hoc analysis of the MISOAC-AF trial focused on hospitalized AF patients aged ≥ 75 years prescribed OAC at discharge. Predictors of VKA and reduced DOAC dosing were identified using adjusted odds ratios (aORs). Cox regression models calculated adjusted hazard ratios (aHRs) for primary (all-cause mortality) and secondary outcomes (stroke, bleeding, AF or heart failure hospitalization, cardiovascular death).</p><p><strong>Results: </strong>Among 450 elderly patients, 63.6% received DOACs and 36.4% received VKAs. Higher CHA2DS2-VASc and HAS-BLED scores and antiplatelet use predicted VKA prescription. Hypertension, prior stroke, and bleeding history favored DOAC use. Advanced age and chronic kidney disease correlated with reduced DOAC dosing. Over a 3.7-year follow-up period, there was no significant difference in all-cause mortality between the DOAC and VKA groups (aHR 0.79, 95% CI 0.58-1.06) or between the full-dose and reduced-dose DOAC groups (aHR 0.96, 95% CI 0.60-1.53). Secondary analyses also did not yield statistically significant results in either comparison.</p><p><strong>Conclusions: </strong>Clinical profile parameters in elderly AF patients predict VKA or DOAC use. Clinical outcomes were similar between different OAC therapies.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709869","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":"Obesity-Induced PVAT Dysfunction and Atherosclerosis Development: The Role of GHSR-1a in Increased Macrophage Infiltration and Adipocytokine Secretion.","authors":"Sorin Nicolae Peiu, Florin Zugun-Eloae, Bogdan Stoica, Ecaterina Anisie, Diana Gabriela Iosep, Mihai Danciu, Iustina Silivestru-Crețu, Fawzy Akad, Andrei Nicolae Avadanei, Laura Condur, Radu Florin Popa, Veronica Mocanu","doi":"10.3390/jcdd12030087","DOIUrl":"10.3390/jcdd12030087","url":null,"abstract":"<p><p>In obesity, recent research revealed that increased expression of the growth hormone secretagogue receptor (GHSR) in macrophages plays a pivotal role in the development of meta-inflammation, promoting macrophage infiltration and pro-inflammatory polarization. This study aimed to examine the association between GHSR-1a expression in atherosclerotic plaques and adjacent perivascular adipose tissue (PVAT) from 11 patients with obesity and peripheral artery disease (PAD) who underwent revascularization procedures. Immunohistochemistry was used to assess the expression of CD68, CD80, and CD14, while tissue homogenate levels of adiponectin, leptin, IL-6, and CRP were quantified via ELISA. Serum markers of inflammation were also measured. Among patients with GHSR-1a-positive (+) macrophages in atherosclerotic plaques, we observed significantly higher white blood cell counts and platelet-to-lymphocyte ratios in serum, a lower adiponectin-to-leptin ratio, and elevated IL-6 levels in both arterial and PVAT homogenates. Our findings suggest a link between GHSR-1a and macrophage/monocyte infiltration, macrophage polarization, and adipocytokine secretion in atherosclerotic plaques associated with obesity-induced PVAT dysfunction.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709866","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":"Gender Differences for His Bundle Pacing Long-Term Performance in the Elderly Population.","authors":"Catalin Pestrea, Ecaterina Cicala, Dragos Lovin, Adrian Gheorghe, Florin Ortan, Rosana Manea","doi":"10.3390/jcdd12030088","DOIUrl":"10.3390/jcdd12030088","url":null,"abstract":"<p><strong>Background and aims: </strong>His bundle pacing (HBP) is considered the most physiological form of cardiac pacing. Although feasibility studies have included older patients, specific data for HBP in this population are scarce. This study aimed to evaluate gender differences in HBP long-term performance in elderly patients with atrioventricular (AV) block.</p><p><strong>Methods: </strong>This retrospective study included 73 patients aged over 65 years with successful HBP and at least 2 years of follow-up. The patients' baseline and follow-up clinical and procedural characteristics were recorded.</p><p><strong>Results: </strong>The mean age of the cohort was 72.8 ± 6.3 years, with 43 males and 30 females. The paced QRS complex was significantly narrower than the baseline value for both genders. Females had a narrower-paced QRS complex without differences in detection, type of His bundle capture, impedance, or fluoroscopy time. The pacing threshold increased progressively, reaching statistical significance compared to the baseline values at the two-year follow-up. The pacing threshold increased by more than 1 V over the follow-up period in twenty-four patients (32.9%) and by more than 2 V in six patients (8.2%), with no significant difference between genders. The pacing threshold increase occurred within the first year for most patients, without gender differences. Multivariate Cox regression analysis demonstrated that the paced QRS duration, left ventricular ejection fraction, and ischemic cardiomyopathy were significantly associated with the pacing threshold increase over time.</p><p><strong>Conclusion: </strong>In elderly patients with AV block, HBP remains a feasible pacing method, without significant gender differences, over a long-term follow-up period. Pacing threshold increases are expected in up to one-third of the patients, requiring regular follow-ups to adjust the programmed parameters and optimize battery longevity.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709585","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":"Predictive Threshold Value of the Breathing Reserve for the Decline in Cardiorespiratory Fitness Among the Healthy Middle-Aged Population.","authors":"Tao Shen, Yang Wang, Jinglin Li, Shunlin Xu, Peng Wang, Wei Zhao","doi":"10.3390/jcdd12030085","DOIUrl":"10.3390/jcdd12030085","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the cut-off value of the breathing reserve for predicting a decline in cardiorespiratory fitness (CRF) among healthy middle-aged Chinese individuals.</p><p><strong>Methods: </strong>Healthy middle-aged individuals who underwent cardiopulmonary exercise testing (CPET) at the Peking University Third Hospital from May to October 2021 were selected. The study included 321 participants, with an average age of 48.8 ± 5.7 years. They were divided into two groups based on the peak oxygen uptake (VO₂peak): the adequate CRF group and the CRF decline group. Multivariate logistic regression analysis was used to explore the factors influencing CRF.</p><p><strong>Results: </strong>In the male CRF decline group, heart rate, alanine aminotransferase, end-tidal partial pressure of carbon dioxide (PETCO₂), and breathing reserve (BR%) were significantly higher, while the oxygen uptake at the anaerobic threshold (VO₂@AT) was lower. An elevated BR% was independently associated with CRF decline (OR = 1.111, 95% CI: 1.068-1.156). The female CRF decline group had significantly higher FEV1/FVC and BR% and significantly lower age, fasting glucose, hemoglobin, and VO₂@AT compared to the adequate CRF group. Elevated BR% was independently associated with CRF decline (OR = 1.086, 95% CI: 1.038-1.137). The receiver operating characteristic (ROC) curve for the males showed an area under the curve (AUC) of 0.769 (95% CI: 0.703-0.827) with an appropriate BR% cut-off value of 49.9%, sensitivity of 59.9%, and specificity of 77.8%. For the females, the ROC curve displayed an AUC of 0.694 (95% CI: 0.607-0.773) with an appropriate BR% cut-off value of 57.0%, sensitivity of 58.7%, and specificity of 86.0%.</p><p><strong>Conclusions: </strong>The breathing reserve was independently associated with CRF. The appropriate cut-off values for BR% to predict CRF decline were 49.9% for the males and 57.0% for the females.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709874","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":"Not All SAVR Are Created Equal: All the Approaches Available for Surgical Aortic Valve Replacement.","authors":"Francesco Cabrucci, Serge Sicouri, Massimo Baudo, Dimitrios E Magouliotis, Yoshiyuki Yamashita, Beatrice Bacchi, Dario Petrone, Beman Wasef, Aleksander Dokollari, Massimo Bonacchi, Basel Ramlawi","doi":"10.3390/jcdd12030084","DOIUrl":"10.3390/jcdd12030084","url":null,"abstract":"<p><p>Surgical Aortic Valve Replacement (SAVR) is still one of the pillars of cardiac surgery practice, and its role is evolving into a more complex operation. The competition with structural valve therapies and the urgent demand for less invasive solutions have unleashed surgeons' creativity in adapting to these new challenges. All the possible ways to surgically replace the aortic valve are analyzed in this review. Surgical techniques, advantages and disadvantages, and key differences are listed, helping surgeons navigate the available options. Sternotomy SAVR is the benchmark, but that is becoming obsolete and, in some cases, no longer performed for teaching purposes. Mini sternotomy is the easiest way to achieve minimal invasiveness in all anatomic situations, while right anterior thoracotomy is an elegant solution mastered by fewer surgeons. Endoscopic and robotic-assisted techniques are shaping the future of SAVR, yet they still lack wide adoption. The choice of approach is mainly dictated by the anatomic features of the patient and the surgeon's skills. A flow diagram to overcome the learning curve and advance toward more complex surgery is provided here. Mastering as many techniques as possible is paramount when offering a patient-tailored approach and performing a safe and less invasive operation.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709863","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":"Developmental and Evolutionary Heart Adaptations Through Structure-Function Relationships.","authors":"Makena Phillips, Marina Nimmo, Sandra Rugonyi","doi":"10.3390/jcdd12030083","DOIUrl":"10.3390/jcdd12030083","url":null,"abstract":"<p><p>While the heart works as an efficient pump, it also has a high level of adaptivity by changing its structure to maintain function during healthy and diseased states. In this Review, we present examples of structure-function relationships across species and throughout embryonic development in mammals and birds. We also summarize current research on avian models aiming at understanding how biophysical and biological mechanisms closely interact during heart formation. We conclude by underscoring similarities between cardiac adaptations and structural changes over developmental and evolutionary time scales and how understanding the mechanisms behind these adaptations can help prevent or alleviate the effects of cardiac malformations and contribute to cardiac regeneration efforts.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709931","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":"The Relationship Between Vitamin D Levels and Cardiac Remodelling in a Pediatric Dilated Cardiomyopathy Population: A Case-Control Study.","authors":"Asmaa Carla Hagau, Ioana-Octavia Matacuta-Bogdan, Lacramioara Eliza Chiperi, Beatrix-Jullia Hack, Iolanda Muntean","doi":"10.3390/jcdd12030082","DOIUrl":"10.3390/jcdd12030082","url":null,"abstract":"<p><p>Dilated cardiomyopathy (DCM) is a significant contributor to heart failure (HF) in the pediatric population despite its lower incidence compared to adults.</p><p><strong>Method: </strong>We present a case-control study that investigates serum levels of Vitamin D, measured as 25-hydroxyvitamin D (25-OHD), in children diagnosed with DCM and explores the relationship between Vitamin D levels and left ventricular (LV) dimensions and systolic function.</p><p><strong>Results: </strong>Thirty patients (mean age: 10.61 ± 6.54 years) with DCM were included, with a control group of thirty-one matched healthy children. We found a high prevalence of 25-OHD deficiency (67%) in the DCM group, which was statistically significant compared to the control group (<i>p</i> < 0.05). Notably, a significant negative correlation was observed between 25-OHD levels and both LV end-diastolic diameter (LVEDD; r = -0.43, <i>p</i> < 0.01) and end-systolic diameter (LVESD; r = -0.46, <i>p</i> < 0.01). However, no significant correlation was found between Vitamin D levels and LV ejection fraction or shortening fraction.</p><p><strong>Conclusion: </strong>These findings emphasise the importance of assessing Vitamin D status in pediatric DCM patients and may suggest that Vitamin D supplementation can be beneficial in managing this condition through its potential effects on cardiac remodelling and function. Further research is warranted to clarify the underlying mechanisms and therapeutic implications.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709822","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}