Espen Fengsrud , Carina Blomström-Lundqvist , A. John Camm , Andreas Goette , Peter R. Kowey , Jose L. Merino , Jonathan P. Piccini , Sanjeev Saksena , James A. Reiffel , Giuseppe Boriani
{"title":"Antiarrhythmic drug use in atrial fibrillation among different European countries – as determined by a physician survey","authors":"Espen Fengsrud , Carina Blomström-Lundqvist , A. John Camm , Andreas Goette , Peter R. Kowey , Jose L. Merino , Jonathan P. Piccini , Sanjeev Saksena , James A. Reiffel , Giuseppe Boriani","doi":"10.1016/j.ijcha.2025.101709","DOIUrl":"10.1016/j.ijcha.2025.101709","url":null,"abstract":"<div><h3>Background</h3><div>There is limited knowledge of physicians’ antiarrhythmic drug (AAD) treatment practices for patients with atrial fibrillation and adherence to guidelines in European countries.</div></div><div><h3>Methods</h3><div>An online survey (n = 321) of cardiologists, cardiac electrophysiologists and interventional electrophysiologists was conducted in Germany (DE; n = 83), Italy (IT; n = 95), Sweden (SE; n = 60) and the United Kingdom (UK; n = 83) including 96 questions on treatment practices.</div></div><div><h3>Results</h3><div>ESC guidelines were the most important non-patient factor influencing treatment practice (55–72 %). However, while amiodarone was frequently (88–93 %) used in heart failure with reduced left ventricular ejection fraction, it was also a typical treatment choice for minimal/no-structural heart disease (SHD) (28 %), particularly in UK. Other deviations from guidelines were the use of class 1C drugs in coronary artery disease (CAD) and other SHD, and use of sotalol in left ventricular hypertrophy and renal impairment. In-hospital initiation of sotalol was low, with the exception of SE. Sotalol (16–41 %) and dronedarone use (10–54 %) in CAD varied among countries. For frequent, symptomatic paroxysmal AF, ablation was generally favoured, but AADs were preferred by 53 % in SE. In asymptomatic or subclinical AF, AADs were used by 41 % (range: 22–60 %), ablation by 11 % (range 2–18 %). In contrast to guidelines that prioritize safety, anticipated efficacy was more important (51 %) than safety (31 %) when selecting AADs.</div></div><div><h3>Conclusions</h3><div>Despite recognizing the importance of guidelines, deviations in AAD use were common with the potential to compromise patient safety. These findings indicate the need for more educational support for optimal AAD selection in AF management.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101709"},"PeriodicalIF":2.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anticoagulation use in rheumatic heart disease-associated atrial fibrillation: a study of real-world practice in Central Australia","authors":"Sonia Sawant , Gabrielle Freedman , Ana Garcia , Sally Terrett , Chinmay Khandkar , Anosh Sivashanmugarajah , Angus Baumann","doi":"10.1016/j.ijcha.2025.101711","DOIUrl":"10.1016/j.ijcha.2025.101711","url":null,"abstract":"<div><h3>Background</h3><div>Rheumatic heart disease (RHD) disproportionately impacts minority groups. Indigenous Australians living in remote areas such as Central Australia account for 3.8% of the population and 92% of RHD cases. A complication of RHD is valvular atrial fibrillation (vAF). Previous studies favour Vitamin K antagonist (VKA) use in vAF over direct oral anti-coagulants (DOACs). However, challenges to VKA use remain. This real-world retrospective observational study aimed to compare clinical outcomes between patients prescribed VKAs or DOACs for vAF in Central Australia over a five-year period.</div></div><div><h3>Methods</h3><div>Patients with RHD and vAF on the Northern Territory RHD Register in January 2019 were identified and five-year outcome data collected. Patients were grouped and analysed according to prescribed oral anticoagulant therapy in January 2019 (intention to treat (ITT)) or in January 2024/time of event (as-treated analysis (AT)). The primary outcome was major adverse cardiac and cerebrovascular events (MACCE). The safety endpoint was major bleeding.</div></div><div><h3>Results</h3><div>Of patients with vAF, 49 were included in the ITT analysis and 51 in the AT analysis. The mean age was 61.9 ± 13.9 years and 68.9 % were female. There was no difference in MACCE (25.0 % vs 22.2 %, p = 0.86) or major bleeding (20.0 % vs 11.1 %, p = 0.53) between VKAs and DOACs in the ITT analysis. Findings were similarly non-significant in AT analysis.</div></div><div><h3>Conclusion</h3><div>This study demonstrates no significant advantage to VKA over DOAC therapy in vAF in a small cohort of RHD patients living in remote Australia. Further investigation is required to optimise treatment strategies in this important group.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101711"},"PeriodicalIF":2.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Three-year clinical outcomes of a fractional flow reserve-guided percutaneous coronary intervention (PCI) strategy: A comparison of nicorandil and ATP","authors":"Yuki Numajiri , Daisuke Wada , Yuki Ishii , Yuka Tanizaki , Yosuke Takei , Hiromoto Sone , Kazuma Tashiro , Takuya Mizukami , Tokutada Sato , Takaaki Matsuyama , Hiroshi Suzuki , Hiroyoshi Mori","doi":"10.1016/j.ijcha.2025.101708","DOIUrl":"10.1016/j.ijcha.2025.101708","url":null,"abstract":"<div><h3>Background</h3><div>Nicorandil is used to induce hyperemia when measuring fractional flow reserve (FFR). However, it is unknown whether the clinical outcome of patients assessed using nicorandil is similar to that of patients assessed using adenosine triphosphatase (ATP). We aimed to compare the clinical outcomes of nicorandil and ATP in the PCI and deferred groups.</div></div><div><h3>Methods</h3><div>This retrospective study examined 492 patients with chronic coronary syndrome who underwent FFR assessment between February 2016 and December 2021. The patients received either nicorandil or ATP to induce hyperemia. The primary endpoints were all-cause death, myocardial infarction, and urgent revascularization. These clinical outcomes were followed up for three years and compared between the groups.</div></div><div><h3>Results</h3><div>In the PCI group (161 patients), primary endpoint events occurred in 9 % of the nicorandil group and 11 % of the ATP group (Adjusted HR 1.10, 95 % CI 0.35–3.40, P = 0.87). In the deferred group (331 patients), primary events occurred in 7 % of the patients in both groups (Adjusted HR 1.39, 95 % CI 0.55–3.49, P = 0.49). Kaplan-Meier curves showed no significant differences in event rates between nicorandil and ATP in either group.</div></div><div><h3>Conclusions</h3><div>In the evaluation of FFR, nicorandil is a safe and simple alternative that shows similar clinical outcomes to ATP.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101708"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annemieke C. Ziedses des Plantes , Jari A. van der Eijk , Shengnan Liu , Isabella Kardys , Nicolas M. Van Mieghem , Ernest Spitzer , Shengxian Tu , Joost Daemen
{"title":"Validation of artificial intelligence-enabled versus visual quantification of calcification by optical coherence tomography","authors":"Annemieke C. Ziedses des Plantes , Jari A. van der Eijk , Shengnan Liu , Isabella Kardys , Nicolas M. Van Mieghem , Ernest Spitzer , Shengxian Tu , Joost Daemen","doi":"10.1016/j.ijcha.2025.101704","DOIUrl":"10.1016/j.ijcha.2025.101704","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101704"},"PeriodicalIF":2.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Puja K. Mehta , Shafa-at A. Sheikh , Esha K. Dave , Rahim K. Shakoor , Tina Torbati , Amit Shah , Marc D. Thames , Liu Qiang , Yi-An Ko , Janet Wei , Chrisandra Shufelt , Michael D. Nelson , Bruce Samuels , Babak Azarbal , Jeanie Park , Michael R. Irwin , David S. Krantz , C. Noel Bairey Merz
{"title":"Parasympathetic response in women with coronary vascular dysfunction during mental stress compared to those with non-cardiac chest pain and reference controls","authors":"Puja K. Mehta , Shafa-at A. Sheikh , Esha K. Dave , Rahim K. Shakoor , Tina Torbati , Amit Shah , Marc D. Thames , Liu Qiang , Yi-An Ko , Janet Wei , Chrisandra Shufelt , Michael D. Nelson , Bruce Samuels , Babak Azarbal , Jeanie Park , Michael R. Irwin , David S. Krantz , C. Noel Bairey Merz","doi":"10.1016/j.ijcha.2025.101673","DOIUrl":"10.1016/j.ijcha.2025.101673","url":null,"abstract":"<div><h3>Background</h3><div>Coronary vascular dysfunction (CVaD) contributes to ischemia even in the absence of obstructive coronary artery disease. We hypothesize that abnormal autonomic reactivity to mental stress is a key pathophysiologic mechanism in CVaD compared to non-cardiac chest pain (NCCP) and reference control (RC) groups.</div></div><div><h3>Methods</h3><div>Seventy women (35 with CVaD diagnosed by coronary function testing, 19 with NCCP, and 16 RC) underwent mental stress testing (arithmetic and anger recall) in the Cardiac Autonomic Nervous System study. RC group was asymptomatic with no risk factors and normal exercise treadmill testing. Frequency domain heart rate variability (HRV, ms<sup>2</sup>) was obtained at baseline and during mental stress, with high frequency (HF) power as an accepted parasympathetic measure. Low frequency (LF)/HF ratio may reflect sympathetic dominance. ANOVA was used for comparisons.</div></div><div><h3>Results</h3><div>CVaD group was older compared to NCCP (57.1 ± 9.6 vs. 50.4 ± 11.3 years, p = 0.025, respectively), but age-matched to RC group (54.6 ± 14.5, p = 0.45). HRV was similar at baseline among the groups. During anger recall, CVaD group had lower HF HRV vs. NCCP (5.03 ± 1.05 vs 6.00 ± 1.17, p = 0.006, respectively), but not vs. RC (5.74 ± 1.02, p = 0.077). During arithmetic, CVaD group had lower HF HRV vs. NCCP (5.06 ± 1.12 vs. 6.00 ± 1.17, p = 0.007, respectively) and RC (6.04 ± 0.83, p = 0.01) groups. LF/HF ratio did not differ among the three groups.</div></div><div><h3>Conclusions</h3><div>Women with CVaD demonstrate a greater stress-induced vagal withdrawal compared to those with NCCP and RC women. Further work to investigate altered autonomic responses as a mechanism in CVaD is warranted.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101673"},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antros Louca , Petur Petursson , Joakim Sundström , Araz Rawshani , Henrik Hagström , Magnus Settergren , Stefan James , Sasha Koul , Kristofer Skoglund , Dan Ioanes , Sebastian Völz , Anna Myredal , Oskar Angerås , Truls Råmunddal
{"title":"Comparative outcomes of transcatheter aortic valve replacement in bicuspid vs. tricuspid aortic valve stenosis patients: insights from the SWEDEHEART registry","authors":"Antros Louca , Petur Petursson , Joakim Sundström , Araz Rawshani , Henrik Hagström , Magnus Settergren , Stefan James , Sasha Koul , Kristofer Skoglund , Dan Ioanes , Sebastian Völz , Anna Myredal , Oskar Angerås , Truls Råmunddal","doi":"10.1016/j.ijcha.2025.101705","DOIUrl":"10.1016/j.ijcha.2025.101705","url":null,"abstract":"<div><h3>Background</h3><div>Limited data exist on transcatheter aortic valve replacement (TAVR) outcomes in patients with bicuspid aortic valve (BAV) stenosis. This study compared TAVR outcomes in BAV versus tricuspid aortic stenosis.</div></div><div><h3>Methods</h3><div>This observational study included all patients who underwent TAVR in Sweden from 2016 to 2022, excluding those with pure aortic insufficiency and valve-in-valve procedures. Only Evolut-, SAPIEN-, ACURATE-, and Portico/Navitor-family devices were included. A doubly robust method was used, combining propensity score estimation and multivariable regression.</div></div><div><h3>Results</h3><div>Among 7,095 patients, 577 (8.1 %) had BAV stenosis. The mean EUROSCORE II-predicted mortality risk was 3.8 % for BAV and 4.5 % for TAV. BAV patients were younger, predominantly male, and had fewer comorbidities but higher baseline aortic valve gradients, larger annulus diameters, and more reduced ejection fraction.</div><div>After matching, 30-day mortality and all-cause mortality (median follow-up: 690 days) were similar between BAV and TAV patients (p = 0.8 for both). While BAVs had numerically lower technical success per VARC-3 criteria, this was not statistically significant (p = 0.08). However, BAV patients had lower device success (aOR = 0.8, p = 0.04) and a higher incidence of post-TAVR pacemaker implantation (aOR = 1.76, 95 % CI: 1.14–2.58, p = 0.007). No significant differences were observed in prosthesis-patient mismatch (p = 0.3), paravalvular leakage (p = 0.6), stroke (p = 0.3), or post-TAVR gradients (p > 0.9).</div></div><div><h3>Conclusion</h3><div>TAVR in BAV patients yields similar mortality and hemodynamic outcomes as in TAV patients. However, BAVs are associated with lower device success and higher pacemaker rates. While TAVR is a viable alternative to SAVR, treatment should be individualized, especially in younger BAV patients, considering lifetime management and coronary access.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101705"},"PeriodicalIF":2.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mijin Kim , Ha Hye Jo , Sahmin Lee , Byung Joo Sun , Ho Jin Kim , Joon Bum Kim , Sung-Ho Jung , Jong-Min Song , Dae-Hee Kim
{"title":"Initial surgery versus conservative management of chronic severe aortic regurgitation in mild symptomatic older patients","authors":"Mijin Kim , Ha Hye Jo , Sahmin Lee , Byung Joo Sun , Ho Jin Kim , Joon Bum Kim , Sung-Ho Jung , Jong-Min Song , Dae-Hee Kim","doi":"10.1016/j.ijcha.2025.101698","DOIUrl":"10.1016/j.ijcha.2025.101698","url":null,"abstract":"<div><h3>Background</h3><div>Aortic valve replacement (AVR) for severe aortic regurgitation (AR) should be weighed against its operative risk. Mortality is lower in patients with mild symptoms than in those with severe symptoms, while the surgical risk remains high in older patients. This study aimed to evaluate the survival benefit of AVR in mildly symptomatic older patients with severe AR.</div></div><div><h3>Methods</h3><div>From 1996 to 2016, we evaluated 127 older patients with severe AR and mild symptoms. We compared all-cause and cardiac mortality between patients who underwent AVR (OP group, n = 35) and those who were conservatively managed (CONV group, n = 92).</div></div><div><h3>Results</h3><div>Although patients in the OP group were younger than those in the CONV group (74.2 ± 3.2 vs. 77.3 ± 5.2, p = 0.003), no differences were observed in the Society of Thoracic Surgeons score (1.93 ± 0.95 vs. 2.51 ± 1.8, p = 0.12), comorbidity, indexed left ventricular dimensions (LVEDDi: 41.3 ± 4.4 vs. 41.6 ± 5.9 mm/m<sup>2</sup>, p = 0.80; LVESDi 30.7 ± 4.6 vs. 30.6 ± 5.2 mm/m<sup>2</sup>, p = 0.90), and ejection fraction (46.7 ± 9.9 % vs. 46.9 ± 7.9 %, p = 0.89). Over a median follow-up of 4.2 years, the OP group had significantly lower all-cause (22.9 % vs. 62.0 %, p = 0.010) and cardiac mortality (8.6 % vs. 33.7 %, p = 0.019). In multivariate Cox analysis, AVR remained independently associated with reduced all-cause (HR 0.41; 95 % CI 0.19–0.90; p = 0.027) and cardiac mortality (HR 0.29; 95 % CI 0.09–0.99; p = 0.048).</div></div><div><h3>Conclusion</h3><div>In mildly symptomatic older patients with severe AR, AVR significantly reduced all-cause and cardiac mortality and should not be withheld solely due to age.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101698"},"PeriodicalIF":2.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"MAGGIC risk score and drug-related adverse events of sacubitril/valsartan: Insights from the REVIEW-HF registry","authors":"Daiki Akagaki , Tatsuhiro Shibata , Kodai Shibao , Koshiro Kanaoka , Takahito Nasu , Shunsuke Ishii , Nobuyuki Kagiyama , Keisuke Kida , Wataru Fujimoto , Atsushi Kikuchi , Takeshi Ijichi , Yoshihiro Fukumoto , Shingo Matsumoto","doi":"10.1016/j.ijcha.2025.101702","DOIUrl":"10.1016/j.ijcha.2025.101702","url":null,"abstract":"<div><h3>Background</h3><div>Although the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score is a validated mortality risk tool in heart failure (HF), its utility in assessing drug-related adverse events (DAEs) associated with sacubitril/valsartan initiation remains unclear. This study evaluated the association between the MAGGIC risk score and DAEs related to sacubitril/valsartan initiation in a Japanese multicenter cohort.</div></div><div><h3>Methods</h3><div>We analyzed 787 patients with HF initiated on sacubitril/valsartan 100 mg/day between August 2020 and August 2021. Patients were stratified into tertiles based on MAGGIC risk scores. The primary outcome was DAEs within 90 days of initiation, defined as hypotension, hyperkalemia, renal events, or angioedema. Secondary outcomes included drug discontinuation and clinical outcomes.</div></div><div><h3>Results</h3><div>DAEs occurred in 22.7 % patients. Higher MAGGIC risk scores were significantly associated with increased DAEs (adjusted odds ratio [OR] for highest vs. lowest tertile: 2.64, 95 % confidence interval [CI]: 1.66–4.25, p for trend < 0.001) and sacubitril/valsartan discontinuation (21.3 % of patients; adjusted OR for highest vs. lowest tertile: 2.68, 95 % CI: 1.69–4.32, p for trend < 0.001). Time-dependent Cox proportional hazard analyses revealed that the association between DAEs and clinical outcomes varied across the MAGGIC risk score tertiles, with significant interactions between the composite outcome and hospitalization for HF, particularly in lower-risk groups.</div></div><div><h3>Conclusions</h3><div>The MAGGIC risk score was associated with DAEs risk following sacubitril/valsartan initiation in patients with HF. The impact of DAEs on outcomes varied across risk tertiles, suggesting potential utility for risk stratification and monitoring approaches in HF management.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101702"},"PeriodicalIF":2.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Atrial ischemia and incident atrial fibrillation: An unexpected turn of events?","authors":"Flemming Javier Olsen , Manan Pareek","doi":"10.1016/j.ijcha.2025.101701","DOIUrl":"10.1016/j.ijcha.2025.101701","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101701"},"PeriodicalIF":2.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}