Hellenic Journal of Cardiology最新文献

{"title":"Comprehensive analysis of clinical characteristics, management, and prognosis in patients with dilated cardiomyopathy discharged from Spanish hospitals.","authors":"Alberto Esteban-Fernández, Manuel Anguita-Sánchez, Nicolás Rosillo, José Luis Bernal Sobrino, Náyade Del Prado, Cristina Fernández-Pérez, Luis Rodríguez-Padial, Francisco Javier Elola Somoza","doi":"10.1016/j.hjc.2024.12.005","DOIUrl":"10.1016/j.hjc.2024.12.005","url":null,"abstract":"<p><strong>Objective: </strong>Dilated cardiomyopathy (DCM) is a leading cause of heart failure (HF) characterized by left ventricular dilatation and systolic dysfunction not explained by abnormal loading conditions. Despite its prevalence, DCM's epidemiology and prognosis remain poorly studied in our country.</p><p><strong>Methods: </strong>A retrospective observational study encompassed patients discharged from all Spanish public hospitals between 2016 and 2021 diagnosed with DCM. Data were extracted from the Minimum Basic Data Set. The study focused on hospital admissions, comorbidities, in-hospital mortality, and readmission rates for circulatory system diseases at 30 and 365 days.</p><p><strong>Results: </strong>Among 27,402 index episodes, DCM was the primary diagnosis in 12.4%, predominantly affecting men (72.5%). In-hospital mortality was 8.7%, with significant predictors including cardiogenic shock (OR: 12.4, 95% CI: 9.6-15.9), advanced or metastatic cancer (OR: 4.3, 95% CI: 3.8-5.0), renal failure (OR: 2.4, 95% CI: 2.2-2.7), and chronic liver disease (OR: 2.4, 95% CI: 2.1-2.8). Readmission rates were 7.9% at 30 days and 25.5% at 365 days, predominantly due to HF. Multivariate analysis identified age (IRR: 1.02, 95% CI: 1.01-1.02), female sex (IRR: 0.87, 95% CI: 0.79-0.96), severe hematological diseases (IRR: 2.12, 95% CI: 1.45-3.10), and metastatic cancer (IRR: 1.65, 95% CI: 1.31-2.07) as predictors of 30-day readmissions. At 365 days, predictors included age (IRR: 1.02, 95% CI: 1.01-1.02), female sex (IRR: 0.80, 95% CI: 0.74-0.86), severe hematological diseases (IRR: 2.43, 95% CI: 1.66-3.56), and renal failure (IRR: 1.42, 95% CI: 1.31-1.55).</p><p><strong>Conclusion: </strong>This study highlights the substantial hospitalization burden and mortality risk among DCM patients, emphasizing the necessity for advanced management strategies and specialized cardiac care.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of echocardiographic cardiac chamber longitudinal strains in advanced light chain cardiac amyloidosis.","authors":"Xinhao Li, Xiaohang Liu, Xiaojin Feng, Tianchen Guo, Guangcheng Liu, Danni Wu, Xue Lin, Ligang Fang, Wei Chen","doi":"10.1016/j.hjc.2024.12.004","DOIUrl":"10.1016/j.hjc.2024.12.004","url":null,"abstract":"<p><strong>Objective: </strong>Patients with advanced light chain cardiac amyloidosis (AL-CA) have a poor prognosis. We aimed to (1) assess the prognostic significance of all cardiac chamber longitudinal strains and (2) to further determine whether the combination of longitudinal strains with the Mayo staging system could provide additional prognostic value.</p><p><strong>Methods: </strong>Patients classified as Mayo 2012 stage III and IV were included in our study. We documented major adverse cardiac events (MACEs), including hospitalization for heart failure and all-cause mortality. Right ventricular free wall strain (RV-FWS), left ventricular global longitudinal strain (LV-GLS), left atrial longitudinal peak strain (LAPS), and right atrial longitudinal peak strain (RAPS) were assessed using echocardiography.</p><p><strong>Results: </strong>This research enrolled 140 advanced AL-CA patients, with 49.3% at Mayo 2012 stage IV. During follow-up, 84 patients developed MACEs. LV-GLS, RV-FWS, LAPS, and RAPS were independent risk factors for advanced AL-CA patients. Kaplan-Meier curves revealed that cutoff values of all heart-chamber longitudinal strains had significant additional prognostic values for the Mayo 2012 stage. According to multivariate Cox regression, Age, gender, Mayo 2012, LAPS, RAPS, RV-FWS, and LV-GLS were included in the predictive model. The AUCs of the Model were 0.887, 0.907, and 0.883 for 1-, 3-, and 5-year MACEs, respectively. The model was internally validated using 200 bootstrapped resamples, yielding a corrected C-index of 0.810. A nomogram was developed and dynamically accessed via the following link: https://lxhadvancedalliexiantu.shinyapps.io/ALCA/.</p><p><strong>Conclusion: </strong>In patients with advanced AL-CA, it is essential to thoroughly evaluate all cardiac chamber longitudinal strains, particularly focusing on LV-GLS, RV-FWS, LAPS, and RAPS.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordant diagnosis of coronary microvascular dysfunction by microvascular resistance reserve: Transthoracic Doppler echocardiography vs bolus thermodilution method.","authors":"Masahiro Hada, Eisuke Usui, Nobutaka Wakasa, Masahiro Hoshino, Yoshihisa Kanaji, Tatsuhiro Nagamine, Kai Nogami, Hiroki Ueno, Mirei Setoguchi, Tomohiro Tahara, Takashi Mineo, Taishi Yonetsu, Tetsuo Sasano, Tsunekazu Kakuta","doi":"10.1016/j.hjc.2024.12.003","DOIUrl":"10.1016/j.hjc.2024.12.003","url":null,"abstract":"<p><strong>Objective: </strong>Epicardial stenosis and coronary microvascular dysfunction (CMD) may coexist in patients with chronic coronary syndrome (CCS). Microvascular resistance reserve (MRR) has been demonstrated to be a valid cross-modality metric using continuous saline infusion thermodilution and intracoronary Doppler flow velocity methods. This study aimed to investigate the prevalence and diagnostic concordance of CMD defined by MRR using two methods-stress transthoracic Doppler echocardiography (S-TDE) and the invasive bolus thermodilution method (B-Thermo)-in patients with functionally significant epicardial stenosis.</p><p><strong>Methods: </strong>We retrospectively investigated 204 left anterior descending artery (LAD) territories in CCS. All patients underwent physiological assessment using a pressure-temperature wire and S-TDE before elective fractional flow reserve (FFR)-guided percutaneous coronary intervention. The concordance rate was evaluated using κ values.</p><p><strong>Results: </strong>In the final analysis, the median age was 72 years, and 72.5% of patients were male. The median FFR value was 0.69. MRR_S-TDE and MRR_B-Thermo were similar (3.41 vs 3.48, P = 0.877), whereas only a weak, albeit significant relationship was observed between these two metrics (r = 0.167, P = 0.017). CMD was diagnosed in 20.6% and 32.8% of patients using S-TDE and B-Thermo, respectively, when a cutoff MRR value of 2.7 was applied. The concordance rate of CMD diagnosis between the two methods was low (κ = 0.079).</p><p><strong>Conclusion: </strong>MRR_S-TDE and MRR_B-Thermo showed a very weak correlation in the LAD territory with functionally significant stenosis in patients with CCS. The prevalence of CMD diagnosed using MRR_S-TDE and MRR_B-Thermo was not comparable, and the diagnostic concordance of CMD using these two methods was very low.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and anxiety in patients with hypertrophic cardiomyopathy: a call for action.","authors":"George Michas, Ioannis Liatakis, Panagioula Niarchou, Dimitra Kentroti, Efstathia Prappa, Athanasios Trikas","doi":"10.1016/j.hjc.2024.12.001","DOIUrl":"10.1016/j.hjc.2024.12.001","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between preoperative uric acid concentration and the occurrence of atrial fibrillation following cardiac surgery: an observational prospective study.","authors":"Christian de Tymowski, Anne Boutten, Michael Thy, Guilhem Fournier, Pascal Augustin, Sophie Provenchere, Philippe Montravers, Dan Longrois","doi":"10.1016/j.hjc.2024.11.004","DOIUrl":"10.1016/j.hjc.2024.11.004","url":null,"abstract":"<p><strong>Objectives: </strong>Uric acid (UA) concentration is associated with increased risk of atrial fibrillation, but few studies have investigated this association after cardiac surgery. This study investigated the statistical association between postoperative atrial fibrillation (POAF) and preoperative UA concentration according to the type of cardiac surgery.</p><p><strong>Methods: </strong>Consecutive patients undergoing cardiac surgery at a tertiary center from January to May 2019 were eligible. Patients were separated into two groups according to POAF occurrence. Subgroup analyses were performed in patients undergoing coronary artery bypass grafting (CABG) or valve surgery. Binary logistic regression models were used to assess independent factors of POAF. Principal component analyses (PCA) were performed to investigate whether CABG or valve surgeries were associated with different biological profiles for POAF.</p><p><strong>Results: </strong>The study included 221 patients, of whom 76 experienced at least one POAF episode. The UA concentration was higher in the POAF group compared with the POAF-free group (352 μmol/l [295-420] vs. 321 μmol/l [249-380], p = 0.004). This association persisted in multivariable analysis (for 10 μmol, odds ratio = 1.04 [1.34-8,7], p = 0.014) and in patients undergoing isolated CABG. In patients undergoing valve surgery, despite a high incidence of POAF, no association was found. PCA identified different blood biological profiles associated with POAF after CABG vs. valve surgery.</p><p><strong>Conclusion: </strong>The preoperative UA concentration was independently associated with the occurrence of POAF after CABG but not after valve surgery. PCA results indicate that different biological profiles contribute to POAF occurrence according to the type of cardiac surgery, thus suggesting different strategies for prevention/intervention.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on CTO PCI: analysis from the PROGRESS-CTO registry.","authors":"Dimitrios Strepkos, Michaella Alexandrou, Deniz Mutlu, Pedro E P Carvalho, Ali Bahbah, James W Choi, Sevket Gorgulu, Farouc A Jaffer, Raj Chandwaney, Khaldoon Alaswad, Mir B Basir, Lorenzo Azzalini, Bavana V Rangan, Olga C Mastrodemos, Konstantinos Voudris, Ahmed Al-Ogaili, M Nicholas Burke, Yader Sandoval, Emmanouil S Brilakis, Luiz F Ybarra","doi":"10.1016/j.hjc.2024.11.005","DOIUrl":"10.1016/j.hjc.2024.11.005","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verification of persistent pulmonary vein isolation with electroanatomical mapping 3 months after ablation using a novel PFA platform.","authors":"Athanasios Kordalis, Dimitrios Tsiachris, Christos-Konstantinos Antoniou, Ioannis Doundoulakis, Konstantinos Tsioufis","doi":"10.1016/j.hjc.2024.11.002","DOIUrl":"10.1016/j.hjc.2024.11.002","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factor analysis of microvascular obstruction after percutaneous coronary intervention for ST-segment elevation myocardial infarction.","authors":"Jiali Wang, Tianyu Geng, Xiaole Li, Jianwei Zeng, Chunfeng Hu, Kai Xu","doi":"10.1016/j.hjc.2024.10.011","DOIUrl":"10.1016/j.hjc.2024.10.011","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the risk factors of microvascular obstruction (MVO) after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).</p><p><strong>Methods: </strong>A retrospective analysis was performed on 165 patients with STEMI who successfully underwent emergency PCI and completed cardiac magnetic resonance (CMR) within 1 week after PCI. Total ischemia time (symptom onset to wire, S2W), first medical contact to wire (FMC2W), and door to wire (D2W) were compared with the recommended critical time nodes for STEMI treatment. Left ventricular function was evaluated by CMR cine, and myocardial infarction characteristics and MVO were evaluated by late-gadolinium enhancement (LGE). Binary logistic regression analysis was used to evaluate the effect of delay in treatment of STEMI on the occurrence of MVO after PCI.</p><p><strong>Results: </strong>In this study, 89 (53.9%) patients with STEMI presented with MVO after emergency PCI. The FMC2W time and S2W time in the MVO (+) group were significantly longer than those in the MVO (-) group (P < 0.05). Compared with the MVO (-) group, the MVO (+) group had larger myocardial infarction size (IS) and lower left ventricular ejection fraction (LVEF) (P < 0.05). Patients with FMC2W time >120 min and S2W time >300 min had greater myocardial IS and MVO than the FMC2W ≤ 120 min and S2W time ≤300 min group, respectively. Logistic regression analysis showed that S2W time >300 min (P = 0.039, OR = 2.756, 95% CI = 1.053-7.213) was an independent predictor of MVO after PCI in patients with STEMI.</p><p><strong>Conclusion: </strong>Shortening the total time of myocardial ischemia and increasing the proportion of early reperfusion therapy can prevent or reduce MVO after PCI.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of right ventricular function on cardiopulmonary exercise capacity in mitral regurgitation patients undergoing transcatheter mitral valve intervention.","authors":"Muhammed Gerçek, Maria Ivannikova, Mustafa Gerçek, Maximilian Mörsdorf, Johannes Kirchner, Felix Rudolph, Arseniy Goncharov, Tanja K Rudolph, Volker Rudolph, Kai P Friedrichs, Daniel Dumitrescu","doi":"10.1016/j.hjc.2024.10.009","DOIUrl":"10.1016/j.hjc.2024.10.009","url":null,"abstract":"<p><strong>Objective: </strong>Transcatheter mitral valve interventions (TMVI) have been proven to reduce symptom burden and improve outcomes in patients with severe mitral regurgitation (MR). However, the impact of right ventricular function (RVF) on exercise capacity in MR patients is less well understood.</p><p><strong>Methods: </strong>Cardiopulmonary exercise testing (CPET) is the most comprehensive approach to assess maximum exercise capacity. Submaximal exercise capacity (SEC), assessed by constant work rate exercise time testing (CWRET), is presumed to be relevant in daily life activities and gives a more differentiated physiological insight into the nature of exercise intolerance. Thus, 28 MR patients underwent CPET and CWRET (at 75% of the maximum work rate in the initial incremental exercise test) prior to TMVI and 3 months post-procedurally.</p><p><strong>Results: </strong>Patients' mean age was 75.0 ± 8.7 years and 32.1% were female. One patient presented with an MR reduction of less than two grades. RVF was at least moderately impaired in 25% of the patients. SEC of these patients was lower but did not significantly differ (416.4s ± 359.6 vs. 296.1 ± 216.5s; p=) from patients without RVF-deterioration. At follow-up, the SEC improved significantly (from 337.4 ± 262.2s to 517.4 ± 393.5s; p = 0.006). Maximum oxygen uptake (peakVO₂) showed a positive trend, but no statistically significant difference (10.3 ± 3.1 ml/min/kg vs. 11.3 ± 3.4 ml/min/kg; p = 0.06). RVF improved in 35.7% of the patients and these patients showed a significantly higher SEC increase (471.7 ± 153.9s vs. 82.7 ± 47.0s, p = 0.003).</p><p><strong>Conclusion: </strong>SEC is significantly increased in MR patients undergoing TMVI, reflecting an improvement, especially regarding daily life activities. This may be related to TMVIś beneficial effect on right ventricular remodeling.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular complications in TAVI procedures: assessment, management, and outcomes-a retrospective study.","authors":"Cheilas Vasileios, Kosmas Ilias, Filandrianos George, Smparouni Eutyxia, Leontiadis Euaggelos, Martinos Antonios, Papadis Athanasios, Malakos Ioannis, Saplaouras Athanasios, Kostopoulou Anna, Konstantinos Letsas, Panayiota Georgiadou, Voudris Vasileios, Michalis Efremidis, Iakovou Ioannis","doi":"10.1016/j.hjc.2024.10.006","DOIUrl":"10.1016/j.hjc.2024.10.006","url":null,"abstract":"<p><strong>Objective: </strong>Transcatheter Aortic Valve Implantation (TAVI) has emerged as a pivotal therapeutic modality for aortic stenosis, predominantly in the elderly population. Despite its clinical success, the incidence and implications of vascular complications during TAVI remain a subject of critical concern.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 140 patients who experienced vascular complications during TAVI procedures from a total cohort of 1343 cases. Patient demographics, clinical profiles, and procedural characteristics were scrupulously examined. Vascular complications, both intraoperative and postoperative, were identified through various diagnostic modalities. Statistical analyses were employed to discern associations and significance levels. Comparative assessments with international literature were performed to gain broader insights.</p><p><strong>Results: </strong>The study unveiled an overall incidence of vascular complications at approximately 10.44%. Coronary Artery Disease (CAD)-p-value (0.013), choice of valve type-p-value (0.016), and access point-p-value (0.027) demonstrated significant correlations with these complications. Complication incidences in TAVI procedures included pseudoaneurysms (4.76%), arteriovenous fistulas (1.49%), hematomas (0.37%), dissections (2.24%), arterial perforations (0.15%), stenosis/occlusion (0.37%), and closure device failures (1.94%). Over 70% of complications at the valve entry point result from dissections and closure device failures, while the pigtail entry point is predominantly linked to over 70% of pseudoaneurysms. Extended hospitalization (7.84 ± SD 3.14) was observed for patients experiencing vascular complications, underlining the importance of vigilant postprocedural care.</p><p><strong>Conclusion: </strong>This study provides comprehensive insights into vascular complications during TAVI procedures, shedding light on their incidence, risk factors, clinical presentations, diagnostic methodologies, and management strategies.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}