Pulmonary Circulation最新文献

{"title":"Treatment pathways in Finnish patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH).","authors":"Markku Pentikäinen, Piia Simonen, Pauliina Leskelä, Terttu Harju, Pertti Jääskeläinen, Christian Asseburg, Minna Oksanen, Erkki Soini, Christina Wennerström, Airi Puhakka, Katriina Kahlos","doi":"10.1002/pul2.12440","DOIUrl":"https://doi.org/10.1002/pul2.12440","url":null,"abstract":"<p><p>Treatment patterns of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) in Finland are unknown. Guidelines now recommend early escalation of treatment for PAH. We evaluated how well Finnish practice follows guidelines, and how treatment initiations and outcomes are related. The pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension patients in Finland cohort includes all PAH and CTEPH patients diagnosed between 2008 and 2020 in all Finnish university hospitals. Drug therapy was analysed in patients with medical/procedural history available, and changes in the 4-tier comparative, prospective registry of newly initiated therapies for pulmonary hypertension (COMPERA) 2.0 risk score were evaluated. PAH patients (<i>n</i> = 268) were initially treated with monotherapy (52%) or double therapy (24%). After year 2015, double therapy use increased to 39%. PAH treatment at 1 year after diagnosis included phosphodiesterase 5 inhibitors (71%), endothelin-receptor antagonist (48%), prostacyclin analogue (7%), calcium channel blocker (12%) and selexipag (1%). 35% achieved low risk at 1 year, increasing to 44% for patients diagnosed after 2015. Those remaining at intermediate-high (IH) or high risk (H) (28%) were not treated less aggressively than others but were older, had more comorbidities, and often history of smoking. CTEPH patients (<i>n</i> = 189) were treated with pulmonary endarterectomy (PEA) (27%), balloon pulmonary angioplasty (BPA) (11%) and medical therapy only (41%) within 1 year from diagnosis. 45% achieved low risk at 1 year. We present additional results on treatment of IH and H patients, patient characteristics preceding death, and treatment persistence. We found less treatment of PAH patients with double or triple therapies and of CTEPH patients with PEA and BPA than expected but with good results. Patients not reaching low or intermediate COMPERA 2.0 were old and had comorbidities.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e12440"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Hypertension: A Personal Journey.","authors":"Lewis J Rubin","doi":"10.1002/pul2.70047","DOIUrl":"https://doi.org/10.1002/pul2.70047","url":null,"abstract":"","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70047"},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revised Precapillary Pulmonary Hypertension Criteria and Their Prognostic Value in IPF Transplant Waitlist Survival.","authors":"Zehra Dhanani, Michael J Nicholson, Shameek Gayen","doi":"10.1002/pul2.70046","DOIUrl":"10.1002/pul2.70046","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) is a leading indication for lung transplantation. Pulmonary hypertension (PH), a common comorbidity in IPF, has gained renewed attention following the updated ESC/ERS guidelines, which redefine diagnostic thresholds for PH. This study evaluates the impact of the revised PH criteria on transplant waitlist outcomes among IPF patients. Specifically, we assessed the prevalence of PH under the new guidelines and its association with waitlist survival. We conducted a retrospective analysis using the OPTN/SRTR database, including 14,156 IPF candidates listed for lung transplantation. Survival analyses were performed using Kaplan-Meier and multivariate models to examine the influence of revised mPAP and PVR thresholds on waitlist mortality. The prevalence of PH, defined by the revised criteria, was significantly higher compared to the prior definition. Kaplan-Meier analysis demonstrated worse waitlist survival for patients with PH under both diagnostic thresholds. However, multivariate analysis revealed that mPAP and PVR thresholds were not independently predictive of mortality. Instead, clinical parameters, including 6MWD, functional status, BMI, FVC, PaCO2, and double lung transplant preference, were significant predictors of waitlist mortality. In conclusion, while the revised PH diagnostic criteria increase PH prevalence in IPF patients, their independent prognostic utility for waitlist survival is limited. This national transplant database study underscores the importance of comprehensive clinical evaluation and timely referral for transplantation in managing IPF with PH.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70046"},"PeriodicalIF":2.2,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wenshen Yiqi Granule Alleviates Chronic Obstructive Pulmonary Disease via the Long Noncoding RNA-XIST/MicroRNA-200c-3p Axis.","authors":"Haoran Deng, Shiping Zhu, Fei Yu, Xue Song, Xinlai Jin, Xuchun Ding","doi":"10.1002/pul2.70040","DOIUrl":"10.1002/pul2.70040","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a major challenge to global public health. Evidence showed that long noncoding RNA (lncRNA)-XIST/microRNA (miRNA)-200c-3p axis regulated apoptosis and inflammation in cigarette smoke extract (CSE)-exposed human bronchial epithelial cells. Wenshen Yiqi granule (WSYQG) is a Traditional Chinese medicine compound prescription and often used for treating COPD. However, the current understanding of the mechanism by which WSYQG improves COPD is still limited, which has somewhat restrained its widespread application. Therefore, this study aims to investigate the effects and biological mechanisms of WSYQG on CSE-exposed type II alveolar epithelial (AEC II) cells with cell transfection and miRNA mimics/inhibitors intervention. Cell counting kit-8, flow cytometry, Transwell, Western blot, real-time quantitative reverse transcription PCR, and fluorescence in situ hybridization assays were used. Results showed that WSYQG intervention increased cell viability and decreased levels of IFN-γ, TNF-α and apoptosis, also preventing cell migration in CSE-exposed ACE II cells. Additionally, expression of epithelial marker (ZO-1), Notch1/4 decreased, and mesenchymal markers (vimentin) and Notch2 expression increased in CSE-exposed ACE II cells, while WSYQG intervention antagonized them and also decreased N-cadherin and increased E-cadherin. Silencing lncRNA-XIST enhanced WSYQG's effects on CSE-exposed ACE II cells, while inhibiting miR-200c-3p reversed silencing lncRNA-XIST's effects. Furthermore, dual-luciferase reporter assay system and RNA immunoprecipitation assay proved that lncRNA-XIST acts as a miR-200c-3p sponge. This study highlights the importance of the lncRNA-XIST/miR-200c-3p axis in WSYQG improving COPD, providing a research basis for WSYQG to improve COPD and expanding the possibility of expanding its clinical application.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70040"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long-Term Cohort Study.","authors":"María Berenice Torres-Rojas, Dulce Iliana Navarro-Vergara, Marisol García-Cesar, Gustavo Acosta-Altamirano, Leslie Marisol González-Hermosillo, Galileo Escobedo, Guillermo Cueto-Robledo","doi":"10.1002/pul2.70035","DOIUrl":"10.1002/pul2.70035","url":null,"abstract":"<p><p>Interstitial lung disease (ILD) can lead to pulmonary hypertension (ILD-PH), worsening prognosis and increasing mortality. Diagnosing ILD-PH is challenging due to the limitations of imaging methods. Right heart catheterization (RHC) is the gold standard for diagnosing PH but is limited to ILD patients considered for lung transplantation. This study assessed the usefulness of RHC in diagnosing ILD-PH in a large cohort of 105 patients followed for at least 72 months, examining hemodynamic parameters for survival analysis. We conducted an ambispective cohort study, diagnosing PH as mean pulmonary artery pressure ≥ 20 mmHg, pulmonary arterial wedge pressure < 15 mmHg, and pulmonary vascular resistance > 2 Wood units by RHC. We registered demographic, biochemical, echocardiographic, respiratory, and hemodynamic parameters for survival analyses. Using RHC, we found a PH prevalence of 84.7% among ILD patients who previously exhibited an intermediate-to-high probability of PH by echocardiography. Thirty-nine ILD-PH patients died, yielding a 5-year survival rate of 35%, whereas ILD patients without PH had a survival rate of 100%. Connective tissue disease-associated ILD and interstitial pneumonia with autoimmune features were the predominant ILD subtypes in ILD-PH patients. The ILD-PH group had worse pulmonary function, lower forced vital capacity, and more severe hypoxemia. Kaplan-Meier analyses showed significantly lower survival rates in ILD-PH patients with a 6-min walking distance < 360 m, tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio < 0.35 mm/mmHg, venous oxygen saturation < 65%, and pulmonary artery compliance < 2.2 mm/mmHg. RHC accurately characterizes ILD-PH and provides long-term survival predictors.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70035"},"PeriodicalIF":2.2,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adding a New Dimension to PH Imaging.","authors":"Andrew Bradley, Mardi Gomberg-Maitland","doi":"10.1002/pul2.70044","DOIUrl":"10.1002/pul2.70044","url":null,"abstract":"","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70044"},"PeriodicalIF":2.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipid-Lowering Drugs and Pulmonary Vascular Disease: A Mendelian Randomization Study.","authors":"Xingya Yuan, Peiwei Hong, JinQiu Zhou","doi":"10.1002/pul2.70043","DOIUrl":"10.1002/pul2.70043","url":null,"abstract":"<p><p>The therapeutic value of lipid-lowering drugs in pulmonary vascular disease remains uncertain due to insufficient studies and evidence. This study aims to investigate the causal effects of lipid-lowering drugs (specifically, inhibitors of APOB, CETP, HMGCR, NPC1L1, and PCSK9) on pulmonary vascular diseases using a Mendelian randomization (MR) approach. We utilized summary-level statistics from genome-wide association studies (GWAS) to simulate the exposure to low-density lipoprotein cholesterol (LDL-C) and its outcomes on pulmonary arterial hypertension (PAH), pulmonary embolism (PE), and pulmonary heart disease (PHD). Single-nucleotide polymorphisms (SNPs) within or near drug target-associated LDL-C loci were selected as proxies for the lipid-lowering drugs. Data from the FinnGen cohort and UK Biobank (UKB) were incorporated to enhance the robustness and generalizability of the findings. The inverse variance weighted (IVW) and MR-Egger methods were employed to estimate MR effects. Our MR analysis indicated that LDL-C mediated by NPC1L1 (odds ratio [OR] = 104.76, 95% confidence interval [CI] = 2.01-5457.01, <i>p</i> = 0.021) and PCSK9 (OR = 10.20, 95% CI = 3.58-29.10, <i>p</i> < 0.001) was associated with an increased risk of PAH. In contrast, LDL-C mediated by APOB was associated with a decreased risk of PE (FinnGen: OR = 0.74, 95% CI = 0.60-0.91, <i>p</i> = 0.005; UKB: OR = 0.998, 95% CI = 0.996-1.000, <i>p</i> = 0.031) and PHD (FinnGen: OR = 0.73, 95% CI = 0.59-0.91, <i>p</i> = 0.004). However, LDL-C mediated by CETP and HMGCR did not show significant associations with the risks of PAH, PE, or PHD. This MR study revealed the causal effects of NPC1L1 and PCSK9 inhibitors on increased PAH risk, while APOB inhibitors appear to reduce the risks of PE and PHD. These findings enhance our understanding of the potential roles of lipid-lowering drugs in pulmonary vascular disease.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70043"},"PeriodicalIF":2.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET/CT Imaging of the Right Heart Perfusion and Glucose Metabolism Depending on a Risk Status in Patients With Idiopathic Pulmonary Arterial Hypertension.","authors":"Natalia Goncharova, Daria Ryzhkova, Kirill Lapshin, Anton Ryzhkov, Aryana Malanova, Elizaveta Andreeva, Olga Moiseeva","doi":"10.1002/pul2.70042","DOIUrl":"10.1002/pul2.70042","url":null,"abstract":"<p><p>Right ventricular heart failure (RV HF) is the leading cause of death in pulmonary arterial hypertension (PAH). Relevance of the low-risk status assessment using available diagnostic tools requires a reliable confirmation. The study aimed to evaluate right ventricular perfusion and glucose metabolism using positron emission tomography (PET)/computed tomography (CT) with [13N]-ammonia and [18F]-fluorodeoxyglucose ([18F]-FDG) in 30 IPAH patients (33.8 ± 9.4 years) according to ESC/ERS 2022 risk status. The ratio of SUVmax_RV/LV metabolism and SUVmax_RV/LV perfusion showed significant positive correlation with pulmonary artery pressure, right heart dilatation, NT-proBNP level and negative correlation with the RV ejection fraction. The SUVmax_RV/LV perfusion and SUVmax_RV/LV metabolism ratios differed significantly according to risk status. Low risk patients had a SUVmax_RV/LV metabolism comparable to the controls without PH. The SUVmax_RV/LV perfusion ratio was elevated in low-risk IPAH patients compared with controls. Increased SUVmax_RV/LV perfusion may be an early marker of coronary flow adaptation to RV pressure overload in low-risk IPAH patients and requires further evaluation. Further long-term studies are needed to determine the clinical relevance and cut-off values for the RV/LV PET/CT with [13N]-ammonia and [18F]-fluorodeoxyglucose ([18F]-FDG) uptake in different IPAH risk groups.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70042"},"PeriodicalIF":2.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiscale Three-Dimensional Evaluation and Analysis of Murine Lung Vasculature From Macro- to Micro-Structural Level.","authors":"Birger Tielemans, Nora F Marain, Axelle Kerstens, Nicolas Peredo, Montserrat Coll-Lladó, Nicola Gritti, Perrine de Villemagne, Paul Dorval, Vincent Geudens, Michaela Orlitová, Sebastian Munck, Bartosz Leszczyński, Jim Swoger, Greetje Vande Velde","doi":"10.1002/pul2.70038","DOIUrl":"10.1002/pul2.70038","url":null,"abstract":"<p><p>The pulmonary vasculature plays a pivotal role in the development and progress of chronic lung diseases. Due to limitations of conventional two-dimensional histological methods, the complexity and the detailed anatomy of the lung blood circulation might be overlooked. In this study, we demonstrate the practical use of optical serial block face imaging (SBFI), ex vivo microcomputed tomography (micro-CT), and nondestructive optical tomography for visualization and quantification of the pulmonary circulation's 3D architecture from macro- to micro-structural levels in murine lung samples. We demonstrate that SBFI can provide rapid, cost-effective, and label-free visualization of mouse lung macrostructures and large pulmonary vessels. Micro-CT offers high-resolution imaging and captures microvascular and (pre)capillary structures, with microstructural quantification. Optical microscopy techniques such as optical projection tomography (OPT) and light sheet fluorescence microscopy, allows noninvasive, mesoscopic imaging of optically cleared mouse lungs, still enabling 3D microscopic reconstruction down to the precapillary level. By integrating SBFI, micro-CT, and nondestructive optical microscopy, we provide a framework for detailed and 3D understanding of the pulmonary circulation, with emphasis on vascular pruning and rarefaction. Our study showcases the applicability and complementarity of these techniques for organ-level vascular imaging, offering researchers flexibility in selecting the optimal approach based on their specific requirements. In conclusion, we propose 3D-directed approaches for a detailed whole-organ view on the pulmonary vasculature in health and disease, to advance our current knowledge of diseases affecting the pulmonary vasculature.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70038"},"PeriodicalIF":2.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Medical Pretreatment for Balloon Pulmonary Angioplasty: Overshoot or Stride Toward Optimal Multimodal Treatment.","authors":"D P Staal, F J van Leusden, M C J van Thor, J Peper, B J M W Rensing, J P van Kuijk, B J M Mulder, D van den Heuvel, K A Boomars, S Boerman, J J Mager, M C Post","doi":"10.1002/pul2.70028","DOIUrl":"10.1002/pul2.70028","url":null,"abstract":"<p><p>In patients with chronic thromboembolic pulmonary hypertension (CTEPH) who undergo balloon pulmonary angioplasty (BPA), pretreatment with PH-targeted medical therapy may be beneficial to improve clinical parameters and pulmonary hemodynamics. This study aims to describe clinical results of PH-targeted therapy prior to BPA. All consecutive patients with CTEPH who underwent BPA treatment were selected from our CTEPH database. Medical treatment strategy, clinical parameters, and pulmonary hemodynamics at time of diagnosis and at the first BPA were analyzed. In total 92 CTEPH patients who started BPA treatment (64.1% women; 60.4 ± 14.1 years of age; 62.0% NYHA FC III/IV) were included. Most patients received dual oral PH-targeted medical therapy (68.5%) prior to BPA. Between diagnosis and first BPA (median time 13.9 [7.5-30.7] months) significant improvements were observed in patients treated with PH-targeted medical therapy for both clinical (6MWD: +28.2 m [5.1-51.3], log NTproBNP: -0.4 pg/ml [-0.8 to -0.1]) as well as pulmonary hemodynamic parameters (mPAP: -6.5 mmHg [-8.5 to -4.5], CO: +0.6 L/min [0.2-1.0] and PVR: -2.8 WU [-3.5 to -2.1]). The overall complication rate per BPA (out of a total of 441 procedures) was 15.0% for patients on monotherapy and 14.9% for those on dual/triple PH-targeted medical therapy. No severe complications occurred. In conclusion, pretreatment with PH-targeted medical therapy prior to BPA results in an improvement in clinical- and pulmonary hemodynamic parameters.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70028"},"PeriodicalIF":2.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}