Acta Cardiologica Sinica最新文献

{"title":"Challenges of Intra-Aortic Balloon Pump and Extracorporeal Membrane Oxygenation in Cardiogenic Shock: Real-World Outcomes.","authors":"Wei-Ting Wang, Chiu-Yang Lee, Shao-Sung Huang, Erik Fung, Po-Hsun Huang, Pai-Feng Hsu, Hsin-Bang Leu, Tse-Min Lu, Shih-Hwa Chiou, Chin-Tien Wang, Tao-Cheng Wu","doi":"10.6515/ACS.202605_42(3).20250924A","DOIUrl":"10.6515/ACS.202605_42(3).20250924A","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the long-term outcomes of patients treated with intra-aortic balloon pump (IABP) alone and in combination with extracorporeal membrane oxygenation (ECMO), focusing on the real-world effectiveness and patient survival.</p><p><strong>Objective: </strong>To evaluate the effectiveness and survival outcomes of patients undergoing IABP support alone versus those receiving combined IABP and ECMO support in a tertiary care setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis of 544 patients, of whom 362 received IABP support and 182 received combined IABP and ECMO support. The study was set in a tertiary care environment. Using Cox proportional hazard regression models, we examined biochemical, echocardiographic data, comorbidities, and medication histories to identify factors associated with mortality.</p><p><strong>Results: </strong>From January 2001 to June 2018 (median follow-up: 30 months), 544 patients received IABP with or without ECMO. Among the IABP-only group, non-survivors were older and had worse renal function, lower cholesterol, and more frequent cardiopulmonary resuscitation, pulseless electrical activity (PEA), ventricular tachycardia/ventricular fibrillation, and sepsis. Age and PEA independently predicted all-cause mortality (hazard ratio [HR]: 1.020 and 1.653, respectively), while age, peak creatine kinase, shock, and PEA were associated with cardiovascular (CV) death. In the IABP + ECMO group, mortality was similarly associated with older age, renal dysfunction, coronary artery disease, and PEA. After adjustment, age remained an independent predictor of all-cause (HR: 1.012) and CV mortality (HR: 1.014). Compared to IABP alone, the combination group had more critical illness features and higher adjusted risks of all-cause (HR: 1.827) and CV death (HR: 1.953).</p><p><strong>Conclusions: </strong>This study underscores the need for precise patient selection for advanced mechanical circulatory support, focusing on age and comorbidities. Our findings advocate for targeted management strategies to enhance the therapeutic potential of mechanical support in cardiogenic shock and improve survival rates among critically ill cardiac patients.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 3","pages":"413-428"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-High-Dose Intracoronary Diltiazem as a Last-Resort Strategy for Refractory No-Reflow.","authors":"Tolga Sinan Guvenc, Yalcin Velibey, Rengin Cetin Guvenc","doi":"10.6515/ACS.202605_42(3).20260202A","DOIUrl":"10.6515/ACS.202605_42(3).20260202A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 3","pages":"504-508"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Mortality Index Unveils Smoking's Role in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention.","authors":"Man-Ju Ting, Chien-Chieh Hsieh, Pau-Chung Chen","doi":"10.6515/ACS.202605_42(3).20251008C","DOIUrl":"10.6515/ACS.202605_42(3).20251008C","url":null,"abstract":"<p><strong>Background: </strong>Early risk stratification is crucial in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Conventional indices fail to fully capture the combined effects of hemodynamic compromise and hypoxemia. The Hypoxia-Age-Shock Index (HASI) integrates age, circulatory status, and peripheral oxygen saturation (SpO₂) and can be rapidly calculated at triage. In addition, the prognostic role of smoking remains controversial. We evaluated the ability of the HASI to predict in-hospital mortality and assessed the impact of smoking on short- and medium-term outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included 711 STEMI patients (455 smokers, 256 non-smokers) treated with primary PCI from 2019 to 2022. Shock Index (SI), Age Shock Index (ASI) and HASI were calculated using vital signs and SpO₂. Mortality was assessed at 30 and 120 days. Logistic regression was used to identify independent predictors, and receiver operating characteristic curve analysis was used to compare predictive performance.</p><p><strong>Results: </strong>The HASI demonstrated superior discrimination for in-hospital mortality compared to the ASI and SI (area under the curve 0.747 vs. 0.700 and 0.628). At a cutoff of 0.524, the HASI showed high sensitivity (97.5%). Multivariable analysis identified HASI [odds ratio (OR) 8.14, 95% confidence interval (CI) 1.59-10.05] as an independent predictor; smoking was not significant (OR 0.81, 95% CI 0.36-1.84). Kaplan-Meier analysis showed comparable 30- and 120-day survival between smokers and non-smokers.</p><p><strong>Conclusions: </strong>The HASI is a rapid, non-invasive, easily computed triage tool that outperformed conventional indices in predicting mortality in STEMI patients undergoing primary PCI in this study. Acute physiological derangements, rather than smoking, drove the outcomes. Its simplicity and speed make the HASI particularly valuable for immediate pre-laboratory risk stratification in high-volume or resource-limited emergency settings.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 3","pages":"381-394"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Safety and Efficacy of a Pitavastatin-Ezetimibe Combination Therapy in Taiwanese Patients after PCI.","authors":"Ya Wen Lu, Ching-Chang Fang, Yu-Tsung Cheng","doi":"10.6515/ACS.202605_42(3).20251013A","DOIUrl":"10.6515/ACS.202605_42(3).20251013A","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing percutaneous coronary intervention (PCI) have a higher risk of recurrence. While lipid and glucose control can improve the prognosis, concerns remain about side effects such as myopathy, liver dysfunction, and potential new-onset diabetes mellitus. This study aimed to evaluate the real-world safety and efficacy of dual lipid-lowering therapy with pitavastatin 4 mg/day (P4) and ezetimibe 10 mg/day (E10), hereafter referred to as P4/E10 in post-PCI patients in Taiwan.</p><p><strong>Methods: </strong>The retrospective cohort study enrolled patients who underwent PCI between 2008 and 2021 at two institutes in Taiwan and received P4/E10 combination therapy for longer than a year. The primary endpoint was the overall adverse event rate associated with P4/E10. Efficacy evaluations included changes from baseline in lipid profile and glycemic markers.</p><p><strong>Results: </strong>A total of 120 patients were enrolled. No adverse events were recorded during the study period. After 12 months of therapy, the average low-density lipoprotein cholesterol level decreased by 32.54% from baseline, and there were decreases in glycated hemoglobin and triglyceride glucose index (-0.40% and -0.23, respectively) in diabetic patients.</p><p><strong>Conclusions: </strong>In this real-world study of Taiwanese patients, P4/E10 combination therapy was safe and effective in both lipid and glycemic index control. Nevertheless, further large-scale studies are warranted to validate our findings.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 3","pages":"453-463"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Vein Ostial Thrombosis after Atrial Fibrillation Ablation Leading to Stroke: Clinical Insights from a Rare Case.","authors":"Hatice Tolunay, Yunus Öz, Doğukan Yazıcı, Özer Kandemir, Özcan Özdemir","doi":"10.6515/ACS.202605_42(3).20260309A","DOIUrl":"10.6515/ACS.202605_42(3).20260309A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 3","pages":"496-499"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence of Atrial Fibrillation After Repeat Catheter Ablation: A Systematic Review and Meta-Analysis.","authors":"Natee Deepan, Parinda Ansusinha, Adivitch Sripusanapan, Narathorn Kulthamrongsri, Thanaboon Yinadsawaphan, Pattara Rattanawong","doi":"10.6515/ACS.202605_42(3).20250929A","DOIUrl":"10.6515/ACS.202605_42(3).20250929A","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation is a key treatment for atrial fibrillation (AF); however, recurrence often requires repeat procedures. This meta-analysis evaluates the efficacy of repeat ablation for recurrent atrial arrhythmia, focusing on ablation technique, anatomical targets, and pulmonary vein (PV) reconnection.</p><p><strong>Methods: </strong>A systematic literature search of MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials was conducted on studies assessing repeat and initial ablation outcomes until February 2025. Data on atrial arrhythmia recurrence, ablation technique, targets, and PV reconnection were extracted. A random-effects model meta-analysis was used to estimate the pooled recurrence rate after repeat ablation.</p><p><strong>Results: </strong>Fifty-three studies (8,117 patients) were included. The recurrence rate after repeat ablation was 30% (95% confidence interval [CI]: 27%-34%), with PV reconnection observed in 90% of cases following the initial ablation. The lowest recurrence rate was observed with cryoballoon ablation (CBA) followed by radiofrequency ablation (RFA) at 23% (95% CI: 15%-33%, I² = 83%). Recurrence rates varied by strategy, with pulmonary vein isolation (PVI) alone resulting in a 25% recurrencerate (95% CI: 18%-35%, I² = 88.5%). PV reconnection rates also varied, with the left inferior PV (LIPV) showing the lowest rateat 23% (95% CI: 22%-24%, I² = 20.3%).</p><p><strong>Conclusions: </strong>Repeat ablation for AF was associated with the risk of recurrence, mainly due to PV reconnection. Strategies involving CBA followed by RFA and PVI-based approaches showed favorable outcomes, while lower reconnection rates in left-sided PVs, especially the LIPV, highlighting the need for optimized techniques.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 3","pages":"339-359"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taiwan Association of Thoracic and Cardiovascular Surgery (TATCS) Position Statement: Surgeon's Role in the Present Era of Isolated Severe Aortic Stenosis Patient Management.","authors":"Chung-Yi Chang, Yung-Tsai Lee, Chih-Yuan Lin, Jui-Chih Chang, I-Chen Chen, Shao-Wei Chen, Ying-Cheng Chen, Bor-Chih Cheng, Nai-Hsin Chi, Chong-Chao Hsieh, Chiao-Po Hsu, Pei-Leun Kang, Hung-Yen Ke, Ping-Chun Li, Chia-Hsun Lin, Jun-Neng Roan, Ta-Chung Shen, Yi-Ting Tsai, Chih-Hsien Wang, Nan-Chun Wu, Chun-Che Shih","doi":"10.6515/ACS.202605_42(3).20251216A","DOIUrl":"10.6515/ACS.202605_42(3).20251216A","url":null,"abstract":"<p><strong>Background: </strong>Aortic stenosis (AS) is the most common primary valvular disease, with a high prevalence (12.4%) among older patients aged ≥ 75 years. Early intervention for AS is critical, as untreated moderate and severe AS are associated with high mortality rates. Evolving patient demographics and procedural trends in surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) call for a structured framework of favorable treatment options for AS comorbidities and cardiac anatomic variants.</p><p><strong>Methods: </strong>The Taiwan Association of Thoracic and Cardiovascular Surgery held multiple meetings in 2024-2025 for local experts to examine the latest evidence and current trends and to facilitate discussion on the management of isolated severe AS in Taiwan.</p><p><strong>Results: </strong>Patient age, comorbidities, and unique cardiac structure frequently involve complex situations requiring treatment beyond SAVR or TAVI in AS management, emphasizing the need for thorough patient evaluation, accurate valvular imaging, and comprehensive patient-centered care with a multi-disciplinary heart team.</p><p><strong>Conclusions: </strong>Treatment options for individual patients must be carefully considered regarding their risk factors, anticipated life expectancy, and baseline health status. The cardiac surgeon provides valuable insights into surgical and alternative treatment methods tailored to individual patient conditions, and plays a critical role in the shared decision-making process in AS management.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 3","pages":"479-485"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning-Based Electrocardiogram Analysis for Pulmonary Embolism Diagnosis: A Systematic Review and Meta-Analysis.","authors":"Chen-Shu Wu, Chia-Hsin Liu, Gen-Min Lin, Yen-Lien Chou, Chiao-Chin Lee, Chin-Sheng Lin, Po-Huang Chen, Pang-Yen Liu","doi":"10.6515/ACS.202605_42(3).20251020A","DOIUrl":"10.6515/ACS.202605_42(3).20251020A","url":null,"abstract":"<p><strong>Background: </strong>Although computed tomography pulmonary angiography (CTPA) is the diagnostic gold standard for confirming pulmonary embolism (PE), it has limitations such as the risks associated with contrast media and logistical delays. Electrocardiography (ECG) is a widely accessible and safe alternative; however, it also has a low diagnostic sensitivity.</p><p><strong>Objectives: </strong>This meta-analysis aimed to evaluate the diagnostic performance of artificial intelligence (AI)-based deep learning models using ECG data for PE detection and identify their strengths, limitations, and future directions.</p><p><strong>Methods: </strong>PubMed, Embase, and the Cochrane Library were comprehensively searched to identify studies evaluating AI models using ECG for PE detection. Studies were included if CTPA was used as the reference standard.</p><p><strong>Results: </strong>Five studies involving 467,017 patients were analyzed. The pooled sensitivity and specificity of the AI-based ECG models for PE detection were 70% (95% confidence interval [CI]: 68-72%) and 67% (95% CI: 66-67%), respectively. The pooled diagnostic odds ratio was 3.68 (95% CI: 3.31-4.09), and the summary receiver operating characteristic analysis yielded an area under the summary receiver operating characteristic curve of 0.754, indicating moderate diagnostic accuracy. Significant heterogeneity was observed across the studies (I² > 90%). Compared with ECG-only approaches, multimodal models integrating ECG with clinical data demonstrated superior diagnostic performance.</p><p><strong>Conclusions: </strong>Current AI-based deep learning models for ECG analysis have moderate accuracy in detecting acute PE, with promising potential for clinical screening. However, the significant heterogeneity and limited external validation highlight the need for standardized methodologies and larger multicenter studies.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 3","pages":"464-478"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nirmatrelvir/Ritonavir-Induced Calcium Channel Blocker Intoxication Successfully Treated by High Dose Insulin Therapy.","authors":"Chun-Yuan Chen, Cong-Tat Cia","doi":"10.6515/ACS.202603_42(2).20251213B","DOIUrl":"10.6515/ACS.202603_42(2).20251213B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 2","pages":"282-284"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goal Attainment Rate in Secondary Prevention in Taiwan - A Chang Gung Research Database Study.","authors":"Tien-Yu Chen, Chia-Chen Wu, Yi-Ting Chen, Bang-Yan Hou, Cheng-I Cheng","doi":"10.6515/ACS.202603_42(2).20251012A","DOIUrl":"10.6515/ACS.202603_42(2).20251012A","url":null,"abstract":"<p><strong>Background: </strong>Effective lipid control is essential in the secondary prevention of cardiovascular disease to reduce recurrent events. However, the low-density lipoprotein cholesterol (LDL-C) goal attainment rates among high-risk patients in Taiwan remain unclear.</p><p><strong>Objective: </strong>This study aimed to evaluate LDL-C goal attainment and adherence to lipid-lowering therapy (LLT) in Taiwanese patients with atherosclerotic cardiovascular disease (ASCVD) using data from the Chang Gung Research Database.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of 116,228 ASCVD patients treated between 2017 and 2021. LDL-C levels, LLT intensity, and goal attainment (< 70 mg/dL) were analyzed. Multivariate logistic regression was used to identify factors associated with LDL-C goal attainment.</p><p><strong>Results: </strong>The mean age of the patients was 67.4 years, and 63.8% were male. Coronary artery disease (CAD) comprised 57.3% of the diagnoses. At baseline, 12.2% of the patients achieved LDL-C < 70 mg/dL, improving to 25.1% at 12 months. High-intensity LLT was associated with a significantly higher likelihood of goal attainment (relative risk 1.54, p < 0.001). Male sex, diabetes mellitus, and prior percutaneous coronary intervention were positively correlated with LDL-C goal attainment. Despite treatment, LDL-C control remained suboptimal, particularly in cerebrovascular disease and peripheral artery disease subgroups.</p><p><strong>Conclusions: </strong>Real-world LDL-C goal attainment among Taiwanese ASCVD patients is low, underscoring the need for intensified lipid management and improved adherence to guideline-based therapy. Tailored interventions are especially warranted for non-CAD ASCVD patients to reduce cardiovascular risk.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 2","pages":"258-268"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}