Journal of the Saudi Heart Association最新文献

{"title":"Comparative Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Elderly Patients With Severe Symptomatic Aortic Stenosis: A Systematic Review.","authors":"Omar Hamodat, Saif Almuzainy, Salma Nizar","doi":"10.37616/2212-5043.1393","DOIUrl":"10.37616/2212-5043.1393","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic stenosis is the most common valvular heart disease globally; while transcatheter aortic valve replacement (TAVR) has proven to be a competitive alternative to surgical aortic valve replacement (SAVR) and revolutionized treatment, its safety and efficacy has yet to be comprehensively assessed against SAVR for certain subsets of aortic stenosis patients; therefore, this study aims to systematically analyze all the available clinical evidence from randomized clinical trials on TAVR versus SAVR among intermediate and low-risk patients with severe symptomatic aortic stenosis.</p><p><strong>Methodology: </strong>We performed a systematic review of the randomized controlled trials (RCT), studies comparing TAVR and SAVR in low- and intermediate-risk patients were identified by a comprehensive search of the major databases. Mortality, stroke, length of stay, and other perioperative outcomes were assessed.</p><p><strong>Results: </strong>A comprehensive screening of 14,384 records identified 9 studies, encompassing 8884 patients with a mean age of 77.76 years and 49.47% male. TAVR demonstrated a significantly lower all-cause mortality at both 30 days and 1 year compared to SAVR, with comparable outcomes at 2 years, underscoring its potential for enhanced survival. Stroke incidence was markedly lower with TAVR at both 30 days and 1 year, highlighting its favorable neurological safety profile. Additionally, TAVR showed a reduced rate of myocardial infarction within the initial 30 days post-procedure. Prosthetic valve endocarditis rates remained low and comparable between the two approaches at both 30 days and 1 year. Notably, TAVR was associated with a significantly shorter hospital stay, suggesting a faster recovery trajectory and improved patient throughput. These findings collectively emphasize the superior efficacy and safety profile of TAVR over SAVR.</p><p><strong>Conclusion: </strong>TAVR may serve as a viable therapeutic option for intermediate and low-risk patients with severe symptomatic aortic stenosis. Future research should focus on long-term outcomes and TAVR device durability, especially in younger, lower-risk populations.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 3","pages":"242-251"},"PeriodicalIF":0.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11517992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522236","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":"A Rare Case of Large Nonvalvular Papillary Fibroelastoma Manifesting as Vertigo and Exertional Dyspnea.","authors":"Mohaddeseh Behjati, Mohsen Mirmohammadsadeghi, Ehsan Abadi, Mohammad H Paknahad, Parisa Adib-Hajbagheri","doi":"10.37616/2212-5043.1394","DOIUrl":"https://doi.org/10.37616/2212-5043.1394","url":null,"abstract":"<p><strong>Background: </strong>Papillary fibroelastoma (PFE) is an uncommon benign cardiac tumor, typically arising from valvular structures. Nonvalvular PFEs are exceedingly rare and may present with diverse symptoms.</p><p><strong>Case presentation: </strong>We present a case of a 46-year-old woman with positional vertigo and exertional dyspnea. Transthoracic echocardiography revealed a mobile oval-shaped mass in the left ventricle. Cardiac magnetic resonance imaging suggested a large papillary fibroelastoma. The tumor was successfully resected, and histopathological examination confirmed the diagnosis.</p><p><strong>Conclusion: </strong>This case highlights the importance of thorough imaging and surgical intervention in managing large, nonvalvular PFEs, which, although rare, can lead to significant complications.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 3","pages":"237-241"},"PeriodicalIF":0.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11477084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468668","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":"Consensus of the National Heart Center in collaboration With the Saudi Arabian Cardiac Interventional Society on the Clinical Use of Intracoronary Imaging.","authors":"Mirvat Alasnag, Mognee Alameer, Ahmed AlShehri, Hind Alosaimi, Faisal Alqoofi, Hussain Alzayer, Wail AlKashkari, Adel Tash, Waqar H Ahmed","doi":"10.37616/2212-5043.1387","DOIUrl":"10.37616/2212-5043.1387","url":null,"abstract":"<p><strong>Objectives: </strong>Studies show that intracoronary imaging (ICI)-guided PCI is associated with a significantly lower risk of stroke, Q-wave myocardial infarction, and death compared to angiography-guided PCI in the management of acute coronary syndromes, complex coronary lesions and left-main interventions. Despite these well-established clinical benefits, the utilization of ICI-guided PCI in Saudi Arabia remains suboptimal.</p><p><strong>Methods: </strong>The National Heart Center (NHC) and the Saudi Arabian Cardiac Interventional Society (SACIS) gathered national experts to develop a consensus document on how to integrate ICI-guided PCI in routine clinical practice in Saudi Arabia. The consensus was based on the nominal group technique, whereby a committee of interventional cardiologists affiliated with the NHS and SACIS developed and discussed a number of statements on the clinical use of intracoronary imaging based on a systematic review of the literature.</p><p><strong>Results: </strong>A total of 17 statements were discussed in light of scientific evidence and agreed upon. Initiatives to improve operator skills when it comes to image acquisition and interpretation are crucial in the incorporation of ICI-imaging guided PCI in Saudi Arabia. Local data on reference diameters and measurements and epidemiological data on Saudi patients being treated in catheterization laboratories are necessary.</p><p><strong>Conclusions: </strong>Herein, we provide the first national consensus on the use of ICI-guided PCI in Saudi Arabia. We anticipate that this document contributes to a more optimal and integrative use of ICI-guided PCI in the Kingdom.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 2","pages":"137-157"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522232","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":"Intraoperative Remifentanil Use Reduces Atrial Fibrillation After Coronary Artery Bypass Surgery.","authors":"Yasuhiko Imashuku, Susumu Hiraoka, Motoi Inoue, Takayoshi Mizuno, Misuzu Oyagi, Hirotoshi Kitagawa","doi":"10.37616/2212-5043.1390","DOIUrl":"10.37616/2212-5043.1390","url":null,"abstract":"<p><strong>Objectives: </strong>Atrial fibrillation after coronary artery bypass grafting is a relatively well known complication that has been observed for a long time. Though the management and drugs in the perioperative period have changed, their impact on the generation of postoperative atrial fibrillation remains unclear. Therefore, we investigated various perioperative management methods and the occurrence of postoperative atrial fibrillation.</p><p><strong>Methods: </strong>The patients underwent off-pump coronary artery bypass grafting between January 2010 and October 2019. The study was a retrospective observational study, and we investigated the incidence of atrial fibrillation during all 5 postoperative days. Patient factors included age, sex, height, and weight, preoperative factors included oral statin, HbA1c, left ventricular ejection fraction, and left atrial diameter; intraoperative factors included operation time, remifentanil use, beta-blocker use, magnesium-containing infusions use, in-out balance, and number of vascular anastomoses.</p><p><strong>Results: </strong>Postoperative atrial fibrillation was recognized in 81 out of 276 cases. There were significant differences between the two groups in terms of age, left atrial diameter, and intraoperative remifentanil use. A logistic regression analysis presented the effects of age (OR 1.045, 95% CI 1.015-1.076, P < 0.01), preoperative left atrial diameter (OR 1.072, 95% CI 1.023-1.124, P < 0.01), and intraoperative remifentanil use (OR 0.492, 95% CI 0.284-0.852, P = 0.011) on postoperative atrial fibrillation.</p><p><strong>Conclusions: </strong>Operative time did not affect postoperative atrial fibrillation. Age and left atrial diameter had previously been shown to affect postoperative atrial fibrillation, and our results were similar. This study showed that the use of remifentanil reduced the incidence of postoperative atrial fibrillation. On the other hand, no other factors were found to have an effect.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 3","pages":"232-236"},"PeriodicalIF":0.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140425","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":"Saudi Heart Association/National Heart Center/Saudi Arabian Cardiac Interventional Society/Saudi Society for Cardiac Surgeons/Saudi Cardiac Imaging Group 2023 TAVI Guidelines.","authors":"Turki Albacker, Adel Tash, Hussein Alamri, Mirvat Alasnag, Wail Alkashkari, Fawaz Almutairi, Faisal Alqoofi, Ahmed Alsaileek, Uthman Aluthman, Ghormallah Alzahrani, Mohammed Balghith, Fahd Makhdom","doi":"10.37616/2212-5043.1379","DOIUrl":"10.37616/2212-5043.1379","url":null,"abstract":"<p><p>Saudi Arabia has seen a significant improvement in its healthcare system over the past four decades resulting in an increase in life-expectancy. Transcatheter aortic valve implantation (TAVI) has spread widely in Saudi Arabia and has become a routine procedure in many centers. The expanding clinical indications and the availability of the technology have made it possible for many large and intermediate centers all over the country to commence their own TAVI programs. So, the aim of this document is to standardize TAVI practices in different Saudi Arabian centers through reasonable guidelines based on the evaluation and summarization of the best available evidence. The review committee, composed of different experts in several aspects of the management of patient undergoing TAVI, based their recommendations on the reviewed and analyzed evidence and the class and level of recommendations were discussed until a consensus was reached by the panel.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 2","pages":"184-231"},"PeriodicalIF":0.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133042","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":"\"Two is Company, Three is a Crowd\" - A Case Presentation of Cardiac Amyloidosis, Hypertrophic Cardiomyopathy Plus Coronary Heart Disease.","authors":"Carolina M Gonçalves, Mariana Carvalho, Célia Domingues, Fátima Saraiva, João Morais","doi":"10.37616/2212-5043.1389","DOIUrl":"10.37616/2212-5043.1389","url":null,"abstract":"<p><p>A 76-year-old man was referred to our appointment with complaints of exertional dyspnea. He had a medical history consisting of chronic coronary syndrome, hypertrophic cardiomyopathy, and an implantable cardioverter-defibrillator for primary prevention. A transthoracic echocardiogram revealed features suspicious for cardiac amyloidosis. Haematologic and genetic tests were negative, and scintigraphy was positive, confirming wild-type transthyretin amyloidosis, not eligible for tafamidis. Several months later with optimized medical therapy, he had two worsening heart failure events. This clinical case highlights the importance of differential diagnosis. Our patient had both hypertrophic cardiomyopathy and transthyretin amyloidosis, a rare association that constitutes a diagnostic and treatment challenge.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 2","pages":"178-183"},"PeriodicalIF":0.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522229","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":"Spontaneous Interatrial Hematoma: Still an Unresolved Critical Conundrum.","authors":"Fayaz M Khazi, Imthiaz Manoly, Nayyer R Siddiqi, Tarek A Aziz, Obaid Aljassim","doi":"10.37616/2212-5043.1388","DOIUrl":"10.37616/2212-5043.1388","url":null,"abstract":"<p><p>Spontaneous interatrial hematoma is a rare clinical entity leading to the obliteration of the left atrial cavity and causing haemodynamic compromise, necessitating immediate surgical intervention. Herein, we report a patient with acute chest pain with normal coronaries and echocardiographic evidence of left atrial mass. The investigations revealed the mass to be a thrombus rather than tumour. The patient underwent surgery to remove a large thrombus completely enclosed within the interatrial septum. The septum was then repaired using a pericardial patch. No apparent etiological factor was found. Spontaneous atrial wall dissection should be considered in the differential diagnosis of acute chest pain.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 2","pages":"174-177"},"PeriodicalIF":0.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522233","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":"Consensus of National Heart Center and the Saudi Arabian Cardiac Interventional Society on the Current Landscape of the Management of Intracoronary Calcification in Saudi Arabia.","authors":"Khaled Al-Shaibi, Mirvat Alasnag, Owayed AlShemmari, Ayman AlSaleh, Wail AlKashkari, Fawaz AlMutairi, Nouf Alanazi, Mognee Alameer, Adel Tash","doi":"10.37616/2212-5043.1385","DOIUrl":"10.37616/2212-5043.1385","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to develop a streamlined algorithm for the management of intracoronary calcification that includes guidance on intracoronary imaging and the appropriate selection of atherectomy devices.</p><p><strong>Methods: </strong>National experts representing both the National Heart Center (NHC) and the Saudi Arabian Cardiac Interventional Society (SACIS) met to develop a consensus document on the assessment and management of intracoronary calcification in Saudi Arabia. The nominal group technique was utilized; a number of statements on the assessment and management of coronary artery calcification were developed based on a systematic review of the literature. The authors discussed the developed statements until a consensus was reached.</p><p><strong>Results: </strong>Twenty statements were discussed and agreed upon. Invasive and non-invasive imaging modalities in the assessment of coronary artery calcification, and management of intracoronary calcification using calcium ablation techniques, excimer laser coronary atherectomy, ballon-based techniques, and shockwave lithotripsy; were all thoroughly discussed in light of scientific evidence and the experts' clinical practice.</p><p><strong>Conclusions: </strong>We present a national consensus on the assessment and the multifaceted management of intracoronary calcification in Saudi Arabia.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 2","pages":"158-173"},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522231","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":"Cardioprotective Efficacy of Sevoflurane in Patients With Rheumatic Heart Disease Undergoing Heart Valve Surgery Under Cardiopulmonary Bypass.","authors":"Vu T Lam, Nguyen Q Kinh, Nguyen M Ly","doi":"10.37616/2212-5043.1384","DOIUrl":"10.37616/2212-5043.1384","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we investigated whether cardioprotective properties of sevoflurane were expressed in patients with rheumatic heart disease undergoing heart valve surgery under cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>Fifty patients with rheumatic heart disease undergoing heart valve surgery under CPB were randomly assigned to receive total anesthesia with sevoflurane or propofol during surgery. Except for this, anesthetic and surgical management was the same in all patients. The primary outcomes were postoperative high-sensitive cardiac troponin T (hs-cTnT) and creatine kinase-myocardial band (CK-MB) release. The secondary outcomes were hemodynamic events and short-term clinical outcomes (within 30 days after surgery).</p><p><strong>Results: </strong>The plasma concentrations of hs-cTnT at 24-hour and CK-MB from 6-hour to 48-hour in the sevoflurane group were lower than those in the control group (the propofol group). After aortic unclamping, heartbeat recovery was faster and the rate of sinus rhythm was higher in the sevoflurane group than in the control group. Moreover, a lower proportion of pacemaker use and the need for intraoperative and postoperative inotropes were also found in the sevoflurane group. Nevertheless, there were no differences between the two groups regarding short-term clinical outcomes (durations of mechanical ventilation, intensive care unit stay, hospital stay, morbidity, and mortality rates).</p><p><strong>Conclusion: </strong>Sevoflurane administered during the entire anesthetic procedure had a myocardial protective effect with less evidence of myocardial damage in the first 48-hour postoperatively but short-term clinical outcomes were not significantly different when compared with the control group in patients with rheumatic heart disease undergoing heart valve surgery under CPB.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 2","pages":"120-127"},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522230","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":"To Evaluate Efficiency of Various Coronary Artery Disease Risk Scores With Traditional Risk Factors in Patients Undergoing Coronary Angiography.","authors":"Sharma Kamal, Panwar Jasraj, Patel Krutika, Parmar Devratsinh, Kalyani Maulik, Dhorajiya Dixit","doi":"10.37616/2212-5043.1386","DOIUrl":"10.37616/2212-5043.1386","url":null,"abstract":"<p><strong>Objective: </strong>To analyze and compare various cardiovascular disease risk scores in Western Indian patients undergoing Coronary angiogram (CAG).</p><p><strong>Methods: </strong>In this prospective cross-sectional study, 1213 patients who underwent conventional coronary angiography; clinical risk profile and biochemical investigations were evaluated prior to undergoing CAG. Apart from the demographic information, 10-year absolute risk of having a major cardiovascular event (cardiovascular death, myocardial infarction or stroke) was calculated for each patient using various available Traditional Risk Scores (TRS). The population was divided in low, intermediate and high-risk categories for each of these scores.</p><p><strong>Results: </strong>Traditional cardiovascular risk factors like hypertension (41.8%) and diabetes mellitus-II (26.9%) were the two most prevalent risk factors in our study population. A higher risk value for all these TRS was more likely to be associated with obstructive coronary artery disease (OCAD) on CAG. Patients with high risk (≥20% for 10-year) QRESEARCH (QRISK3) score category had higher number of patients with obstructive CAD (49.6%) as compared to high risk category of risk score for those with high Global Registry of Acute Coronary Events (GRACE) score (46.6%) or risk Framingham (FRS CHD) score (29.2%) and risk atherosclerotic cardiovascular disease (ASCVD) score (30.1%) (P < 0.0001). A higher TRS was more likely to be associated with obstructive CAD, with the highest predictability being with QRISK3 (QRISK3 score 60.9%, GRACE score 54.9%, FRS-CHD score 34% and ASCVD score 42.1% respectively; P < 0.0001). A substantial study population (27.4%) cannot be identified using any of these TRS and hence a need of indigenous or modified risk scores is proposed.</p><p><strong>Conclusion: </strong>QRISK3 score was most efficacious for predicting obstructive CAD in our Indian study population on CAG. A higher risk score also correlated with the number of vessels involved on coronary angiogram. A substantial obstructive CAD patient could not be identified using traditional risk scores hence need for an indigenous or modified score.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 2","pages":"128-136"},"PeriodicalIF":0.7,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620253","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}