Journal of Geriatric Cardiology最新文献

{"title":"The systemic inflammatory response index as a risk factor for all-cause and cardiovascular mortality among individuals with coronary artery disease: evidence from the cohort study of NHANES 1999-2018.","authors":"Dao-Shen Liu, Dan Liu, Hai-Xu Song, Jing Li, Miao-Han Qiu, Chao-Qun Ma, Xue-Fei Mu, Shang-Xun Zhou, Yi-Xuan Duan, Yu-Ying Li, Yi Li, Ya-Ling Han","doi":"10.26599/1671-5411.2025.07.002","DOIUrl":"10.26599/1671-5411.2025.07.002","url":null,"abstract":"<p><strong>Background: </strong>The association of systemic inflammatory response index (SIRI) with prognosis of coronary artery disease (CAD) patients has never been investigated in a large sample with long-term follow-up. This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States.</p><p><strong>Methods: </strong>A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were included in this study. Cox proportional hazards model, restricted cubic spline (RCS), and receiver operating characteristic curve (ROC) were performed to investigate the association of SIRI with all-cause and cause-specific mortality. Piece-wise linear regression and sensitivity analyses were also performed.</p><p><strong>Results: </strong>During a median follow-up of 7.7 years, 1454 all-cause mortality occurred. After adjusting for confounding factors, higher lnSIRI was significantly associated with higher risk of all-cause (HR = 1.16, 95% CI: 1.09-1.23) and CVD mortality (HR = 1.17, 95% CI: 1.05-1.30) but not cancer mortality (HR = 1.17, 95% CI: 0.99-1.38). The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI, respectively. ROC curves showed that lnSIRI had robust predictive effect both in short and long terms.</p><p><strong>Conclusions: </strong>SIRI was independently associated with all-cause and CVD mortality, and the dose-response relationship was J-shaped. SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 7","pages":"668-677"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977703","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":"Age-specific outcomes after transcatheter left atrial appendage occlusion with the watchman device.","authors":"Ritu Yadav, Sia Savant, Meghana Prakash, H Waraich, Abhishek C Sawant","doi":"10.26599/1671-5411.2025.07.007","DOIUrl":"10.26599/1671-5411.2025.07.007","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter left atrial appendage occlusion (LAAO) has become a suitable alternative to anticoagulation in patients with atrial fibrillation (AF). However, outcomes among patients age > 75 years undergoing LAAO are lacking.</p><p><strong>Methods: </strong>We included 723 consecutive patients with AF undergoing LAAO from August 2015 to March 2020. Patient data including clinical, laboratory, procedural characteristics, medications and outcomes were collected. The primary composite outcome was major adverse cardiac events (MACE) including mortality, stroke, bleeding and readmissions at 60-days.</p><p><strong>Results: </strong>Mean age was 75 ± 8 years and 434 (60%) were males. Median CHA₂DS₂-VASc score was 4 (IQR: 4, 5) points and median HASBLED score was 4 (IQR: 3, 4) points. Composite MACE outcome was significantly higher among patients age > 75 years in both unadjusted (17.1% <i>vs.</i> 11.5%, <i>P</i> = 0.03) and adjusted (Odds Ratio = 1.59, 95% CI: 1.02 - 2.46, <i>P</i> = 0.04) analysis. Composite MACE was primarily driven by higher all-cause mortality (1.3% <i>vs.</i> 0, <i>P</i> = 0.04) among patients age > 75 years. The secondary outcome of procedural success was also lower among patients age > 75 years (92.2% <i>vs.</i> 96.2%, <i>P</i> = 0.02). The occurrence of stroke (<i>P</i> = 0.38), major bleeding (<i>P</i> = 0.29) and readmissions (<i>P</i> = 0.15) did not differ between patients age > 75 years and less than 75 years.</p><p><strong>Conclusion: </strong>Patients age >75 years undergoing LAAO have worse outcomes primarily driven by higher all-cause mortality and are less likely to achieve procedural success. Future prospective studies evaluating these findings are warranted.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 7","pages":"648-655"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977486","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":"Transcatheter aortic valve replacement for older patients with isolated aortic regurgitation.","authors":"José C González, Ignacio J Amat","doi":"10.26599/1671-5411.2025.07.010","DOIUrl":"10.26599/1671-5411.2025.07.010","url":null,"abstract":"<p><p>Aortic regurgitation (AR) poses distinct challenges in interventional cardiology, necessitating novel approaches for treatment. This editorial examined the evolving landscape of transcatheter aortic valve replacement (TAVR) as an alternative therapeutic strategy for AR, particularly in patients deemed high risk for surgery. We explored the anatomical and pathophysiological disparities between AR and aortic stenosis (AS) and elucidates the technical nuances of TAVR procedures in AR patients, emphasizing the need for precise prosthesis positioning and considerations for excessive stroke volume. Additionally, we discussed the safety and efficacy of TAVR compared to SAVR in AR management, drawing insights from recent case series and registry data. Notably, dedicated TAVR devices tailored for AR, such as the J-Valve and JenaValve, demonstrate promising outcomes in reducing residual AR and ensuring procedural success. Conversely, \"off-label\" TAVR devices, including balloon-expandable and self-expandable platforms, offer feasible alternatives-particularly for large aortic annuli-with favorable device success rates and low residual AR rates. We highlighted the need for further research, including randomized trials, to delineate the definitive role of TAVR in AR treatment and to address remaining questions regarding device selection and long-term outcomes. In conclusion, TAVR emerges as a viable option for patients with AR, particularly those facing high surgical risks or frailty, with ongoing investigations poised to refine its position in the therapeutic armamentarium.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 7","pages":"611-614"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977678","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":"Study design and rationale of the TXL-CAP trial: a randomized, double-blind, placebo-controlled, multicenter clinical trial assessing the effect of Tongxinluo capsules on the stability of coronary atherosclerotic plaques.","authors":"Mei Ni, Yun Ti, Yan Qi, Meng Zhang, Dayue Darrel Duan, Chen Yao, Zhen-Hua Jia, Yun Zhang, Pei-Li Bu","doi":"10.26599/1671-5411.2025.07.004","DOIUrl":"10.26599/1671-5411.2025.07.004","url":null,"abstract":"<p><p>Recent clinical trials have demonstrated a protective effect in using traditional Chinese medicine Tongxinluo (TXL) capsule to treat atherosclerosis. However, clinical evidence of the effects of TXL treatment on coronary plaque vulnerability is unavailable. In response, we developed this study to investigate the hypothesis that on the basis of statin therapy, treatment with TXL capsule may stabilize coronary lesions in patients with acute coronary syndrome (ACS). The TXL-CAP study was an investigator-initiated, randomized, double-blind clinical trial conducted across 18 medical centers in China. Patients with ACS aging from 18 to 80 years old who had a non-intervened coronary target lesion with a fibrous cap thickness (FCT) < 100 μm and lipid arc > 90° as defined by optical coherence tomography (OCT) were recruited. A total of 220 patients who met the selection criteria but did not meet the exclusion criteria will be finally recruited and randomized to receive treatment with TXL (<i>n</i> = 110) or placebo (<i>n</i> = 110) for a duration of 12 months. The primary endpoint was the difference in the minimum FCT of the coronary target lesion between TXL and placebo groups at the end of the 12-month follow-up. Secondary endpoints included: (1) changes of the maximum lipid arc and length of the target plaque, and the percentage of lipid, fibrous, and calcified plaques at the end of the 12-month period; (2) the incidence of composite cardiovascular events and coronary revascularization within the 12 months; (3) changes in the grade and scores of the angina pectoris as assessed using the Canadian Cardiovascular Society (CCS) grading system and Seattle angina questionnaire (SAQ) score, respectively; and (4) changes in hs-CRP serum levels. The results of the TXL-CAP trial will provide additional clinical data for revealing whether TXL capsules stabilizes coronary vulnerable plaques in Chinese ACS patients.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 7","pages":"615-624"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977700","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":"Scratch & slide technique recanalization of long chronic iliac occlusion.","authors":"Gianluca Rigatelli, Dobrin Vassilev, Giuseppe Marchese, Ervis Hiso, Andrea Bertolini, Marco Zuin","doi":"10.26599/1671-5411.2025.07.003","DOIUrl":"10.26599/1671-5411.2025.07.003","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 7","pages":"690-694"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977728","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":"Multiple biomarkers risk score for accurately predicting the long-term prognosis of patients with acute coronary syndrome.","authors":"Zhi-Yong Zhang, Xin-Yu Wang, Cong-Cong Hou, Hong-Bin Liu, Lyu Lyu, Mu-Lei Chen, Xiao-Rong Xu, Feng Jiang, Long Li, Wei-Ming Li, Kui-Bao Li, Juan Wang","doi":"10.26599/1671-5411.2025.07.001","DOIUrl":"10.26599/1671-5411.2025.07.001","url":null,"abstract":"<p><strong>Background: </strong>Biomarkers-based prediction of long-term risk of acute coronary syndrome (ACS) is scarce. We aim to develop a risk score integrating clinical routine information (C) and plasma biomarkers (B) for predicting long-term risk of ACS patients.</p><p><strong>Methods: </strong>We included 2729 ACS patients from the OCEA (Observation of cardiovascular events in ACS patients). The earlier admitted 1910 patients were enrolled as development cohort; and the subsequently admitted 819 subjects were treated as validation cohort. We investigated 10-year risk of cardiovascular (CV) death, myocardial infarction (MI) and all cause death in these patients. Potential variables contributing to risk of clinical events were assessed using Cox regression models and a score was derived using main part of these variables.</p><p><strong>Results: </strong>During 16,110 person-years of follow-up, there were 238 CV death/MI in the development cohort. The 7 most important predictors including in the final model were NT-proBNP, D-dimer, GDF-15, peripheral artery disease (PAD), Fibrinogen, ST-segment elevated MI (STEMI), left ventricular ejection fraction (LVEF), termed as CB-ACS score. C-index of the score for predication of cardiovascular events was 0.79 (95% CI: 0.76-0.82) in development cohort and 0.77 (95% CI: 0.76-0.78) in the validation cohort (5832 person-years of follow-up), which outperformed GRACE 2.0 and ABC-ACS risk score. The CB-ACS score was also well calibrated in development and validation cohort (Greenwood-Nam-D'Agostino: <i>P</i> = 0.70 and <i>P</i> = 0.07, respectively).</p><p><strong>Conclusions: </strong>CB-ACS risk score provides a useful tool for long-term prediction of CV events in patients with ACS. This model outperforms GRACE 2.0 and ABC-ACS ischemic risk score.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 7","pages":"656-667"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977730","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":"Development of cardiovascular clinical research data warehouse and real-world research.","authors":"Dan-Dan Li, Ya-Ni Yu, Zhi-Jun Sun, Chang-Fu Liu, Tao Chen, Dong-Kai Shan, Xiao-Dan Tuo, Jun Guo, Yun-Dai Chen","doi":"10.26599/1671-5411.2025.07.006","DOIUrl":"10.26599/1671-5411.2025.07.006","url":null,"abstract":"<p><strong>Background: </strong>Medical informatics accumulated vast amounts of data for clinical diagnosis and treatment. However, limited access to follow-up data and the difficulty in integrating data across diverse platforms continue to pose significant barriers to clinical research progress. In response, our research team has embarked on the development of a specialized clinical research database for cardiology, thereby establishing a comprehensive digital platform that facilitates both clinical decision-making and research endeavors.</p><p><strong>Methods: </strong>The database incorporated actual clinical data from patients who received treatment at the Cardiovascular Medicine Department of Chinese PLA General Hospital from 2012 to 2021. It included comprehensive data on patients' basic information, medical history, non-invasive imaging studies, laboratory test results, as well as peri-procedural information related to interventional surgeries, extracted from the Hospital Information System. Additionally, an innovative artificial intelligence (AI)-powered interactive follow-up system had been developed, ensuring that nearly all myocardial infarction patients received at least one post-discharge follow-up, thereby achieving comprehensive data management throughout the entire care continuum for high-risk patients.</p><p><strong>Results: </strong>This database integrates extensive cross-sectional and longitudinal patient data, with a focus on higher-risk acute coronary syndrome patients. It achieves the integration of structured and unstructured clinical data, while innovatively incorporating AI and automatic speech recognition technologies to enhance data integration and workflow efficiency. It creates a comprehensive patient view, thereby improving diagnostic and follow-up quality, and provides high-quality data to support clinical research. Despite limitations in unstructured data standardization and biological sample integrity, the database's development is accompanied by ongoing optimization efforts.</p><p><strong>Conclusion: </strong>The cardiovascular specialty clinical database is a comprehensive digital archive integrating clinical treatment and research, which facilitates the digital and intelligent transformation of clinical diagnosis and treatment processes. It supports clinical decision-making and offers data support and potential research directions for the specialized management of cardiovascular diseases.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 7","pages":"678-689"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977551","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":"Falls in older persons living with heart failure - taking a step back & thinking beyond GDMTs.","authors":"Nur Ezzati Alias, Aimy Abdullah, Norashikin Saidon, Noor Azleen Ahmad Tarmizi, Raja Ezman Raja Shariff","doi":"10.26599/1671-5411.2025.07.005","DOIUrl":"10.26599/1671-5411.2025.07.005","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 7","pages":"695-700"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977561","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":"Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity.","authors":"Mei Zhang, Dian-Fu Li, Jun Pu","doi":"10.26599/1671-5411.2025.05.006","DOIUrl":"10.26599/1671-5411.2025.05.006","url":null,"abstract":"<p><p>Cardiovascular damage caused by cancer treatment has become an important cause of death for tumor survivors. With the recognition of cardiovascular diseases and cancer therapy-related cardiovascular toxicity (CTR-CVT) in tumor patients, noninvasive imaging technologies play pivotal roles in the risk stratification, early diagnosis, monitoring and follow-up for CTR-CVT. In recent years, the field of cardio-oncology has witnessed continual updates in diagnostic and therapeutic strategies, with several pertinent guidelines and expert consensus documents issued in China and abroad. However, there remains a conspicuous absence of systematic guidance documents on the application of imaging techniques in the clinical practice of cardio-oncology. Therefore, the Chinese Anti-Cancer Association Society of Integrative Cardio-oncology, the Ultrasound Branch of the Chinese Medical Association, and the Chinese Society of Echocardiography convened experts to formulate the \"Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity\". Building upon the systematic evaluation of guidelines and the latest evidence-based medical research in the field of cardio-oncology domestically and abroad, and in conjunction with data derived from evidence-based medical research in China, this guideline proposes noninvasive imaging examination methods and monitoring strategies for CTR-CVT, aiming to further standardize and guide the clinical practice of multidisciplinary physicians specializing in cardio-oncology in China.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 5","pages":"477-496"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555604","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":"Geriatric assessment for predicting outcomes among patients with aortic stenosis undergoing transcatheter aortic valve implantation.","authors":"Calvo E, Castillo P, Romaguera R, Llaó I, Zafrilla R, Domene G, Alegre O, Lorente V, Muntané-Carol G, Formiga F, de la Cuerda Fj, Gomez Hospital Ja, Ariza-Solè A","doi":"10.26599/1671-5411.2025.05.005","DOIUrl":"10.26599/1671-5411.2025.05.005","url":null,"abstract":"<p><strong>Background: </strong>There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis (AS). We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation (TAVI) and to analyze the ability of different tools for predicting clinical outcomes in this context.</p><p><strong>Methods: </strong>This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge. The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.</p><p><strong>Results: </strong>A total of 377 patients were included (mean age of 80.4 years). Most patients were independent or mildly dependent, with an optimal cognitive status. The proportion of frailty ranged from 17.6% to 49.8%. A total of 20 patients (5.3%) died and 110/377 patients (29.2%) died or were readmitted during follow up. Overall, most components of the geriatric assessment showed an association with clinical outcomes. Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission. The association between frailty and clinical outcomes was higher for short physical performance battery (SPPB), essential frailty toolset (EFT) and the frailty index based on comprehensive geriatric assessment (IF-VIG) and lower for Fried criteria and FRAIL scale.</p><p><strong>Conclusions: </strong>AS patients from this series presented a good physical performance, optimal cognitive status and a reasonably low prevalence of frailty. The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT, SPPB and the IF-VIG.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 5","pages":"516-524"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555606","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}