American journal of physiology. Heart and circulatory physiology最新文献

{"title":"Mutations in the Txnip PPXY motifs protect against myocardial infarction despite enhanced protein stability.","authors":"Yoshinobu Nakayama, Atsuhiro Kitaura, Syed Amir Abdali, Truong D Nguyen, Jun Yoshioka","doi":"10.1152/ajpheart.00023.2026","DOIUrl":"10.1152/ajpheart.00023.2026","url":null,"abstract":"<p><p>Thioredoxin-interacting protein (Txnip), a member of α-arrestin superfamily, is best known for inhibiting thioredoxins and glucose transporters, increasing oxidative and metabolic stress. Through these functions, Txnip has emerged as a key contributor to the pathogenesis of heart diseases. Txnip contains C-terminal PPXY motifs that are conserved among α-arrestins across diverse species. Nevertheless, the physiological significance of these motifs remains unknown. We demonstrate that mutation of Txnip PPXY motifs to AAXA uncouples Txnip's canonical functions from its cytotoxic effects. Although the mutant reduced glutathione levels and glucose uptake to the same extent as wild-type Txnip, it attenuated cell death. To assess translational relevance, we engineered inducible, cardiomyocyte-restricted Txnip PPXY-to-AAXA knock-in mice. These mice displayed normal cardiac structure and function at baseline but were strongly protected after myocardial infarction, exhibiting improved left ventricular performance and overall survival. Mechanistically, structural modeling identified the E3 ubiquitin ligase ITCH as the principal PPXY-binding partner. The PPXY mutation abolished Txnip ubiquitination and stabilized Txnip protein, revealing a paradoxical dissociation between Txnip levels and cardiotoxicity. Transcriptomic profiling uncovered enrichment of PPAR-α/PGC-1α-associated pathways, although metabolic assays and untargeted lipidomics did not support these findings. Instead, immediate early genes of the Fos/Jun AP-1 network were consistently downregulated after ischemic injury, and AP-1 DNA-binding activity was diminished in PPXY mutant hearts. These results identify the Txnip PPXY motifs as key regulators of Txnip protein turnover and injury-responsive transcriptional programs. Disruption of these motifs stabilizes Txnip yet confers cardioprotection, providing evidence that elevated Txnip levels do not invariably drive cardiotoxicity.<b>NEW & NOTEWORTHY</b> This study reveals that Txnip's conserved PPXY motifs regulate its cytotoxicity independently of its canonical redox and metabolic functions. Mutating motifs (PPXY-to-AAXA) uncouples Txnip function from cell death, stabilizes the protein by preventing Itch-mediated ubiquitination, and confers striking cardioprotection in knock-in mice after myocardial infarction. Despite elevated Txnip levels, mutant hearts show reduced AP-1 signaling and improved survival, demonstrating that PPXY-dependent pathways, not Txnip abundance, drive cardiotoxicity.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1732-H1748"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primed for metabolic syndrome: evidence of cardiac mitochondrial dysfunction preceding disease.","authors":"Gemma Vilahur, Gabriela O Girón, Sebastià Alcover, Teresa Padró","doi":"10.1152/ajpheart.00248.2026","DOIUrl":"10.1152/ajpheart.00248.2026","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1729-H1731"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posture matters: how body position shapes cardiopulmonary response to maximal exercise testing.","authors":"Massimo Mapelli, Fiorella Puttini, Irene Mattavelli, Elisabetta Salvioni, Arianna Galotta, Giovanni Ferrarini, Mattia Canevari, Robin Willixhofer, Rebecca Caputo, Simona Costantino, Matteo Biroli, Camilla Lustri, Davide Grandi, Andrea Teglia, Massimo Valenti, Piergiuseppe Agostoni","doi":"10.1152/ajpheart.00068.2026","DOIUrl":"10.1152/ajpheart.00068.2026","url":null,"abstract":"<p><p>Body posture influences cardiovascular and respiratory responses during exercise, yet in a clinical setting, differences in body positions are not considered when comparing different methodologies analyzing physical effort, such as cardiopulmonary exercise testing (CPET), stress echo, or invasive hemodynamic. We aimed to investigate how upright (UP), semirecumbent (SR), and supine (SP) positions affect key CPET variables and cardiac output (CO) in healthy adults. Twelve healthy volunteers (30.9 ± 4.4 yr; 50% female) performed three randomized CPETs in UP, SR, and SP positions. Breath-by-breath gas exchange data [oxygen uptake (V̇o₂) carbon dioxide production (V̇co₂), minute ventilation (V̇e), tidal volume (TV), respiratory rate (RR)] and hemodynamic parameters [CO by thoracic bioimpedance, stroke volume (SV), heart rate (HR)] were continuously monitored. Data were analyzed at rest, anaerobic threshold, iso-watt stages, and peak exercise. At rest and submaximal workloads, HR decreased, and SV increased with more reclined positions, maintaining CO. V̇e and TV were lower in SR and SP positions, whereas RR and peripheral oxygen saturation ([Formula: see text]) were unchanged. At peak exercise, V̇o₂, V̇co₂, workload, and exercise duration declined progressively from UP to SP (V̇o₂: 2,587 ± 1,009, 2,520 ± 982, 2,269 ± 847 mL/min; <i>P</i> < 0.001), with lower V̇e driven by reduced TV. Despite reduced metabolic and ventilatory demands, CO was unchanged via increased SV. Dyspnea perception was lower in reclined postures. Body posture modulates cardiopulmonary responses during exercise. Semirecumbent and supine positions reduce V̇o₂ and V̇e preserving CO. These findings highlight the importance of posture-specific reference values for accurate interpretation in clinical practice.<b>NEW & NOTEWORTHY</b> Body position during exercise testing profoundly affects cardiopulmonary responses, even in healthy individuals. Results obtained in different postures are not directly comparable. Upright, semirecumbent, and supine exercise produce systematic changes in oxygen uptake, ventilation, workload, and dyspnea, with lower performance in reclined positions. Despite this, cardiac output is preserved through adjustments in heart rate and stroke volume, indicating that posture-rather than cardiac dysfunction-drives differences. Without posture-specific reference values, disease severity may be misinterpreted.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1715-H1722"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"There is strength in numbers: the case for another model of cardiometabolic HFpEF.","authors":"Sadia Ashraf, Hunter A Hidalgo, Romain Harmancey","doi":"10.1152/ajpheart.00300.2026","DOIUrl":"10.1152/ajpheart.00300.2026","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1723-H1725"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking aortic stenosis quantification: from linear assumptions to sigmoid reality-critical considerations for clinical translation.","authors":"Sachiko Kanki","doi":"10.1152/ajpheart.00267.2026","DOIUrl":"10.1152/ajpheart.00267.2026","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1726-H1728"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular flow dynamics in preterm infants assessed with high frame rate echocardiography with blood speckle tracking.","authors":"Koert de Waal, Edward Crendal, Solveig Fadnes, Kristian Soerensen, Siri Ann Nyrnes","doi":"10.1152/ajpheart.00111.2026","DOIUrl":"https://doi.org/10.1152/ajpheart.00111.2026","url":null,"abstract":"<p><p>Background The typical intracardiac blood flow pattern of a healthy left ventricle includes vortex formations to help store energy, facilitate valve closure and propagation of blood flow toward the outflow tract. Intracardiac blood flow patterns can be visualised with high frame rate echocardiography with blood speckle tracking (BST) and analysed for measures of cardiac efficiency such as kinetic energy (KE), energy loss (EL), vorticity (VO) and vortex complexity (VC). Preterm infants are at high risk of cardiac compromise, but mechanistic pathways are unclear. The aim of this study is to gather BST reference values in stable preterm infants. Methods Stable low risk preterm infants < 30 weeks gestation underwent echocardiography with BST early and late in the neonatal admission period. PyUSview software was used for intracardiac flow analysis. Results 55 stable preterm infants we included. KE, EL, VO and VC were significantly higher in diastole when compared to systole and most BST parameters increased during the admission period. EL/KE as measure of cardiac efficiency remained stable around 3% during systole, but EL/KE during diastole increased from 4.9 to 9.2% along with increasing E and A velocities, which is higher than reported in healthy term infants. Conclusion Reference ranges of BST intracardiac flow parameters in stable low risk preterm infants suggest relatively poor cardiac inflow efficiency due to high EL. This data can assist in the development of further clinical applications for BST in preterm infants, such as predicting disease progression, monitoring treatments and early diagnosis of adverse LV remodeling.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Pregnancy Obesity, Gestational Weight Gain, and Their Relationship with Maternal Lipid Levels at Delivery Across Racial and Ethnic Populations.","authors":"Xinyuan X Laufer, Antonina I Frolova, Nandini Raghuraman, Samantha L Martin, Sarah K England, Molly J Stout, Valene Barry","doi":"10.1152/ajpheart.00927.2025","DOIUrl":"https://doi.org/10.1152/ajpheart.00927.2025","url":null,"abstract":"<p><p>Maternal dyslipidemia is associated with adverse pregnancy outcomes and long-term cardiovascular risk. Pre-pregnancy obesity and excessive gestational weight gain may exacerbate dysfunctional lipid profiles, particularly at full term gestation when lipid burden peaks. However, studies on maternal lipids at delivery are lacking. This study aims to examine the associations of pre-pregnancy BMI (pBMI) and gestational weight gain (GWG) with maternal lipids at delivery across a cohort composed of two dominant ethnicities. This was a secondary analysis of a prospective study and comprised of 500 singleton pregnancies delivering at term (≥37 weeks). The association of pBMI and GWG with total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) were examined by multivariate models. Analyses adjusted for potential confounders and stratified by race. Sensitivity analyses omitted gestational diabetes and hypertensive disorders. Participants had pBMI of 28.4 ± 7.5 kg/m² and GWG of 26.5 ± 15.0 lbs. The pBMI was inversely associated with HDL-C only among White women (p<0.01). GWG distribution varied by pBMI (p<0.0001). Among women with obesity, GWG was positively associated with HDL-C in the full cohort and in Black women and inversely associated with TC and LDL-C in White women. Associations with GWG were attenuated after excluding those with gestational diabetes or hypertensive disorders. GWG and pBMI shape maternal lipid profiles at delivery with substantial differences between White and Black patients. One-size-fits-all guidelines for pBMI and GWG may not appropriately manage maternal dyslipidemia and address associated adverse pregnancy outcomes or long-term cardiovascular morbidity.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absolute and Workload-indexed Exercise Blood Pressure responses: Associations with cardiac output, vascular resistance and cardiorespiratory fitness in females.","authors":"Kristel Janssens, Erin J Howden, Amy M Mitchell, Leah Wright, Rachel E Climie, Evelyn B Parr, Mark J Haykowsky, Andre La Gerche, Stephen J Foulkes","doi":"10.1152/ajpheart.00015.2026","DOIUrl":"https://doi.org/10.1152/ajpheart.00015.2026","url":null,"abstract":"<p><p>During exercise, vascular resistance - the ratio of arterial pressure to blood flow (i.e., cardiac output (CO)) - is an important component of the hemodynamic response determining peak oxygen uptake (V̇O_2peak). However, how systolic blood pressure (SBP) responses reflect this pressure-flow relationship, and their association with V̇O_2peak remain incompletely understood. We performed cardiopulmonary exercise testing in 135 females (51±8 years) across a broad fitness spectrum to evaluate V̇O_2peak and SBP responses. SBP responses were stratified by maximal SBP (SBP_max <190 mmHg or ≥190 mmHg) and workload-indexed SBP (SBP/W-slope; low vs. high based on sex- and age-specific median values). Peak CO (CO_peak) was quantified from exercise cardiac magnetic resonance imaging. SBP_max ≥190 mmHg occurred in 74 participants (55%), high SBP/W-slope in 41 (30%), and 26 (19%) had both. A high SBP/W-slope was associated with lower V̇O_2peak (1.7±0.4 vs. 2.1±0.6 L/min, p<0.001), CO_peak (12.8±2.3 vs. 15.7±3.5 L/min, p<0.001) and higher total peripheral resistance (TPR_peak; 11.2±2.3 vs. 9.0±2.0 mmHg·min/L, p<0.001). In contrast, a low SBP/W-slope despite SBP_max ≥190 mmHg had the highest V̇O_2peak, CO_peak, and larger reductions in TPR compared with high SBP/W-slope groups. SBP_max ≥190 mmHg in isolation was associated with higher V̇O_2peak and CO_peak, although it also identified females with low-fitness and CO_peak. Thus, SBP/W-slope provides a framework for interpreting SBP relative to flow, with higher slopes indicating an unfavorable pressure-flow profile characterized by higher vascular resistance, lower CO_peak and reduced V̇O_2peak. In contrast, SBP_max reflects both flow and resistance. Incorporating SBP/W-slope may therefore improve identification of females with impaired pressure-flow regulation.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological sex modulates dynamic cerebral autoregulation and its directional sensitivity.","authors":"Lawrence Labrecque, Marc-Antoine Roy, Shahrzad Soleimani Dehanvi, Mahmoudreza Taghizadeh, Florence Pagé, Patrice Brassard","doi":"10.1152/ajpheart.00641.2025","DOIUrl":"https://doi.org/10.1152/ajpheart.00641.2025","url":null,"abstract":"<p><p>Dynamic cerebral autoregulation (dCA) exhibits directional sensitivity, characterized by greater buffering capacity of cerebral blood flow when mean arterial pressure (MAP) increases than when MAP decreases. Although dCA is known to differ between sexes, it remains unclear whether its hysteresis like pattern is sex dependent. In 35 healthy participants (17 females and 18 males; age: 29  7 years), we assessed the influence of sex on dCA and its directional sensitivity. Participants underwent seven minutes of oscillatory lower body negative pressure (OLBNP) at 0.05 Hz (20-s cycles) and 0.10 Hz (10-s cycles) while middle cerebral artery mean blood velocity (MCAv) and MAP were recorded. dCA was quantified using transfer function analysis (TFA) and absolute and relative directional sensitivity was assessed using time-corrected ratios of MCAv to MAP changes (ΔMCAv_T/ΔMAP_T and RelMCAv_T/RelMAP_T). TFA metrics did not differ between sexes at either oscillation frequency except TFA phase at 0.10 Hz OLBNP, which was higher in females (1.14  0.38 vs. 0.85  0.35 radians vs.; p=0.0431). At 0.05 Hz OLBNP, ∆MCAv_T/∆MAP_T showed neither a MAP direction effect (p = 0.0714) nor a biological sex effect (p = 0.0629). RelMCAv_T/RelMAP_T showed a MAP direction effect (p = 0.0405) but no biological sex effect. At 0.10 Hz, ∆MCAv_T/∆MAP_T demonstrated significant effects of MAP direction (p < 0.0001), biological sex (p = 0.0150) and their interaction (p = 0.0075). Post-hoc analysis revealed that ∆MCAv_T/∆MAP_T^INCREASE was lower than ∆MCAv_T/∆MAP_T^DECREASE in females only. These findings indicate that females exhibit better dCA and greater directional sensitivity at 0.10 Hz OLBNP.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attenuated Pressor and Sympathetic Neural Responses to Exercise in Long-Term Breast Cancer Survivors: Role of the Muscle Metaboreflex.","authors":"João E Izaias, Bruna E Ono, Artur O Sales, Thais S Rodrigues, Gabrielly Mps Silva, Roberta F Lima, Camila S Nunes, Matheus A Bittencourt, Priscilla S Pentagna, Vera Mc Salemi, Fernanda Mc Colombo, Maria Cc Irigoyen, Amanda G Rodrigues, Carlos E Negrão, Laura Testa, Katia de Angelis, Andreia M Porcari, Helena Nm Rocha, Gabriel F Teixeira, Natalia G Rocha, Antonio Cl da Nóbrega, Daniel H Craighead, Zachary S Clayton, Renata J Moll-Bernardes, Allan R K Sales","doi":"10.1152/ajpheart.00252.2026","DOIUrl":"https://doi.org/10.1152/ajpheart.00252.2026","url":null,"abstract":"<p><p>Previous studies have reported blunted increases in blood pressure (BP) during physical exercise in cancer survivors treated with cardiotoxic chemotherapy. However, the sympathetic neural mechanisms underlying this attenuated response remain unknown. We hypothesized that long-term breast cancer (BC) survivors exhibit impaired muscle metaboreflex function, which would partially explain the reduced sympathetic-cardiovascular responses to exercise. Nineteen BC survivors (age 49±2 years; body mass index [BMI] 27±1 kg/m²) and 14 sex-, age-, and BMI-matched controls (age 48±2 years; BMI 26±1 kg/m²) were studied. Muscle sympathetic nerve activity (MSNA, microneurography), mean arterial pressure (MAP, Finometer), stroke volume, cardiac output, and total peripheral resistance (SV, CO, and TPR; Modelflow), and heart rate (HR, ECG) were continually measured at baseline, during 3 min of static handgrip (HG) at 30% maximal voluntary contraction followed by post-exercise ischemia (PEI) to isolate muscle metaboreflex activation. BC survivors were evaluated ~ 9 years after treatment completion. Changes in MAP during HG were attenuated in BC survivors versus controls, and this difference persisted during PEI (Δ12.0±2.0 vs. 21.0±2.0 mmHg, <i>P</i>=0.001). Similarly, the MSNA burst frequency response to HG was lower in BC survivors than controls, and the difference remained during PEI (Δ3.0±1.0 vs. 9.0±1.0 bursts/min, <i>P</i>=0.001). SV and CO were reduced during HG in BC survivors (<i>P</i><0.05) but not during PEI. No group differences were observed in HR or TPR. Collectively, these findings indicate that the attenuated pressor and sympathetic neural responses to exercise in long-term BC survivors are explained, at least in part, by attenuated muscle metaboreflex control.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}