European Journal of Heart Failure最新文献

{"title":"Left ventricular ejection fraction and benefit of tricuspid valve interventions - insights from the international TRIGISTRY.","authors":"Gregor Heitzinger, Julien Dreyfus, Varius Dannenberg, Yan Topilsky, Giovanni Benfari, Nina Ajmone Marsan, Maurizio Taramasso, Giulio Russo, Yohann Bohbot, Christos Iliadis, Marcel Weber, Luis Nombela-Franco, Andrea Eixerés-Esteve, Baptiste Bazire, Bernard Iung, Jean-François Obadia, Rodrigo Estevez Loureiro, Elisabeth Riant, Erwan Donal, Gilbert Habib, Yoan Lavie-Badie, Jörg Hausleiter, Lucas Stolz, Luigi Badano, Thierry Le Tourneau, Augustin Coisne, Thomas Modine, Fabien Praz, Jose Luis Zamorano, Ralph Stephan von Bardeleben, Rebecca T Hahn, Neil Fam, Horst Sievert, Denisa Muraru, Mariana Adamo, Samuel Heuts, Mohammed Nejjari, Vincent Chan, Michele De Bonis, Manuel Carnero-Alcazar, Volker Rudolph, Juan Crestanello, Philipp Lurz, Jeroen Bax, Roja Gauda, Jordan Bernick, George A Wells, Francesco Maisano, Maurice Enriquez-Sarano, Philipp Bartko, David Messika-Zeitoun","doi":"10.1002/ejhf.3797","DOIUrl":"https://doi.org/10.1002/ejhf.3797","url":null,"abstract":"<p><strong>Aims: </strong>The impact of treatment for tricuspid regurgitation (TR) across different levels of left ventricular ejection fraction (LVEF) remains uncertain. This study aimed to compare the outcomes of surgical and transcatheter tricuspid valve interventions (TTVI) to conservative (medical) management across LVEF categories.</p><p><strong>Methods and results: </strong>Patients with severe isolated TR from the TRIGISTRY, a multicentre international registry, were categorized based on LVEF (preserved ejection fraction [pEF]: ≥50%, mildly reduced ejection fraction [mrEF]: 41-49%, and reduced ejection fraction [rEF]: ≤40%). We assessed the impact of treatment modality and procedural success (mild-to-moderate or lower residual TR) on 2-year survival within each LVEF category. Among 2384 patients, 1383 had pEF, 400 had mrEF, and 601 had rEF. Compared to conservative management, surgery (p < 0.0005) and TTVI (p < 0.0001) were associated with a survival benefit in patients with pEF. No significant survival advantage was observed in patients with mrEF (p = 0.28 for both), nor in those with rEF (p = 0.76 and p = 0.22, respectively). Similar results were obtained when surgical and transcatheter interventions were grouped (p < 0.0001, p = 0.17 and p = 0.29 in patients with pEF, mrEF and rEF, respectively). Patients with residual TR after TTVI exhibited a trend toward worse survival compared to those managed conservatively across all LVEF categories (p = 0.47, p = 0.33 and p = 0.008 in pEF, mrEF and rEF, respectively).</p><p><strong>Conclusions: </strong>Transcatheter tricuspid valve intervention, whether surgical or transcatheter-based, was associated with improved survival in patients with pEF but not in those with mrEF or rEF. Residual TR remained a significant prognostic factor across the entire LVEF spectrum. These findings highlight the need for careful patient selection when considering TTVI in individuals with rEF.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144937291","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":"Why do people with heart failure die? Rationale and design of the RHYTHM‐HF study","authors":"Simon A.S. Beggs, Mark C. Petrie, Sylvia Wright, Derek T. Connelly, Gary A. Wright, Iain Squire, Theresa A. McDonagh, Luke McSpadden, Chunlan Jiang, Kyungmoo Ryu, John J.V. McMurray, Roy S. Gardner","doi":"10.1002/ejhf.70014","DOIUrl":"https://doi.org/10.1002/ejhf.70014","url":null,"abstract":"AimsThe aim of RHYTHM‐HF is to provide novel insights into the causes and mechanisms of death in near‐consecutive patients discharged following a heart failure hospitalization using data from insertable cardiac monitors (ICMs) and autopsy examinations.MethodsRHYTHM‐HF enrolled an unselected, prospective, near‐consecutive, observational cohort of 257 patients admitted to hospital with a primary diagnosis of decompensated heart failure over a 2‐year period. Potential participants were screened using N‐terminal pro‐B‐type natriuretic peptide and echocardiography. All enrolled participants received a subcutaneously implanted ICM (which provides long‐term cardiac rhythm recordings) before hospital discharge. An optional sub‐study invited participants to consent prospectively to autopsy in the event of death. Following hospital discharge, there was no physical follow‐up, with longitudinal ICM data obtained by remote upload. Participants were followed for up to 4 years. Data permitting determination of the cause, mode and mechanism of death were collected, including ICM‐derived terminal cardiac rhythm and pathological findings at autopsy. Rigorous stepwise clinical adjudication processes were employed in the study (step 1 using clinical data alone, step 2 using additional post‐mortem data, and step 3 using additional terminal rhythm data).ConclusionsThe RHYTHM‐HF study is a contemporary natural history study which investigated causes and mechanisms of death in patients with heart failure. It is the largest study to report terminal rhythm data in patients with heart failure, the largest contemporary prospective autopsy study in heart failure, and the only study to describe the interaction between terminal rhythm and pathological cause of death using modern adjudication standards. We anticipate new mechanistic insights into the cause and mode of death in heart failure. These findings will generate hypotheses for future clinical research into reducing death in heart failure.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"51 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919052","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":"Cardiovascular outcomes with tirzepatide in heart failure with preserved ejection fraction associated with obesity","authors":"Laurent Fauchier, Lisa Lochon, Thibault Lenormand, Bertrand Pierre, Alexandre Bodin, Mickael Guglieri, Arnaud Bisson","doi":"10.1002/ejhf.70012","DOIUrl":"https://doi.org/10.1002/ejhf.70012","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"54 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919051","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":"Parvovirus B19 – more than a bystander in the prognosis of non‐ischaemic heart failure","authors":"Tobias Harm, Andre Keren, Oliver Borst","doi":"10.1002/ejhf.70008","DOIUrl":"https://doi.org/10.1002/ejhf.70008","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"23 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906484","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 the letter regarding the article ‘Incident heart failure is common and underrecognized in patients with biopsy‐proven metabolic dysfunction‐associated steatotic liver disease’","authors":"Kara Wegermann, Marat Fudim","doi":"10.1002/ejhf.3777","DOIUrl":"https://doi.org/10.1002/ejhf.3777","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"18 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906460","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":"Diuretic resistance and the efficacy of hydrochlorothiazide in acute decompensated heart failure: A post‐hoc analysis of the CLOROTIC trial","authors":"Ambarish Pandey, Matthew W. Segar, Neil Keshvani, Pau Llácer, Jesús Casado, José Luis Morales‐Rull, Francesc Formiga, Luis Manzano, Harriette G.C. Van Spall, Joan Carles Trullàs","doi":"10.1002/ejhf.70002","DOIUrl":"https://doi.org/10.1002/ejhf.70002","url":null,"abstract":"AimsDiuretic resistance (DR) in acute decompensated heart failure (ADHF) is associated with poor outcomes. The CLOROTIC trial demonstrated hydrochlorothiazide (HCTZ) with intravenous furosemide improved weight loss in ADHF. We assessed performance of the BAN‐ADHF DR score and association between DR risk and HCTZ treatment response.Methods and resultsWe included participants from CLOROTIC and assessed BAN‐ADHF performance in identifying lowest net diuretic efficiency phenogroup, as identified with a random forest classifier. Participants were stratified by the BAN‐ADHF score (≤12: low DR risk and &gt;12: high DR risk) to compare treatment effect of HCTZ versus placebo across DR risk. Outcomes were weight change and area under the curve (AUC) of dyspnoea visual analogue scale (VAS) at 72/96 h, fluid loss at 72 h, and 30/90‐day mortality. Among 220 participants (50.9% male, mean age 83 years), the BAN‐ADHF score demonstrated good performance in identifying low net diuretic efficiency phenogroup (area under the receiver operating characteristic curve: 0.81). Weight change and VAS AUC at 72 h was similar across DR risk strata, however, participants with high versus low DR risk had lower fluid loss at 72 h (686 vs. 889 ml, <jats:italic>p</jats:italic> = 0.003), higher 30‐day (11.1% vs. 2.4%, <jats:italic>p</jats:italic> = 0.035) and 90‐day mortality (23.0% vs. 10.6%, <jats:italic>p</jats:italic> = 0.033). The treatment effect of HCTZ (vs. placebo) on weight change was similar across DR risk (<jats:italic>p</jats:italic><jats:sub>int</jats:sub> = 0.75 at 72 h; <jats:italic>p</jats:italic><jats:sub>int</jats:sub> = 0.50 at 96 h). DR risk modified efficacy of HCTZ versus placebo on dyspnoea VAS, with high (vs. low) DR risk having attenuated improvement at 72 h (−236 vs. 476 mm; <jats:italic>p</jats:italic><jats:sub>int</jats:sub> = 0.03) and 96 h (−400 vs. 777 mm; <jats:italic>p</jats:italic><jats:sub>int</jats:sub> = 0.001).ConclusionsThe BAN‐ADHF score demonstrated good performance in identifying DR, and high DR risk was associated with worse outcomes. HCTZ treatment response on weight loss was similar across DR risk, but improvement in dyspnoea with HCTZ was attenuated in high DR risk.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"138 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906057","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":"Randomized investigation of heart failure therapy in patients with advanced cancer at risk of cardiac wasting: Rationale and design of the EMPATICC trial","authors":"Markus S. Anker, Amir A. Mahabadi, Matthias Totzeck, Mitra Tewes, Raluca Mincu, Muhammad Shahzeb Khan, Javed Butler, Ulrich Keller, Johann Ahn, Lars Bullinger, Dominik P. Modest, Ulf Landmesser, Lorenz H. Lehmann, Sven Bercker, Ulrich Laufs, Michael Böhm, Bela Merkely, Monika Diek, Tim Heise, Martin Hellmich, Marius Placzek, Tim Friede, Stefan D. Anker, Tienush Rassaf","doi":"10.1002/ejhf.3799","DOIUrl":"https://doi.org/10.1002/ejhf.3799","url":null,"abstract":"AimsEnd‐stage cancer may resemble a heart failure (HF)‐like phenotype marked by cardiac wasting, dysfunction, and symptoms such as dyspnoea, congestion, and impaired physical function. The EMPATICC (EMPower the heArt of patients with TermInal Cancer using Cardiac medicines) trial evaluates the safety and efficacy of optimized HF therapy in patients with advanced cancer to improve self‐care ability.MethodsEMPATICC is a multicentre, investigator‐initiated, randomized, double‐blind, controlled, proof‐of‐concept trial employing a joint cardio‐oncology care approach. Patients were randomized 1:1 to optimized HF therapy (sacubitril/valsartan, empagliflozin, ivabradine, ferric carboxymaltose) plus usual care, or usual care alone, for 30 days, followed by a 30‐day open‐label extension. Eligible patients had stage IV solid tumours (per Union for International Cancer Control), were receiving palliative care, had a 1–6 month life expectancy, and were on optimized analgesia. At baseline, first patients had to meet ≥2 criteria of the following indicating cardiovascular risk: heart rate ≥70 bpm, N‐terminal pro‐B‐type natriuretic peptide ≥600 pg/ml, elevated high‐sensitivity troponin, left ventricular ejection fraction &lt;55%, left ventricular mass loss &gt;15%, transferrin saturation &lt;20%, or moderate/high likelihood of HF with preserved ejection fraction (based on the HFA‐PEFF score); and they had to meet at least one criterion of the following indicating functional limitation: ≥6 s to walk 4 m, inability to wash ≥3 days of the last 7 days, or symptoms of dyspnoea at rest. Enrolment ended 30 January 2025; 93 patients completed randomization. The primary endpoint is a hierarchical composite (analysed by win ratio): (1) days alive and able to wash, (2) 4 m walking ability, and (3) patient global assessment of well‐being.ConclusionsEMPATICC evaluates whether HF therapy can improve function and well‐being in advanced cancer, potentially reshaping care in this population.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906056","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 ‘Incident heart failure is common and underrecognized in patients with biopsy‐proven metabolic dysfunction‐associated steatotic liver disease’","authors":"Shio‐Shin Jean, Chih‐Cheng Lai","doi":"10.1002/ejhf.3769","DOIUrl":"https://doi.org/10.1002/ejhf.3769","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"15 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906058","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":"What's new in heart failure? July 2025","authors":"Philipp Markwirth,&nbsp;Julian Hoevelmann,&nbsp;Mert Tokcan,&nbsp;Bernhard Haring","doi":"10.1002/ejhf.70007","DOIUrl":"https://doi.org/10.1002/ejhf.70007","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 7","pages":"1155-1158"},"PeriodicalIF":10.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885053","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":"Sodium zirconium cyclosilicate, hyperkalaemia, and spironolactone optimization in heart failure with reduced ejection fraction: The REALIZE-K open-label run-in phase","authors":"Mark C. Petrie,&nbsp;David Z.I. Cherney,&nbsp;Akshay S. Desai,&nbsp;Jeffrey M. Testani,&nbsp;Subodh Verma,&nbsp;Khaja Chinnakondepalli,&nbsp;David Dolling,&nbsp;Shachi Patel,&nbsp;Magnus Dahl,&nbsp;James M. Eudicone,&nbsp;Lovisa Friberg,&nbsp;Mario Ouwens,&nbsp;Murillo O. Antunes,&nbsp;Kim A. Connelly,&nbsp;Vagner Madrini Jr,&nbsp;Luca Kuthi,&nbsp;Anuradha Lala,&nbsp;Miguel Lorenzo,&nbsp;Patrícia O. Guimarães,&nbsp;Marta Cobo Marcos,&nbsp;Béla Merkely,&nbsp;David Gonzales-Calle,&nbsp;Julio Nuñez Villota,&nbsp;Iain Squire,&nbsp;Jan Václavík,&nbsp;Jerzy Wranicz,&nbsp;Mikhail N. Kosiborod","doi":"10.1002/ejhf.3787","DOIUrl":"10.1002/ejhf.3787","url":null,"abstract":"&lt;p&gt;In heart failure with reduced ejection fraction (HFrEF), mineralocorticoid receptor antagonists (MRAs) reduce mortality and HF hospitalizations, and are one of the key cornerstones of guideline-directed medical therapy.&lt;span&gt;&lt;sup&gt;1-4&lt;/sup&gt;&lt;/span&gt; Hyperkalaemia (or fear of hyperkalaemia) is a major reason for their underuse.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; In the randomized-withdrawal phase of the REALIZE-K trial, of patients with HFrEF and prevalent hyperkalaemia or at risk of hyperkalaemia, continued use of the potassium (K&lt;sup&gt;+&lt;/sup&gt;) binder sodium zirconium cyclosilicate (SZC) led to large increases in the number of participants on optimal-dose spironolactone with normokalaemia, and reduced the risk of hyperkalaemia and \u0000down-titration/discontinuation of spironolactone compared with withdrawal to placebo.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Prior to the placebo-controlled, randomized-withdrawal phase of REALIZE-K, there was a run-in phase in which SZC was used to manage hyperkalaemia and spironolactone dose was optimized.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;This analysis evaluated the efficacy of SZC in lowering serum (s)K&lt;sup&gt;+&lt;/sup&gt; and enabling SZC titration during the run-in phase among those with prevalent hyperkalaemia on no or low-dose (12.5 mg) spironolactone; and in those identified as at high risk of hyperkalaemia on no or low-dose spironolactone, to evaluate the incidence of hyperkalaemia during spironolactone dose titration during the run-in phase and use of SZC to lower sK&lt;sup&gt;+&lt;/sup&gt; and enable maintenance of spironolactone.&lt;/p&gt;&lt;p&gt;This was a post-hoc analysis of REALIZE-K, which was a prospective phase 4, double-blind, placebo-controlled, randomized-withdrawal trial evaluating the role of SZC in enabling MRA therapy in patients with HFrEF and hyperkalaemia.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; Patient eligibility criteria have been reported previously.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; Briefly, trial participants were required to have a left ventricular ejection fraction ≤40% and to be on a stable dose of angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, or angiotensin receptor–neprilysin inhibitor, as well as a beta-blocker. Patients had to be either untreated with, or on a low dose of, MRA (&lt;25 mg daily of spironolactone or eplerenone) because of either: prevalent hyperkalaemia (Cohort 1), defined as sK&lt;sup&gt;+&lt;/sup&gt; 5.1–5.9 mEq/L at screening and estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;; or at high risk of hyperkalaemia (Cohort 2), defined as either documented history of hyperkalaemia (sK&lt;sup&gt;+&lt;/sup&gt; &gt;5.0 mEq/L) in the previous 36 months and eGFR ≥30 ml/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;, or sK&lt;sup&gt;+&lt;/sup&gt; 4.5–5.0 mEq/L, and either eGFR 30–60 ml/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; or aged &gt;75 years.&lt;/p&gt;&lt;p&gt;Participants who fulfilled the eligibility criteria entered the open-label run-in phase. This analysis included all participants who entered the open-label period and received at least one dose of SZC or spironolactone. In Cohort","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 8","pages":"1491-1495"},"PeriodicalIF":10.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.3787","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}