Case Reports in Cardiology最新文献

{"title":"Dextrocardia in Heterotaxy Syndrome (Polysplenia Variant) in a 36-Year-Old Ethiopian Woman: A Case Report and Literature Review.","authors":"Kedir Negesso Tukeni, Ramadan Jemal Dekema, Mohammed Kedir Shukri, Jafer Yasin Mohammed, Michael Deyu Jima, Merid Lemma Kebede","doi":"10.1155/cric/6419535","DOIUrl":"10.1155/cric/6419535","url":null,"abstract":"<p><strong>Background: </strong>Heterotaxy syndrome-polysplenia variant (left isomerism) with dextrocardia is a rare constellation of laterality defects characterized by left-isomerism, multiple splenic nodules, and associated vascular and visceral anomalies. This report describes an adult Ethiopian woman who presented with nonspecific abdominal pain and was found to have imaging features diagnostic of heterotaxy (polysplenia variant).</p><p><strong>Case presentation: </strong>A 36-year-old Ethiopian female presented with a three-day history of mild to moderate, nonradiating anterior abdominal pain. Physical examination revealed the apical impulse on the right and mild left upper quadrant tenderness. Contrast-enhanced CT of the chest and abdomen demonstrated dextrocardia with the cardiac apex directed to the right, right-sided aortic arch, interrupted inferior vena cava with azygos continuation, bilobed lungs consistent with left isomerism, multiple splenic nodules clustered in the left upper quadrant (polysplenia), and a short pancreas. Routine laboratory tests were unremarkable. The final diagnosis was heterotaxy syndrome-polysplenia variant (left isomerism) with dextrocardia. The patient was managed conservatively for presumed costochondritis, counseled about her anatomical variation, advised to carry a medical alert card, and remained symptom-free at two-week follow-up.</p><p><strong>Conclusion: </strong>Imaging features in this patient are most consistent with heterotaxy syndrome (polysplenia variant) rather than isolated situs inversus totalis. Clear, consistent diagnostic terminology (heterotaxy-polysplenia variant with dextrocardia) is essential for accurate communication, appropriate counseling, and safe planning of future interventions. Recognition of such cases in underreported regions supports improved diagnostic awareness and tailored care.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"6419535"},"PeriodicalIF":0.5,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297313","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":"Acute Pulmonary Embolism With Multiple ST-Segment Elevations in Anterior and Inferior Leads: A Case Report.","authors":"Xiaorui Zhao, Xiaoqing Fu, Wenqiang Li, Jie Tan","doi":"10.1155/cric/5240200","DOIUrl":"10.1155/cric/5240200","url":null,"abstract":"<p><strong>Background: </strong>Acute pulmonary embolism (APE) is a common and potentially life-threatening cardiovascular emergency. Although APE typically presents with nonspecific electrocardiogram (ECG) abnormalities, a rare but critical presentation may mimic ST-segment elevation myocardial infarction. We report a case of APE with multiple ST-segment elevations in the anterior and inferior leads.</p><p><strong>Case presentation: </strong>A 74-year-old man presented with chest tightness and dyspnea. His initial ECG revealed sinus tachycardia with ST-segment elevation in Leads III, aVF, and V1-V4, along with T-wave inversion and pathological Q waves. He did not report typical ischemic chest pain. Cardiac troponin I was 0.43 ng/mL on admission and peaked at 0.84 ng/mL over the next 2 days. Plasma D-dimer was markedly elevated at 4.59 mg/L. Deep vein thrombosis was detected in the left posterior tibial vein, and echocardiography showed mild pulmonary hypertension without left ventricular regional wall motion abnormalities. Emergency CT pulmonary angiography confirmed multiple thromboemboli in both the left and right pulmonary arteries. The patient was diagnosed with APE, treated with intravenous heparin followed by oral anticoagulation, and discharged after 9 days of treatment.</p><p><strong>Conclusions: </strong>APE should be considered in the differential diagnosis of patients presenting with ST-segment elevation. Awareness of the ECG changes associated with APE and early diagnostic intervention can help prevent misdiagnosis and ensure timely treatment.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"5240200"},"PeriodicalIF":0.5,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213350","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":"Isolated Parachute Mitral Valve and Calcified Papillary Muscle in a 70-Year-Old Female: Case Report.","authors":"Murad Azamtta, Salma Hajj Qasem, Adil Alsweis, Yunis Daralammouri","doi":"10.1155/cric/8871063","DOIUrl":"10.1155/cric/8871063","url":null,"abstract":"<p><p>The parachute mitral valve (PMV) is a rare congenital cardiac defect in which all chordae tendineae are attached to one papillary muscle, giving the valve its parachute-like appearance. This anatomical defect can result in mitral valve stenosis or regurgitation, which can impede normal blood flow. The diagnosis is often shown by echocardiography, which reveals the valve's unique features. Papillary muscle calcification is an uncommon echocardiographic condition mainly attributed to advancing age, cardiac ischemia, and degenerative valve disease, and its incidence in relation to PMV is not well established. PMV treatment depends on the severity of the condition, with severe instances frequently necessitating mitral valve repair or replacement. It is estimated that approximately two-thirds of those with PMV will require surgical treatment. In our instance, a 70-year-old patient was diagnosed with isolated PMV and calcified papillary muscle during routine echocardiography as part of high blood pressure evaluation. This case demonstrates the diagnostic and therapeutic difficulties related to PMV, particularly if patients are asymptomatic, and emphasizes the importance of continued monitoring and individualized treatment options.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"8871063"},"PeriodicalIF":0.5,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201129","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":"Revealing the Hidden Severity: A Case Report on Managing Complex Aortic Stenosis With TAVI.","authors":"Thomas Stefoulis, James Sindone, Mahiar Mahjoub, Samuel Jay-Jackson Pack, Sean Lal","doi":"10.1155/cric/1945506","DOIUrl":"10.1155/cric/1945506","url":null,"abstract":"<p><p>Aortic stenosis (AS) is a progressive condition prevalent in older adults, with severity determined through clinical evaluation and imaging. However, diagnostic dilemmas arise when imaging results conflict with clinical symptoms. This report examines an 84-year-old male with chronic kidney disease, prior abdominal aortic aneurysm repair and other comorbidities, presenting with decompensated heart failure. Initial echocardiography findings suggested moderate AS, insufficient to qualify for transcatheter aortic valve implantation (TAVI) under national guidelines, despite clinical evidence of worsening heart failure. A multimodal diagnostic approach, incorporating Agatston scoring, dobutamine stress echocardiography (DSE), and invasive haemodynamics, was undertaken to resolve this discordance. DSE demonstrated persistent discordance between Doppler- and Simpson-derived flow estimates, whereas CT calcium scoring and left heart catheterisation ultimately confirmed severe AS, with an aortic valve area of 0.75 cm². The patient underwent preoperative optimisation, including multidisciplinary team (MDT) input and targeted interventions to manage comorbidities and optimise haemodynamics. TAVI was performed successfully, resulting in significant improvements in symptoms, exercise tolerance and renal function. This case highlights the necessity of a multimodal diagnostic strategy when initial investigations do not align with clinical presentation, emphasising MDT collaboration and preoperative optimisation. It demonstrates how multimodality imaging can prevent underestimation of AS severity and support timely intervention in clinically complex patients.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"1945506"},"PeriodicalIF":0.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201135","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 Case Report on Opioid Withdrawal-Induced Stress Cardiomyopathy and a Review of the Current Literature.","authors":"Reeju Maharjan, Vidhi Patel, Saba Roa, Khalid Kainat","doi":"10.1155/cric/9735423","DOIUrl":"10.1155/cric/9735423","url":null,"abstract":"<p><p>Takotsubo cardiomyopathy (TTC), also known as stress-induced cardiomyopathy or apical ballooning syndrome, is a temporary heart condition characterized by a sudden and reversible weakening of the heart muscle, often triggered by significant emotional or physical stress. First identified in Japan in 1990, the term \"Takotsubo\" describes the heart's distinctive shape during this condition, resembling an octopus trap as seen in imaging studies. Opioid withdrawal-induced stress cardiomyopathy is likely mediated by increased sympathetic activity and catecholamine surge. It may present with acute chest pain, electrocardiographic changes mimicking acute coronary syndrome, modest troponin elevation, and characteristic left ventricular systolic dysfunction with apical or mid-ventricular ballooning on echocardiography in the absence of obstructive coronary artery disease. Early detection and management with methadone or buprenorphine (an opioid agonist therapy) is important to improve the clinical outcome of the patient. In the context of rising opioid-related complications, physicians particularly in emergency settings should maintain a high index of suspicion for life threatening conditions. This case report presents an atypical manifestation of Takotsubo cardiomyopathy in the opioid withdrawal population, detailing the patient's clinical progression, diagnostic evaluation, management, and outcome. Such cases provide valuable insights for clinicians to improve early detection and optimize treatment strategies, ultimately ensuring better patient outcomes.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"9735423"},"PeriodicalIF":0.5,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201126","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":"When the Pacemaker Goes Rogue: Pacemaker-Induced Tachycardia, Syncope, and Car Crash.","authors":"Hanna Grogg, Nikola Kozhuharov, Andreas Haeberlin, Stephan van Gool, Miriam Luginbühl, Mathieu Stadelmann, Bruno Schnegg","doi":"10.1155/cric/5546851","DOIUrl":"10.1155/cric/5546851","url":null,"abstract":"<p><p>A 78-year-old male with a history of ischemic heart disease with prior myocardial infarction, severe left ventricular systolic dysfunction, and a device-related implantable cardioverter defibrillator (DR ICD) was admitted following a road traffic accident due to a sudden loss of control of the vehicle following a syncope. Initial investigations ruled out acute coronary syndrome and did not point to neurological causes. Device interrogation revealed the presence of pacemaker-mediated tachycardia (PMT), but since the episode trigger had been programmed off, it was not possible to determine when they occurred, how long they lasted, or their rate. However, atrial threshold testing promptly provoked a PMT. The induced PMT led to a tachycardia of 130 bpm, causing severe symptomatic hypotension with a mean blood pressure falling below 50 mmHg. This could be easily reproduced several times. Given the patient's severe left ventricular systolic dysfunction and the absence of any overt alternative explanation, the PMT likely triggered the syncope preceding the car accident. Management focused on reprogramming the DR ICD. The most critical adaptation was a mode switch from DDD to DDIR to prevent atrial tracking, effectively terminating PMT episodes. A prolongation of the postventricular atrial refractory period (PVARP) was not possible due to the very slow VA conduction. The follow-up revealed no other episodes of PMT and the patient no longer experiences episodes of presyncope or syncope. This report highlights the potential for PMTs to induce severe hemodynamic instability and syncope, underscoring the importance of meticulous device evaluation.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"5546851"},"PeriodicalIF":0.5,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044342","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 Recurrence of Cardiac Myxomas in an Adolescent With Carney Complex: Clinical Clues Preceding Imaging Findings-A Case Report.","authors":"Bastian Abarca-Rozas, Francisco Saavedra, Juan Pablo Retamal, Francisco Vergara, Javier Revello, Pamela Zelada, Demian Andrés Fullerton","doi":"10.1155/cric/7261880","DOIUrl":"10.1155/cric/7261880","url":null,"abstract":"<p><strong>Background: </strong>Carney complex is a rare autosomal dominant syndrome characterized by multiple cardiac myxomas with early onset and high recurrence rates, associated with a significant risk of intracardiac obstruction and embolic events.</p><p><strong>Case presentation: </strong>A female patient was diagnosed at age 14 with multiple intracardiac masses involving both atria and the right ventricle, which were confirmed as myxomas and surgically resected. She also presented with mucocutaneous lentiginosis and a pituitary microadenoma, establishing a clinical diagnosis of Carney complex despite negative genetic testing. During follow-up, new masses were initially interpreted as intracardiac thrombi and treated with anticoagulation but were subsequently reclassified as tumor recurrence based on multimodal imaging. Progressive tumor burden led to a second surgical intervention with complete resection of multicameral lesions, with favorable clinical evolution.</p><p><strong>Conclusion: </strong>This case illustrates the systemic and recurrent nature of Carney complex and highlights the critical role of cardiac magnetic resonance imaging in differentiating thrombus from tumor, optimizing therapeutic decision-making, and avoiding unnecessary interventions.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"7261880"},"PeriodicalIF":0.5,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044322","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":"Incessant Focal Atrial Tachycardia Originating From the Right Inferior Pulmonary Vein With Extremely Short Cycle Length and Variable Exit Block.","authors":"Hidemori Hayashi, Gaku Sekita, Tohru Minamino","doi":"10.1155/cric/9933004","DOIUrl":"10.1155/cric/9933004","url":null,"abstract":"<p><p>The underlying mechanism of focal atrial tachycardia (AT) is usually considered to be abnormal automaticity, typically with a cycle length (CL) exceeding 120 ms. We present a case of a 29-year-old female with recurrent symptomatic palpitations. She was referred for electrophysiologic study and catheter ablation. Twelve-lead ECG showed a sinus rhythm with incessant atrial ectopic beats and occasional aberrant conduction. P-wave morphology during ectopic revealed positive deflections in Leads I, II, aVL, aVF, and V1-V6, suggesting a left-sided origin. Intracardiac recordings obtained using a circular multipolar mapping catheter demonstrated incessant, repetitive, regular spike potentials with an extremely short CL at the posterior aspect of the right inferior pulmonary vein (RIPV). The tachycardia CL within the RIPV was approximately 70 ms and was conducted to the left atrium (LA) with variable exit block ranging from 2:1 to 4:1 conduction. Successful ablation was performed at the earliest activation and shortest CL site outside the RIPV with exit block from the RIPV to LA. The mechanism for this tachycardia is uncertain, but the very short CL suggests that a localized spiral wave re-entry may be involved.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"9933004"},"PeriodicalIF":0.5,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018685","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":"Beyond the Common Femoral Artery: The Overlooked Risk of External Pudendal Artery Injury.","authors":"Ayham Al-Shatanawi, Uzma Aftab, Patrick Tran, Sohail Q Khan","doi":"10.1155/cric/9570668","DOIUrl":"10.1155/cric/9570668","url":null,"abstract":"<p><p>Femoral arterial access is a cornerstone of numerous interventional procedures including percutaneous coronary intervention (PCI), structural valve and neurovascular interventions. Although common femoral artery (CFA) injuries are well-recognised, branch-vessel injuries, such as the external pudendal artery, remain underreported, despite the potential for significant bleeding and haemodynamic compromise. We present a 91-year-old lady who developed a rapidly expanding groin haematoma following PCI via femoral access, despite optimal technique using a micropuncture access kit under ultrasound guidance. She developed haemodynamic collapse, necessitating multiple blood transfusions. CT angiography revealed active extravasation from the external pudendal artery, which was successfully managed with coil embolisation. The patient stabilised postprocedure and was eventually discharged home. As PCI expands to older and higher risk cohorts, this case underscores the need for heightened awareness of branch vessel anatomy, advocating for a multimodal approach integrating fluoroscopic wire tracking with ultrasound guidance to mitigate branch vessel injury.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"9570668"},"PeriodicalIF":0.5,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965594","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":"Tirofiban-Associated Profound Thrombocytopenia in a Patient With Glucose-6-Phosphate Dehydrogenase Deficiency Undergoing Primary Percutaneous Coronary Intervention: A Case Report.","authors":"Chuanwei Zhao, Yansi Wang, Shizhen Gao, Wei Meng, Yane Yang, Wenjie Tan","doi":"10.1155/cric/3617791","DOIUrl":"10.1155/cric/3617791","url":null,"abstract":"<p><strong>Background: </strong>Profound thrombocytopenia after tirofiban exposure during primary percutaneous coronary intervention (PCI) is rare but clinically important. Causal attribution may be challenging when unfractionated heparin is coadministered, and the relevance of glucose-6-phosphate dehydrogenase (G6PD) deficiency remains uncertain.</p><p><strong>Case presentation: </strong>A 34-year-old man with known G6PD deficiency presented with an inferior ST-segment elevation myocardial infarction and underwent primary PCI. He received aspirin, ticagrelor, and unfractionated heparin. Coronary angiography showed multivessel coronary disease with complete occlusion of the mid-to-distal right coronary artery and a large thrombus burden. After aspiration thrombectomy and drug-eluting stent implantation, intracoronary tirofiban (2500 <i>μ</i>g bolus), followed by intravenous tirofiban infusion (0.15 <i>μ</i>g/kg/min), was administered as bailout antithrombotic therapy. Within 6 h, the platelet count fell from 207 × 10⁹ to 1 × 10⁹/L. Peripheral blood smear showed no platelet clumping or abnormal cells. Sepsis and disseminated intravascular coagulation were not supported by laboratory findings. Heparin-induced thrombocytopenia was considered highly unlikely because the 4Ts score was 1, reflecting the extremely early onset, absence of new thrombosis, and the presence of a more plausible alternative explanation. The clinical course was therefore most consistent with acute tirofiban-associated profound thrombocytopenia.</p><p><strong>Interventions and outcomes: </strong>Tirofiban and heparin were discontinued immediately, and intravenous immunoglobulin (20 g/day) was administered. The platelet count recovered to 25 × 10⁹/L at 48 h, 48 × 10⁹/L at 72 h, and 124 × 10⁹/L on Day 4. Clopidogrel was restarted at 48 h, followed by indobufen at 72 h. No major bleeding or thrombotic complications occurred.</p><p><strong>Conclusions: </strong>This case supports tirofiban-associated acute profound thrombocytopenia as the most likely diagnosis and underscores the importance of prompt drug withdrawal, structured differential diagnosis against heparin-induced thrombocytopenia, and individualized antithrombotic reinitiation. The contribution of G6PD deficiency remains hypothetical and requires further study.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"3617791"},"PeriodicalIF":0.5,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943813","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}