American Journal of Hypertension最新文献

{"title":"The association between diabetes and hypertension time course, their cumulative co-exposure, and post-coronary artery bypass graft outcomes.","authors":"Mana Jameie, Behrad Saeedian, Mina Pashang, Nastaran Babajani, Ahmad Vakili, Fatemeh Chichagi, Sepehr Nayebi Rad, Arash Jalali, Mani K Askari, Shahab Toursavadkohi, Mushabbar Syed, Adrian V Hernandez, Soheil Mansourian, Kaveh Hosseini","doi":"10.1093/ajh/hpaf074","DOIUrl":"https://doi.org/10.1093/ajh/hpaf074","url":null,"abstract":"<p><strong>Background: </strong>The association between patient outcomes and cumulative effects of cardiovascular risk factors over time is recognized but poorly quantified. This study quantitively addressed the impact of diabetes and hypertension duration, and their combined effect, on post-coronary artery bypass grafting (CABG) outcomes.</p><p><strong>Methods: </strong>This single-center cohort study included patients who underwent coronary angiography followed by isolated CABG (n=10803, median follow-up: 111.3 months) from 2007 to 2017. Study outcomes comprised all-cause mortality and major adverse cardiocerebrovascular events (MACCE). Cox regressions were used to assess the association between risk factors' duration (<5 years, 5-10 years, ≥10 years) and study outcomes among the total cohort and stratified by the co-presence of risk factors.</p><p><strong>Results: </strong>The study population aged 65.56 ± 10.00 years (75.3% male, 40.1% diabetes, 64.1% hypertension). The risk of study outcomes increased with increasing duration of diabetes (adjusted-hazard ratio from \"0-5y\" to \"≥10y\" group for all-cause mortality: 1.37[95%CI: 1.23-1.52] to 1.91[1.69-2.16], and for MACCE: 1.23[1.14-1.34] to 1.59[1.44-1.76]). When stratified by hypertension status, the association between shorter diabetes duration and study outcomes became non-significant among non-hypertensive patients, while the association persisted for their hypertensive counterparts (reference group: non-diabetic patients). An increasing risk pattern was observed with longer hypertension duration (from 1.38[1.25-1.53] to 1.51[1.30-1.75] for all-cause mortality and 1.27[1.18-1.37] to 1.39[1.24-1.55] for MACCE). This risk enhancement was more pronounced when diabetes co-existed.</p><p><strong>Conclusion: </strong>Our results highlight the significance of risk factor exposure duration in patient risk assessment. These insights could be valuable for enhancing existing risk assessment tools and developing tailored preventive strategies.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061936","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":"Adrenal Ablation for Primary Aldosteronism: A Novel Alternative or Complement to Traditional Treatments.","authors":"Zhiming Zhu, Hao Wu, Hongbo He","doi":"10.1093/ajh/hpaf067","DOIUrl":"https://doi.org/10.1093/ajh/hpaf067","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962115","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":"The Impact of Aortic Pulsatile Hemodynamics on Renal Function Trajectories in Acute Heart Failure.","authors":"Yi-Tsang Fu, Shih-Hsien Sung, Hao-Min Cheng, Wen-Chung Yu, Chern-En Chiang, Chen-Huan Chen","doi":"10.1093/ajh/hpaf058","DOIUrl":"https://doi.org/10.1093/ajh/hpaf058","url":null,"abstract":"<p><strong>Background: </strong>Perturbation of aortic pulsatile hemodynamics and the presence of impaired renal function (IRF) may increase post-discharge events in patients hospitalized for acute heart failure (AHF). The present study investigated whether on-admission aortic pulsatile hemodynamics is associated with IRF and in-hospital changes in renal function, and modulates its impact on post-discharge adverse events in patients with AHF.</p><p><strong>Methods: </strong>A total of 240 AHF patients (69.3±15.6 years, 76.7% men) were enrolled and followed for outcomes of heart failure hospitalization and death up to 3 years after discharge. Measures of renal function and aortic pulsatile hemodynamics, including carotid-femoral pulse wave velocity (cf-PWV) and the amplitude of the reflected wave (Pb), were obtained within 24 hours of admission and before discharge. IRF was defined by an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m².</p><p><strong>Results: </strong>On admission, 159 patients (66.3%) presented with IRF. At discharge, eGFR significantly improved by 6.6±13.4 mL/min/1.73m² (19.3±44.7%, P<0.001) in patients with on-admission IRF. Increased on-admission aortic pulsatile hemodynamics was significantly associated with the presence of IRF and inversely associated with the in-hospital improvement of eGFR. Persistent IRF on both admission and discharge (hazard ratio 1.579, 95% confidence interval 1.078-2.315), change of eGFR per 1 standard deviation increment (0.747, 0.597-0.934), and over 30% improvement of eGFR (0.492, 0.306-0.792) were significantly predictive of post-discharge events in multivariable Cox models incorporating either cf-PWV or Pb.</p><p><strong>Conclusions: </strong>On-admission aortic pulsatile hemodynamics was significantly associated with IRF and in-hospital changes in renal function in patients with AHF, and both were significantly associated with post-discharge adverse events independent of aortic pulsatile hemodynamics.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952247","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":"Delayed Treatment, Lasting Consequences: The Need for Early Hypertension Diagnosis and Management in Young Adults.","authors":"Kathryn Foti, Shakia T Hardy","doi":"10.1093/ajh/hpaf073","DOIUrl":"https://doi.org/10.1093/ajh/hpaf073","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955777","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":"Salt-induced vascular damage in hypertension involves redox activation of PARP/TRPM2 signalling and inflammasome assembly.","authors":"Rheure Alves-Lopes, Karla B Neves, Sheon Mary, Delyth Graham, Augusto C Montezano, Christian Delles, Rhian M Touyz","doi":"10.1093/ajh/hpaf071","DOIUrl":"https://doi.org/10.1093/ajh/hpaf071","url":null,"abstract":"<p><strong>Objectives: </strong>Excess sodium intake induces vascular dysfunction. Molecular mechanisms underlying this are unclear. Here we investigated the role of reactive oxygen species (ROS), Ca2+ signalling and inflammation in salt-induced vascular injury, focusing on the interplay between redox-sensitive Poly(ADP-ribose) polymerase (PARP), which activates transient receptor potential melastatin 2 (TRPM2) Ca2+ channel, and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome. Specifically, we sought to determine if salt excess induces a pro-oxidant environment, leading to PARP-induced TRPM2 activation and increased Ca2+ influx, inflammasome assembly, and consequent vascular damage.</p><p><strong>Methods and results: </strong>Vascular smooth muscle cells (VSMCs) from rats and humans were exposed to normal NaCl (140 mM) and high salt conditions (180 mM). High salt increased ROS generation, PARP activation, and TRPM2-mediated Ca2+ transients. Osmotic controls had no effect on these processes. High-salt medium promoted release of pro-inflammatory cytokines IL-18 and IL-1β and increased phosphorylation of myosin light chain (MLC) in VSMCs. These effects were attenuated by inhibitors of PARP (Olaparib), TRPM2 (8-Br-cADPR) and NLRP3 inflammasome (MCC950). To validate these findings in in vivo, mice were subjected to a high-salt diet (4% NaCl, 5 weeks), resulting in elevated blood pressure and vascular remodelling and dysfunction. Exposure of vessels to olaparib and MCC950 attenuated the hypercontractility associated with high-salt diet.</p><p><strong>Conclusion: </strong>salt-induced vascular injury in hypertension involves ROS generation in VSMCs leading to activation of the PARP/TRPM2 axis, increased Ca2+ influx, NLRP3 activation and vascular injury. Our study provides new insights into molecular pathways involved in high-salt diet-induced vascular dysfunction, important in hypertension.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959546","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":"Effect of combining obtusifolin and amlodipine on their antihypertensive effects and its potential mechanism.","authors":"Zhongxia Guo, Xiaolin An, Hui Liu","doi":"10.1093/ajh/hpaf070","DOIUrl":"https://doi.org/10.1093/ajh/hpaf070","url":null,"abstract":"<p><strong>Background: </strong>Both amlodipine and obtusifolin have been demonstrated to possess anti-hypertensive effects, which increases their potential to be combined. The interaction between amlodipine and obtusifolin was evaluated with in vivo rat models and in vitro liver microsomes experiment, aiming to guide the clinical prescription of these two drugs.</p><p><strong>Methods: </strong>The anti-hypertensive effects of amlodipine with or without the combination of obtusifolin were evaluated in hypertension rat models established by abdominal aortic coarctation (AAC) in male Sprague-Dawley (SD) rats. Pharmacokinetics and metabolic stability of amlodipine were assessed in rats and liver microsomes, respectively. The effect of obtusifolin on the activity of CYP3A4 was estimated in liver microsomes.</p><p><strong>Results: </strong>Obtusifolin significantly enhanced the anti-hypertensive effect of amlodipine (P < 0.01). The metabolism of amlodipine was suppressed by the co-administration of obtusifolin with increasing Cmax (P < 0.01), prolonging t1/2 (P < 0.01), and decreasing clearance rate (P < 0.001). In vitro results also confirmed the improving metabolic stability of amlodipine by obtusifolin. Obtusifolin showed a significant inhibitory effect on the activity of CYP3A4 in a concentration-dependent manner with the IC50 value of 15.13 μM.</p><p><strong>Conclusions: </strong>Co-administration of amlodipine with obtusifolin induced increasing systemic exposure of amlodipine through inhibiting CYP3A4. Hypotension should be vigilant under their combination.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962034","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 dietary patterns and incident hypertension in REGARDS (REasons for Geographic And Regional Differences in Stroke) participants.","authors":"K F Morton, J E Scheinuk, S Bowman, H D Nanavati, S A Clarkson, V Bittner, K A Williams, T B Plante, J M Shikany, S E Judd","doi":"10.1093/ajh/hpaf063","DOIUrl":"https://doi.org/10.1093/ajh/hpaf063","url":null,"abstract":"<p><strong>Background: </strong>Diet contributes to the development of hypertension. We examined associations between five dietary patterns and incident hypertension in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort.</p><p><strong>Methods: </strong>Participants without prevalent hypertension (blood pressure <130/80 mmHg or antihypertensive medication use) were evaluated at baseline and follow-up. Dietary patterns were developed using food frequency questionnaires. Diet adherence was divided into quartiles and Modified Poisson regression estimated risk ratios of incident hypertension by quartile. We adjusted for covariates sequentially. Sex and race interactions were tested with a priori stratified analyses. An identical sensitivity analysis was completed using the Joint National Comission-7 definition of hypertension, the prevailing hypertension definition at the time of enrollment (>140/90 mmHg or antihypertensive medication use).</p><p><strong>Results: </strong>Of 30,239 REGARDS participants, 3,423 met inclusion criteria and 1,439 (42.0%) developed hypertension. Participants highly adherent to the Alcohol/Salad pattern had an increased risk of incident hypertension [RR=1.12, 95% CI (1.00, 1.27)]. This persisted in White females after controlling for alcohol [RR=1.27, 95% CI (1.04, 1.54)]. The remaining dietary patterns had no associations in fully adjusted models. Sex/race interactions were not significant. The sensitivity analysis included 6,582 participants, of whom 2,295 (34.9%) developed hypertension. No associations were found between diet and incident hypertension in fully adjusted models.</p><p><strong>Conclusions: </strong>The Alcohol/Salad dietary pattern portends the highest risk of incident hypertension. No further associations existed between other dietary patterns and incident hypertension after adjusting for covariates. Our findings suggest that diet is contributory, but not an exclusive cause, of incident hypertension.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963021","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":"Home blood pressure monitoring among adolescents and young adults, NHANES 2009-2014.","authors":"Rushelle L Byfield, Eunhee Choi, Jordana B Cohen, Ian M Kronish, Michael Rakotz, Daichi Shimbo","doi":"10.1093/ajh/hpaf069","DOIUrl":"https://doi.org/10.1093/ajh/hpaf069","url":null,"abstract":"<p><strong>Background: </strong>Among middle aged and older adults, home blood pressure (BP) monitoring (HBPM) is a tool for both diagnosis and management of hypertension. Pediatric guidelines recommend HBPM as an adjunct to office BP measurement among children and adolescents with hypertension. Little is known about the prevalence and frequency of HBPM in the US among youth with hypertension, and what factors are associated with HBPM use.</p><p><strong>Methods: </strong>We examined data from NHANES (National Health and Nutrition Examination Survey) 2009-2014 cycles to determine HBPM use in adolescents (16 to <20 years) and young adults (20 to <25 years), n=2919. HBPM frequency was defined as none, less than once a month, or at least monthly. Using multivariable logistic regression, we assessed the association between HBPM and sociodemographic factors including age, sex, race/ethnicity, obesity, income, insurance status, and education.</p><p><strong>Results: </strong>An estimated 10.3% of adolescents and young adults reported performing HBPM in the past year. Of those with hypertension, 22.8% reported performing any HBPM in the past year. Compared to adolescents, a higher percentage of young adults reported performing HBPM (12.5% vs 7.3%). In adjusted models, having health insurance [OR 1.84 (95%CI 1.25 -2.73)], high school education or greater [OR 1.79 (95%CI 1.13 -2.82), and obesity [OR 1.83 (95%CI 1.10 -3.05)] were associated with reporting any HBPM use.</p><p><strong>Conclusions: </strong>In this analysis of nationally representative US data, HBPM was reported in less than a quarter of adolescents and young adults with hypertension. Obesity, insurance status, and education were associated with any HBPM use.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965911","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":"The association between neck circumference and cardiac electrical remodeling in Chinese hypertension patients with obesity: A cross-sectional study.","authors":"Pengjie Gao, Danni Wang, Tingting Zheng, Xiyang Li, Chaodi Luo, Suining Xu, Gang Tian","doi":"10.1093/ajh/hpaf064","DOIUrl":"https://doi.org/10.1093/ajh/hpaf064","url":null,"abstract":"<p><strong>Background: </strong>Hypertension and obesity promote cardiac electrical remodeling. Neck circumference (NC) was correlated with cardiometabolic diseases. This study investigated the association between NC and cardiac electrical remodeling among Chinese hypertensive adults with obesity.</p><p><strong>Methods: </strong>1,123 hospitalized hypertension patients were finally included after excluding patients with secondary hypertension, atrial fibrillation, severe hepatic or renal disorders and cancers. They were classified into four groups according to obesity status and the median NC values. Atrial electrical remodeling was defined by P-wave dispersion (Pwd) and the maximum P-wave duration (Pmax). Increased transmural dispersion of ventricular repolarization (TDR) was defined by Tpeak-to-Tend interval (Tpe) and Tpe/QT. The correlations between NC and cardiac electrical remodeling were evaluated using restricted cubic spline (RCS), logistic regression and receiver operating characteristic curve (ROC). Stratified analysis was applied to evaluate differences in different subgroups.</p><p><strong>Results: </strong>Total participants included 479 (42.7%) obesity patients, of which the median NC was 41cm. RCS showed the risk of atrial electrical remodeling increased exponentially when NC exceeded 37.73cm. In hypertension patients with obesity, NC was independently associated with atrial electrical remodeling after adjusting for confounding factors. Stratified analysis showed a strong correlation between NC and atrial electrical remodeling in males and snoring patients. ROC suggested that NC can identify atrial electrical remodeling. Regarding the ventricular electrical remodeling, NC was only correlated with TDR, but not associated with traditional ventricular remodeling parameters.</p><p><strong>Conclusions: </strong>Large NC is an independent risk factor for atrial electrical remodeling in Chinese hypertension patients with obesity, especially for males and snoring patients.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955889","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":"Cardiac Biomarkers in Pregnancies with and without Hypertension.","authors":"Lara C Kovell, Mawulorm K I Denu, Julia Berkowitz, Sravya Shankara, Cassie Shao, Ekaterina Skaritanov, Gianna Wilkie, Tiffany A Moore Simas, Stephen P Juraschek","doi":"10.1093/ajh/hpaf061","DOIUrl":"https://doi.org/10.1093/ajh/hpaf061","url":null,"abstract":"<p><strong>Background: </strong>Mechanisms of injury due to hypertension (HTN) in pregnancy remain poorly characterized. This study examined trends in markers of cardiac injury (high-sensitivity troponin I, hs-cTnI), strain (N-terminal pro-B-type natriuretic peptide, NT-proBNP), and inflammation (high-sensitivity C-reactive protein, hs-CRP) in pregnancies with and without HTN.</p><p><strong>Methods: </strong>This prospective, 1:1 case-control study enrolled pregnant women with and without HTN (24-32 weeks gestation) from 2019-2022. HTN was defined by a clinical diagnosis of HTN or baseline blood pressure (BP)≥140/90 mmHg. Serum was collected at baseline, pre-delivery, and postpartum day 1. Mixed effects tobit models compared log-transformed hs-cTnI, NT-proBNP, and hs-CRP across HTN groups and over time, adjusted for age and BMI.</p><p><strong>Results: </strong>Mean baseline BP was 130.5 (17.5)/88.2 (13.5) mmHg for the HTN group (n=38, 86.8% chronic, 13.2% gestational HTN), and 112.0 (9.8)/70.9 (8.2) mmHg for those without HTN (n=38). Over pregnancy, the HTN group had higher hs-cTnI than those without HTN (2.12 [0.43] vs. 1.07 [0.25], Δ1.05 [95%CI: 0.07-2.03] ng/L). Compared to baseline, hs-cTnI increased at pre-delivery and postpartum for both groups. Overall, the two groups had similar NT-proBNP (HTN: 39.0 [4.5] vs. no HTN: 35.6 [4.3] pg/mL) and hs-CRP (HTN: 12.0 [1.7] vs. no HTN: 9.9 [1.5] mg/L). For both groups, NT-proBNP and hs-CRP increased from baseline to postpartum (NT-proBNP, HTN: 127% [58-227%], no HTN: 120% [51-219%]; hs-CRP: HTN: 550% [343-853%], no HTN: 664% [415-1034%]).</p><p><strong>Conclusion: </strong>HTN was associated with markers of cardiac injury during pregnancy, while delivery alone led to increases in markers of strain and inflammation. These biomarker changes associated with HTN in pregnancy may represent potential mechanisms to explain adverse cardiovascular events.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956389","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}