Journal of the Saudi Heart Association最新文献

{"title":"Pediatric Cardiac Imaging With Second- and Third-generation Dual Source CT Scanners: Radiation Dose, and Diagnostic Accuracy in Comparison With Echocardiography and MRI-A Systematic Review and Meta-analysis.","authors":"Lamia G Jamjoom, Razan K Daghistani","doi":"10.37616/2212-5043.1497","DOIUrl":"https://doi.org/10.37616/2212-5043.1497","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate the diagnostic accuracy, imaging speed, radiation dose, and clinical utility of second- and third-generation dual source computed tomography scanners, in comparison with echocardiography and magnetic resonance imaging in diagnosing congenital heart disease in paediatric patients.</p><p><strong>Material and methods: </strong>A systematic literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials from 1 January 2006 to 30 April 2025. Eligible studies included pediatric populations undergoing cardiac imaging with modern computed tomography scanners and compared outcomes against echocardiography or magnetic resonance imaging. Study selection followed PRISMA guidelines. Risk of bias was assessed using QUADAS-2 and ROBINS-I tools. Meta-analysis was performed for sensitivity outcomes, and pooled odds ratios were calculated using fixed-effects models.</p><p><strong>Results: </strong>Twenty-four studies met the inclusion criteria, comprising 3 prospective and 21 retrospective studies involving pediatric patients with congenital heart disease. Diagnostic accuracy of computed tomography ranged from 91% to 100%, with pooled sensitivity significantly favoring computed tomography over echocardiography (OR = 3.87; 95% CI: 2.78-5.38; P < 0.00001). Radiation doses were consistently low, ranging from 0.21 to 0.70 mSv with high-pitch and electrocardiogram-gated protocols. Several studies reported clinical impact, including changes in surgical planning and improved anatomical visualization. Risk of bias was moderate in most studies, primarily due to confounding and retrospective designs.</p><p><strong>Conclusions: </strong>Cardiac computed tomography demonstrates high diagnostic accuracy and provides detailed anatomical visualization in pediatric patients with congenital heart disease. It is particularly valuable for assessing extracardiac structures and complex vascular anatomy, where it may complement echocardiography and cardiac magnetic resonance imaging. While radiation exposure has been substantially reduced with newer-generation technologies, the interpretation of findings should consider the methodological limitations of included studies. Further prospective research is needed to strengthen the evidence base.</p><p><strong>Prospero registration: </strong>CRD420251042099.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"2"},"PeriodicalIF":1.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report--Late Presentation of Shone's Complex With Severe Left Ventricular Dysfunction.","authors":"Refal Mahrouqi, Asayil Almarjan, Ahmed Sultan, Sheeren Khaled, Elnazeer Ahmed","doi":"10.37616/2212-5043.1489","DOIUrl":"https://doi.org/10.37616/2212-5043.1489","url":null,"abstract":"<p><strong>Background: </strong>Shone's complex is a rare Congenital Heart Disease (CHD), often including supravalvular mitral ring, parachute Mitral Valve (MV), subaortic stenosis, and coarctation of the aorta. Variants of this complex have been reported with considerable anatomical and clinical heterogeneity.</p><p><strong>Case presentation: </strong>A 14-year-old girl with severe cachexia and cardiac failure, referred for CHD evaluation. Echocardiography and CT revealed a bicuspid Aortic Valve (AV), severe valvular and subvalvular aortic stenosis, a subaortic membrane, a muscle ridge causing Left Ventricular Outflow Tract (LVOT) obstruction, dilated LV with EF 25-30%, and a ventricular septal defect.</p><p><strong>Intervention: </strong>MV replacement, Konno procedure with LVOT and annular enlargement, AV replacement, and Tricuspid Valve (TV) repair. She had an uneventful ICU course.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"13"},"PeriodicalIF":1.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Original Article--Evaluation of Radial Artery Anatomy With Various Anatomical Variants in Patients Undergoing Transradial Catheterization.","authors":"Nisarg Desai, Sharadkumar Jain, Kunal Parwani, Pooja Vyas, Yaqub Sidatar","doi":"10.37616/2212-5043.1490","DOIUrl":"https://doi.org/10.37616/2212-5043.1490","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the incidence of radial artery anomalies in a large cohort of patients undergoing TRA and to evaluate their specific impact as predictors of procedural failure and access site complications.</p><p><strong>Methods: </strong>This prospective, observational, single-center study enrolled 1000 consecutive patients undergoing coronary angiography or intervention via TRA between 2022 and 2024. Radial artery anatomy was assessed using retrograde radial arteriography immediately following sheath insertion. Anatomical variants were categorized into high bifurcation (origin proximal to the cubital fossa), Radial artery loops (full 360-degree curvature), Tortuosity (curve of more than 45° in the vessel), Narrow calliber, Spasm, and Ulnar absent. Procedural success was defined by completion of the procedure via the initial radial access site. Binary logistic regression was used to identify independent predictors of procedural failure (crossover to alternate access).</p><p><strong>Results: </strong>Radial artery anomalies were observed in 9.3% (n = 93) of the total cohort. High bifurcation (4.7%) was the most common variant, followed by loops (2.3%) and tortuosity (1.5%). Overall procedural success via the initial radial site was 93.8%. The presence of an anatomical anomaly was a highly significant independent predictor of procedural failure/crossover (Odds Ratio [OR]: 8.16; 95% CI: 4.29 to 15.52; P < 0.0001). Specifically, radial loops were associated with a failure rate of 32.3% ( <i>p</i> < 0.05). Furthermore, patients exhibiting anomalies had a significantly smaller mean RA diameter (2.54 ± 0.47 mm) compared to those with normal anatomy (2.76 ± 0.39 mm; P < 0.0001). Smaller radial artery diameter (OR: 0.38; <i>P</i> = 0.001) and older age (OR: 1.03; <i>P</i> = 0.005) also predicted failure.</p><p><strong>Conclusion: </strong>Radial artery variants, particularly loops, are significant predictors of procedural crossover but remain rare (~2%) and are successfully negotiated in nearly two-thirds of cases. These findings do not support routine upfront radial angiography, which increases radiation exposure and costs without meaningfully improving success rates. Instead, a selective angiographic approach is recommended for challenging cases. While distal radial access (dTRA) is a promising alternative, its adoption is tempered by a steeper learning curve and smaller vessel calibers.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome and Clinical Characteristics of Diaphragm Dysfunction After Pediatric Cardiac Surgery: From Detection to Plication.","authors":"Muhammad Shahzad, Mohammed Bokir, Haifa AlMuhanna, Abdulaziz Alanazi, Zehra AlAbbas, Reem Beheri, Yasser A Alheraish, Khaled Alarwan","doi":"10.37616/2212-5043.1486","DOIUrl":"https://doi.org/10.37616/2212-5043.1486","url":null,"abstract":"<p><strong>Background: </strong>Diaphragm paralysis (DP) due to phrenic nerve injury is a rare but serious complication of pediatric cardiac surgery (0.3-5% of cases). It presents as an extubation failure or difficulty weaning from ventilation. Early recognition and management are essential.</p><p><strong>Objectives: </strong>This study aimed to evaluate the incidence, clinical characteristic and outcome of diaphragm paralysis after heart surgery in children.</p><p><strong>Methods: </strong>A retrospective single-center review (2019-2024) was conducted of ultrasound-confirmed DP case. Demographics, surgical details, ventilatory course, interventions, and outcomes were analyzed. Partial and complete DP were compared using multivariate logistic regression to identify predictors.</p><p><strong>Results: </strong>Out of 2280 surgeries, 108 children (4.7 %) developed DP, with 75 % being infants (median age 6.3 months). Partial paresis happened in 2.9 % and complete paralysis in 1.8 %. The left side was affected most, 46 % of total cases. Children with complete DP were younger (median 5.8 vs 7.4 months, <i>p</i> < 0.05) and most had an open sternum. Plication was done in 40 % of complete DP cases, none in partial cases. Complete DP led to longer hospital stays (26 vs 21 days, <i>p</i> < 0.05). Male sex (OR 3.76, <i>p</i> < 0.01) and open sternum (OR 3.26, <i>p</i> < 0.05) were independent predictors of complete paralysis. Survival was 93.</p><p><strong>Conclusion: </strong>Diaphragm paralysis after heart surgery is a serious problem in children, especially infants. Partial paralysis improved with non-invasive ventilation and physiotherapy, but complete paralysis often need surgery. Protecting the phrenic nerve, using early imaging, and the prompt actions may improve the outcome.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"14"},"PeriodicalIF":1.3,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrocardiac Innominate Vein: A Rare Vascular Anomaly Associated With Congenital Heart Disease.","authors":"Ali Alakhfash, Osama Alrusaini, Fahad Alhabshan, Khaled Alhawri, Abdulrahman Almesned","doi":"10.37616/2212-5043.1484","DOIUrl":"https://doi.org/10.37616/2212-5043.1484","url":null,"abstract":"<p><p>Atrial septal defects are common congenital heart anomalies and may coexist with rare systemic venous abnormalities. We describe a one-year-old female with a large secundum atrial septal defect and an unusual retrocardiac innominate vein. Transthoracic echocardiography suggested a persistent left superior vena cava, but the innominate vein was absent from its usual location and the coronary sinus was not dilated. Cardiac CT angiography demonstrated a retrocardiac innominate vein draining into the azygos system and subsequently to the right atrium. Surgical atrial septal defect closure was successful. Recognition of this anomaly is essential for accurate diagnosis and procedural planning.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"9"},"PeriodicalIF":1.3,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent Double Dorsal Aorta and Complex Congenital Heart Disease - A Case Report.","authors":"Anhar A Baeshen, Mohammad A G Rasol, Riad Abouzahr, Zaheer A Ahmad","doi":"10.37616/2212-5043.1480","DOIUrl":"https://doi.org/10.37616/2212-5043.1480","url":null,"abstract":"<p><strong>Background: </strong>Double dorsal aorta is a rare congenital embryological vascular anomaly resulting from incomplete regression and fusion of the dorsal aortae during embryogenesis. This anomaly could be associated with various other congenital heart defects (CHDs), including transposition of the great arteries, ventricular septal defect (VSD), persistent truncus arteriosus, tetralogy of Fallot (TOF), and Coarctation of the aorta (COA).</p><p><strong>Clinical presentation: </strong>This is a 9 year old girl with complex congenital heart disease and a double dorsal aorta who underwent a single ventricle palliation and this anomaly was detected during pre Fontan evaluation. She presented at age of 2 weeks with cyanosis, initial diagnosis was situs inversus, Dextrocarida, DORV with malposed great arteries, subpulmonary and valvular pulmonary stenosis, Patent ductal arteriosus and left superior vena cava. Patient was discussed with cardiothoracic team and Underwent left bidirectional Glenn at 10 months of age (2017) During pre-Fontan catheterization (June 2021) → incidental discovery of double descending (double dorsal) aorta, subsequently confirmed by CTA Fontan Completion: Deferred due to multiple severe comorbidities.</p><p><strong>Conclusion: </strong>Double dorsal aorta is an extremely rare embryologic vascular anomaly due to failure of fusion of the paired dorsal aortae. Although was asymptomatic, its identification is important in complex congenital heart disease because it may affect surgical planning and catheter based interventions. In this patient, the anomaly was detected incidentally during pre Fontan evaluation emphasizing the value of detailed preoperative imaging.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"7"},"PeriodicalIF":1.3,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor Regarding: \"Evaluation of Left Ventricular Function in Coronary Artery Ectasia: The Added Value of 2D Speckle-tracking Echocardiography\".","authors":"Osama A Elshaer","doi":"10.37616/2212-5043.1476","DOIUrl":"10.37616/2212-5043.1476","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 4","pages":"21"},"PeriodicalIF":1.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma CA125 Levels as a Predictor of Major Adverse Cardiac Events in Patients With Acute Coronary Syndrome: A Six-month Follow-up Study.","authors":"Nazlı Dilek Çolak, Turgut Karabağ, Onuralp Çalışkan, Songül Tezcan","doi":"10.37616/2212-5043.1478","DOIUrl":"https://doi.org/10.37616/2212-5043.1478","url":null,"abstract":"<p><strong>Objectives: </strong>Carbohydrate antigen 125 (CA125) is associated with different cardiovascular conditions. This study aimed to determine CA125 levels in patients with acute coronary syndrome (ACS) and the potential relationship between major adverse cardiac events (MACE) in the short-term following.</p><p><strong>Methods: </strong>This prospective cohort study was conducted in a coronary care unit between May and November 2022. Plasma CA125 levels were measured only once upon hospital admission. Patients were followed for six months. All-cause mortality, recurrent acute coronary syndrome, requirement for revascularization, decompensated heart failure, cardiogenic pulmonary edema, atrial fibrillation, and stroke were recorded as MACE.</p><p><strong>Results: </strong>A total of 127 patients were included in this study. The mean left ventricular ejection fraction (LVEF) was 50.5 %. The median plasma CA125 level was 14.6 KU/L. There was a, significant positive relationship between CA125 and high-sensitivity cardiac troponin (hs-cTn) (r = 0.315, p < 0.001) and pro-B-type natriuretic peptide (proBNP) (r = 0.423, p < 0.001), and a weak negative relationship with LVEF (r = -0.186, p = 0.037) value.</p><p><strong>Conclusions: </strong>Plasma CA125 levels were correlated with the pro-BNP and hs-cTn, established ACS biomarkers. An additional notable finding was the weak correlation with LVEF. Elevated plasma CA125 levels might be used to identify patients with ACS who are at higher risk of MACE at six months.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"6"},"PeriodicalIF":1.3,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Compression to Closure: Efficacy and Safety of Vascular Closure Devices (VCD) Versus Manual Compression: A Comparative Analysis of Hemostatic Strategies of Obtura, Angioseal, and ProGlide VCD.","authors":"Kumar Himanshu, Mohit Sachan, Ali Mohamed, Mukesh J Jha, Santosh K Sinha, Awadhesh K Sharma, Puneet Aggarwal, Mahmodullah Razi, Praveen Shukla, Umeshwar Pandey, Neeraj Prakash, Rakesh K Verma","doi":"10.37616/2212-5043.1477","DOIUrl":"https://doi.org/10.37616/2212-5043.1477","url":null,"abstract":"<p><strong>Objective: </strong>Use of vascular closure devices (VCDs) for femoral artery puncture site hemostasis has increased but their safety and efficacy have remained unclear. This study was designed to compare safety and efficacy of Obtura, Angioseal, and Proglide VCD to manual compression (MC) and also between for femoral artery haemostasis.</p><p><strong>Methods: </strong>This was prospective, randomized controlled study where patients were randomly assigned on 1:1:1:1 basis. Primary endpoints were time to hemostasis (TTH) and ambulation time (AT) while secondary endpoints were deployment success, device related adverse events and technical success rate. ANOVA and Tukey HSD was conducted to draw significant difference between individual strategies. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Total of 1000 patients (250 in each arm) who underwent transfemoral intervention at LPS Institute of Cardiology, Kanpur, India between January 2025 and March 2025 were evaluated. Sheath size, common femoral artery diameter and device size did not differ significantly across all the groups. Mean TTH was shortest for Angioseal (1.30 min) followed by Obtura (2.58 min), Perclose (3.97 min), and MC (17.61 min). Similarly, mean AT was shortest for Angio-Seal (123.06 min) followed by Perclose ProGlide (162.56 min), Obtura (185.42 min) and MC (743.23 min). Technical success in Angio-Seal, Obtura and Perclose ProGlide were 99.1%, 97.4% and 94.6% respectively. No access site complications (re-bleeding, infection, arteriovenous fistula, and transient access site nerve injury) were noted. There were 2(0.8%), 5(2%), 7(3.2%) and 12 (4.8%) cases of haematoma in Angio-Seal, Obtura, Perclose ProGlide and MC arm respectively. There were 2(0.8%), 2(0.8%), and 4 (1.6%) case of arterial pseudoaneurysm Obtura, Perclose ProGlide and MC arm respectively while none in Angio-Seal arm.</p><p><strong>Conclusion: </strong>Vascular closure devices showed significantly faster haemostasis and shorter ambulation time compared to manual compression highlighting their clinical efficiency and Angio-Seal was superior safety and efficacy over Obtura and Perclose ProGlide.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"5"},"PeriodicalIF":1.3,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Ultrasound Evaluation of Left Ventricular Function in Coronary Artery Ectasia: The Added Value of 2D Speckle-tracking Echocardiography\".","authors":"Eman Aslam, Maryam Amjad","doi":"10.37616/2212-5043.1471","DOIUrl":"https://doi.org/10.37616/2212-5043.1471","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 4","pages":"19"},"PeriodicalIF":1.3,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}