Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques最新文献

{"title":"Right Ventricular Morphology in PA/IVS: Integrating Developmental Pathology With Echocardiographic Prognostication","authors":"Ghassan Alnaami","doi":"10.1111/echo.70190","DOIUrl":"https://doi.org/10.1111/echo.70190","url":null,"abstract":"<p>The manuscript by Moras et al. [<span>1</span>] introduces a critical framework for individualized post-interventional care in neonates with pulmonary atresia with intact ventricular septum (PA/IVS) or critical pulmonary stenosis (CPS) by leveraging echocardiographic classification of right ventricular (RV) morphology. Their work aligns directly with the developmental understanding of RV anatomy, as outlined in the next paragraph on RV developmental pathology.</p><p>Failure of development or muscular obliteration of the apical and/or infundibular segments leads to bipartite or monopartite RVs. (Figure 1) These developmental anomalies underlie many presentations of congenital heart disease, including tricuspid or PA, and significantly influence the RV's ability to respond to decompression interventions (See Table 1)</p><p>In their study, Moras et al. classify patients into two groups based on this anatomical distinction: Group A (tripartite RVs) and Group B (bipartite RVs). This classification strongly predicted complications post-Pulmonary Valve Balloon Dilatation (PVBD): Tripartite RVs were associated with left ventricular (LV) systolic dysfunction due to volume redistribution and interventricular interaction. Bipartite RVs were prone to infundibular spasm, evidenced by dynamic outflow obstruction requiring beta-blockade.</p><p>The clinical implications of this work are profound. Moras et al. demonstrate that 92.9% of patients with tripartite RVs experienced transient LV dysfunction, necessitating inodilator therapy and prolonged ventilation. In contrast, 76.9% of bipartite RV patients exhibited infundibular spasm managed effectively with beta-blockers.</p><p>In tripartite RVs, the left ventricle often encounters a sudden increase in preload following decompression due to restored antegrade pulmonary flow. This surge in pulmonary venous return, compounded by ventricular interdependence and an under-conditioned LV, can result in transient systolic dysfunction. The LV may be particularly susceptible if it was relatively underloaded in utero. These physiologic shifts necessitate early initiation of inodilator therapy, cautious fluid management, and delayed enteral feeding until hemodynamic stability is achieved [<span>2</span>].</p><p>By individualizing care based on early echocardiographic findings, outcomes may improve, and unnecessary interventions may be avoided.</p><p>In addition to phenotype-specific care, our knowledge of RV developmental pathology adds valuable context comparing transcatheter RV decompression with open-heart surgical strategies. Although transcatheter approaches offer minimally invasive access with the potential to promote RV growth, high reintervention rates and unsuitability for RV-dependent coronary circulation limit their use in certain morphologies. Open-heart surgery remains a viable, though more invasive, option with potential for definitive repair in select cases, typically RV-dependent coronary circulation and n","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085269","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":"Diastolic Function in Acute Myocardial Infarction: Do We Need to Relax More?","authors":"Ioana Dregoesc, Judy W. Hung, Jacob P. Dal-Bianco","doi":"10.1111/echo.70199","DOIUrl":"https://doi.org/10.1111/echo.70199","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling Chamber-Wide Mechanics in HFpEF: Toward a Multichamber Diagnostic Paradigm","authors":"Hidekazu Tanaka","doi":"10.1111/echo.70197","DOIUrl":"https://doi.org/10.1111/echo.70197","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of Detecting Valvular Invasion in the Patient With Rheumatoid Arthritis","authors":"Tomoko Tani","doi":"10.1111/echo.70191","DOIUrl":"https://doi.org/10.1111/echo.70191","url":null,"abstract":"<div>\u0000 \u0000 <p>Although cardiovascular diseases, particularly valvular involvement, are not frequently observed in patients with rheumatoid arthritis, they can exhibit a wide spectrum of pathological manifestations.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic Assessment of Cardiac Phenotype Predicts Complications and Guides Intensive Care Management Following Pulmonary Valve Balloon Dilation in Neonates With Pulmonary Atresia/Critical Pulmonary Stenosis With Intact Ventricular Septum","authors":"Patrizio Moras,&nbsp;Pasquini Luciano,&nbsp;Cosimo Marco Campanale,&nbsp;Marco Masci,&nbsp;Ventrella Serena,&nbsp;Di Chiara Luca,&nbsp;Butera Gianfranco,&nbsp;Alessandra Toscano","doi":"10.1111/echo.70182","DOIUrl":"https://doi.org/10.1111/echo.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pulmonary valve balloon dilation (PVBD) has largely replaced surgical decompression as the preferred treatment for neonates with pulmonary atresia with intact ventricular septum (PAIVS) or critical pulmonary stenosis (CPS). This study aims to evaluate whether echocardiographic morphological and functional assessment can predict early complications and guide intensive care management following PVBD in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 27 neonates with PAIVS or CPS who underwent PVBD between 2017 and 2023. Patients were divided into Group A (tripartite right ventricle [RV], developed infundibulum) and Group B (bipartite RV, hypoplastic infundibulum). Echocardiographic, catheterization, and clinical data were reviewed and compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Group A had higher rates of transient left ventricular systolic dysfunction (92.9% vs. 15.4%, <i>p</i> &lt; 0.001) and required more ventilatory and inotropic support. Group B was more prone to infundibular spasm (76.9% vs. 21.4%, <i>p</i> = 0.004) and often needed beta-blockers or additional pulmonary blood flow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Echocardiographic RV phenotype is associated with specific post-PVBD complications and may help guide early post-procedural management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949965","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":"Multimodal Imaging to Detect Rare Coronary Artery Fistula Drainage","authors":"Nancy N. Suarez-Lara,&nbsp;Regina De la Mora-Cervantes,&nbsp;David J. Sanchez-Amaya,&nbsp;Juan F. Fritche-Salazar,&nbsp;Edith L. Posada-Martinez","doi":"10.1111/echo.70175","DOIUrl":"https://doi.org/10.1111/echo.70175","url":null,"abstract":"<p>We present the case of a coronary fistula from a dilated left main coronary artery, where multimodal imaging was key to identifying a very rare drainage into the left atrial appendage\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Left Atrial Structure and Function Parameters in Left Ventricular Remodeling in Patients With Type 2 Diabetes Mellitus","authors":"Yumeng Xing,&nbsp;Rui Zhao,&nbsp;Xiaoli Zhang,&nbsp;Jiamei Jin,&nbsp;Yiming Yang,&nbsp;Haier Wang,&nbsp;Yan Wang,&nbsp;Chunyan Zhong,&nbsp;Lin Chen,&nbsp;Yinjia Zhang","doi":"10.1111/echo.70196","DOIUrl":"https://doi.org/10.1111/echo.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The 4-dimensional automated left atrial quantification (4D Auto LAQ) technology for the left atrium was recently available. We aimed to evaluate LA function using 4D Auto LAQ in patients with type 2 diabetes mellitus (T2DM) and investigate its value in predicting left ventricular remodeling (LVR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 106 T2DM patients (56 with left ventricular [LV] remodeling and 50 with normal geometry) and 46 age- and sex-matched controls were enrolled. LA total emptying fraction (LATEF), LA active emptying fraction (LAAEF), LA passive emptying fraction (LAPEF), and strain parameters, including LA reservoir longitudinal/circumferential strain (LASr/LASr-c), LA conduit longitudinal/circumferential strain (LAScd/LAScd-c), and LA contraction longitudinal/circumferential strain (LASct/LASct-c), were assessed with 4D Auto LAQ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to controls, LASr, LAScd, and LAPEF significantly decreased in both groups of T2DM patients (<i>p</i> &lt; 0.001). T2DM patients with LVR had significantly lower LASr and LAScd than those with normal geometry (<i>p</i> &lt; 0.001). LATEF was also reduced in T2DM patients with LVR compared to the control group (<i>p</i> &lt; 0.05). Among the 4D-LAQ parameters, only LASr (odds ratio [OR]: 0.860, <i>p</i> = 0.016) was associated with LV remodeling (LVR) in multivariate analysis. Receiver operating characteristic (ROC) curves identified a LASr value of ≤22.5% as the optimal cutoff point to predict LVR in the T2DM cohort (sensitivity, 86.0%; specificity, 64.3%; area under the curve [AUC], 0.770; <i>p</i> &lt; 0.001). In addition, LASr was found to be negatively correlated with both LV mass index (LVMI) and relative wall thickness (RWT) but positively correlated with the absolute value of the LV global longitudinal strain (LVGLS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Impairment of LA reservoir and conduit functions can be observed in patients with T2DM, particularly in those with LVR. LASr may serve as a predictor of LVR in patients with T2DM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Feasibility of Early Targeted Neonatal Echocardiography and a Focused Assessment Protocol in Neonates With Congenital Diaphragmatic Hernia","authors":"John T. Wren Jr,&nbsp;Rachael M. Hyland,&nbsp;Stephanie Acosta,&nbsp;Patrick J. McNamara","doi":"10.1111/echo.70189","DOIUrl":"https://doi.org/10.1111/echo.70189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Congenital diaphragmatic hernia (CDH) is a complex disease with significant morbidity and mortality. The use of echocardiography, traditionally a pediatric cardiology echocardiogram (PCE), has significantly advanced the management of CDH but its availability can be limited, and there are concerns regarding clinical stability during the assessment. Neonatologist-performed targeted neonatal echocardiography (TNE) has been proposed as a supplementary modality in CDH. Herein, we evaluate the feasibility and safety of integrating early TNE and a focused assessment protocol in CDH care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective, single-center study of neonates with CDH who received either an initial PCE (<i>n</i> = 26) or complete TNE (<i>n</i> = 20). The timing, images, and duration of the study were collected, as well as clinical stability data. A focused TNE protocol for cases of clinical instability was similarly evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Despite similar clinical risk predictors, TNE was performed sooner (mean 3.0 vs. 11.6 h, <i>p </i>&lt; 0.0001) and quicker (mean 25.9 vs. 44.4 min, <i>p</i> = 0.0001) than a PCE. While fewer images were obtained (mean 102.0 vs. 143.2 images, <i>p </i>&lt; 0.0001), no cases of congenital heart disease were missed. TNE and PCE were equally well tolerated. When indicated, a focused TNE protocol was utilized that provided actionable information with a mean duration of 7.2 min (<i>n</i> = 4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TNE can be performed early, quickly, and safely in neonates with CDH. A focused TNE protocol may be useful even in non-TNE centers for the acute care of critically ill neonates with CDH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938791","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":"Role of Real-Time 3D-Echocardiography in Predicting Success of Redo-Percutaneous Balloon Mitral Valvuloplasty","authors":"Rohit Walse,&nbsp;Bhagwati Pant,&nbsp;Harikrishnan Sivadasapillai,&nbsp;Sanjay Ganapathi,&nbsp;Ajitkumar Valaparambil","doi":"10.1111/echo.70194","DOIUrl":"https://doi.org/10.1111/echo.70194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Echocardiographic predictors of procedural success of redo-percutaneous balloon mitral valvuloplasty (redo-pBMV) have not been extensively studied, and current indications are primarily based on the Wilkins score (WS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to evaluate the role of real-time 3D echocardiography in predicting the success rates of redo-pBMV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>We analyzed 42 patients who underwent pBMV at our center from January 2022 to November 2022. These patients were divided into two groups: Group I (patients undergoing redo-pBMV) and Group II (patients undergoing pBMV for the first time). Immediate procedural outcomes were assessed, and the 3D echocardiographic score was compared with the traditional WS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean WS was 9.69 ± 1.08 in Group I, compared to 9.5 ± 1.33 in Group II (<i>p</i> = 0.575). The 3D echocardiographic analysis revealed a numerically higher 3D score in Group I (11.2 ± 1.83 vs. 10.9 ± 1.52, <i>p</i> = 0.631). ROC curve analysis showed an area under the curve (AUC) of 0.9785 for the 3D score, indicating that it was a better predictor of success compared to the WS (ROC AUC = 0.8289).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The real-time 3D echocardiographic score provides a detailed morphological assessment of the mitral valve and was found to be a better predictor of procedural success than the traditional WS in patients undergoing redo mitral stenosis intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrioventricular and Ventricular Mechanical Interdependence Assessment by Automated Function Imaging in Heart Failure With Preserved Ejection Fraction","authors":"Mengyi Liu,&nbsp;Jingru Lin,&nbsp;Yuqi Cai,&nbsp;Jian He,&nbsp;Minjie Lu,&nbsp;Ying Zhao,&nbsp;Jin Tao,&nbsp;Wenjing Yang,&nbsp;Zhenhui Zhu,&nbsp;Yawen Wang,&nbsp;Jiangtao Wang,&nbsp;Hao Wang,&nbsp;Weichun Wu","doi":"10.1111/echo.70183","DOIUrl":"https://doi.org/10.1111/echo.70183","url":null,"abstract":"<div>\u0000 \u0000 <p>Abnormal left ventricular (LV) mechanics may adversely affect the mechanical function of other chambers as heart failure with preserved ejection fraction (HFpEF) progresses. This study aimed to explore the atrioventricular and ventricular mechanical interdependence and compare the diagnostic and prognostic value of myocardial mechanics in HFpEF patients. A total of 170 patients were classified into HFpEF group (<i>n</i> = 90, scores ≥ 5 points) and suspected HFpEF group (<i>n</i> = 80, between 2 and 4 points) according to the HFA-PEFF scoring system. Strain parameters of the left atrium (LA), right atrium (RA), left ventricle (LV), and right ventricle (RV), as well as strain coupling indices, were analyzed using automated function imaging. Compared to the suspected HFpEF group, HFpEF patients showed worse biventricular systolic function and bi-atrial reservoir and conduit function. In HFpEF patients, lower LV global longitudinal strain (LVGLS) was significantly associated with impaired RV and RA strain (all <i>p</i> &lt; 0.05), but not with LA strain. In suspected HFpEF patients, most results were opposite, except for RV global strain. LA reservoir strain (LASr) showed the highest diagnostic accuracy (area under the curve = 0.802), while the LASr/LVGLS ratio showed the best prognostic value (C-index = 0.670), with reduced ratios predicting adverse outcomes. Impaired LVGLS was independently associated with RV and RA dysfunction in HFpEF, but only associated with LA mechanical impairment in the early stages. LASr outperformed LVGLS for diagnosis, while the LASr/LVGLS ratio provided the best prognostic value, underscoring the relevance of interchamber mechanical coupling in HFpEF evaluation.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}