American heart journal最新文献

{"title":"Corrigendum to “Medical treatment of hypercortisolism with relacorilant: Final results of the phase 3 GRACE study” [American Heart Journal 278S (2024) Pages 10-11]","authors":"Rosario Pivonello , Giorgio Arnaldi , Richard J. Auchus , Corin Badiu , Robert S. Busch , Salvatore Cannavo , Ulrich Dischinger , Georgiana A. Dobri , Diane Donegan , Atanaska Elenkova , Pouneh K. Fazeli , Richard A. Feelders , Rogelio Garcia-Centeno , Aleksandra Gilis-Januszewska , Oksana Hamidi , Zeina C. Hannoush , Harold J. Miller , Aurelian-Emil Ranetti , Monica Recasens , Martin Reincke , Andreas G. Moraitis","doi":"10.1016/j.ahj.2025.107286","DOIUrl":"10.1016/j.ahj.2025.107286","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107286"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681385","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":"Anatomical, physiological and inflammatory characterization of nonculprit vessels in patients undergoing primary PCI for ST-elevation myocardial infarction in the presence of multivessel disease: Rationale and design of the PICNIC study","authors":"Michael Mahmoudi PhD ,&nbsp;Zoe Nicholas BSc ,&nbsp;Richard J. Jabbour PhD ,&nbsp;James Shambrook BM ,&nbsp;Ausami Abbas MBBS ,&nbsp;Tevin Browne MBBS ,&nbsp;Jonathan Hinton DM ,&nbsp;Charalambos Antoniades FMedSci ,&nbsp;Mamas Mamas DPhil ,&nbsp;Jonathon Leipsic PhD ,&nbsp;Campbell Rogers MD ,&nbsp;Bon-Kwon Koo PhD ,&nbsp;Rasha Al-Lamee PhD ,&nbsp;Evangelos Kontopantelis PhD ,&nbsp;Nick Curzen PhD","doi":"10.1016/j.ahj.2025.107298","DOIUrl":"10.1016/j.ahj.2025.107298","url":null,"abstract":"<div><h3>Background</h3><div>Up to 50% of patients presenting with ST-elevation myocardial infarction (STEMI) have multivessel coronary artery disease (CAD). Randomized trials suggest that complete revascularization improves outcomes, but the mechanism and identification of patients who benefit remain unclear. This study aims to assess the association between blood and coronary imaging biomarkers and clinical events, to identify patient-, vessel-, and lesion-specific risk in STEMI patients with bystander disease.</div></div><div><h3>Method</h3><div>PICNIC is a multicenter, international, prospective, observational study enrolling 320 patients with STEMI and multivessel CAD undergoing primary PCI of the culprit vessel without complete revascularization. Participants will undergo blood sampling for inflammatory markers and coronary CT angiography (CTCA) to assess: (1) plaque burden and morphology, (2) artificial intelligence-enabled fractional flow reserve derived from CTCA (FFR_CT) analysis of plaque and hemodynamic features, and (3) fat attenuation index (FAI) to evaluate perivascular inflammation.</div><div>The primary analysis will evaluate the association between a composite 24-month clinical endpoint (including all-cause mortality, myocardial infarction, ischemia-driven revascularization as first layer and cardiac arrest, heart failure, stroke, and ventricular tachyarrhythmia (second layer)) and: (1) serum inflammatory markers, and (2) anatomical and physiological characteristics of non–infarct-related arteries (NIRA) assessed by CTCA, FFR_CT, and FAI. Statistical and machine learning methods will be applied to determine which combinations of clinical, imaging, and biomarker data best predict patient-, vessel-, and lesion-specific risk.</div></div><div><h3>Conclusion</h3><div>PICNIC will characterize the anatomical, physiological, and inflammatory features of NIRA lesions in STEMI patients treated with culprit-only PCI in order to develop an AI-based risk prediction model. If such a model is successful it could be used to inform personalized revascularization strategies.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107298"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450621","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":"Enhancing risk stratification for incident systolic heart failure through machine learning and natural language processing","authors":"Sirtaz Adatya MD ,&nbsp;Anika S. Naidu MD ,&nbsp;Keane K. Lee MD ,&nbsp;Andrew P. Ambrosy MD, MPH ,&nbsp;Amir W. Axelrod MD ,&nbsp;Howard H. Dinh MD ,&nbsp;Eric Au MD ,&nbsp;Ankeet S. Bhatt MD ,&nbsp;Thida C. Tan MPH ,&nbsp;Rishi V. Parikh MPH ,&nbsp;Alan S. Go MD","doi":"10.1016/j.ahj.2025.09.012","DOIUrl":"10.1016/j.ahj.2025.09.012","url":null,"abstract":"<div><h3>Background</h3><div>Clinical guidelines advocate use of validated risk models in patients experiencing heart failure with reduced ejection fraction (HFrEF) to inform prognosis and assist with management. We developed models for worsening HF (WHF) hospitalizations and death within 1 year of incident HFrEF using data available within electronic health records (EHR).</div></div><div><h3>Methods</h3><div>Adults with incident HFrEF were identified from 2013 to 2022 within an integrated healthcare delivery system. We developed decision tree-based models to estimate risks of WHF hospitalization and death within 1 year of the incident HFrEF date. WHF hospitalizations were ascertained using validated natural language processing algorithms. We evaluated the models using cross-validation and measured final performance (i.e., model discrimination using area under the curve [AUC] and model calibration using the Brier score and calibration plots) on a contemporary hold-out test set of patients from 2021 to 2022.</div></div><div><h3>Results</h3><div>Among 28,292 adults with incident HFrEF, 17.3% experienced WHF hospitalization and 15.1% all-cause death at 1 year of follow-up. We observed an AUC of 0.698 (95% CI: 0.682-0.714) for WHF hospitalization and 0.849 (95% CI: 0.836-0.861) for death and calibrated with a wide range of predicted risks. In comparison, a claims-based risk score displayed an AUC of 0.577 (95% CI: 0.570-0.606) for WHF hospitalization and a smaller dynamic range. Of patients classified as high risk for WHF hospitalization, only 12.0% were receiving full guideline-directed medical therapy at 6 months after HFrEF diagnosis.</div></div><div><h3>Conclusion</h3><div>Risk models derived using EHR-based data elements can predict both 1-year WHF hospitalization and all-cause mortality in adults with incident HFrEF more accurately than claims-based approaches. These models can be used to improve population management and better target personalized strategies of care.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107280"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136230","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":"Bioimpedance phase angle is associated with increased heart failure hospitalization risk","authors":"Kivanc Ozonat PhD ,&nbsp;Corey Centen B.Eng ,&nbsp;Sarah Smith B.Eng ,&nbsp;V. Burak Aydemir PhD ,&nbsp;Marat Fudim MD, MHS ,&nbsp;Adam D. DeVore MD, MHS","doi":"10.1016/j.ahj.2025.107288","DOIUrl":"10.1016/j.ahj.2025.107288","url":null,"abstract":"<div><h3>Background</h3><div>Outcomes for patients living with heart failure (HF) remain poor with high rates of death and hospitalization due to worsening HF. Noninvasive tools may be useful to identify patients at risk for disease progression before these outcomes occur. For example, loss of cell mass and compromised cell membrane integrity throughout the body are associated with chronic disease, mortality, frailty, and malnutrition. As the cell membrane loses its integrity, its electrical capacitance decreases, lowering bioelectrical phase angle. Data collected during the SCALE-HF 1 study (NCT04882449) was used to evaluate bioelectrical phase angle as a marker for heart failure (HF) hospitalization risk. Phase angle was measured by the FDA-cleared Bodyport Cardiac Scale.</div></div><div><h3>Methods</h3><div>SCALE-HF 1 was a multicenter, prospective, observational study, investigating HF event prediction. Baseline phase angle was measured during the first week in the study with the patient standing barefoot on the Cardiac Scale at home for approximately 20 seconds. HF hospitalizations were independently adjudicated. The analysis was based on univariable and multivariable Cox regression models adjusted for age, sex, race, body mass index (BMI), left ventricular ejection fraction (LVEF), inpatient status at enrollment, and selected comorbidities and laboratory tests.</div></div><div><h3>Results</h3><div>329 participants with HF were enrolled across 8 US sites with 238 patient-years of follow-up. 312 (95%) of the participants had a baseline phase angle, and 57 (18%) of those had a HF hospitalization during the follow-up period. Participants with baseline phase angle in the lowest quartile (suggesting worse cell membrane integrity) were at increased risk for HF hospitalization compared to participants with baseline phase angle in the highest quartile (Hazard ratio: 3.44, 95% CI: 1.55 to 7.63, <em>P</em> = .002). When adjusted for risk factors selected from age, sex, race, BMI, LVEF, laboratory tests and comorbidities in the multivariable model, participants with baseline phase angle in the lowest quartile continued to be at increased risk for HF hospitalization compared to participants with baseline phase angle in the highest quartile (Hazard ratio: 3.51, 95% CI: 1.73 to 7.12, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Phase angle was found to be independently associated with HF hospitalization risk. The noninvasive measurement, acquired with a familiar scale form factor, may help guide remote care and triage.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov NCT04882449. <span><span>https://clinicaltrials.gov/study/NCT04882449</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107288"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249401","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":"Cumulative effect of hyperglycemia and insulin resistance on cardiac dysfunction: The coronary artery risk development in young adults (CARDIA) study","authors":"Yilin Yoshida PhD ,&nbsp;Yuanhao Zu MS ,&nbsp;David Aguilar MD ,&nbsp;Keith C. Ferdinand MD ,&nbsp;Vivian A. Fonseca MD","doi":"10.1016/j.ahj.2025.09.008","DOIUrl":"10.1016/j.ahj.2025.09.008","url":null,"abstract":"<div><div>We investigated whether cumulative fasting glucose (FG) and insulin resistance (IR) over 20 years are associated with midlife cardiac dysfunction in young adults with or without type 2 diabetes (T2D)/prediabetes. We included young adults with T2D/prediabetes (N = 279) and matched euglycemic individuals (N = 514) who had repeated measures of fasting glucose (FG) and insulin resistance (IR) and echocardiography assessment from the Coronary Artery Risk Development in Young Adults study (CARDIA). We found that cumulative hyperglycemia is associated with midlife diastolic dysfunction in patients with early-onset T2D, and sustained IR negatively affects systolic and diastolic function regardless of T2D status.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107276"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091098","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":"Letter to the Editor regarding “Association between vasopressin administration and mortality in patients with cardiogenic shock”","authors":"Niloufar Dadashpour MD,&nbsp;Majid Golestanieraghi MD","doi":"10.1016/j.ahj.2025.09.001","DOIUrl":"10.1016/j.ahj.2025.09.001","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107269"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681379","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":"Cerebral embolic protection in TAVR: Moving beyond all-comers to a targeted high-risk approach","authors":"Artur Dziewierz MD, PhD ,&nbsp;Paweł Kleczyński MD, PhD","doi":"10.1016/j.ahj.2025.09.007","DOIUrl":"10.1016/j.ahj.2025.09.007","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107275"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681384","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":"Design and rationale of aspirin versus aspirin and fondaparinux prior to early invasive strategy in patients with NSTEMI: The FOXY trial","authors":"Christian Byskov Fur MD ,&nbsp;Niels Thue Olsen MD, PhD ,&nbsp;Jens Flensted Lassen MD, PhD ,&nbsp;Ashkan Eftekhari MD ,&nbsp;Carsten Stengaard MD, PhD ,&nbsp;Claus Kjær Pedersen MD, PhD ,&nbsp;Martin Bøhme Rasmussen MD, PhD ,&nbsp;Christian Juhl Terkelsen MD, DmSC, PhD","doi":"10.1016/j.ahj.2025.09.006","DOIUrl":"10.1016/j.ahj.2025.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines recommend a combination therapy with aspirin and a parenteral anticoagulant in patients with non-ST-elevation myocardial infarction (NSTEMI) prior to invasive assessment. However, these recommendations are based on clinical trials conducted at a time when NSTEMI patients were not routinely assessed invasively. Today, nearly all NSTEMI patients in Denmark undergo coronary angiography within 72 hours, and the necessity of routine anticoagulation remains uncertain. The FOXY trial aims to assess whether aspirin alone is noninferior to a combination therapy with aspirin and fondaparinux in preventing death, recurrent myocardial infarction, and refractory ischemia while lowering the risk of bleeding.</div></div><div><h3>Trial Design</h3><div>The FOXY trial is a multicenter, open-label, noninferiority, randomized controlled trial enrolling 5,076 patients with NSTEMI. Participants will be randomized 1:1 to receive either aspirin alone or aspirin plus fondaparinux before invasive evaluation. The primary endpoint is a composite of 30-day mortality, recurrent MI, and refractory ischemia. Secondary outcomes include long-term ischemic events, cerebrovascular accidents, left ventricular function, hospital length of stay, and major bleeding. The study will be conducted across multiple cardiology centers, with the first patients enrolled in spring 2025.</div></div><div><h3>Conclusion and Perspective</h3><div>The FOXY trial is the first study to investigate parenteral anticoagulant use in NSTEMI patients undergoing routine invasive management. By comparing aspirin alone to combination therapy, the study seeks to challenge current guideline recommendations and potentially simplify NSTEMI treatment. If noninferiority is demonstrated, the trial may support a shift toward a safer and more cost-effective management of NSTEMI patients. This could lead to a revision of clinical guidelines, minimizing bleeding risk, improving patient safety, and reducing healthcare costs.</div></div><div><h3>Trial registration</h3><div>EU Trial Number: 2024-517229-18-00; ClinicalTrials.gov identifier: NCT06710184.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107274"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058249","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":"Yoga vs regular exercise for atrial fibrillation: Design of the yoga-AF randomized controlled trial","authors":"Rose Crowley Bmed, MD ,&nbsp;Sonia Azzopardi RN ,&nbsp;Annie Curtin RN ,&nbsp;Georgia Rendell RN ,&nbsp;Louise Segan MBBS ,&nbsp;Jeremy William MBBS ,&nbsp;Kenneth Cho MBBS ,&nbsp;Nicholas D’Elia MBBS ,&nbsp;Margareta Sutija PhD ,&nbsp;Tommy Kende MBBS, PhD ,&nbsp;David Chieng MBBS, PhD ,&nbsp;Hariharan Sugumar MBBS, PhD ,&nbsp;Aleksandr Voskoboinik MBBS, PhD ,&nbsp;Sandeep Prabhu MBBS, PhD ,&nbsp;Liang-Han Ling MBBS, PhD ,&nbsp;Vaughan G Macefield BSc, PhD, DSc ,&nbsp;Jonathan M Kalman MBBS, PhD ,&nbsp;Peter M Kistler MBBS, PhD","doi":"10.1016/j.ahj.2025.09.010","DOIUrl":"10.1016/j.ahj.2025.09.010","url":null,"abstract":"<div><h3>Background</h3><div>Lifestyle modification is a key pillar of atrial fibrillation (AF) management. Yoga has beneficial effects on cardiovascular health and has shown promise as an intervention in AF. However, randomized data are absent.</div></div><div><h3>Objectives</h3><div>To determine the effect of regular yoga on AF episodes and AF burden in people with paroxysmal or persistent AF over a 12-month period.</div></div><div><h3>Methods</h3><div>This is a randomized control trial of a yoga program in addition to standard care, compared to standard care alone in people with paroxysmal or persistent AF undergoing a rhythm control management strategy. 222 participants will be randomized 1:1 to the yoga intervention or control. Yoga will be conducted in studio and online with a target of at least 3 classes/week. Controls will be instructed to exercise for at least 150 minutes/week. Rhythm monitoring will be with implantable loop recorder, or ECG capable smartwatch with AF detection and twice daily ECGs. Autonomic metrics will be assessed in the laboratory by HRV, blood pressure variability and direct recordings of muscle sympathetic nerve activity. Following a 3-month training period, the dual primary endpoints of AF recurrence (time to recurrence, as defined by any sustained atrial tachyarrhythmia lasting &gt;1 hour) and AF burden will be determined at 12 months.</div></div><div><h3>Conclusions</h3><div>This study aims to determine the impact of yoga on AF recurrence and burden in people with paroxysmal and persistent AF. Yoga may provide an effective noninvasive, nonpharmacologic lifestyle strategy in the management of AF.</div></div><div><h3>Trial Registration</h3><div>The trial was preregistered with the Australian New Zealand Clinical Trials Registry (ACTRN12624000264583).</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107278"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136249","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":"Developing therapeutics for rare cardiovascular diseases","authors":"Joseph B Lerman MD ,&nbsp;Dwight D. Koeberl MD, PhD ,&nbsp;Shilpi Epstein MD ,&nbsp;Lothar Roessig MD ,&nbsp;Rodica Stan PhD ,&nbsp;Meghan Halley PhD ,&nbsp;Anjali T. Owens MD ,&nbsp;Barry Greenberg MD ,&nbsp;Kevin M. Alexander MD ,&nbsp;Sharlene M. Day MD ,&nbsp;Mathew S. Maurer MD ,&nbsp;Eric D. Adler MD ,&nbsp;Adrian F. Hernandez MD ,&nbsp;Euan A Ashley MD, PhD ,&nbsp;G. Michael Felker MD","doi":"10.1016/j.ahj.2025.09.004","DOIUrl":"10.1016/j.ahj.2025.09.004","url":null,"abstract":"<div><div>Rare cardiovascular diseases, while individually uncommon, collectively affect millions of people worldwide and are associated with significant morbidity, mortality, and economic burden. Despite this considerable impact, most rare cardiovascular diseases lack approved treatments. Developing therapies for rare cardiovascular diseases requires overcoming a unique set of challenges<strong>.</strong> This includes barriers to accurate patient diagnosis (and therefore to trial cohort generation), small cohort sizes, the choice of effective clinical trial endpoints, unique ethical and regulatory concerns, and the often-substantial costs of such therapies (which may limit public access to treatment). Despite such challenges, the past decade has witnessed a significant increase in the successful development of rare cardiovascular disease therapies. This review provides an overview of the challenges, while also highlighting potential strategies to advance the field.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107272"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063085","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}