Eurointervention最新文献

{"title":"Development and validation of the D-PACE scoring system to predict delayed high-grade conduction disturbances after transcatheter aortic valve implantation.","authors":"Francesco Bendandi, Nevio Taglieri, Leonardo Ciurlanti, Alessandro Mazzapicchi, Marco Foroni, Laura Lombardi, Francesco Palermo, Francesco Filice, Gabriele Ghetti, Antonio Giulio Bruno, Mateusz Orzalkiewicz, Giuliano Costa, Valentina Frittitta, Alessandro Comis, Sofia Sammartino, Maria Chiara Calì, Elena Dipietro, Luigi La Rosa, Corrado Tamburino, Tullio Palmerini, Marco Barbanti, Francesco Saia","doi":"10.4244/EIJ-D-24-00850","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00850","url":null,"abstract":"<p><strong>Background: </strong>New conduction disturbances are frequent after transcatheter aortic valve implantation (TAVI). Refining our ability to predict high-grade atrioventricular block (AVB) occurring later than 24 hours after the procedure would be useful in order to select patients eligible for early discharge.</p><p><strong>Aims: </strong>This study was designed to identify predictors of high-grade AVB occurring between 24 hours and 30 days after TAVI and to develop and validate a predictive risk score.</p><p><strong>Methods: </strong>We analysed clinical, procedural, and electrocardiographic parameters of 1,290 TAVI patients. Independent predictors of delayed high-grade AVB were used to develop the predictive score, which was then externally validated in a cohort of 936 patients.</p><p><strong>Results: </strong>Implantation of self-expanding valves, greater implantation depth, longer PR interval in preprocedural electrocardiogram (ECG) and greater increase of PR duration in next-day ECG, preprocedural right bundle branch block (RBBB) and new-onset left bundle branch block or RBBB that persisted in next-day ECG were independent predictors of delayed high-grade AVB and were combined to develop the Delayed atrioventricular block Prediction for eArly disChargE (D-PACE) score. The areas under the curve of the score were 0.879 (95% confidence interval [CI]: 0.835-0.923) and 0.799 (95% CI: 0.730-0.868) in the derivation and validation cohorts, respectively. Based on the score, patients can be classified into three risk categories; low-risk patients demonstrated an incidence of delayed AVB of less than 1% and are ideal candidates for next-day discharge.</p><p><strong>Conclusions: </strong>The D-PACE score can be used to stratify TAVI patients according to their risk of delayed high-grade AVB and thereby identify those suitable for next-day discharge.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-flow, low-gradient aortic stenosis: an understanding is still a long way off.","authors":"John Webb, Sophie Offen","doi":"10.4244/EIJ-E-24-00052","DOIUrl":"10.4244/EIJ-E-24-00052","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1364-1365"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TAVI patients with bystander coronary artery disease should receive PCI: pros and cons.","authors":"Josep Rodés-Cabau, Marisa Avvedimento, Benedict McDonaugh, Tiffany Patterson","doi":"10.4244/EIJ-E-24-00054","DOIUrl":"10.4244/EIJ-E-24-00054","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1366-1369"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of redo-TAVI in the self-expanding ACURATE neo2 valve: a computed tomography study.","authors":"Gintautas Bieliauskas, Yusuke Kobari, Arif A Khokhar, Mohamed Abdel-Wahab, Ahmed Abdelhafez, Miho Fukui, Klaus Fuglsang Kofoed, Dariusz Dudek, Andreas Fuchs, Joao Cavalcante, Kentaro Hayashida, Gilbert H L Tang, Darren Mylotte, Vinayak N Bapat, Ole De Backer","doi":"10.4244/EIJ-D-24-00367","DOIUrl":"10.4244/EIJ-D-24-00367","url":null,"abstract":"<p><strong>Background: </strong>Redo-transcatheter aortic valve implantation (TAVI) may be unfeasible because of the risk of compromising coronary flow or coronary access by the pinned back leaflets of the index transcatheter aortic valve.</p><p><strong>Aims: </strong>We aimed to evaluate the feasibility of redo-TAVI using the balloon-expandable SAPIEN 3 (S3) implanted within the self-expanding ACURATE neo2 (ACn2) valve and to identify predictors associated with a high risk of compromising coronary flow.</p><p><strong>Methods: </strong>A total of 153 post-ACn2 TAVI cardiac computed tomography scans were analysed. Redo-TAVI using an S3 was simulated in two positions: S3 outflow to the ACn2 upper crown (low implant) and S3 outflow to the base of the ACn2 commissural posts (high implant). The risk for coronary flow compromise and inaccessibility was determined by the height of the neoskirt created by the pinned back leaflets and the valve-to-aorta distances.</p><p><strong>Results: </strong>At a low S3 implant position, risk of coronary flow compromise was predicted in only 8% of patients and this increased to 60% with a high S3 position. In accordance, coronary access was predicted to be unrestricted in 52% versus 13% of patients with a low versus high S3 implantation. Female sex, a small aortic annular dimension and a sinotubular junction-to-aortic annulus mean diameter ratio <1.15 were independent predictors associated with a high risk for coronary flow compromise.</p><p><strong>Conclusions: </strong>The feasibility of redo-TAVI with an S3 in an ACn2 depends on the implant depth of the S3 and the geometry of the surrounding aorta. A low S3 implant may reduce the risk of coronary flow compromise and inaccessibility.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1405-1415"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors and clinical impact of worsening left ventricular ejection fraction after mitral transcatheter edge-to-edge repair.","authors":"Sachiyo Ono, Shunsuke Kubo, Takeshi Maruo, Naoki Nishiura, Kazunori Mushiake, Kohei Osakada, Kazushige Kadota, Masanori Yamamoto, Mike Saji, Masahiko Asami, Yusuke Enta, Shinichi Shirai, Masaki Izumo, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Junichi Yamaguchi, Yoshifumi Nakajima, Toru Naganuma, Hiroki Bota, Yohei Ohno, Masahiro Yamawaki, Hiroshi Ueno, Kazuki Mizutani, Toshiaki Otsuka, Kentaro Hayashida, Ocean-Mitral Investigators","doi":"10.4244/EIJ-D-23-01092","DOIUrl":"10.4244/EIJ-D-23-01092","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the effects of left ventricular ejection fraction (LVEF) worsening after transcatheter edge-to-edge valve repair (TEER) for mitral regurgitation (MR).</p><p><strong>Aims: </strong>This study investigated the predictors and clinical impact of LVEF worsening after TEER for primary MR (PMR) and secondary MR (SMR).</p><p><strong>Methods: </strong>This study included 2,019 patients (493 with PMR and 1,526 with SMR) undergoing successful TEER (postprocedural MR grade ≤2+) in the OCEAN-Mitral registry. The patients were categorised into worsened LVEF (wEF), defined as a relative decrease of >12.9% in LVEF at discharge, and preserved LVEF (pEF). The serial changes in left ventricular (LV) function at 1 year were also evaluated.</p><p><strong>Results: </strong>Following TEER, 657 (32%) patients demonstrated wEF. The pEF group demonstrated both decreased left ventricular end-diastolic volumes (LVEDV) and end-systolic volumes (LVESV), and the wEF group showed significantly increased LVESV at discharge. Higher LVEF, larger LVEDV, higher B-type natriuretic peptide levels, and moderate/severe aortic regurgitation predicted wEF. Compared with baseline, the wEF group still demonstrated lower LVEF (46% to 43%; p<0.001) but significantly increased stroke volume (48 mL to 53 mL; p=0.001) at 1 year. The incidence of death or heart failure hospitalisation was similar between the wEF and pEF groups (hazard ratio 1.14, 95% confidence interval: 0.72-1.80; p=0.84) and also in patients with PMR and SMR.</p><p><strong>Conclusions: </strong>LVEF worsening after TEER was not uncommon and was caused by the increased LVESV. LV volumes and some patient-specific factors predicted worsened LVEF which was not associated with long-term clinical outcomes. OCEAN-Mitral registry: UMIN-CTR ID: UMIN000023653.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1430-1441"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term survival after TAVI in low-flow, low-gradient aortic valve stenosis.","authors":"Francesco Cardaioli, Luca Nai Fovino, Tommaso Fabris, Giulia Masiero, Federico Arturi, Andrea Panza, Andrea Bertolini, Giulio Rodinò, Saverio Continisio, Massimo Napodano, Giulia Lorenzoni, Dario Gregori, Chiara Fraccaro, Giuseppe Tarantini","doi":"10.4244/EIJ-D-24-00442","DOIUrl":"10.4244/EIJ-D-24-00442","url":null,"abstract":"<p><strong>Background: </strong>In patients undergoing transcatheter aortic valve implantation (TAVI), the presence of a low-flow, low-gradient (LFLG) status has been associated with higher mortality at short-term follow-up.</p><p><strong>Aims: </strong>We aimed to evaluate long-term survival after TAVI in patients with classical (cLFLG) and paradoxical LFLG (pLFLG) aortic stenosis (AS) compared to high-gradient (HG)-AS.</p><p><strong>Methods: </strong>Patients undergoing TAVI at our centre with a hypothetical minimum 5-year follow-up were divided into 3 groups: (1) HG-AS (mean gradient [MG] >40 mmHg), (2) cLFLG-AS (MG <40 mmHg, ejection fraction [EF] <50%), and (3) pLFLG-AS (MG <40 mmHg, EF ≥50%). The primary endpoint of the study was all-cause mortality. Propensity score-weighted survival analysis was performed to adjust for possible baseline confounders.</p><p><strong>Results: </strong>A total of 574 subjects were included (73% HG-AS, 15% pLFLG-AS, 11% cLFLG-AS). The median survival time was 4.8 years, with a maximum of 12.3 years. Patients with cLFLG-AS presented the highest baseline cardiovascular risk. At unadjusted survival analysis, patients with cLFLG-AS showed the worst long-term prognosis, with a rapid decrease in survival within the first year, while pLFLG- and HG-AS patients presented similar survival rates (p=0.023). At weighted long-term analysis, cLFLG- and HG-AS had similar survival rates. Baseline EF was not related to long-term mortality, while patients with a post-TAVI left ventricular ejection fraction (LVEF) improvement >10% lived significantly longer (p=0.02).</p><p><strong>Conclusions: </strong>Classical LFLG-AS patients had lower long-term survival rates as compared to pLFLG-AS and HG-AS patients. However, after adjustment for possible baseline confounders, a low-flow status per se did not have an impact on long-term mortality after TAVI. Post-TAVI LVEF recovery was associated with improved long-term outcome.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1380-1389"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of left ventricular outflow tract obstruction in transapical mitral valve replacement: the MitraCut procedure.","authors":"Martin Andreas, Tillmann Kerbel, Markus Mach, Andreas Zierer, Elmar Kuhn, Jude S Sauer, Hendrik Ruge, Ander Reguiero, Andrea Colli","doi":"10.4244/EIJ-D-24-00490","DOIUrl":"10.4244/EIJ-D-24-00490","url":null,"abstract":"<p><strong>Background: </strong>The MitraCut procedure employs beating heart transapical (TA) cannulation and endoscopic scissors for dividing the anterior mitral leaflet (AML) to prevent left ventricular outflow tract (LVOT) obstruction in transapical transcatheter mitral valve replacement (TA-TMVR).</p><p><strong>Aims: </strong>We present the first multicentre experience of the MitraCut procedure prior to TA-TMVR to prevent LVOT obstruction.</p><p><strong>Methods: </strong>In 6 European centres, the clinical outcomes of all 13 high-risk patients who had undergone the MitraCut procedure during TA-TMVR procedures were retrospectively reviewed regarding technical success, procedural details and outcome.</p><p><strong>Results: </strong>The MitraCut procedure was successfully completed in 11 patients with 1 cutting attempt, while 2 patients had 2 cutting attempts, with an average procedure duration of 9.0±5.4 min. No patient demonstrated postoperative LVOT obstruction, and all mitral valve (MV) prostheses were competent throughout the follow-up period. However, 1 patient developed a MitraCut-related paravalvular leak (PVL; technical success rate: 12/13). The mean LVOT gradient was 3.9±4.4 mmHg directly after valve expansion and 3.6±3.1 mmHg at follow-up. In-hospital and 30-day mortality were 0%. One patient experiencing MitraCut-related PVL was successfully treated by interventional PVL closure (reintervention rate: n=1). One patient died at 47 days due to cardiac arrhythmia, unrelated to the AML-directed procedure. The mean follow-up at the time of data analysis was 52±34 days.</p><p><strong>Conclusions: </strong>The MitraCut procedure was effective and reproducible for preventing potential LVOT obstruction in TA-TMVR patients during its initial exploration in 6 European hospitals. Considerations regarding the scissors' characteristics, their handling and cut length are mandatory for safe performance of the procedure.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1419-1429"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redo-TAVI feasibility and coronary accessibility following index TAVI with the Evolut valve in patients with bicuspid aortic valve stenosis.","authors":"Ketina Arslani, Gabriela Tirado-Conte, Nicolas M Van Mieghem, Darren Mylotte, Gilbert H L Tang, Vinayak N Bapat, Lionel Leroux, Didier Tchétché, Kendra J Grubb, Ole De Backer","doi":"10.4244/EIJ-D-24-00702","DOIUrl":"10.4244/EIJ-D-24-00702","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1416-1418"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redo-TAVI with the SAPIEN 3 valve in degenerated calcified CoreValve/Evolut explants.","authors":"David Meier, Anish Nigade, Althea Lai, Kyle Dorman, Hacina Gill, Shahnaz Javani, Mariama Akodad, David A Wood, Toby Rogers, Rishi Puri, Keith B Allen, Adnan K Chhatriwalla, Michael J Reardon, Gilbert H L Tang, Vinayak N Bapat, John G Webb, Shinichi Fukuhara, Stephanie L Sellers","doi":"10.4244/EIJ-D-24-00619","DOIUrl":"10.4244/EIJ-D-24-00619","url":null,"abstract":"<p><strong>Background: </strong>Redo-transcatheter aortic valve implantation (TAVI) is the treatment of choice for failed transcatheter aortic valves. Currently, implantation of a SAPIEN 3 (S3) is indicated for redo-TAVI in degenerated CoreValve/Evolut (CV/EV) transcatheter aortic valves (TAVs) but is not well understood.</p><p><strong>Aims: </strong>We aimed to evaluate S3 function following implantation in explanted calcified CV/EV TAVs and to assess the impact of CV/EV pathology on redo-TAVI outcomes.</p><p><strong>Methods: </strong>Ex vivo hydrodynamic testing was performed per the International Organization for Standardization (ISO) 5840-3 standard on 4 S3 TAVs implanted at node 5 in calcified CV/EV explants. The mean gradient (MG), effective orifice area (EOA), peak velocity, regurgitant fraction (RF), geometric orifice area (GOA), leaflet overhang, leaflet pinwheeling, neoskirt height, and frame deformation were evaluated.</p><p><strong>Results: </strong>CV/EV explants were calcified and stenotic. Following S3 implantation, the MG and peak velocity decreased. As per the ISO standard, all S3 implants showed adequate EOA, and 3 out of 4 had an RF within the accepted value (<20%). CV/EV leaflet overhang ranged from 25-37%. Calcified leaflets remained stationary throughout the cardiac cycle (difference <9%) and were not pinned in a manner that constrained S3 systolic flow or appeared to prevent selective frame cannulation. The downstream CV/EV GOA was larger than the upstream S3 GOA during systole. S3 frame underexpansion was seen, resulting in leaflet pinwheeling (range 13-30%). Above the neoskirt, calcium protrusion was observed in contact with the S3 leaflets.</p><p><strong>Conclusions: </strong>S3 implantation at node 5 in calcified CV/EV valves resulted in satisfactory hydrodynamic performance in most configurations tested with stable leaflet overhang throughout the cardiac cycle. The long-term implications of S3 underexpansion, leaflet pinwheeling, and calcium protrusion require future studies.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1390-1404"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends in characteristics of patients undergoing transcatheter tricuspid edge-to-edge repair for tricuspid regurgitation.","authors":"Karl-Patrik Kresoja, Lukas Stolz, Anne Schöber, KarlPhilipp Rommel, Sebastian Rosch, Florian Schlotter, Muhammed Gerçek, Christoph Pauschinger, Wolfgang Rottbauer, Mohammad Kassar, Bjoern Goebel, Paolo Denti, Tienush Rassaf, Manuel Barreiro-Perez, Peter Boekstegers, Monika Zdanyte, Marianna Adamo, Flavien Vincent, Philipp Schlegel, Ralph-Stephan von Bardeleben, Mirjam G Wild, Stefan Toggweiler, Mathias H Konstandin, Eric van Belle, Marco Metra, Tobias Geisler, Rodrigo Estévez-Loureiro, Peter Luedike, Francesco Maisano, Philipp Lauten, Fabien Praz, Mirjam Kessler, Andreas Ruck, Daniel Kalbacher, Volker Rudolph, Christos Iliadis, Holger Thiele, Jörg Hausleiter, Philipp Lurz, On Behalf Of The EuroTR Investigators","doi":"10.4244/EIJ-D-24-00158","DOIUrl":"10.4244/EIJ-D-24-00158","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1442-1446"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}