Archives of Cardiovascular Diseases最新文献

{"title":"Drug-induced spontaneous coronary artery dissection: Analysis of the World Health Organization's pharmacovigilance database","authors":"Paul Gautier , Charles Khouri , Michel Galinier , Meyer Elbaz , François Montastruc","doi":"10.1016/j.acvd.2024.08.011","DOIUrl":"10.1016/j.acvd.2024.08.011","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Pages 133-135"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693921","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":"Questionnaire on sustainability practices in French rhythmology departments","authors":"Raoul Bacquelin ,&nbsp;Pascal Defaye","doi":"10.1016/j.acvd.2024.10.320","DOIUrl":"10.1016/j.acvd.2024.10.320","url":null,"abstract":"<div><h3>Background</h3><div>On the one hand, climate change affects health and healthcare systems worldwide. On the other hand, the healthcare system contributes to environmental pollution. These environmental issues concern rhythmology, particularly because of the use of complex, often plastic, single-use devices.</div></div><div><h3>Aims</h3><div>To assess current practices, as well as the training received by rhythmologists and their willingness to implement the necessary changes.</div></div><div><h3>Methods</h3><div>A four-part questionnaire with 15 questions was designed, and was distributed online to rhythmologists, via the French Society of Cardiology.</div></div><div><h3>Results</h3><div>Eighty-seven responses were received from 42 French departments. Most rhythmologists (98.9%) had never attended courses on climate change and its impact on human health during their medical studies; they thought it would be relevant to offer courses on these issues as part of initial medical training (59.5% of answers), continuing medical education (62.3% of answers) and training in interventional rhythmology (55.9% of answers). The participants had already been able to implement actions in their healthcare establishments, in the following categories: transport; food; waste management; scientific studies; and political work. One hundred percent of rhythmologists were willing to change some of their interventional practices if the changes did not alter the risk for the patient or diminish the clinical benefit. However, there were numerous obstacles to overcome: “I don’t know where to start”; “I’m not helped by my healthcare institution”; “regulatory constraints are too important”; “I don’t have the time” and “I don’t know what's relevant”.</div></div><div><h3>Conclusions</h3><div>These responses reinforce the importance of supporting these doctors so that their interventional practices can evolve. This evolution in interventional practices, based on scientific studies, and within a legislative and regulatory framework adapted to environmental issues, will enable the development of a more sustainable rhythmology practice.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Pages 93-100"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693926","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":"Clinical outcomes for 2788 patients with transthyretin amyloidosis: Tafamidis meglumine early access program in France","authors":"Olivier Lairez ,&nbsp;Patricia Réant ,&nbsp;Jocelyn Inamo ,&nbsp;Julien Jeanneteau ,&nbsp;Fabrice Bauer ,&nbsp;Gilbert Habib ,&nbsp;Jean-Christophe Eicher ,&nbsp;Benoit Lequeux ,&nbsp;Damien Legallois ,&nbsp;Constant Josse ,&nbsp;Aurelie Hippocrate ,&nbsp;Mathilde Bartoli ,&nbsp;Margaux Dubois ,&nbsp;Charlotte Noirot Cosson ,&nbsp;Pierre-Alexandre Squara ,&nbsp;Stephane Fievez ,&nbsp;Aurore Quinault ,&nbsp;Jeremie Rudant ,&nbsp;Mounira Kharoubi ,&nbsp;Thibaud Damy","doi":"10.1016/j.acvd.2024.08.006","DOIUrl":"10.1016/j.acvd.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Early access experience in France with tafamidis meglumine, a selective transthyretin stabilizer for transthyretin-related amyloidosis cardiomyopathy (ATTR-CM), following transthyretin-related amyloidosis (ATTR) polyneuropathy approval and positive ATTR-ACT study results.</div></div><div><h3>Aim</h3><div>To describe the characteristics and clinical outcomes for patients in the French ATTR-CM tafamidis meglumine early access programme (28 Nov 2018 to 01 Jun 2021).</div></div><div><h3>Methods</h3><div>Patients with confirmed ATTR-CM received tafamidis meglumine 20<!--> <!-->mg/day or 80<!--> <!-->mg/day. Demographic and clinical data were collected prospectively until patients discontinued treatment or died, or the programme ended.</div></div><div><h3>Results</h3><div>Overall, 222 physicians from 126 centres enrolled 2788 patients. The median age was 82<!--> <!-->years, 81.6% were male and New York Heart Association severity was class I for 12.8%, class II for 60.1% and class III for 27.0%. Overall, 1943 (74.6%) had genetic testing, and the results were available at tafamidis start for 1208 (62.2%) patients: 995 (82.4%) had wild-type ATTR and 213 (17.6%) had hereditary ATTR. Most patients started treatment<!--> <!-->≤<!--> <!-->12<!--> <!-->months after diagnosis (88.3%): 2268 (81.3%) at 20<!--> <!-->mg/day, with 401 (17.7%) increasing to 80<!--> <!-->mg/day. Median follow-up duration was 11.8<!--> <!-->months. New York Heart Association class improved or remained stable for 1299 (77.6%), whereas 376 (22.4%) worsened between inclusion and last follow-up. Among patients initiated at 80<!--> <!-->mg, 297 (81.1%) improved or remained stable and 69 (18.9%) worsened. New York Heart Association class progression did not vary with age. The 18-month survival rates were 89.8% (95% confidence interval: 87.0–92.0) among patients aged<!--> <!-->&lt;<!--> <!-->80<!--> <!-->years, and 86.5% (95% confidence interval: 83.9–88.7) among those aged<!--> <!-->≥<!--> <!-->80<!--> <!-->years.</div></div><div><h3>Conclusions</h3><div>Early tafamidis meglumine access was given to 2788 patients with ATTR-CM. New York Heart Association class progression and survival were consistent with previously published data.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Pages 123-132"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481646","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":"Response to a letter from Modumudi et al. commenting on the article “Cardiogenic shock and infection: A lethal combination”","authors":"Miloud Cherbi ,&nbsp;Hamid Merdji ,&nbsp;Clément Delmas","doi":"10.1016/j.acvd.2024.09.005","DOIUrl":"10.1016/j.acvd.2024.09.005","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Pages 138-139"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559556","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 obesity on tolerance and persistence of statins in patients within 3 months following an acute myocardial infarction: A real-world study","authors":"Morgane Brobst ,&nbsp;Nicolas Chapet ,&nbsp;Daylale Benchalkha ,&nbsp;Elise Bourgeois ,&nbsp;Fanchon Herman ,&nbsp;Nicolas Molinari ,&nbsp;Florence Leclercq ,&nbsp;Jean-Luc Pasquié ,&nbsp;Cyril Breuker ,&nbsp;Ariane Sultan ,&nbsp;François Roubille","doi":"10.1016/j.acvd.2024.10.332","DOIUrl":"10.1016/j.acvd.2024.10.332","url":null,"abstract":"<div><h3>Background</h3><div>Recommended treatment after acute coronary syndrome (ACS) involves high-intensity statin therapy to achieve the low-density lipoprotein (LDL-C) target of<!--> <!-->&lt;<!--> <!-->1.4<!--> <!-->mmol/L (European guidelines), but many patients discontinue statins because of real or perceived side-effects. Whether body mass index (BMI) influences statin intolerance remains unclear.</div></div><div><h3>Aim</h3><div>To assess statin tolerance 3<!--> <!-->months after initiation, and to identify factors determining tolerance and persistence.</div></div><div><h3>Methods</h3><div>STATIC was a single-centre cohort study (November 2021 to April 2023) of patients admitted to cardiac intensive care units for ACS. The study had three stages: T0 (admission); W6 (6 weeks after ACS: statin efficiency); and M3 (3<!--> <!-->months after ACS: statin tolerance and persistence). SAMS score was used to evaluate imputability in patients reporting muscular side-effects. Multivariable analysis identified factors influencing tolerance; statin persistence was assessed using pharmacy dispensing data.</div></div><div><h3>Results</h3><div>Overall, 289 patients were included (77.9% men; mean age 64.2<!--> <!-->years; 22.7% with BMI<!--> <!-->≥<!--> <!-->30<!--> <!-->kg/m²). At T0, 38.1% had hypertension, 28.5% dyslipidaemia and 15.9% diabetes. At discharge, 269 patients received statins: 97.0% had a high-intensity statin; 43.5% had a statin/ezetimibe combination. At W6, mean LDL-C was 1.58<!--> <!-->mmol/L, with 45.5% at the LDL-C target. At M3, 6.0% reported side-effects (3.6% muscular, 1.2% liver, 1.2% gastrointestinal). Mean SAMS score was 5.67. No significant differences in muscular or hepatic side-effects were found between patients with BMI<!--> <!-->≥<!--> <!-->30 versus<!--> <!-->&lt;<!--> <!-->30 kg/m². Persistence was 98.4% at M3 follow-up. The proportion of patients on a high-intensity statin or a statin/ezetimibe did not change from discharge to M3 (<em>P</em> <!-->=<!--> <!-->0.45 and <em>P</em> <!-->=<!--> <!-->1.00, respectively).</div></div><div><h3>Conclusions</h3><div>Statins are effective, but not always enough to reach LDL-C target. Tolerance and persistence were good, with muscular side-effects as expected, but without any guarantee of statin imputability. BMI did not influence statin tolerance in this study.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Pages 85-92"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addendum to “Scientific statement from the French neurovascular and cardiac societies for improved detection of atrial fibrillation after ischaemic stroke and transient ischaemic attack” [Arch. Cardiovasc. Dis. 117 (2024) 542–557]","authors":"Nicolas Gaillard ,&nbsp;Jean-Claude Deharo ,&nbsp;Laurent Suissa ,&nbsp;Pascal Defaye ,&nbsp;Igor Sibon ,&nbsp;Christophe Leclercq ,&nbsp;Sonia Alamowitch ,&nbsp;Céline Guidoux ,&nbsp;Ariel Cohen ,&nbsp;French Neurovascular Society,&nbsp;French Society of Cardiology","doi":"10.1016/j.acvd.2024.10.001","DOIUrl":"10.1016/j.acvd.2024.10.001","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Page 140"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous circulatory assistance in an interventional cardiology centre without on-site cardiac surgery","authors":"Ibrahim Hatoum ,&nbsp;Paul Luporsi ,&nbsp;Philippe Riccini ,&nbsp;Frédéric Collart ,&nbsp;Ziad Boueri","doi":"10.1016/j.acvd.2024.10.331","DOIUrl":"10.1016/j.acvd.2024.10.331","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous extracorporeal membrane oxygenation (ECMO) has been developed thanks to the progress in the field of cannulation, but still justifies the presence of an on-site cardiac resuscitation department. Corsica is a French island without an on-site cardiac surgery department.</div></div><div><h3>Aim</h3><div>To evaluate the percutaneous ECMO programme in Corsica.</div></div><div><h3>Methods</h3><div>All patients who received ECMO at the Bastia Hospital Centre between 01 January 2016 and 30 April 2022 were included.</div></div><div><h3>Results</h3><div>ECMO was implanted in 39 patients. The mean age was 52.7<!--> <!-->years, with male predominance (84.6%). The majority of veno-arterial ECMOs were placed in the coronary angiography laboratory, whereas venovenous ECMOs were preferentially placed in the medical intensive care unit. Twenty patients (51.3%) were medically transferred to other referral centres after canulation. Percutaneous vascular cannulation was performed with ultrasound guidance in all cases (100%), and was successfully performed without immediate complications in all patients except two (who presented an immediate complication during cannulation), which is similar to large trials, despite the absence of on-site cardiac surgery. The use of ultrasound guidance (and sometimes fluoroscopy guidance) during cannulation and the experience of the medical team facilitated control over correct positioning of the cannulas and decreased implantation failure, without the need for a surgical approach.</div></div><div><h3>Conclusions</h3><div>Percutaneous ECMO by trained interventional cardiologists without a surgical approach appears to be safe. Widespread use of percutaneous cannulation without cardiac surgery would increase survival for some patients who are far from these centres.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Pages 101-105"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866497","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":"Letter commenting on the article entitled “Cardiogenic shock and infection: A lethal combination” by Cherbi et al.","authors":"Sravani Modumudi,&nbsp;Vanessa Rodriguez,&nbsp;Laura Calderon Suarez","doi":"10.1016/j.acvd.2024.08.010","DOIUrl":"10.1016/j.acvd.2024.08.010","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Pages 136-137"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513460","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":"Abatacept dose-finding phase II triaL for immune checkpoint inhibitors myocarditis (ACHLYS) trial design","authors":"Joe-Elie Salem ,&nbsp;Stephane Ederhy ,&nbsp;Lisa Belin ,&nbsp;Noel Zahr ,&nbsp;Florence Tubach ,&nbsp;Adrien Procureur ,&nbsp;Yves Allenbach ,&nbsp;Michelle Rosenzwjag ,&nbsp;Marie Bretagne","doi":"10.1016/j.acvd.2024.12.005","DOIUrl":"10.1016/j.acvd.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitor (ICI)-induced myocarditis is a life-threatening adverse drug reaction. Abatacept (a CTLA-4-immunoglobulin fusion protein) has been proposed as a compassionate-use treatment for ICI myocarditis (in combination with corticosteroids and ruxolitinib) but no clinical trial has yet been performed. The abatacept dose can be adjusted using real-time assessment of its target, the CD86 receptor occupancy on circulating monocytes (CD86RO).</div></div><div><h3>Methods</h3><div>The ACHLYS trial is an ongoing dose-finding, Phase II, randomized, double-blind trial in which three different abatacept doses are being tested, aiming to reach CD86RO<!--> <!-->≥<!--> <!-->80% after the first dose and sustainably during the first 3 weeks of ICI myocarditis treatment (primary outcome). Adult patients with cancer presenting severe or corticosteroid-resistant ICI myocarditis have been included. ICI are withheld after inclusion and for the study duration. Abatacept is administered by intravenous injection on Days 1, 5<!--> <!-->±<!--> <!-->2 and 14<!--> <!-->±<!--> <!-->2 at 10, 20 or 25<!--> <!-->mg/kg depending on the randomization arm (<em>n</em> <!-->=<!--> <!-->7 per arm) with concomitant ruxolitinib and corticosteroids. After evaluation of the primary outcome on Day 21, complementary injections of abatacept (for<!--> <!-->≤<!--> <!-->3 months) and a ruxolitinib/corticosteroids weaning strategy are standardized depending on criteria evaluating resolution of ICI myocarditis severity (troponin T level and clinical assessment). Secondary objectives compare immunological, myocardial and muscular proxies of treatment response between randomization arms, and cancer progression-free and overall survivals up to 1 year.</div></div><div><h3>Conclusion</h3><div>The ACHLYS trial will define the most appropriate starting dose of abatacept to treat life-threatening ICI myocarditis, in combination with ruxolitinib and corticosteroids.</div></div><div><h3>Clinicaltrials.gov</h3><div><span><span>NCT05195645</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Pages 106-115"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Convergent procedure for long-standing persistent atrial fibrillation in heart failure with reduced ejection fraction","authors":"Frédéric A. Sebag ,&nbsp;Konstantinos Zannis ,&nbsp;Manel Miled ,&nbsp;Justine Durand ,&nbsp;Pierre Jorrot ,&nbsp;Olivier Villejoubert ,&nbsp;Nicolas Mignot ,&nbsp;Jean-Marc Darondel ,&nbsp;Baptiste Courty ,&nbsp;Edouard Simeon ,&nbsp;Eric Bergoend ,&nbsp;Randall Lee ,&nbsp;Nicolas Lellouche","doi":"10.1016/j.acvd.2024.10.333","DOIUrl":"10.1016/j.acvd.2024.10.333","url":null,"abstract":"<div><h3>Background</h3><div>Catheter ablation for atrial fibrillation in patients with heart failure with reduced ejection fraction is associated with a significant reduction in morbimortality. The convergent procedure is a valid ablation option for the treatment of long-standing persistent atrial fibrillation.</div></div><div><h3>Aim</h3><div>To describe the outcomes of patients with heart failure with reduced ejection fraction and long-standing persistent atrial fibrillation who underwent the convergent procedure.</div></div><div><h3>Methods</h3><div>We studied consecutive patients included in two French centres between 2009 and 2020. Primary endpoint was freedom from any atrial arrhythmia assessed on 24-hour Holter electrocardiogram at 3, 6 and 12 months after the procedure. Left ventricular ejection fraction was assessed on transthoracic echocardiography before and 1 year after the procedure. All patients had at least 12 months of follow-up.</div></div><div><h3>Results</h3><div>Forty-three patients were included (86% were men). Baseline left ventricular ejection fraction was 38<!--> <!-->±<!--> <!-->10.5% and indexed left atrial volume was 50<!--> <!-->±<!--> <!-->27<!--> <!-->mL/m². Among the study population, 34 patients (79%) were free from atrial fibrillation/tachycardia at the end of follow-up. No periprocedural death occurred. We observed two groin haematomas and four mild pericardial effusions. At 12-month follow-up, 21 patients (49%) were still on antiarrhythmic drug therapy, and a reduction in antiarrhythmic drug dosage was achieved in 10 patients (23%). The absolute median improvement in left ventricular ejection fraction was 8% at 12 months (<em>P</em> <!-->=<!--> <!-->0.003).</div></div><div><h3>Conclusions</h3><div>The convergent procedure has been shown to be effective and safe for patients with patients with heart failure with reduced ejection fraction and long-standing persistent atrial fibrillation, with significant left ventricular function improvement.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 2","pages":"Pages 116-122"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}