European Journal of Heart Failure最新文献

{"title":"Intravenous ferric carboxymaltose in heart failure with iron deficiency (FAIR‐HF2 DZHK05 trial): Sex‐specific outcomes","authors":"Mahir Karakas, Tim Friede, Javed Butler, Khawaja M. Talha, Marius Placzek, Thomas Asendorf, Monika Diek, Anna Nosko, Adriane Stas, Stefan Kluge, Dominik Jarczak, Geraldine DeHeer, Meike Rybczynski, Antoni Bayes‐Genis, Michael Böhm, Andrew J.S. Coats, Frank Edelmann, Gerasimos Filippatos, Gerd Hasenfuß, Wilhelm Haverkamp, Mitja Lainscak, Ulf Landmesser, Iain C. Macdougall, Bela Merkely, Burkert M. Pieske, Fausto J Pinto, Tienush Rassaf, Jennifer K. Visser‐Rogers, Giuseppe Rosano, Maurizio Volterrani, Stephan von Haehling, Markus S. Anker, Wolfram Doehner, Hüseyin Ince, Friedrich Koehler, Gianluigi Savarese, Muhammad Shahzeb Khan, Ursula Rauch Kröhnert, Tommaso Gori, Teresa Trenkwalder, Ibrahim Akin, Christina Paitazoglou, Iwona Kobielusz‐Gembala, Luca Kuthi, Norbert Frey, Manuela Licka, Stefan Kääb, Karl‐Ludwig Laugwitz, Piotr Ponikowski, Stefan D. Anker","doi":"10.1002/ejhf.3742","DOIUrl":"https://doi.org/10.1002/ejhf.3742","url":null,"abstract":"AimsIntravenous iron has emerged as a guideline‐recommended therapy in patients with heart failure and iron deficiency, but the potential sex‐related differences in efficacy are unknown. We aimed to assess sex‐specific outcomes in the Intravenous Iron in Patients with Systolic Heart Failure and Iron Deficiency to Improve Morbidity &amp; Mortality (FAIR‐HF2‐DZHK05) trial.Methods and resultsFAIR‐HF2 included 1105 heart failure patients with a left ventricular ejection fraction ≤45% and iron deficiency. A total of 368 women (mean age 68.7 ± 13.0 years) and 737 men (mean age 70.5 ± 11.0 years) were randomized to intravenous ferric carboxymaltose or placebo. The three primary endpoints were (i) time to cardiovascular death or first heart failure hospitalization, (ii) total heart failure hospitalizations, and (iii) time‐to‐first event of cardiovascular death or heart failure hospitalization only in patients with transferrin saturation &lt;20% at baseline. The hazard ratio (HR) for the first primary outcome was 1.07 (95% confidence interval [CI] 0.63–1.82, <jats:italic>p</jats:italic> = 0.80) in women and 0.74 (95% CI 0.57–0.95, <jats:italic>p</jats:italic> = 0.016) in men, while the rate ratios (RRs) for the second primary outcome were 1.06 (95% CI 0.55–2.05, <jats:italic>p</jats:italic> = 0.86) and 0.79 (95% CI 0.58–1.08, <jats:italic>p</jats:italic> = 0.136), respectively, and the HRs for the third primary outcome event were 1.21 (95% CI 0.62–2.36, <jats:italic>p</jats:italic> = 0.58) and 0.73 (95% CI 0.55–0.97, <jats:italic>p</jats:italic> = 0.028), respectively. Regarding safety outcomes, the HR for all‐cause mortality was 1.46 (95% CI 0.78–2.76, <jats:italic>p</jats:italic> = 0.24) in women, suggesting increased mortality risk under iron supplementation, in contrast to 0.86 (95% CI 0.64–1.16, <jats:italic>p</jats:italic> = 0.33) in men (<jats:italic>p</jats:italic> for interaction = 0.13).ConclusionsThis analysis indicates relevant differential efficacy of intravenous iron in heart failure across both sexes. While men receiving ferric carboxymaltose experienced a clinically relevant reduction in cardiovascular death and heart failure hospitalizations, women did not derive similar benefits. The results are clinically relevant and prompt validation in other large outcome trials of intravenous iron supplementation in heart failure.Clinical Trial Registration: ClinicalTrials.gov NCT03036462.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"718 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to 'Expanding the horizon of medication adherence strategies in acutely decompensated heart failure'.","authors":"Michael Kunz,Martin Schulz,Felix Mahfoud","doi":"10.1002/ejhf.3803","DOIUrl":"https://doi.org/10.1002/ejhf.3803","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"21 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the horizon of medication adherence strategies in acutely decompensated heart failure. Letter regarding the article 'Medication adherence in patients with acutely decompensated heart failure: A cross-sectional study in the emergency department (ADHF-ED)'.","authors":"Rong Sun,Deqi Kong,Tengying Jiang","doi":"10.1002/ejhf.3805","DOIUrl":"https://doi.org/10.1002/ejhf.3805","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"123 15 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved risk assessment in parvovirus B19‐positive patients with heart failure by multiparametric analysis of endomyocardial biopsy using machine learning methods","authors":"Christian Baumeier, Johannes Starlinger, Ganna Aleshcheva, Gordon Wiegleb, Felicitas Escher, Philip Wenzel, Amin Polzin, Heinz‐Peter Schultheiss","doi":"10.1002/ejhf.3798","DOIUrl":"https://doi.org/10.1002/ejhf.3798","url":null,"abstract":"AimsThe analysis of endomyocardial biopsies (EMB) is a prerequisite for a definitive diagnosis in patients with unexplained heart failure (HF). The use of machine learning (ML) methods may help to identify high‐risk patients and to initiate therapy. In this study, we develop ML models for risk stratification of parvovirus B19 (B19V) positive patients with HF based on key features from multiparametric EMB analyses.Methods and resultsWe retrospectively enrolled 263 B19V‐positive patients with HF (mean age 51 ± 15 years, 62% male) and followed them over a median period of 22 months (interquartile range 4–35 months). All‐cause mortality, left ventricular (LV) deterioration and persistent LV systolic dysfunction were used as clinical combined endpoint. EMB were analysed for a variety of inflammatory and infectious markers, and patient prognosis was assessed using ML methods (logistic regression, random forest, support vector machines and gradient boosting). Detection of intramyocardial inflammation and B19V viral activity was associated with poor clinical outcome (hazard ratio 3.50, 95% confidence interval 1.96–6.23, <jats:italic>p</jats:italic> &lt; 0.001). Linear combination of demographic and clinical data with multiparametric EMB markers increased the prognostic performance (area under the curve [AUC] = 0.724) compared to using single features (AUC = 0.667). The use of gradient boosting ML methods significantly improved the accuracy of risk prediction (AUC = 0.926).ConclusionsIntramyocardial inflammation and B19V viral activity were detected more frequently in patients with poor clinical outcome, suggesting that they are risk factors for death and LV dysfunction. Using multiparametric EMB data, we present an ML‐based prognostic tool that can determine the clinical outcome of patients with a high degree of accuracy. This could be helpful in assessing the progression of the disease and making appropriate treatment decisions.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"30 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of geranylgeranylacetone on diastolic and microvascular function in patients with heart failure with a preserved ejection fraction: A phase 2, randomized, placebo-controlled, crossover trial.","authors":"Soufiane Nassiri,Geert H D Voordes,Loek van Heerebeek,Daniël H van Raalte,Marianne C Verhaar,Daan J Touw,Merle M Krebber,Dirk J Duncker,Etto C Eringa,M Louis Handoko,Adriaan A Voors, ","doi":"10.1002/ejhf.3711","DOIUrl":"https://doi.org/10.1002/ejhf.3711","url":null,"abstract":"AIMSHeart failure with preserved ejection fraction (HFpEF) is a major healthcare burden with limited treatment options. Geranylgeranylacetone (GGA) has been shown to improve myocardial compliance and endothelial function in preclinical models. Given the mechanistic profile of GGA and established safety as an over-the-counter drug in Asia, we performed a phase 2 clinical trial in patients with HFpEF.METHODS AND RESULTSGLADIATOR-HFpEF (NCT05672134, EudraCT2022-000655-36-NL) is a phase 2, double-blind, randomized, placebo-controlled, crossover trial. Patients were randomized 1:1 to GGA or placebo and treated for 3 months with a washout-period of 6 weeks. The dual primary endpoints were diastolic function (E/e') and reactive hyperaemia index (RHI). Secondary endpoints were renal haemodynamic measurements; measured glomerular filtration rate and effective renal plasma flow, New York Heart Association class and 6-min walking test distance, cardiac biomarkers (N-terminal pro-B-type natriuretic peptide [NT-proBNP], high-sensitivity C-reactive protein), quality of life and laser speckle contrast analysis. Between March 2023 and December 2023, 43 patients were randomized and 39 were included in the per-protocol analysis. The cohort consisted of 28 women (72%), mean left ventricular ejection fraction was 59% and median NT-proBNP was 238 ng/L. There were no significant differences in the primary outcomes; E/e' (-0.24 [-0.90-0.41], p = 0.46) and RHI (-0.02 [-0.36-0.33], p = 0.92). We found a decrease in BSA-adjusted ERPF (-29.62[-57.52;1.71], p = 0.038) and BSA-adjusted RBF (-50.20 [-95.80; -4.61], p = 0.032). There were no significant differences in safety outcomes.CONCLUSIONSGeranylgeranylacetone, a drug that showed promising effects on myocardial relaxation and endothelial function in preclinical studies, had no effects on diastolic function, endothelial function and exercise capacity in patients with HFpEF. GGA reduced effective renal plasma flow and renal blood flow. There were no differences in safety outcomes between GGA and placebo.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"59 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of frailty at admission and in-hospital changes of frailty status in elderly patients with acute heart failure.","authors":"Christoph C Kaufmann, Amro Ahmed, Paul F Harbich, Lisa Auer, Lorenz Propst, Patrick Weltler, Achim Leo Burger, David Zweiker, Alexander Geppert, Kurt Huber, Bernhard Jäger","doi":"10.1002/ejhf.3779","DOIUrl":"https://doi.org/10.1002/ejhf.3779","url":null,"abstract":"<p><strong>Aims: </strong>To comprehensively assess the prognostic value of frailty at admission and trajectories of frailty during hospitalization in acute heart failure (AHF).</p><p><strong>Methods and results: </strong>This retrospective, single-centre study (AHF-COR Registry) includes hospitalized AHF patients ≥65 years, admitted to a tertiary hospital in Vienna between 2012 and 2019. Frailty was assessed at admission and discharge by nursing staff, based on care needs in personal hygiene, nutrition, mobility, bowel and bladder control, categorizing patients into three groups: non-frailty, moderate frailty, and severe frailty. Our study encompassed 2619 patients admitted for AHF (mean age 81 ± 8 years), of whom 31% died within 1 year. A total of 46% of patients were not frail, 42% were moderately frail, and 12% were severely frail. Patients with frailty were more likely to be female and had a higher cardiovascular comorbidity burden. We identified moderate and severe frailty as independent prognostic markers of 1-year mortality (adjusted hazard ratio [HR] 1.89; 95% confidence interval [CI] 1.60-2.23; p < 0.001; adjusted HR 2.91; 2.36-3.59; p < 0.001). Similar results were found for 28-day and 5-year mortality risk. Improvement in frailty status during hospitalization resulted in a significantly lower risk of 1-year mortality (adjusted HR 0.65; 95% CI 0.49-0.88; p < 0.001), while worsening of frailty was associated with higher risk (adjusted HR 3.18; 95% CI 2.07-4.91; p < 0.001). Prescription of guideline-directed medical therapy in patients with heart failure with reduced ejection fraction decreased with increasing frailty but was consistently associated with a reduced risk of mortality, regardless of frailty status, as no significant interaction effect was observed (p_{frailty-interaction} = 0.592).</p><p><strong>Conclusions: </strong>Frailty is an independent prognostic marker of increased mortality risk in patients with AHF. Improvement of frailty status during hospitalization reduces mortality risk while worsening of frailty increases mortality risk.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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 somatic mutations in myeloid cells of men with chronic heart failure - interaction between loss of Y chromosome and clonal haematopoiesis.","authors":"Sebastian Cremer, Moritz von Scheidt, Klara Kirschbaum, Lukas Tombor, Silvia Mas-Peiro, Wesley Abplanalp, Tina Rasper, Akshay Ware, Andrin Schuff, Alexander Berkowitsch, Johannes Krefting, David Leistner, Heribert Schunkert, Thimoteus Speer, Stefanie Dimmeler, Andreas Michael Zeiher","doi":"10.1002/ejhf.3778","DOIUrl":"https://doi.org/10.1002/ejhf.3778","url":null,"abstract":"<p><strong>Aims: </strong>Age-associated clonal haematopoiesis of indeterminate potential (CHIP) has been linked to increased incidence and worse prognosis of chronic heart failure (CHF). CHIP arises from somatic mutations in haematopoietic stem and progenitor cells. Mosaic loss of Y chromosome (LOY), the most common somatic mutation in male blood cells, increases with age, drives clonal expansion of myeloid cells, and has been experimentally associated with cardiac fibrosis and heart failure in mice. However, its prognostic value and interplay with CHIP in CHF patients remain unclear.</p><p><strong>Methods and results: </strong>We analysed 781 male CHF patients across the full spectrum of left ventricular ejection fraction to assess the prevalence and prognostic relevance of LOY and the two most common CHIP-driver mutations, DNMT3A and TET2. Both LOY and CHIP mutations increased with age and co-occurred in 27.1% of men >70 years. LOY independently predicted all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). The co-occurrence of LOY and DNMT3A/TET2 mutations further increased mortality among CHIP carriers. This detrimental prognostic effect of LOY was confirmed in a validation cohort of HFrEF patients. Single-cell RNA sequencing of peripheral blood mononuclear cells from HFrEF patients with ischaemic heart failure revealed elevated pro-fibrotic signalling in LOY monocytes, characterized by increased inflammatory and remodelling markers (S100A8, TLR2, CLEC4D) and decreased expression of transforming growth factor-β inhibitors (SMAD7, TGIF2). In patients with both LOY and DNMT3A mutations, monocytes showed enhanced pro-inflammatory gene expression, including alarmins (S100A8, HMGB2) and interferon-related genes (IFNGR1, TRIM56, CD84).</p><p><strong>Conclusions: </strong>Somatic mutations in blood cells-particularly LOY-are associated with increased mortality in male CHF patients, with LOY emerging as an independent prognostic marker.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence fully automated analysis of handheld echocardiography in real-world patients with suspected heart failure.","authors":"Ross T Campbell,Mark C Petrie,Kieran F Docherty,Katriona J M Brooksbank,Gemma McKinley,Caroline Haig,Alex McConnachie,Carolyn S P Lam,Carly Adamson,Elaine Butler,James P Curtain,Nick Hartshorne-Evans,Fraser J Graham,Helen Hainey,John Jarvie,Matthew M Y Lee,Leeanne Macklin,Kenneth Mangion,Aimee McCoubrey,Kirsty McDowell,Aileen McIntyre,Sabrina Nordin,Joanna Osmanska,Pierpaolo Pellicori,Joanne Simpson,Piotr Sonecki,Karen Taylor,Daniel Taylor-Sweet,Pamela Turnbull,Paul Welsh,John J V McMurray,Clare L Murphy,David J Lowe","doi":"10.1002/ejhf.3783","DOIUrl":"https://doi.org/10.1002/ejhf.3783","url":null,"abstract":"AIMSEchocardiography is a rate-limiting step in the timely diagnosis of heart failure (HF). Automated reporting of echocardiograms has the potential to streamline workflow. The aim of this study was to test the diagnostic accuracy of fully automated artificial intelligence (AI) analysis of images acquired using handheld echocardiography and its interchangeability with expert human-analysed cart-based echocardiograms in a real-world cohort with suspected HF.METHODS AND RESULTSIn this multicentre, prospective, observational study, patients with suspected HF had two echocardiograms: one handheld portable and one cart-based scan. Both echocardiograms were analysed using fully automated AI software and by human expert sonographers. The primary endpoint was the diagnostic accuracy of AI-automated analysis of handheld echocardiography to detect left ventricular ejection fraction (LVEF) ≤40%. Other endpoints included the interchangeability (assessed using individual equivalence coefficient [IEC]), between AI-automated and human analysis of cart-based LVEF. A total of 867 patients participated. The AI-automated analysis produced an LVEF in 61% of the handheld scans and 77% of the cart-based scans, compared to 76% and 77% of human analyses of the handheld and cart-based scans, respectively. The AI-automated analysis of handheld echocardiography had a diagnostic accuracy of 0.93 (95% confidence interval [CI] 0.90, 0.95) for identifying LVEF ≤40% (compared to the human analysis of cart-based transthoracic echocardiography scans). AI-automated analysis of LVEF on handheld devices was interchangeable with cart-based LVEF reported by two expert humans (IEC -0.40, 95% CI -0.60, -0.16).CONCLUSIONSArtificial intelligence-automated analysis of handheld echocardiography had good diagnostic accuracy for detecting LVEF ≤40%. AI-automated analysis of LVEF of handheld scans was interchangeable with cart-based expert human analysis.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"105 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter regarding the article ‘Sodium chloride versus glucose solute as a volume replacement therapy for more effective decongestion in acute heart failure (SOLVRED‐AHF): A prospective, randomized, mechanistic study’","authors":"Elapulli Sankaranarayanan Prakash","doi":"10.1002/ejhf.3790","DOIUrl":"https://doi.org/10.1002/ejhf.3790","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"90 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond pharmacotherapy: Addressing system‐level barriers in women's heart failure care. Letter regarding the article ‘Sex‐based differences in heart failure management and outcomes: Insights from the French‐DataHF cohort’","authors":"Haiyan Zhang, Wenxin Gao","doi":"10.1002/ejhf.3791","DOIUrl":"https://doi.org/10.1002/ejhf.3791","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"143 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}