Journal of Tehran University Heart Center最新文献

{"title":"The Pragmatic Role of COVID-19 on the Thrombus Grade of Patients with Contemporary ST-Segment-Elevation Myocardial Infarction.","authors":"Ata Firouzi,&nbsp;Zahra Hosseini,&nbsp;Zeinab Norouzi,&nbsp;Zohre Hosseini,&nbsp;Afshin Amirpour,&nbsp;Hamed Talakoob,&nbsp;Arash Amin,&nbsp;Abbas Soleimani,&nbsp;Nasrolah Moradifar,&nbsp;Shahrokh Karbalai,&nbsp;Mohammadhossein Mozafarybazargani,&nbsp;Hamidreza Hekmat,&nbsp;Majid Maleki,&nbsp;Parham Sadeghipour,&nbsp;Seyedeh Mahnaz Mirbod,&nbsp;Mina Ghorbanpoor Kohnaki,&nbsp;Hooman Bakhshandeh,&nbsp;Masoomeh Kalaei Nia,&nbsp;Fatemeh Sadate Habibizade,&nbsp;Sara Iraninejad,&nbsp;Mohammadreza Baay,&nbsp;Ehsan Khalilipur","doi":"10.18502/jthc.v17i3.10842","DOIUrl":"https://doi.org/10.18502/jthc.v17i3.10842","url":null,"abstract":"<p><strong>Background: </strong>Limited data exist on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) presenting with ST-segment-elevation myocardial infarction (STEMI).</p><p><strong>Methods: </strong>This multicenter study, conducted in 6 centers in Iran, aimed to compare baseline clinical and procedural data between a case group, comprising STEMI patients with COVID-19, and a control group, comprising STEMI patients before the COVID-19 pandemic, and to determine in-hospital infarct-related artery thrombus grades and major adverse cardio-cerebrovascular events (MACCEs), defined as a composite of deaths from any cause (cardiovascular and noncardiovascular), nonfatal strokes, and stent thrombosis.</p><p><strong>Results: </strong>No significant differences were observed between the 2 groups regarding baseline characteristics. Primary percutaneous coronary intervention (PPCI) was performed in 72.9% of the cases and 98.5% of the controls (P=0.043), and primary coronary artery bypass grafting was performed in 6.2% of the cases and 1.4% of the controls (P=0.048). Successful PPCI procedures (final TIMI flow grade III) were significantly fewer in the case group (66.5% vs 93.5%; P=0.001). The baseline thrombus grade before wire crossing was not statistically significantly different between the 2 groups. The summation of thrombus grades IV and V was 75% in the case group and 82% in the control group (P=0.432). The rate of MACCEs was 14.5% and 2.1% in the case and control groups, respectively (P=0.002).</p><p><strong>Conclusion: </strong>In our study, the thrombus grade had no significant differences between the case and control groups; however, the in-hospital rates of the no-reflow phenomenon, periprocedural MI, mechanical complications, and MACCEs were statistically significantly higher in the case group.</p>","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 3","pages":"103-111"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/e1/JTHC-17-103.PMC10222945.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9545786","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 Patient with Repeated Carotid Stent Thrombosis.","authors":"Arash Amin,&nbsp;Majid Maleki,&nbsp;Zeinab Norouzi,&nbsp;Mohammad Almasian,&nbsp;Mina Ghorbanpoor Kohnaki","doi":"10.18502/jthc.v17i3.10851","DOIUrl":"https://doi.org/10.18502/jthc.v17i3.10851","url":null,"abstract":"This article has no abstract.","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 3","pages":"159-164"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/43/JTHC-17-159.PMC10222934.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600089","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":"Left Partial Anomalous Pulmonary Venous Connection and Vertical Vein.","authors":"Masoud Tarbiat,&nbsp;Seyed Kamaledin Hadei,&nbsp;Nakisa Khansari","doi":"10.18502/jthc.v17i2.9848","DOIUrl":"https://doi.org/10.18502/jthc.v17i2.9848","url":null,"abstract":"The Article Abstract is not available.","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 2","pages":"86-87"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/2f/JTHC-17-86.PMC9748232.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435815","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":"The Association between Vitamin D Levels and Thrombus Burden in Patients with ST-Elevation Myocardial Infarction.","authors":"Faysal Şaylık,&nbsp;Murat Selçuk,&nbsp;Tayyar Akbulut,&nbsp;Tufan Çınar","doi":"10.18502/jthc.v17i2.9835","DOIUrl":"https://doi.org/10.18502/jthc.v17i2.9835","url":null,"abstract":"<p><p><b>Background:</b> In current practice, establishing the potential predictors of high thrombus burden (HTB) before primary percutaneous coronary intervention (PCI) is crucial for its management. In this research, we aimed to investigate the association between vitamin D levels and HTB in patients with ST-elevation myocardial infarction (STEMI). <b>Methods:</b> This prospective, observational study was conducted on 257 STEMI patients undergoing primary PCI in Van Education and Research Hospital between March 2020 and March 2021. The thrombus burden grade was determined for each subject. The study population was divided into 2 groups: patients with HTB and those with low thrombus burden (LTB) based on the thrombus burden grade. Demographic, laboratory, and angiographic features were compared between the groups. <b>Results:</b> In total, 154 patients (mean age±SD=63.42±11.53 y, 65.6% male) had HTB and 103 patients had LTB (mean age±SD=61.50±10.23 y, 70.9% male). The patients stratified into the HTB group had lower vitamin D levels than those in the LTB group (8.0 ng/mL vs 17.9 ng/mL, respectively; P<0.001). The patients with HTB and low vitamin D levels had lower post-PCI thrombolysis in myocardial infarction (TIMI) flow, TIMI myocardial perfusion grade, and post-PCI ST resolution. In a multivariable analysis, vitamin D was an independent predictor of HTB among the STEMI patients (OR: 0.76, 95%CI: 0.70-0.82; P<0.001). The ideal value of vitamin D to predict HTB was >17.6 ng/mL with a sensitivity of 81.8% and a specificity of 90.3%. <b>Conclusion:</b> The study results showed that vitamin D levels were an independent predictor of HTB in STEMI patients treated by primary PCI.</p>","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 2","pages":"48-55"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/0c/JTHC-17-48.PMC9748235.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10442867","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":"Latent Avulsion of the Posterior Mitral Leaflet Base from the Mitral Annulus Following a Motor Vehicle Accident: A Case Report.","authors":"Reza Mohseni Badalabadi,&nbsp;Parto Siavosh,&nbsp;Hakimeh Sadeghian","doi":"10.18502/jthc.v17i2.9845","DOIUrl":"https://doi.org/10.18502/jthc.v17i2.9845","url":null,"abstract":"<p><p>Injuries to the heart and great vessels should always be considered after blunt chest trauma. Valvular damage rarely occurs after blunt trauma, but symptoms may be delayed. A 58-year-old woman was referred to our hospital with exertional dyspnea (functional class III) and palpitations for elective transesophageal echocardiography. Her symptoms had exacerbated in the preceding 2 or 3 months. Physical examination showed holosystolic murmurs (IV/VI) at the lower sternal border with extension to the apex. Transesophageal echocardiography revealed avulsion of the base of the posterior mitral valve leaflet (P3) from the annulus. In the past medical history, there was a history of a motor vehicle accident 9 months earlier. The patient was recommended for mitral valve surgery. Mitral valve replacement was performed, and the diagnosis was confirmed by surgery. The patient was discharged without any complications.</p>","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 2","pages":"78-81"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/20/JTHC-17-78.PMC9748236.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435822","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":"Mortality from Acute Coronary Syndrome: Does Place of Residence Matter?","authors":"Seyed Hesameddin Abbasi,&nbsp;Örjan Sundin,&nbsp;Arash Jalali,&nbsp;Joaquim Soares,&nbsp;Gloria Macassa","doi":"10.18502/jthc.v17i2.9838","DOIUrl":"https://doi.org/10.18502/jthc.v17i2.9838","url":null,"abstract":"<p><p><b>Background</b> <b>:</b> Current evidence shows inequality in the outcomes of rural and urban patients treated at their place of residence. This study compared in-hospital mortality between rural and urban patients with acute coronary syndrome (ACS) to find whether there were differences in the outcome and received treatment. <b>Methods</b> <b>:</b> Between May 2007 and January 2018, patients admitted with ACS were included. The patients' demographic, clinical, and laboratory data, as well as their in-hospital medical courses, were recorded. The association between place of residence (rural/urban) and in-hospital mortality due to ACS was evaluated using logistic regression adjusted for potential confounders. <b>Results:</b> Of 9088 recruited patients (mean age =61.30±12.25 y; 5557 men [61.1%]), 838 were rural residents. A positive family history of coronary artery disease (P=0.003), smoking (P=0.002), and hyperlipidemia (P=0.026), as well as a higher body mass index (P=0.013), was seen more frequently in the urban patients, while the rural patients had lower education levels (P<0.001) and higher unemployment rates (P=0.009). In-hospital mortality occurred in 135 patients (1.5%): 10 rural (1.2%) and 125 urban (1.5%) patients (P=0.465). The Firth regression model, used to adjust the effects of possible confounders, showed no significant difference concerning in-hospital mortality between the rural and urban patients (OR, 1.57; 95% CI, 0.376 to 7.450; P=0.585). <b>Conclusion</b> <b>:</b> This study found no significant differences in receiving proper treatment and in-hospital mortality between rural and urban patients with ACS.</p>","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 2","pages":"56-61"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/b8/JTHC-17-56.PMC9748234.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435818","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 a Type IV Dual Left Anterior Descending Artery and Ectopic Left Anterior Descending and Circumflex Arteries Requiring Surgery.","authors":"Muhammad Mansoor,&nbsp;Waqar Ahmad Khan,&nbsp;Fakhar Abbas,&nbsp;Usha Kumari","doi":"10.18502/jthc.v17i2.9842","DOIUrl":"https://doi.org/10.18502/jthc.v17i2.9842","url":null,"abstract":"<p><p>Congenital anomalous coronary arteries (CACAs) comprise an important variant of the coronary vasculature. They are benign in the vast majority of cases, whereas a small minority may be affected by serious consequences such as myocardial infarction, arrhythmia, cardiac arrest, and even death. We herein describe a 62-year-old man with sudden and severe substernal chest pain; Q waves in electrocardiographic leads II, III, and aVF; and positive serum troponin I enzyme. Left heart cardiac catheterization revealed triple coronary vessel disease with a 60% to 70% occlusion in the left main coronary artery (LMCA). The left anterior descending (LAD) and the left circumflex artery arose from the ostium of the right coronary artery. Additionally, a rudimentary type IV dual LAD originated from the LMCA. A coronary artery bypass graft surgery was performed using a left internal mammary artery graft for the LAD and a saphenous vein graft for the diagonal branches (I & II) of the LAD and the posterior descending artery. The patient was discharged after an uneventful 1-week hospital course.</p>","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 2","pages":"71-74"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/ba/JTHC-17-71.PMC9748230.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10442869","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":"Predictors of 1-Year Major Cardiovascular Events after ST-Elevation Myocardial Infarction in a Specialized Cardiovascular Center in Western Iran.","authors":"Parisa Janjani,&nbsp;Sayeh Motevaseli,&nbsp;Nahid Salehi,&nbsp;Reza Heidari Moghadam,&nbsp;Soraya Siabani,&nbsp;Mahdi Nalini","doi":"10.18502/jthc.v17i2.9839","DOIUrl":"https://doi.org/10.18502/jthc.v17i2.9839","url":null,"abstract":"<p><p><b>Background:</b> Identifying the long-term predictors of recurrent cardiovascular events may help improve the quality of care and prevent subsequent events. We aimed to investigate the predictors of 1-year major cardiovascular events (MACE) in patients discharged after ST-elevation myocardial infarction (STEMI) in a tertiary hospital in Iran. <b>Methods:</b> This registry-based cohort study included consecutive STEMI patients between 2016 and 2019 in Imam-Ali Hospital, Kermanshah, Iran. All patients discharged alive from STEMI hospitalization were followed up for 1 year for MACE, consisting of all-cause mortality, nonfatal MI, and nonfatal stroke. We estimated the hazard ratio (HR) and the 95% confidence interval (95% CI) using Cox proportional-hazard models to evaluate potential predictors, including demographic characteristics, medical history, cardiovascular risk factors, laboratory tests, reperfusion therapy, and medications. <b>Results:</b> During 2187.2 person-years, 21 patients were lost to follow-up (success rate =99.1%). Of 2274 post-discharge STEMI patients (mean age =60.26 y; 21.9% female), 151 (6.6%) experienced MACE, including, all-cause mortality (n=115, 5.1%), nonfatal MI (n=20, 0.9%), and nonfatal stroke (n=16, 0.7%). Independent predictors of MACE were age (HR:1.02; 95% CI: 1.00-1.04), no education vs ≥12 years of formal schooling (HR: 2.07; 95% CI: 1.17-3.67), stroke history (HR: 2.37; 95% CI: 1.48-3.81), the glomerular filtration rate (HR: 0.98; 95% CI: 0.97-1.00), the body mass index (HR: 0.94; 95% CI:, 0.89-0.99), peak creatine kinase-MB (HR: 1.00; 95% CI: 1.00-1.002), thrombolysis vs primary percutaneous coronary intervention (HR: 1.85; 95% CI: 1.21-2.81), and left ventricular ejection fraction <35% vs ≥50% (HR: 2.82; 95% CI: 1.46-5.47). <b>Conclusion:</b> Age, education, stroke history, the glomerular filtration rate, the body mass index, peak creatine kinase-MB, reperfusion therapy, and left ventricular function can be independently associated with 1-year MACE.</p>","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 2","pages":"62-70"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/f6/JTHC-17-62.PMC9748231.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10442866","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":"Early Outcomes of a High PaO₂/FiO₂ Ratio during Cardiopulmonary Bypass.","authors":"Hülya Yilmaz Ak,&nbsp;Yasemin Özşahin,&nbsp;Mehmet Ali Yeşiltaş,&nbsp;Baris Sandal,&nbsp;Ziya Salihoglu,&nbsp;Kerem Erkalp","doi":"10.18502/jthc.v17i2.9834","DOIUrl":"https://doi.org/10.18502/jthc.v17i2.9834","url":null,"abstract":"<p><p><b>Background:</b> In cardiac surgery, supraphysiological oxygen levels are frequently applied perioperatively. In this study, we examined the postoperative effect of perioperative hyperoxemia in cardiac surgery. <b>Methods:</b> All patients who underwent mitral valve replacement via the standard sternotomy method between 2010 and 2021 were analyzed by scanning the hospital data system. The patients were divided into 2 groups: the hyperoxemic group (partial pressure of oxygen/fraction of inspired oxygen [PaO₂/FiO₂] > 500 mmHg) (Group I) and the normoxemic group (300 mmHg < PaO₂/FiO₂ < 500 mmHg) (Group II) according to the mean of 3 PaO₂/FiO₂ values calculated by using 3 PaO₂ and 3 FiO₂ levels. Postoperative complications, the mechanical ventilation time, the need for noninvasive mechanical ventilator support, the length of intensive care unit (ICU) stay, the hospitalization period, and the mortality rate of the groups were compared. <b>Results:</b> A total of 78 patients were included in the study, and 53 of the patients (67.9%) were female. The mean age of the patients was 58.89±12.60 years. The total mechanical ventilation time was significantly higher in the hyperoxemic group than in Group II (P<0.001) (18.18±12.90 h and 11.45±7.85 h, respectively). The amount of postoperative bleeding was significantly higher in Group I (P=0.003) (539.47±201.74 mL and 417.50±186.93 mL, respectively). The total amount of blood products administered during surgery and ICU stay was higher in Group I (P=0.041) (3.55±1.59 units and 2.87±1.89 units, respectively). <b>Conclusion:</b> We observed that the group with hyperoxemia during cardiopulmonary bypass had a higher amount of postoperative bleeding and the need for transfusion, as well as a longer duration of mechanical ventilation and intensive care.</p>","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 2","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/83/JTHC-17-41.PMC9748228.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435813","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":"Accessory Mitral Valve Misdiagnosed as Vegetation: A Case Report.","authors":"Rezvanieh Salehi,&nbsp;Naser Khezerlouy-Aghdam,&nbsp;Elnaz Javanshir,&nbsp;Babak Zanjani,&nbsp;Razieh Parizad","doi":"10.18502/jthc.v17i2.9843","DOIUrl":"https://doi.org/10.18502/jthc.v17i2.9843","url":null,"abstract":"<p><p>An accessory mitral valve (AMV) is a rare anomaly of the mitral valve (MV) that often causes left ventricular outflow tract (LVOT) obstruction. We describe a young woman presenting with infrequent palpitations to our outpatient clinic. She was evaluated for mid-systolic murmur at the left sternal border. At the initial transthoracic echocardiography, vegetation on the MV was suspected. The patient was referred to our advanced echocardiography lab, where transesophageal echocardiography revealed an AMV with mild LVOT obstruction. The findings, along with extensive laboratory tests, ruled out vegetation. Additionally, she had a bicuspid aortic valve. At follow-up after 1 year, the patient was asymptomatic regarding the AMV with LVOT obstruction, and the repeat echocardiography depicted no changes compared with the previous echocardiography. Distinguishing AMVs from other MV masses, including vegetation, sometimes poses a challenge and can lead to unnecessary diagnostic and therapeutic measures. This rare MV anomaly is associated with bicuspid aortic valves.</p>","PeriodicalId":39149,"journal":{"name":"Journal of Tehran University Heart Center","volume":"17 2","pages":"75-77"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/c8/JTHC-17-75.PMC9748233.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435811","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}