Revista española de cardiología (English ed.)最新文献

{"title":"Impact of amyloidosis on outcomes after transcatheter aortic valve implantation.","authors":"Luigi Gerra, Tommaso Bucci, Ho Man Lam, Marta Mantovani, Antonios A Argyris, Muath Alobaida, Kully Sandhu, Joseph Mills, Giuseppe Boriani, Gregory Y H Lip","doi":"10.1016/j.rec.2025.01.012","DOIUrl":"10.1016/j.rec.2025.01.012","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Data on the impact of amyloidosis on outcomes after transcatheter aortic valve implantation (TAVI) are limited. The objective of this study was to evaluate the 1-year risk of adverse events post-TAVI in patients with amyloidosis.</p><p><strong>Methods: </strong>Patients undergoing TAVI (between 2005 and 2023) were categorized into 2 groups based on the presence of amyloidosis. The primary outcome was the 1-year risk of a composite endpoint: heart failure (HF), ischemic stroke, pacemaker implantation, acute kidney injury, and all-cause death. Secondary outcomes assessed the individual components of the composite. Propensity score matching was used to balance the groups, and Cox regression was used to assess the risk of adverse outcomes associated with amyloidosis. Composite outcomes were analyzed for early (30-days) and long-term (30-days to 1 year) follow-up.</p><p><strong>Results: </strong>Data from 589 TAVI patients with amyloidosis (mean age 78.9±8.2 years, 31.9% female) were compared with 52 296 individuals without amyloidosis (mean age 78.1±8.8 years, 40.3% female). After propensity score matching, patients with amyloidosis had a significantly higher 1-year risk of adverse events (HR, 1.27; 95%CI, 1.08-1.49). Specifically, patients with amyloidosis showed an increased risk of HF (HR, 1.37; 95%CI, 1.10-1.70). Stroke risk (HR, 1.67; 95%CI, 1.16-2.40) and pacemaker implantation (HR, 2.25; 95%CI, 1.15-4.41) were higher during long-term follow-up, while no differences were found for acute kidney injury or all-cause mortality between the 2 groups.</p><p><strong>Conclusions: </strong>Among patients undergoing TAVI, those with amyloidosis are at a higher risk of adverse events, particularly HF, and have an increased risk of pacemaker implantation and stroke in the long-term.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular ejection fraction decline and cardiovascular events in suspected cardiomyopathy with excessive trabeculation: toward precision medicine.","authors":"Guillem Casas, Eduard Ródenas-Alesina, Javier Limeres, Clara Badia-Molins, José M Larrañaga-Moreira, Jesús G Mirelis, Javier Navarrete-Navarro, Jesús Martín-Jiménez, Juan E Alcalá-López, Josefa González-Carrillo, Albert Teis, Rafaela Soler-Fernández, Gisela Teixidó-Turà, Laura Gutiérrez-García, Paula Fernández-Álvarez, Patricia Muñoz-Cabello, José A Barrabés, Coloma Tirón, Julián Palomino-Doza, José Manuel García-Pinilla, Antoni Bayés-Genís, Tomás Ripoll-Vera, Juan Jiménez-Jáimez, Eduardo Villacorta, Juan Ramón Gimeno-Blanes, Esther Zorio, Pablo García-Pavía, Roberto Barriales-Villa, Andrea Guala, Steffen E Petersen, Ignacio Ferreira-González, José F Rodríguez-Palomares","doi":"10.1016/j.rec.2025.01.011","DOIUrl":"10.1016/j.rec.2025.01.011","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Defining the probability of cardiomyopathy in individuals with excessive trabeculation of the left ventricle (ETLV) is an unmet clinical need. Our aims were: a) to describe the incidence and predictors of left ventricular ejection fraction (LVEF) decline and its correlation with major adverse cardiovascular events (MACE); and b) to identify prognostic factors in low-risk individuals.</p><p><strong>Methods: </strong>Retrospective multicenter study in patients with ETLV and suspected cardiomyopathy. Two endpoints were analyzed: a) LVEF decline (> 10% absolute decrease in LVEF with LVEF <50% at follow-up); and b) MACE, a composite of heart failure, ventricular arrhythmias, systemic embolisms, or cardiovascular mortality. Cardiovascular magnetic resonance core-lab analysis was performed in low-risk individuals (LVEF ≥50% and negative late gadolinium enhancement).</p><p><strong>Results: </strong>A total of 530 patients were included, with a mean age of 44±19 years and 44% were women. The mean LVEF was 49±16%. Over a median echocardiographic follow-up of 4.2 years, 29 patients (6%) showed a decline in LVEF. Late gadolinium enhancement (P=.004) and baseline atrial fibrillation (P=.006) were independently associated with LVEF decline. During a subsequent clinical follow-up of 3.8 years, 106 patients (20%) experienced MACE. Factors that remained associated with MACE after adjustment were baseline LVEF (P<.001), LVEF decline (P=.022), baseline atrial fibrillation (P=.001), and QRS ≥120 ms (P=.009). Among low-risk individuals, left atrial strain correlated with outcomes and distinguished subclinical cardiomyopathy from physiological excessive trabeculation.</p><p><strong>Conclusions: </strong>In ETLV, a decline in LVEF predicts cardiovascular events beyond baseline LVEF. In low-risk individuals, left atrial strain defines the probability of cardiomyopathy. A comprehensive assessment might provide valuable insights for differential diagnosis and risk stratification in this population.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive assessment of coronary microvascular dysfunction and cardiovascular outcomes across the full spectrum of CHD: a meta-analysis","authors":"Yang Xu ,&nbsp;Xiaochen Liu ,&nbsp;Yingying Guo ,&nbsp;Yuyao Qiu ,&nbsp;Yushi Zhang ,&nbsp;Xiao Wang ,&nbsp;Shaoping Nie","doi":"10.1016/j.rec.2024.05.007","DOIUrl":"10.1016/j.rec.2024.05.007","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Coronary microvascular dysfunction (CMD) is highly prevalent and is recognized as an important clinical entity in patients with coronary heart disease (CHD). Nevertheless, the association of CMD with adverse cardiovascular events in the spectrum of CHD has not been systemically quantified.</div></div><div><h3>Methods</h3><div>We searched electronic databases for studies on patients with CHD in whom coronary microvascular function was measured invasively, and clinical events were recorded. The primary endpoint was major adverse cardiac events (MACE), and the secondary endpoint was all-cause death. Estimates of effect were calculated using a random-effects model from published risk ratios.</div></div><div><h3>Results</h3><div><span>We included 27 studies with 11 404 patients. Patients with CMD assessed by invasive methods had a higher risk of MACE (RR, 2.18; 95%CI, 1.80-2.64; </span><em>P</em> <!-->&lt;<!--> <!-->.01) and all-cause death (RR, 1.88; 95%CI, 1.55-2.27; <em>P</em> <!-->&lt;<!--> <span>.01) than those without CMD. There was no significant difference in the impact of CMD on MACE (interaction </span><em>P</em> value<!--> <!-->=<!--> <!-->.95) among different invasive measurement modalities. The magnitude of risk of CMD assessed by invasive measurements for MACE was greater in acute coronary syndrome patients (RR, 2.84, 95%CI, 2.26-3.57; <em>P</em> <!-->&lt;<!--> <!-->.01) than in chronic coronary syndrome patients (RR, 1.77, 95%CI, 1.44-2.18; <em>P</em> <!-->&lt;<!--> <!-->.01) (interaction <em>P</em> value<!--> <!-->&lt;<!--> <!-->.01).</div></div><div><h3>Conclusions</h3><div>CMD based on invasive measurements was associated with a high incidence of MACE and all-cause death in patients with CHD. The magnitude of risk for cardiovascular events in CMD as assessed by invasive measurements was similar among different methods but varied among CHD populations.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 2","pages":"Pages 117-126"},"PeriodicalIF":7.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NT-proBNP in systemic right ventricles: a new cutoff level for risk stratification?","authors":"Fabian Tran ,&nbsp;Francisco Javier Ruperti-Repilado ,&nbsp;Philip Haaf ,&nbsp;Pedro Lopez-Ayala ,&nbsp;Matthias Greutmann ,&nbsp;Markus Schwerzmann ,&nbsp;Judith Bouchardy ,&nbsp;Harald Gabriel ,&nbsp;Dominik Stambach ,&nbsp;Juerg Schwitter ,&nbsp;Kerstin Wustmann ,&nbsp;Michael Freese ,&nbsp;Christian Mueller ,&nbsp;Daniel Tobler","doi":"10.1016/j.rec.2024.05.006","DOIUrl":"10.1016/j.rec.2024.05.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the risk prediction of patients with systemic right ventricles (sRV) is not well defined. The aim of this study was to analyze the prognostic value of NT-proBNP in patients with an sRV.</div></div><div><h3>Methods</h3><div>The prognostic value of NT-proBNP was assessed in 98 patients from the SERVE trial. We used an adjusted Cox proportional hazards model, survival analysis, and c-statistics. The composite primary outcome was the occurrence of clinically relevant arrhythmia, heart failure, or death. Correlations between baseline NT-proBNP values and biventricular volumes and function were assessed by adjusted linear regression models.</div></div><div><h3>Results</h3><div>The median age [interquartile range] at baseline was 39 [32-48] years and 32% were women. The median NT-proBNP was 238 [137-429] ng/L. Baseline NT-proBNP concentrations were significantly higher among the 20 (20%) patients developing the combined primary outcome compared with those who did not (816 [194-1094] vs 205 [122-357]; <em>P</em> <!-->=<!--> <!-->.003). In patients with NT-proBNP concentrations<!--> <!-->&gt; 75th percentile (&gt; 429 ng/L), we found an exponential increase in the sex- and age-adjusted hazard ratio for the primary outcome. The prognostic value of NT-proBNP was comparable to right ventricular ejection fraction and peak oxygen uptake on exercise testing (c-statistic: 0.71, 0.72, and 0.71, respectively).</div></div><div><h3>Conclusions</h3><div>In patients with sRVs, NT-proBNP concentrations correlate with sRV volumes and function and may serve as a simple tool for predicting adverse outcomes.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 2","pages":"Pages 107-116"},"PeriodicalIF":7.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DragonFly mitral valve repair system: first experience in Spain","authors":"Claudio E. Guerreiro ,&nbsp;Rodrigo Estévez-Loureiro ,&nbsp;Manuel Barreiro-Pérez ,&nbsp;Rocío González-Ferreiro ,&nbsp;José A. Baz ,&nbsp;Andrés Íñiguez-Romo","doi":"10.1016/j.rec.2024.07.007","DOIUrl":"10.1016/j.rec.2024.07.007","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 2","pages":"Pages 151-153"},"PeriodicalIF":7.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A minimalist approach for left atrial appendage occlusion with the use of a mini-transesophageal 4D probe","authors":"Laura Sanchis ,&nbsp;Pedro Cepas-Guillén ,&nbsp;Eduardo Flores ,&nbsp;Ander Regueiro ,&nbsp;Marta Sitges ,&nbsp;Xavier Freixa","doi":"10.1016/j.rec.2024.08.005","DOIUrl":"10.1016/j.rec.2024.08.005","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 2","pages":"Pages 156-158"},"PeriodicalIF":7.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of multivessel revascularization in stable patients with STEMI: a systematic review and network meta-analysis","authors":"Felix Voll ,&nbsp;Constantin Kuna ,&nbsp;Maria Scalamogna ,&nbsp;Thorsten Kessler ,&nbsp;Sebastian Kufner ,&nbsp;Tobias Rheude ,&nbsp;Hendrik B. Sager ,&nbsp;Erion Xhepa ,&nbsp;Jens Wiebe ,&nbsp;Michael Joner ,&nbsp;Robert A. Byrne ,&nbsp;Heribert Schunkert ,&nbsp;Gjin Ndrepepa ,&nbsp;Barbara E. Stähli ,&nbsp;Adnan Kastrati ,&nbsp;Salvatore Cassese","doi":"10.1016/j.rec.2024.06.002","DOIUrl":"10.1016/j.rec.2024.06.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Multivessel percutaneous coronary intervention (MV-PCI) is recommended in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (CAD) without cardiogenic shock. The present network meta-analysis investigated the optimal timing of MV-PCI in this context.</div></div><div><h3>Methods</h3><div>We pooled the aggregated data from randomized trials investigating stable STEMI patients with multivessel CAD treated with a strategy of either MV-PCI or culprit vessel-only PCI. The primary outcome was all-cause death. The main secondary outcomes were cardiovascular death, myocardial infarction, and unplanned ischemia-driven revascularization.</div></div><div><h3>Results</h3><div>Among 11 trials, a total of 10 507 patients were randomly assigned to MV-PCI (same sitting, n<!--> <!-->=<!--> <!-->1683; staged during the index hospitalization, n<!--> <!-->=<!--> <!-->3460; staged during a subsequent hospitalization within 45 days, n<!--> <!-->=<!--> <!-->3275) or to culprit vessel-only PCI (n<!--> <!-->=<!--> <!-->2089). The median follow-up was 18.6 months. In comparison with culprit vessel-only PCI, MV-PCI staged during the index hospitalization significantly reduced all-cause death (risk ratio, 0.73; 95%CI, 0.56-0.92; <em>P</em> <!-->=<!--> <!-->.008) and ranked as possibly the best treatment option for this outcome compared with all other strategies. In comparison with culprit vessel-only PCI, a MV-PCI reduced cardiovascular mortality without differences dependent on the timing of revascularization. MV-PCI within the index hospitalization, either in a single procedure or staged, significantly reduced myocardial infarction and unplanned ischemia-driven revascularization, with no significant difference between each other.</div></div><div><h3>Conclusions</h3><div>In patients with STEMI and multivessel CAD without cardiogenic shock, multivessel PCI within the index hospitalization, either in a single procedure or staged, represents the safest and most efficacious approach. The different timings of multivessel PCI did not result in any significant differences in all-cause death.</div><div>This study is registered at PROSPERO (CRD42023457794).</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 2","pages":"Pages 127-137"},"PeriodicalIF":7.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant right pulmonary artery aneurysm in Eisenmenger syndrome","authors":"Xiang-Ting Lu,&nbsp;Yi-Bing Lu,&nbsp;Hai-Long Dai","doi":"10.1016/j.rec.2024.08.001","DOIUrl":"10.1016/j.rec.2024.08.001","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 2","pages":"Pages 161-162"},"PeriodicalIF":7.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous coronary intervention and TAVR: the simpler the better","authors":"Manel Sabaté","doi":"10.1016/j.rec.2024.08.008","DOIUrl":"10.1016/j.rec.2024.08.008","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 2","pages":"Pages 94-96"},"PeriodicalIF":7.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of complex percutaneous coronary intervention in the pre-TAVR workup","authors":"Marisa Avvedimento ,&nbsp;Francisco Campelo-Parada ,&nbsp;Luis Nombela-Franco ,&nbsp;Quentin Fischer ,&nbsp;Pierre Donaint ,&nbsp;Vicenç Serra ,&nbsp;Gabriela Veiga ,&nbsp;Enrique Gutiérrez ,&nbsp;Anna Franzone ,&nbsp;Victoria Vilalta ,&nbsp;Alberto Alperi ,&nbsp;Ander Regueiro ,&nbsp;Lluis Asmarats ,&nbsp;Henrique B. Ribeiro ,&nbsp;Anthony Matta ,&nbsp;Antonio Muñoz-García ,&nbsp;Gabriela Tirado ,&nbsp;Marina Urena ,&nbsp;Damien Metz ,&nbsp;Eduard Rodenas-Alesina ,&nbsp;Josep Rodés-Cabau","doi":"10.1016/j.rec.2024.05.002","DOIUrl":"10.1016/j.rec.2024.05.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>In patients undergoing percutaneous coronary intervention (PCI) in the workup pre-transcatheter aortic valve replacement (TAVR), the clinical impact of coronary revascularization complexity remains unknown. This study sought to examine the impact of PCI complexity on clinical outcomes after TAVR in patients undergoing PCI in the preprocedural workup.</div></div><div><h3>Methods</h3><div>This was a multicenter study including consecutive patients scheduled for TAVR with concomitant significant coronary artery disease. Complex PCI was defined as having at least 1 of the following features: 3 vessels treated, ≥ 3 stents implanted, ≥ 3 lesions treated, bifurcation with 2 stents implanted, total stent length &gt;<!--> <!-->60<!--> <!-->mm, or chronic total occlusion. The rates of major adverse cardiac events (MACE), including cardiovascular mortality, myocardial infarction, and coronary revascularization were evaluated.</div></div><div><h3>Results</h3><div><span>A total of 1550 patients were included, of which 454 (29.3%) underwent complex PCI in the pre-TAVR workup. After a median follow-up period of 2 [1-3] years after TAVR, the incidence of MACE<span> was 9.6 events per 100 patients-years. Complex PCI significantly increased the risk of cardiac death (HR, 1.44; 95%CI, 1.01-2.07), nonperiprocedural myocardial infarction (HR, 1.52; 95%CI, 1.04-2.21), and coronary revascularization (HR, 2.46; 95%CI, 1.44-4.20). In addition, PCI complexity was identified as an independent predictor of MACE after TAVR (HR, 1.31; 95%CI, 1.01-1.71; </span></span><em>P</em> <!-->=<!--> <!-->.042).</div></div><div><h3>Conclusions</h3><div>In TAVR candidates with significant coronary artery disease requiring percutaneous treatment, complex revascularization was associated with a higher risk of MACE. The degree of procedural complexity should be considered a strong determinant of prognosis in the PCI-TAVR population.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 2","pages":"Pages 82-93"},"PeriodicalIF":7.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141041469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}