Cardiology最新文献

{"title":"The Role of Exosomes in Myocardial Ischemia-Reperfusion Injury.","authors":"Yu Gao, Lili Song, Jingtao Xu, Hangshun Li","doi":"10.1159/000542657","DOIUrl":"https://doi.org/10.1159/000542657","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction (AMI) is one of the critical and serious diseases in the cardiovascular system, and reperfusion therapy is the preferred treatment for AMI, but it often worsens cardiac injury and leads to myocardial ischemia reperfusion injury (MIRI), which can further result in arrhythmia, heart failure, and death.</p><p><strong>Summary: </strong>More and more studies have found that mesenchymal stem cells (MSCs)-derived exosomes play an important role in improving the cardiac injury after MIRI, and can exert anti-apoptosis, anti-inflammation, anti-fibrosis, and promotion of endothelial cells and angiogenesis functions. This review summarizes the mechanisms of action of exosomes in the treatment of MIRI and discusses exosomes as a new approach for the treatment of MIRI.</p><p><strong>Key messages: </strong>1) Exosomes play a variety of protective roles in MIRI by carrying miRNAs and other bioactive substances. 2) Exosomes can be used as carriers of drugs or active substances for the treatment of cardiovascular diseases.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-17"},"PeriodicalIF":1.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early and Late Outcomes of Ambulatory Counter Pulsation Devices as a Bridge to Heart Transplantation.","authors":"Hidefumi Nishida, Valluvan Jeevanandam, Christopher Salerno, Atsushi Nemoto, Tae Song, David Onsager, Ann Nguyen, Jonathan Grinstein, Bow Chung, Nitasha Sarswat, Gene Kim, Takeyoshi Ota","doi":"10.1159/000542871","DOIUrl":"https://doi.org/10.1159/000542871","url":null,"abstract":"<p><strong>Introduction: </strong>The intravascular ventricular assist device is a newly developed ambulatory and portable counter pulsation heart assist system. The purpose of this study was to compare the early and late outcomes of counter pulsation devices between intravascular ventricular assist system (iVAS) and axillary intra-aortic balloon pump (IABP) as a bridge to heart transplantation.</p><p><strong>Methods: </strong>This is a single-center, retrospective study. Between April 2016 and March 2020, 24 patients underwent iVAS implantation (Group A), and 73 patients underwent axillary IABP (Group B) as a bridge to heart transplantation. We reviewed and compared perioperative data, as well as late survival outcomes.</p><p><strong>Results: </strong>There were no significant differences in baseline characteristics. All patients in Group A and 97.3% of patients in Group B were able to ambulate and participate in physical therapy (p = 0.28). There were no in-hospital deaths in the two groups. The median duration of device support in Group A was significantly longer than in Group B (A: 37.0 days vs. B: 15.0 days, p < 0.01). After the US Food and Drug Administration approved the discharge of patients with an iVAS, 4 patients (4/14, 28.6%) were discharged home with the device. The success rate of bridge to transplantation was not significantly different between the groups (A: 21/24, 87.5% vs. B: 68/73, 93.2%, p = 0.40). Late survival after heart transplantation also did not differ between the groups (A: 85.7% at 3-year vs. B: 94.0% at 3-year, log rank = 0.22).</p><p><strong>Conclusion: </strong>Both iVAS and axillary IABP showed comparable success rates of bridge to transplantation and late survival after transplantation. The mobile design of iVAS facilitated excellent ambulatory capability and enabled patients to be discharged home.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Small-Airway Disease with Exercise Intolerance and Long-Term Outcomes in Patients with Heart Failure and Reduced or Preserved Ejection Fraction.","authors":"Daina Nagumo, Nobuaki Hamazaki, Kentaro Kamiya, Takashi Miki, Shuken Kobayashi, Kohei Nozaki, Takafumi Ichikawa, Masashi Yamashita, Shota Uchida, Takumi Noda, Kensuke Ueno, Ken Ogura, Emi Maekawa, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Junya Ako","doi":"10.1159/000542856","DOIUrl":"https://doi.org/10.1159/000542856","url":null,"abstract":"<p><strong>Introduction: </strong>Small airway is reportedly more susceptible than central airways in heart failure (HF), which may cause poor outcomes. We investigated clinical significance of small-airway disease (SAD) on exercise intolerance and clinical events in patients with HF and reduced or preserved left ventricular ejection fraction (LVEF).</p><p><strong>Methods: </strong>We studied consecutive patients with HF admitted for medical treatment and measured maximum mid-expiratory flow (MMEF) on spirometry and 6-min walking distance (6MWD) at hospital discharge. SAD and exercise intolerance were defined by MMEF relative to <60% of the predicted value and 6MWD <300 m, respectively. Endpoint was composite clinical events of all-cause death and/or HF readmission.</p><p><strong>Results: </strong>Among 1,016 studied patients, 478 (47.0%) had SAD, the prevalence of which was higher in patients with LVEF ≥40% than LVEF <40%. SAD correlated to 6MWD <300 m (adjusted odds ratio [aOR]: 4.23, 95% confidence interval [CI]: 2.49-7.19). This correlation was consistently observed in both LVEF <40% (aOR: 3.99, 95% CI: 1.59-9.98) and LVEF ≥40% (aOR: 4.50, 95% CI: 2.22-9.13). SAD also showed significant associations with high incidences of clinical events in all patients (adjusted hazard ratio [aHR]: 1.35, 95% CI: 1.05-1.72) and in LVEF <40% (aHR: 1.76, 95% CI: 1.21-2.54) but not in LVEF ≥40% (aHR: 1.10, 95% CI: 0.78-1.53).</p><p><strong>Conclusion: </strong>The prevalence of SAD is high in patients with HF, which is associated with exercise intolerance regardless of LVEF. Additionally, SAD may have a predictive significance for clinical events in these patients, especially in LVEF <40%.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocardiographic Strain and Relationship with Left Ventricular Remodelling and Clinical Outcomes in Patients with Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation.","authors":"Daanyaal Wasim, Abukar Mohamed Ali, Øyvind Bleie, Kjetil H Løland, Ronak Rajani, Svein Rotevatn, Sahrai Saeed","doi":"10.1159/000542529","DOIUrl":"10.1159/000542529","url":null,"abstract":"<p><strong>Introduction: </strong>Left ventricular (LV) remodelling and fibrosis are known to occur in patients with aortic stenosis (AS) and are linked to post-intervention outcomes. These myocardial changes may be detected upon the routine 12-lead electrocardiogram (ECG) by the presence of a LV strain pattern (LVS-ECG). Although LVS-ECG has been related to excessive cardiovascular morbidity and mortality in multiple patient populations, there is currently a dearth of data upon its impact in patients undergoing transcatheter aortic valve implantation (TAVI). The aim of the current study was to investigate the prevalence, predictors, and prognostic value of LVS-ECG.</p><p><strong>Methods: </strong>Between 2012 and 2019, 640 consecutive patients underwent TAVI at Haukeland University Hospital, Bergen. Of these, 600 patients with severe AS were included in the TAVI-NOR study. Patients with known bundle branch block (n = 85) or permanent pacing (n = 25) were excluded, leaving 490 patients (mean age 81 ± 6 years, 52% females) eligible for the analyses. LVS-ECG was defined as down-sloping, convex ST-segment depression with asymmetric T-wave inversion in V5 or V6.</p><p><strong>Results: </strong>LVS-ECG was present in 25.7% patients. Higher levels of NT-proBNP (OR 1.96; 95% CI: 1.08-3.55, p = 0.028), left ventricular ejection fraction (LVEF) <50% (OR 3.14; 95% CI: 1.61-6.13, p = 0.001), increase in LV mass index per SD (32 g/m2) (OR 1.37; 95 CI: 1.06-1.76, p = 0.014), and the presence of LV hypertrophy on ECG (OR 3.23; 95% CI: 1.97-5.32, p < 0.001) were independent predictors of LVS-ECG in the multivariable-adjusted analysis. Although all-cause mortality was significantly higher in patients with LVS-ECG compared to those without (54.8% vs. 44.2%, p = 0.041), the presence of LVS-ECG did not predict all-cause mortality during a mean follow-up of 64 ± 24 months (HR 1.05; 95% CI: 0.79-1.39, p = 0.742). Patients with LVEF <50% and concomitant LVS-ECG had a worse prognosis than those with LVEF >50% and no LVS-ECG (p < 0.001).</p><p><strong>Conclusions: </strong>LVS-ECG may represent a simple marker of structural and functional LV remodelling that signals a propensity to excess mortality during long-term follow-up after TAVI, as it is strongly associated with other prognosticators such as reduced LVEF and increased levels of NT-proBNP.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of the Therapeutic Effects of Radiofrequency Ablation of Ganglionated Plexi Guided by High-Frequency Stimulation and Anatomical Localization Methods in the Treatment of Vagal Syncope in Young People.","authors":"Yan Guo, Yanzhuo Li, Si Li, Jun Ma, Jun Liu, Yunjun Ruan, Jinxia Zhang","doi":"10.1159/000542479","DOIUrl":"10.1159/000542479","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to investigate the differences in safety and efficacy between high-frequency stimulation (HFS) and anatomically guided endocardial catheter ablation (AA) of the ganglionated plexi (GPs) for treating vasovagal syncope (VVS) in individuals engaged in high-intensity physical training.</p><p><strong>Methods: </strong>Forty-five patients (age 22.5 ± 4.4 years) undergoing high-intensity physical training were included from January 2020 to January 2023 at our hospital. Patients underwent GP ablation for recurrent syncope. Comprehensive evaluations, including head MRI, cardiac ultrasound, electrocardiogram (ECG), ambulatory ECG (Holter), ambulatory blood pressure monitoring, plate motion tests, and head-up tilt tests (HUT), were conducted to exclude other systemic disorders causing syncope. HFS- and AA-guided GP ablation were performed on 10 and 35 patients, respectively, all of whom tested positive for HUT. Differences between the two groups were compared regarding ablation sites, ablation time, safety, and effectiveness.</p><p><strong>Results: </strong>The ablation time was significantly shorter in the AA group compared to the HFS group (p < 0.001). The number of GPs selected for ablation using the AA method was reduced (p < 0.001). All patients in the HFS group experienced palpitations and discomfort, whereas only 31.43% of patients in the AA group reported these symptoms (p = 0.001). Fentanyl analgesia was administered in both groups, and no significant complications arose from the ablation. The longest follow-up duration was 52 months, while the shortest was 15 months. One case of pre-syncope occurred in the HFS group 8 months post-ablation, and one case of pre-syncope and 2 cases of syncope occurred in the AA group at 1 and 3 months post-ablation, respectively. There were no statistically significant differences in heart rate variability and cardiac deceleration capacity (DC) between the two groups after ablation (p > 0.05). Two cases in the AA group still exhibited type II second-degree atrioventricular block during sleep. Both groups of patients were able to complete high-intensity physical training and showed significant symptom improvement post-ablation.</p><p><strong>Conclusion: </strong>Young individuals with VVS engaged in high-intensity physical training can benefit from GP ablation using both HFS and AA methods. The AA method requires relatively simple equipment, shorter procedure time, and results in less discomfort during the ablation.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Coronary Microvascular Dysfunction by Angiography-Based Index of Microcirculatory Resistance: An Indirect Meta-Analysis.","authors":"Wei Wen, Yi Chi, Mingwang Liu, Beili Xie, Mengjie Gao, Lulian Jiang, Yiqing Zhang, Keji Chen, Fuhai Zhao","doi":"10.1159/000541630","DOIUrl":"10.1159/000541630","url":null,"abstract":"<p><strong>Introduction: </strong>There is a lack of consensus on diagnosing coronary microvascular dysfunction (CMD) using the angiography-based index of microcirculatory resistance (Angio-IMR) due to the absence of evidence. This study aimed to explore the efficacy of Angio-IMR in diagnosing CMD.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library for studies primarily focusing on Angio-IMR diagnosing CMD, using IMR as the gold standard. The primary results were pooled sensitivity, specificity, and the area under the curve (AUC).</p><p><strong>Results: </strong>A total of 15 studies involving 2,202 individuals and 2,330 vessels were included in our study, Angio-IMR demonstrated high performance in predicting IMR with overall pooled sensitivity and specificity of 0.84 (95% confidence interval (CI): 0.81-0.87) and 0.87 (95% CI: 0.83-0.99), respectively, and AUC = 0.91 (95% CI: 0.89-0.94). This indicates that Angio-IMR has good diagnostic characteristics. Subgroup analysis by indirect meta-analysis showed higher sensitivity in the rest state. However, there is no significant difference in sensitivity and specificity between the hyperemic and rest states when using the AccuIMR system. Furthermore, sensitivity and specificity were more pronounced in the group without coronary pressure monitoring compared to the group with monitoring.</p><p><strong>Conclusion: </strong>Angio-IMR is an alternative tool to identify CMD.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-17"},"PeriodicalIF":1.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Association of the Ins/Del Variant of ACE and Risk of Cardiomyopathy: A Case-Control Study and Updated Meta-Analysis.","authors":"Shikha Bharti, Amrit Sudershan, Dharminder Kumar, Mohd Younis, Meenakshi Bhagat, Ishan Behlam, Surbhi Pathania, Mayushi Gupta, Sheetal Bhagat, Rakesh K Panjalyia, Ashiq Hussain Mir, Najitha Banu, Parvinder Kumar","doi":"10.1159/000542278","DOIUrl":"10.1159/000542278","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiomyopathy is a complex condition influenced by multiple genes and environmental factors. It has been suspected that cardiomyopathy is affected by the ACE gene's I/D polymorphism. Our study aimed to evaluate the association between this polymorphism and cardiomyopathy risk in the Jammu population of North India, alongside a meta-analysis to determine the specific risks associated with different types of cardiomyopathy.</p><p><strong>Method: </strong>In the case-control study, we opted for a convenient sampling technique to gather patients from hospitals. Meanwhile, for the meta-analysis registered under PROSPERO with CRD42024519763, and in line with PRISMA guidelines, we accessed online databases and applied predefined inclusion criteria. Data extraction and quality assessment were performed using the Newcastle-Ottawa scale. Statistical analysis included genotypic frequencies, Hardy-Weinberg equilibrium testing, logistic regression models, and assessments for heterogeneity and publication bias.</p><p><strong>Result: </strong>The case-control study revealed a significant association between the ACE I/D risk variant and cardiomyopathy risk in the Jammu population (odds ratio [OR]: 1.30, confidence interval [CI] [1.04-1.63], p value = 0.021). Furthermore, a total of 34 studies were fund-eligible for the meta-analysis and demonstrated a significant association between the risk variant and both dilated (OR: 1.25, CI [1.03-1.50], p value = 0.022) and hypertrophic (OR: 1.31, CI [1.0876-1.5776], p value = 0.004446) cardiomyopathy.</p><p><strong>Conclusion: </strong>Our study found a significant association between the I/D polymorphism and cardiomyopathy risk in the Jammu population. Further, the meta-analysis strengthens the findings by consistently linking the ACE I/D polymorphism to both dilated and hypertrophic cardiomyopathy. These results underscore the importance of genetic factors in cardiomyopathy risk assessment and further research is needed to understand the underlying mechanisms and potential therapeutic implications.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-24"},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signal-Guided Multitask Learning for Myocardial Infarction Classification Using Images of Electrocardiogram.","authors":"Bo Eun Park, Byungeun Shon, Jungrae Cho, Min-Su Jung, Jong Sung Park, Myeong Seop Kim, Eunkyu Lee, Hyohun Choi, Hyuk Kyoon Park, Yoon Jung Park, Hong Nyun Kim, Namkyun Kim, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Sungmoon Jeong, Se Yong Jang","doi":"10.1159/000542399","DOIUrl":"10.1159/000542399","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of myocardial infarction (MI) needs to be swift and accurate, but definitively diagnosing it based on the first test encountered in clinical practice, the electrocardiogram (ECG), is not an easy task. The purpose of the study was to develop a deep learning (DL) algorithm using multitask learning method to differentiate patients experiencing MI from those without coronary artery disease using image-based ECG data.</p><p><strong>Methods: </strong>A DL model was developed based on 11,227 ECG images. We developed a new ECG interpretation algorithm through signal-guided multitask learning, building on a previously published single-task algorithm. The utility of this model was evaluated by testing 51 physicians in interpreting ECGs with and without the assistance of the DL model.</p><p><strong>Results: </strong>The proposed model demonstrated superior performance, achieving 90.56% accuracy, 83.82% sensitivity, 93.02% specificity, 81.44% precision, and an F1 score of 82.61% in discriminating MI ECG. Overall, the median accuracy of ECG interpretation improved from 62% to 68% with the DL algorithm. Trainees and specialists in internal medicine experienced significant accuracy increases (60-66% for trainees, 72-80% for specialists). In the MI group, NSTEMI accuracy was notably lower than STEMI (33% vs. 80%, p < 0.001), but the DL algorithm improved interpretative capabilities in both NSTEMI and STEMI.</p><p><strong>Conclusions: </strong>Signal-guided multitask DL algorithm demonstrated superior performance compared with previous single-task algorithm. The DL algorithm supports the physicians' decision discriminating MI ECGs from non-MI ECGs. The improvement was consistent in subgroups of STEMI and NSTEMI.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrinolysis Was Replaced before It Was Understood.","authors":"Victor Gurewich, David Segarnick","doi":"10.1159/000542197","DOIUrl":"10.1159/000542197","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Need for New Data on Left Ventricular Remodeling and the Crucial Role of Ejection Time for Our Daily Clinical Practice.","authors":"Erwan Donal, Adrien Al Wazzan","doi":"10.1159/000542317","DOIUrl":"10.1159/000542317","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}