Journal of Cardiovascular Medicine最新文献

{"title":"Clinical congestion patterns in patients with advanced heart failure: an analysis of the HELP-HF Registry.","authors":"Mauro Riccardi, Gianmarco Cozzani, Carlo Mario Lombardi, Mauro Chiarito, Davide Stolfo, Luca Baldetti, Daniela Tomasoni, Riccardo Maria Inciardi, Alessandro Villaschi, Ferdinando Loiacono, Marta Maccallini, Gaia Gasparini, Stefano Contessi, Daniele Cocianni, Maria Perotto, Giuseppe Barone, Marco Merlo, Alberto Maria Cappelletti, Anna Mara Scandroglio, Gianfranco Sinagra, Daniela Pini, Marianna Adamo, Marco Metra, Matteo Pagnesi","doi":"10.2459/JCM.0000000000001907","DOIUrl":"10.2459/JCM.0000000000001907","url":null,"abstract":"<p><strong>Background: </strong>The impact of different clinical congestion phenotypes in advanced heart failure (HF) has not been fully investigated. We aimed to evaluate congestion patterns in patients with advanced heart failure HF (AdvHF).</p><p><strong>Methods: </strong>The HELP-HF registry enrolled consecutive patients with HF and at least one high-risk 'I NEED HELP' marker. Patients' characteristics and outcomes were compared across different clinically defined congestion patterns. The primary endpoint was the composite of all-cause mortality or first HF hospitalization.</p><p><strong>Results: </strong>A total of 1149 patients were included (mean age 75.1 ± 11.5 years, median left ventricular ejection fraction 35%). Among them, 332 patients (28.9%) had no sign of congestion, 327 (28.5%) had peripheral congestion, 144 (12.5%) had pulmonary congestion and 346 (30.1%) had both peripheral and pulmonary congestion. The 1-year rate of the primary endpoint progressively increased across these four groups (36.5%, 44%, 45.8% and 47.7%; P = 0.0002), as did all-cause and cardiovascular (CV) mortality (both P < 0.0001). Compared with no congestion, pulmonary congestion and combined congestion were independently associated with the primary endpoint [adjusted hazard ratio (aHR) 1.60, 95% confidence interval (CI) 1.15-2.21; and aHR 1.36, 95% CI 1.05-1.77, respectively], as well as with all-cause and CV mortality. Peripheral congestion was independently associated with an increased risk of recurrent HF hospitalizations (aHR 1.37, 95% CI 1.01-1.86), whereas pulmonary congestion and combined congestion were not.</p><p><strong>Conclusions: </strong>In our real-world multicentre registry enrolling patients with markers of AdvHF, a simple bedside congestion classification identified distinct clinical characteristics and stratified the risk of clinical events.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 7","pages":"513-523"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562184","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":"Advances in stress echocardiography: myocardial work for myocardial ischemia detection.","authors":"Maurizio Cusmà-Piccione, Roberto Licordari, Roberta Manganaro, Giampiero Vizzari, Francesca Lofrumento, Francesca Parisi, Olimpia Trio, Cesare De Gregorio, Quirino Ciampi, Scipione Carerj, Renuka Jain, Gianluca Di Bella, Antonio Micari, Concetta Zito","doi":"10.2459/JCM.0000000000001905","DOIUrl":"10.2459/JCM.0000000000001905","url":null,"abstract":"<p><strong>Aims: </strong>This study explores the usefulness of myocardial work (MW) analysis for coronary artery disease (CAD) detection in patients undergoing dipyridamole stress echocardiography (Dip-SE).</p><p><strong>Methods: </strong>We included 50 patients subjected to Dip-SE followed by coronary computed tomography angiography (CCTA) and/or invasive coronary angiography (ICA). Patients were subdivided into two groups, according to the results of CCTA/ICA: group 1 with CAD and group 2 without CAD. Subsequently, global longitudinal strain (GLS) and MW parameters were evaluated retrospectively at base, low and high dose in the entire population.</p><p><strong>Results: </strong>GLS showed a nonsignificant increase from baseline to low dose and significantly decreased from low to high dose ( P  = 0.015) in group 1. In contrast, GLS in group 2 increased throughout the test, with the largest increase from baseline to low dose ( P  < 0.001). Global constructive work (GCW) and global wasted work (GWW) showed opposite behaviors in both groups: GCW decreased in group 1 ( P  = 0.009) and remained substantially unchanged in group 2; conversely, GWW increased from low to high dose in group 1 ( P  = 0.003), whereas it decreased in group 2 ( P  = 0.047). The latter result was confirmed by global work efficiency (GWE), which decreased from low to high dose in group 1 ( P  = 0.025) and increased in group 2 ( P  = 0.001). Receiver-operating characteristics analysis revealed that GWE is the best parameter for identifying CAD (area under the curve = 0.845). A decrease in GWE of 1.5% (from low to high dose) provided better sensitivity (73%) and specificity (84%).</p><p><strong>Conclusions: </strong>GWE analysis may be useful in improving CAD detection during Dip-SE.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"549-557"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329733","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":"Hypokinetic nondilated cardiomyopathy: clinical characteristics, prognosis, and therapy response compared to dilated cardiomyopathy.","authors":"Paolo Manca, Samuela Carigi, Luca Fazzini, Vittoria Rizzello, Maria Denitza Tinti, Luisa De Gennaro, Matteo Bianco, Maria Vittoria Matassini, Vittorio Palmieri, Concetta Di Nora, Marco Gorini, Francesco Orso, Alessandro Battagliese, Anna Rita Felici, Mariarosaria Catalano, Marina Floresta, Giuseppe Leonardi, Renata De Maria, Mauro Gori","doi":"10.2459/JCM.0000000000001813","DOIUrl":"10.2459/JCM.0000000000001813","url":null,"abstract":"<p><strong>Aims: </strong>Hypokinetic nondilated cardiomyopathy (HNDC) is defined by left ventricular dysfunction without significant dilatation. The distinct features and prognosis of HNDC compared to classical dilated cardiomyopathy (DCM) are partially unexplored. We investigated the differences between HNDC and DCM cohorts from the multicentric Italian IN-HF registry.</p><p><strong>Methods: </strong>All patients with a diagnosis of DCM enrolled in the registry between 2008 and 2023 were considered. HNDC was defined by a left ventricular end-diastolic diameter of less than 34 mm/m 2 in men and less than 31 mm/m 2 in women, or a left ventricular end-diastolic volume of 70 ml/m 2 or less in men and less than 60 ml/m 2 in women. The primary outcome was a composite of all-cause death and heart failure hospitalizations (HFHs).</p><p><strong>Results: </strong>Of 1748 patients, 568 (32.5%) met the criteria for HNDC. HNDC patients were more likely to be male, with a higher prevalence of obesity and atrial fibrillation. HNDC also showed less advanced disease (less advanced New York Association class, higher left ventricular ejection fraction, lower prevalence of moderate-severe mitral regurgitation, and less atrial dilatation). After a median follow-up of 13 months, the primary outcome occurred less frequently in HNDC compared with DCM [12.5 vs. 17.1%; hazard ratio 0.762, 95% confidence interval (95% CI) 0.581-0.999; P  = 0.049]. However, the adjusted prognosis was similar between groups (hazard ratio 1.031, 95% CI 0.771-1.380; P  = 0.834). Beta-blockers emerged as the most protective drug for HNDC (hazard ratio 0.462, 95% CI 0.258-0.826; P  = 0.009).</p><p><strong>Conclusion: </strong>HNDC appears as a distinct form of DCM with milder clinical presentation. However, the absence of LV dilation did not independently influence prognosis. Beta-blockers may offer the most consistent benefit in HNDC.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"558-567"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952406","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":"Progressive reduction in complications of cryoballoon pulmonary vein isolation for atrial fibrillation.","authors":"Emanuele Bertaglia, Giuseppe Arena, Claudio Tondo, Giulio Molon, Paolo Pieragnoli, Gianfranco Mitacchione, Massimiliano Manfrin, Giovanni Perego, Roberto Rordorf, Danilo Ricciardi, Enrico Chieffo, Massimiliano Marini, Umberto Startari, Giuseppe Boriani, Pietro Turrini, Saverio Iacopino","doi":"10.2459/JCM.0000000000001886","DOIUrl":"10.2459/JCM.0000000000001886","url":null,"abstract":"<p><strong>Aims: </strong>Cryoballoon pulmonary vein isolation (CB-PVI) has become an established treatment for atrial fibrillation and, recently, it has been proposed as first-line therapy for the treatment of paroxysmal atrial fibrillation. Nevertheless, some concerns remain regarding the safety of this thermal energy-based approach. This prospective analysis aimed to assess the procedural complication rate of CB-PVI in a large cohort of consecutive patients over a nearly 13-year period.</p><p><strong>Methods: </strong>Data from consecutive patients treated with CB-PVI for atrial fibrillation between April 2012 and November 2024 in 35 institutions were analyzed. All complications occurring from patient admission up to 3 months postprocedure were recorded.</p><p><strong>Results: </strong>Eight thousand five hundred and thirty-one patients were enrolled (27.2% women, mean age 60.8 ± 10.5 years, 75.7% with paroxysmal atrial fibrillation), and 211 of them (2.49%) experienced at least one procedural adverse event related to CB-PVI. Of note, one cardiac tamponade event led to a sudden cardiovascular death (0.01%). A statistically significant reduction in complication rates was observed amongst three cohorts of product usage: from 2012 to 2015 ( n  = 1326 patients, 5.0%), from 2016 to 2019 ( n  = 3487 patients, 2.5%), and from 2020 to 2024 ( n  = 3718 patients, 1.6%; P  < 0.001). Multivariate logistic regression analysis identified use of the Arctic Front Advance PRO balloon as a significant protective factor against complications [OR 0.26 (0.17-0.40), P  < 0.001], whereas female sex emerged as the strongest predictor of adverse events [OR 1.54 (1.11-2.13), P  < 0.01].</p><p><strong>Conclusion: </strong>CB-PVI for atrial fibrillation ablation has proven to be a well tolerated procedure, with a steadily decreasing complication rate over time.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"465-473"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329804","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":"Atrial premature beats with cycle-dependent J waves/ST-segment elevation.","authors":"Xing Jie Li, Yan Mei Wang","doi":"10.2459/JCM.0000000000001887","DOIUrl":"10.2459/JCM.0000000000001887","url":null,"abstract":"<p><p>The cases reported in this study have the following characteristics: ① no J waves were observed in sinus beats, while transient J waves (Cases 1 and 3) or J point/ST-segment elevation (Case 2) appeared in atrial premature beats (APB), indicating that the occurrence of significant J waves/ST-segment elevation was dependent on short cycles (Cases 1 and 2) or long-short-cycle sequences (Case 3); ② the degree of J waves/ST-segment elevation was significant in all cases. Analysis suggests that short-cycle-dependent or long-short-cycle sequence-dependent J waves/ST-segment elevation is an ECG manifestation that can be caused by different underlying mechanisms, namely repolarization abnormalities and/or depolarization abnormalities.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"502-505"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329718","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":"Enhancing echocardiographic diagnosis of typical Takotsubo syndrome: validation of IAR and ILAR indexes.","authors":"Matteo Pernigo, Marco Berti, Emanuele Maria Renga, Fabiana Cozza, Marco Bernardo Sbolli, Antonio Maggi","doi":"10.2459/JCM.0000000000001890","DOIUrl":"10.2459/JCM.0000000000001890","url":null,"abstract":"<p><strong>Aims: </strong>Takotsubo syndrome (TTS) and anterior ST-elevation myocardial infarction (AMI) with apical involvement often present with overlapping clinical and echocardiographic features, making early differential diagnosis challenging. Novel echocardiographic indices may aid rapid, bedside discrimination. The objective of the study was to evaluate the diagnostic accuracy and reproducibility of two new echocardiographic indices - inferior-apex ratio (IAR) and infero-lateral-apex ratio (ILAR) - in distinguishing typical TTS from anterior STEMI. Secondary objectives included comparison with segmental strain values and inter-observer reproducibility.</p><p><strong>Methods and results: </strong>This retrospective study analyzed 2D and speckle-tracking echocardiography of 50 patients with confirmed TTS and 50 with AMI and apical akinesis. IAR and ILAR were calculated from standard apical views. Diagnostic performance was assessed via receiver-operating characteristic analysis. Longitudinal strain was evaluated in all myocardial segments. Inter-observer reproducibility was tested. ILAR and IAR were significantly lower in TTS vs. AMI (ILAR: 0.78 ± 0.32 vs. 1.99 ± 0.85; IAR: 0.86 ± 0.42 vs. 1.71 ± 0.71; P < 0.001). Both indices showed excellent diagnostic accuracy [area under the curve (AUC) = 0.90 for IAR and 0.94 for ILAR], with optimal cutoffs of 1.01 (ILAR) and 0.95 (IAR). Mid-inferior (MI) and infero-lateral (MIL) strain were more impaired in TTS but had slightly lower AUCs (MI: 0.84; MIL: 0.82). ILAR and IAR remained independently associated with TTS in multivariable analysis. Inter-observer correlation was strong (ICC: 0.81-0.82).</p><p><strong>Conclusions: </strong>IAR and ILAR are simple, reproducible, and accurate echocardiographic markers for differentiating TTS from AMI at the bedside. Their use may improve early diagnostic confidence and guide appropriate clinical management.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"427-436"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329791","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":"Diuretic dose and right atrial function interplay in patients with tricuspid regurgitation.","authors":"Elvin Tafciu, Bianca Rocca, Matteo Pilan, Caterina Maffeis, Corinna Bergamini, Giovanni Benfari, Flavio L Ribichini","doi":"10.2459/JCM.0000000000001885","DOIUrl":"10.2459/JCM.0000000000001885","url":null,"abstract":"<p><strong>Introduction: </strong>Tricuspid regurgitation is frequent, and its related systemic venous congestion is associated with mortality. Diuretics are the main therapy but what shapes their effect is not fully known.</p><p><strong>Aim and methods: </strong>In this single-center cross-sectional study, we aimed to assess the association of right heart metrics of size and function in relation to diuretic dose. In consecutive patients with measurable tricuspid regurgitation regurgitant volume (RVol) by echocardiography, a high diuretic dose (HDD) was considered a furosemide dose (or equivalent) of greater than 40 mg. Parameters of right atrial (RA) and right ventricular (RV) size and function, tricuspid regurgitation degree and congestion signs were compared between groups with or without HDD.</p><p><strong>Results: </strong>Of 120 patients (37% men; age 74 ± 13 years), 31.7% had HDD. HDD was prevalent in 16% of patients with mild tricuspid regurgitation, 25% with moderate tricuspid regurgitation and 49% with severe tricuspid regurgitation ( P  = 0.011). In multivariate analysis including RV and RA parameters of size and function, only the RA strain was independently associated with diuretic therapy ( B -0.111, P  < 0.0001) and HDD ( B -0.101, P  = 0.007). There was a progressive decline in RA strain with increasing diuretic dose ( PANOVA  < 0.0001). The RA strain was lower in HDD patients independently of chronic kidney disease ( P for interaction 0.798) and tricuspid regurgitation severity ( P for interaction 0.712). Most patients with congestive signs showed a lower RA strain (all P  < 0.05).</p><p><strong>Conclusion: </strong>Reduced RA function in tricuspid regurgitation patients with venous congestion is independently associated with a higher dose of diuretic therapy.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"459-464"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329829","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":"Diffuse ST-segment elevation in right bundle branch block: a wraparound LAD occlusion sign.","authors":"Lucio Giuseppe Granata, Simona Giubilato, Marilena Scarabelli, Denise Lo Curto, Francesco Amico","doi":"10.2459/JCM.0000000000001892","DOIUrl":"10.2459/JCM.0000000000001892","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"506-507"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329844","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":"Differentiating Takotsubo syndrome from anterior STEMI: are we getting closer?","authors":"Rodolfo Citro, Eduardo Bossone","doi":"10.2459/JCM.0000000000001891","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001891","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 6","pages":"437-439"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360881","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":"Acute kidney injury and renal function changes in cardiogenic shock.","authors":"Mauro Riccardi, Dario S Cani, Benedetta Thiébat, Lorenza Biava, Lorenzo Zaccaro, Matteo P Vaira, Paolo Scacciatella, Andrea Montisci, Sergio Cattaneo, Riccardo M Inciardi, Carlo M Lombardi, Marianna Adamo, Marco Metra, Matteo Pagnesi","doi":"10.2459/JCM.0000000000001893","DOIUrl":"10.2459/JCM.0000000000001893","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the prognostic role of acute kidney injury (AKI) and estimated glomerular filtration rate (eGFR) in patients with cardiogenic shock (CS).</p><p><strong>Methods: </strong>All consecutive patients admitted for CS were retrospectively included. The association of AKI development within 48 h from admission with in-hospital mortality was evaluated. Predictors of AKI and the role of eGFR reassessment were also evaluated.</p><p><strong>Results: </strong>A total of 313 patients with CS were included. AKI was independently associated with increased in-hospital mortality [adjusted odds ratio (OR) for AKI vs. no-AKI 3.38, 95% confidence interval (CI) 1.82-6.28, P < 0.001]. The risk of mortality progressively increased at increasing AKI stages ( P < 0.001). Higher eGFR was independently associated with a decreased risk of in-hospital mortality when considering either baseline values, 24-h values and 48-h values. The accuracy of 48-h eGFR in predicting in-hospital mortality [area under the curve (AUC) 0.789] was higher compared with 24-h eGFR (AUC 0.754) and baseline eGFR (AUC 0.686). At multivariable logistic regression analysis, chronic kidney disease (CKD) and central venous pressure (CVP) were associated with a higher likelihood of AKI, whereas higher mean arterial pressure (MAP) was associated with a lower likelihood.</p><p><strong>Conclusions: </strong>In patients with CS, AKI development within 48 h was independently associated with in-hospital mortality and the risk progressively increased at increasing AKI stages. An eGFR reassessment at 48 h had a higher accuracy for predicting mortality compared with eGFR values at admission and 24 h. Previous CKD, MAP and CVP were the predictors of AKI development.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"474-483"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329736","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}