Journal of cardiology最新文献

{"title":"Effects of repeated periods of high-intensity interval training on myocardial function in patients with metabolic syndrome: A 16-month follow-up","authors":"Juan F. Ortega MD, PhD,&nbsp;Eva García-Camacho MD,&nbsp;Alejandro Gadella-Fernández MD,&nbsp;Félix A. Morales-Palomo PhD,&nbsp;Alfonso Moreno-Cabañas PhD,&nbsp;Laura Álvarez-Jiménez PhD,&nbsp;Ricardo Mora-Rodriguez PhD,&nbsp;Manuel Gallango-Brejano MSc","doi":"10.1016/j.jjcc.2026.04.007","DOIUrl":"10.1016/j.jjcc.2026.04.007","url":null,"abstract":"<div><h3>Background</h3><div>One program of exercise training is useful to improve myocardial function in patients with cardiovascular disease (CVD) but not in patients with CVD risk factors. However, it is unknown whether repeated periods of high-intensity interval training (HIIT) can reverse the progressive myocardial dysfunction observed in patients with metabolic syndrome (MetS). We aimed to follow MetS patients for 16 months and determine the effect of two periods of HIIT, separated by a year, on their myocardial function.</div></div><div><h3>Methods</h3><div>Eighty-eight middle-aged volunteers with MetS and without heart failure were randomized in one of two groups: HIIT: Two periods of HIIT separated by a year (16 weeks, 3 sessions/week) or, CONTROL: standard medical treatment. Myocardial function, assessed by the left ventricle (LV) global longitudinal strain (GLS), and routine echocardiographic parameters, maximal oxygen consumption (VO_2max), and MetS components were assessed at baseline, after the first HIIT period (4 months), and one year later, after the second HIIT period. Variables were analyzed following the intention-to-treat analysis principle using linear mixed model.</div></div><div><h3>Results</h3><div>At baseline, 29% of participants from HIIT, and 24% from CONTROL had an impaired LV-GLS. However, none had diastolic dysfunction. Fifty-three participants (29 from HIIT and 24 from CONTROL) completed the follow-up. LV-GLS and LV-early rapid filling (e’ wave velocity and E/e’ ratio) improved progressively after the two periods of HIIT in comparison to CONTROL (group*time <em>p</em> = 0.002, <em>p</em> = 0.028, and <em>p</em> = 0.002, respectively). VO_2max improved only in the HIIT group (group*time <em>p</em> = 0.002), while ejection fraction and MetS z-score changes were not different between groups (group*time <em>p</em> = 0.964 and <em>p</em> = 0.419, respectively).</div></div><div><h3>Conclusions</h3><div>Among middle-aged adults receiving medical treatment for MetS, the addition of two HIIT periods, spaced one year apart, led to significant improvements in myocardial function, that were not observed in the control group receiving medical treatment alone.</div></div><div><h3>Clinical trials number</h3><div><span><span>NCT06262256</span><svg><path></path></svg></span></div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 191-196"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838513","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":"Interpretive considerations on real-world use of selexipag and parenteral prostacyclin in pulmonary arterial hypertension","authors":"Fariha Shahid Tanveer MBBS,&nbsp;Muhammad Hassan Saeed MBBS","doi":"10.1016/j.jjcc.2026.02.011","DOIUrl":"10.1016/j.jjcc.2026.02.011","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Page 235"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372645","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":"Comment on “Cardio-ankle vascular index as a screening tool for coronary artery disease in patients with metabolic dysfunction-associated steatotic liver disease”","authors":"Kanishka Harariya MD,&nbsp;Thakur Rohit Singh PhD,&nbsp;Ankita Kalra PhD,&nbsp;Swarupanjali Padhi PhD,&nbsp;Fayaz Ahamed MBBS","doi":"10.1016/j.jjcc.2026.01.016","DOIUrl":"10.1016/j.jjcc.2026.01.016","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 226-227"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132127","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":"Echocardiographic features and prognostic implications in acute type A intramural hematoma and classic aortic dissection","authors":"Jin Kirigaya MD, PhD,&nbsp;Noriaki Iwahashi MD, PhD, FJCC,&nbsp;Tomohiro Yoshii MD,&nbsp;Kyoko Hattori MD,&nbsp;Kensuke Matsushita MD, PhD,&nbsp;Masaomi Gohbara MD, PhD, FJCC,&nbsp;Kozo Okada MD, PhD, FJCC,&nbsp;Tomoki Cho MD, PhD,&nbsp;Shota Yasuda MD, PhD,&nbsp;Masami Kosuge MD, PhD,&nbsp;Toshiaki Ebina MD, PhD,&nbsp;Keiji Uchida MD, PhD,&nbsp;Teruyasu Sugano MD, PhD,&nbsp;Kiyoshi Hibi MD, PhD, FJCC","doi":"10.1016/j.jjcc.2026.02.003","DOIUrl":"10.1016/j.jjcc.2026.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Echocardiography is a first-line modality for evaluating type A acute aortic dissection (TAAAD). However, the diagnostic and prognostic implications of echocardiographic findings may differ between acute type A intramural hematoma (ATAIMH) and classic type A aortic dissection (CAAAD). This study aimed to compare echocardiographic characteristics between ATAIMH and CAAAD and to evaluate their prognostic value for in-hospital mortality, stratified by surgical treatment.</div></div><div><h3>Methods</h3><div>This retrospective single-center study included 434 patients with TAAAD (156 ATAIMH, 278 CAAAD) who underwent admission echocardiography. Findings assessed included direct signs (flap or hematoma), pericardial effusion, tamponade, aortic regurgitation, thoracic aortic enlargement (≥4 cm), and left ventricular wall motion abnormality (LVWMA). Prognostic value was evaluated stratified by surgical treatment (central repair vs. non-operative).</div></div><div><h3>Results</h3><div>Direct signs were less common in ATAIMH than CAAAD (39.1% vs. 66.6%, <em>p</em> &lt; 0.001). Thoracic aortic enlargement ≥4 cm was similarly frequent (94.2% in both). ATAIMH showed more pericardial effusion but less aortic regurgitation than CAAAD. In multivariable analysis, tamponade predicted in-hospital mortality in the overall cohort, ATAIMH, and CAAAD; however, this lost significance in CAAAD after adjustment for central repair. Pericardial effusion was prognostic in the overall cohort and CAAAD, but not ATAIMH. LVWMA was not predictive in ATAIMH but remained significant in CAAAD, even after adjustment for central repair.</div></div><div><h3>Conclusions</h3><div>Thoracic aortic enlargement was the most consistent diagnostic marker, suggesting this finding as a diagnostic priority, whereas direct signs were less frequent in ATAIMH, highlighting diagnostic challenges. Although no single echocardiographic parameter consistently predicted outcomes across all disease subtypes, pericardial effusion, tamponade, and LVWMA should be regarded as dynamic indicators readily assessed by echocardiography.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 166-173"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141935","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":"Disease activity is associated with QTc interval in patients with rheumatoid arthritis: Insights from the KURAMA study","authors":"Xiaoyang Song MD, PhD,&nbsp;Neiko Ozasa MD, PhD,&nbsp;Motomu Hashimoto MD, PhD,&nbsp;Satoshi Shizuta MD, PhD,&nbsp;Chikashi Terao MD, PhD,&nbsp;Hiromu Ito MD, PhD,&nbsp;Masao Tanaka MD, PhD,&nbsp;Takeshi Kimura MD, PhD, FJCC","doi":"10.1016/j.jjcc.2026.03.009","DOIUrl":"10.1016/j.jjcc.2026.03.009","url":null,"abstract":"<div><h3>Background</h3><div>Corrected QT (QTc) prolongation is a frequently observed electrocardiogram (ECG) abnormality in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the association between disease activity and QTc interval in patients with RA.</div></div><div><h3>Methods</h3><div>Data were obtained from the Kyoto University Rheumatoid Arthritis Management Alliance population-based RA cohort. We used a linear model to compare the association between QTc interval and RA-related parameters, including patient characteristics and disease activity assessed using the visual analog scale, C-reactive protein level, erythrocyte sedimentation rate (ESR), disease activity score 28-joint count using ESR (DAS28-ESR), simplified disease activity index (SDAI), clinical disease activity index (CDAI), and health assessment questionnaire (HAQ) score. We also constructed multivariate linear regression models to adjust for confounding effects.</div></div><div><h3>Results</h3><div>The mean QTc interval of 340 patients [mean age: 64.7 ± 12.3 years, female: 289 (85%)] with ECG data was 426.8 ± 30.7 ms, and the mean disease activity indices were as follows: DAS28-ESR, 2.7 ± 1.1 points; CDAI, 5.0 ± 5.2 points; SDAI, 5.4 ± 5.7 points; and HAQ, 0.61 ± 0.71 points. Linear correlations were observed between the QTc interval and all parameters for disease activity in the univariate analysis. Disease activity indices (CDAI, SDAI, or DAS28-ESR) were independently associated with the QTc interval (all <em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Disease activity is significantly associated with the QTc interval in patients with RA. Attention should be given to ECG abnormalities in patients with RA and progressive disease activity.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 174-179"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573787","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":"Mathematical analysis of the breakdown of physiological stability preceding heart failure onset using longitudinal health check-up data","authors":"Naoya Inoue MD,&nbsp;Ryo Ohinata MD,&nbsp;Shuji Morikawa MD, PhD","doi":"10.1016/j.jjcc.2026.06.003","DOIUrl":"10.1016/j.jjcc.2026.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) is a multifactorial syndrome, yet the dynamic processes through which physiological systems become unstable before HF remain incompletely understood.</div></div><div><h3>Methods</h3><div>We analyzed longitudinal data from individuals undergoing health check-ups. In participants who developed HF, the date of first HF hospitalization was defined as the index date. All measurements were aligned to the index date. Using estimated glomerular filtration rate, systolic blood pressure, heart rate, and body mass index, we quantified dynamic indicators via rolling window analyses: resilience based on autoregressive [AR(1)] coefficients, irreversibility proxies, and multivariate instability assessed by the maximum eigenvalue (λ₁) of covariance matrices. Rather than formal hypothesis testing, we focused on the consistency of temporal patterns across analytical conditions.</div></div><div><h3>Results</h3><div>The HF group showed a progressive increase in AR(1) coefficients several years before HF, suggesting declining physiological resilience. Visual inspection of irreversibility trajectories suggested possible time-asymmetric patterns before HF onset, although formal quantification in the HF group was limited by sparse data. Multivariate analyses further demonstrated an increase in λ₁ as HF approached, indicating an increase in shared variance structure across multiple physiological markers.</div></div><div><h3>Conclusions</h3><div>Before HF onset, physiological systems may undergo a dynamic loss of stability characterized by reduced resilience, emergence of irreversible dynamics, and breakdown of multivariate coordination, preceding marked changes in mean biomarker levels.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 197-204"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211326","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":"Beyond avoidance: The unaddressed analgesic gap in patients with heart failure contraindicated for NSAIDs and COX-2 inhibitors","authors":"Chia Siang Kow MPharm,&nbsp;Yii Ching Wong MPharm,&nbsp;Abdullah Faiz Zaihan MPharm,&nbsp;Kaeshaelya Thiruchelvam PhD","doi":"10.1016/j.jjcc.2026.01.012","DOIUrl":"10.1016/j.jjcc.2026.01.012","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 231-232"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137455","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":"Cardiomyocyte-specific Fbxl5 deficiency promotes iron overload-driven hypercontractility and late-onset pathological hypertrophy in mice","authors":"Ryoko Kusaba MD,&nbsp;Keishi Miyata MD, PhD,&nbsp;Tsuyoshi Kadomatsu PhD,&nbsp;Michio Sato MD, PhD,&nbsp;Yoshihiro Ujihara PhD,&nbsp;Yuya Kinoshita MD,&nbsp;Daisuke Torigoe PhD,&nbsp;Momoka Chuman,&nbsp;Yui Sakai,&nbsp;Haruki Horiguchi PhD,&nbsp;Taichi Sugizaki MD, PhD,&nbsp;Jun Morinaga MD, PhD,&nbsp;Keiichi I. Nakayama MD, PhD,&nbsp;Toshiro Moroishi MD, PhD,&nbsp;Tomohiko Wakayama MD, PhD,&nbsp;Kimi Araki PhD,&nbsp;Kimitoshi Nakamura MD, PhD,&nbsp;Yuichi Oike MD, PhD","doi":"10.1016/j.jjcc.2026.05.002","DOIUrl":"10.1016/j.jjcc.2026.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Iron homeostasis in heart is essential for maintaining cardiac function, but its precise role in iron metabolism and its specific function remain incompletely understood.</div></div><div><h3>Methods and results</h3><div>We generated cardiomyocyte-specific <em>Fbxl5</em> deficient mice (<em>αMHC-Cre;Fbxl5</em>^<em>F/F</em>). Those mice showed increased IRP2 protein levels, which in cardiomyocytes undergoes Fbxl5-dependent degradation. Young (12-week-old) <em>αMHC-Cre;Fbxl5</em>^<em>F/F</em> mice also showed upregulated levels of the IRP2, target transferrin receptor 1 (TfR1) and enhanced Fe³⁺ uptake into cardiomyocytes, increasing ferritin, total iron, and Fe²⁺ levels in cardiomyocytes. <em>Fbxl5</em> deficiency increased both mitochondrial respiration capacity in isolated cardiac mitochondria and contractility of isolated cardiomyocytes, and in vivo, young <em>αMHC-Cre;Fbxl5</em>^<em>F/F</em> mice showed augmented cardiac contractility and improved exercise tolerance. By contrast, in aged (24-month-old) <em>αMHC-Cre;Fbxl5</em>^<em>F/F</em> mice, IRP2 levels were elevated relative to controls, but TfR1 upregulation and tissue iron accumulation were not seen. Accordingly, enhanced cardiac contractility and superior exercise tolerance phenotypes seen in young <em>αMHC-Cre;Fbxl5</em>^<em>F/F</em> mice were absent in comparably aged mice, which unexpectedly exhibited pathological cardiac hypertrophy and upregulation of heart failure-associated genes. Furthermore, we found that administration of sodium–glucose cotransporter-2 inhibitors (SGLT2i), whose cardioprotective effects have recently been suggested to involve enhanced myocardial iron storage, improved cardiac performance without altering myocardial iron content, suggesting that SGLT2i exerts cardioprotective effects largely independent of cardiac iron metabolism.</div></div><div><h3>Conclusion</h3><div>Cardiac iron dynamics are precisely regulated and tightly linked to cardiac function and prolonged dysregulation of iron dynamics can trigger cardiac pathological remodeling, even when iron balance is restored.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 180-190"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982057","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":"Prognostic significance of blood urea nitrogen-to-albumin ratio in heart failure: From baseline and age-specific risk stratification to one-year dynamic changes","authors":"Masamichi Yano MD, PhD,&nbsp;Yasuyuki Egami MD,&nbsp;Mikako Kise MD,&nbsp;Taichi Mukai MD,&nbsp;Noriyuki Kobayashi MD,&nbsp;Ayako Sugino MD,&nbsp;Masaru Abe MD,&nbsp;Hiroaki Nohara MD,&nbsp;Shodai Kawanami MD,&nbsp;Koji Yasumoto MD,&nbsp;Naotaka Okamoto MD,&nbsp;Yasuharu Matsunaga-Lee MD,&nbsp;Masami Nishino MD, PhD, FJCC","doi":"10.1016/j.jjcc.2026.02.008","DOIUrl":"10.1016/j.jjcc.2026.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Blood urea nitrogen-to-albumin ratio (BAR) is a prognostic biomarker in heart failure (HF), but its age-specific implications and longitudinal changes remain unclear. This study evaluated the prognostic significance of BAR at discharge and its 1-year change across age groups.</div></div><div><h3>Methods</h3><div>From the <u>A</u>c<u>u</u>te Heart Failure <u>R</u>egistry in <u>O</u>saka <u>R</u>os<u>a</u>i Hospital (AURORA), 1944 patients hospitalized for HF between 2015 and 2022 were analyzed. BAR was calculated as blood urea nitrogen (mg/dL) divided by serum albumin (g/dL). The composite endpoint was HF readmission or all-cause death. Time-dependent receiver operating characteristic (ROC) analysis identified optimal age-specific cut-off values. Among 945 event-free patients 1 year after discharge, the association between a BAR increase (ΔBAR≥20%) and outcomes was evaluated.</div></div><div><h3>Results</h3><div>Median BAR values increased with age (&lt;70 years: 6.32; 70–79 years: 7.47; ≥80 years: 9.39; <em>p</em> &lt; 0.001). Optimal cut-off values for predicting the composite endpoint showed a U-shaped trend (8.06, 7.27, and 10.88). A high BAR (≥9.50, by ROC analysis) independently predicted adverse outcomes in the overall cohort (HR 2.26, 95% CI 2.02–2.54; <em>p</em> &lt; 0.001). Kaplan–Meier analysis revealed consistently higher event rates in the high-BAR group across all ages (log<em>-rank p</em> &lt; 0.001). Among event-free survivors, a BAR increase ≥20% was associated with greater risk of subsequent events. Factors associated with BAR elevation included higher body mass index, diabetes, elevated B-type natriuretic peptide, and vasopressin V₂ receptor antagonist use.</div></div><div><h3>Conclusion</h3><div>BAR increases with age and exhibits age-specific prognostic thresholds. Monitoring BAR dynamics after discharge may enhance risk stratification and guide individualized management of HF patients.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 220-222"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372658","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":"Sacubitril/valsartan in older adults: interpreting hypotension, biomarkers, and dose trajectories in routine care","authors":"Beibei Wang MD,&nbsp;Yiqun Lou MD","doi":"10.1016/j.jjcc.2026.02.005","DOIUrl":"10.1016/j.jjcc.2026.02.005","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Page 234"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306295","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}