Journal of cardiovascular computed tomography最新文献

{"title":"Apparent FFR decline in THRONE: Progression or baseline physiologic discordance?","authors":"Masahiro Hoshino","doi":"10.1016/j.jcct.2026.04.003","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.04.003","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral annular calcification, coronary artery calcification, and risk of incident atrial fibrillation in the multi-ethnic study of atherosclerosis (MESA).","authors":"Parag Anilkumar Chevli, Soroush Masrouri, Alexander C Razavi, Joseph Yeboah, Natalie Bradford, Elsayed Z Soliman, Susan R Heckbert, Takeki Suzuki, Michael D Shapiro, Prashant D Bhave","doi":"10.1016/j.jcct.2026.04.005","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.04.005","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcification (CAC) and mitral annular calcification (MAC) reflect cardiovascular aging and systemic atherosclerosis and have each been associated with the risk of atrial fibrillation (AF).</p><p><strong>Objective: </strong>To examine the joint associations of CAC and MAC with incident AF in the Multi-Ethnic Study of Atherosclerosis (MESA).</p><p><strong>Methods: </strong>CAC and MAC were assessed using cardiac computed tomography and quantified by Agatston scoring. Participants were categorized into four groups: no CAC and no MAC (reference), CAC present without MAC, MAC present without CAC, both CAC and MAC present. Incident AF was identified through hospitalization records and Medicare claims. Multivariable-adjusted Cox proportional hazards models examined the association between CAC/MAC categories and incident AF. Improvement in AF risk prediction with the addition of CAC and MAC to Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE-AF) risk score was assessed using Harrell's C-statistic.</p><p><strong>Results: </strong>Among 6588 participants (mean age 62 ​± ​10 years; 53% female) free of baseline AF, 1306 incident AF events occurred over a median follow-up of 16.5 years. Participants with both CAC and MAC present had the highest risk of AF. Compared with the reference group, CAC present without MAC, MAC present without CAC, and both CAC and MAC present were associated with 39%, 74%, and 96% higher risks of incident AF, respectively. Addition of CAC and MAC improved discrimination of the CHARGE-AF model (C-statistic 0.746 to 0.754; p ​< ​0.01).</p><p><strong>Conclusions: </strong>CAC and MAC were jointly associated with incident AF, and their inclusion in a risk score improved AF risk prediction.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biventricular and biatrial assessment using low-dose cine computed tomography during recirculation phase of contrast agent: Comparison to cine cardiac magnetic resonance.","authors":"Shintaro Yamaguchi, Satoshi Nakamura, Naoki Hashimoto, Akio Yamazaki, Naoki Nagasawa, Suguru Araki, Hajime Sakuma, Kakuya Kitagawa","doi":"10.1016/j.jcct.2026.04.007","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.04.007","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate the accuracy of biventricular and biatrial volume and function measurements by low-dose cardiac cine computed tomography (CT) during recirculation phase of contrast agent with cine cardiac magnetic resonance (CMR) as the reference standard.</p><p><strong>Methods: </strong>Thirty patients who underwent low-dose cine CT on a third-generation dual-source CT scanner within 30 days of CMR were retrospectively studied. Left and right ventricular (LV, RV) end-diastolic volume (EDV) and end-systolic volume, stroke volume, ejection fraction (EF), and LV mass were measured using the Simpson's method on short-axis images. Left and right atrial (LA, RA) maximum volume, minimum volume, and emptying fraction were measured using the biplane area-length method on 2-chamber and 4-chamber images (LA) and area-length method on 4-chamber images (RA).</p><p><strong>Results: </strong>All low-dose cine CT-derived parameters strongly correlated with those from CMR (r ​= ​0.771-0.974). Mean differences (limits of agreement) between low-dose cine CT and CMR were small for LV EDV (10.0 ​mL [-17.9 to 38.0]), LV EF (-0.4% [-9.5 to 8.6]), and RV EF (0.8% [-7.4 to 8.9]), as well as for atrial volumes and emptying fractions. All low-dose cine CT measurements also showed excellent intra- and inter-rater reproducibility. The median effective radiation dose for the low-dose cine CT was 0.85 ​mSv.</p><p><strong>Conclusion: </strong>Low-dose cine CT during recirculation phase of contrast agent provides accurate, reproducible quantification of biventricular and biatrial volume and function compared with cine CMR as the reference, while achieving substantial radiation dose reduction without requiring additional contrast agent.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removal notice to Seasonal patterns in diagnosis of chronic coronary syndrome by Ct-angiography -a retrospective single-center experience with 10.022 patients [J Cardiovasc Comp Tomogr 20 (2026) S18].","authors":"K Finke, S Nienaber, C Gietzen, L Pennig, H Wienemann, J Althoff, S Baldus, S Schäfer","doi":"10.1016/j.jcct.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.04.004","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-based detection of coronary artery calcium score in non-gated chest computed tomography of patients who decline statin therapy: A missed opportunity for prevention.","authors":"Rhanderson Cardoso, Stephanie A Besser, Milena Petranovic, Daniel Huck, Arthur Shiyovich, Camila V Blair, David W Biery, C Justin Brown, Nisarg Shah, Alexander Turchin, Ron Blankstein","doi":"10.1016/j.jcct.2026.03.013","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.03.013","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RedoTAVR coronary obstruction risk in small annuli: A post-TAVR CT study.","authors":"Gaetano Liccardo, Ioannis Skalidis, Luca Esposito, Nicolas Amabile, Hakim Benamer, Stephane Champagne, Bernard Chevalier, Livio D'Angelo, Jerome Garot, Philippe Garot, Thomas Hovasse, Pietro Laforgia, Francesca Sanguineti, Neila Sayah, Thierry Unterseeh, Mariama Akodad, Antoinette Neylon","doi":"10.1016/j.jcct.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.04.002","url":null,"abstract":"<p><strong>Introduction: </strong>Redo-transcatheter aortic valve replacement (redoTAVR) is increasingly relevant as younger patients undergo TAVR. Patients with small annuli may present anatomical constraints.</p><p><strong>Methods: </strong>This study evaluated predicted coronary obstruction (CO) risk in case of redoTAVR in small versus non-small annuli using post-TAVR computed tomography (CT) in patients treated by supra-annular self-expanding valves (SEVs) or balloon-expandable valves (BEVs). 167 post-TAVR CT scans were analyzed. Patients were stratified into small annuli (≤430 ​mm²) and non-small annuli groups (>430 ​mm²). Risk plane for redoTAVR was assessed at node 4, 5 and 6 for SEVs and at the transcatheter heart valve (THV) outflow for BEVs. The minimal valve-to-coronary (VTC) and valve-to-aorta (VTA) distances were measured from the THV to the left main stem (LM)/right coronary artery (RCA) ostia and from the THV to the aorta above the LM/RCA respectively. High CO risk was defined as VTC <4 ​mm or VTA <2 ​mm when the coronary ostium lay below the risk plane.</p><p><strong>Results: </strong>In small annuli, SEVs were associated with increased predicted CO risk after redoTAVR compared to BEVs, considering risk plane at node 6 (OR ​= ​15.52, p ​< ​0.001) or node 5 (OR ​= ​3.13, p ​= ​0.03), while not at node 4. In non-small annuli, SEVs did not increase predicted CO risk versus BEVs.</p><p><strong>Conclusion: </strong>Predicted CO risk at redoTAVR in small annuli depends on index valve type and redo implantation height. Our findings support accurate index-procedure planning and meticulous planning and execution of redoTAVR, particularly in small annuli.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and design of the MAPS trial: A nationwide multicenter prospective validation of CT-derived index of microcirculatory resistance for precision ischemia management.","authors":"Dan Deng, Chen Wan, Yan Lu, Anbang Wang, Xiujian Liu, Zhifan Gao, Haoran Qin, Min Zeng, Shuhui Chen, Yanxiu Chen, Xiaolong Li, Yang Zhou, Wei Chen, Dali Yi, Heye Zhang, William Kongto Hau, Zhihui Zhang","doi":"10.1016/j.jcct.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.04.001","url":null,"abstract":"<p><strong>Background: </strong>Coronary microvascular dysfunction (CMD) is a common, underdiagnosed cause of ischemia linked to adverse cardiovascular outcomes. However, the lack of a direct, readily accessible non-invasive diagnostic tool hampers its timely identification and management. We developed IMR_CT-a non-invasive, CT-derived index of microcirculatory resistance based on computational fluid dynamics (CFD)-enabling comprehensive hemodynamic phenotyping from a single coronary CT angiography (CCTA) examination.</p><p><strong>Objectives: </strong>The MAPS trial is a nationwide, multicenter, prospective study. The primary objective is to evaluate the sensitivity and specificity of IMR_CT for identifying CMD, using invasively measured index of microcirculatory resistance (IMR) as the reference standard. Secondary objectives include assessing the prognostic value of IMR_CT for major adverse cardiovascular events (MACE). Exploratory analyses will assess the agreement of CT-derived coronary flow reserve (CFR_CT) and microvascular resistance reserve (MRR_CT) with their invasive counterparts.</p><p><strong>Methods: </strong>A total of 630 patients referred for clinically indicated invasive coronary physiology assessment will be enrolled. All patients will undergo CCTA followed by invasive measurements of IMR and CFR, and relevant pressure/flow parameters. Patient-specific 3D models and CFD simulations will be used to compute IMR_CT, CFR_CT and MRR_CT. All participants will be followed every six months for ≥2 years to assess MACE and symptom progression.</p><p><strong>Summary: </strong>The MAPS trial is designed to establish IMR_CT as a non-invasive window into coronary microvascular physiology and a potential tool for physiology-guided therapy and longitudinal monitoring through repeat CCTA.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matching the protocol to the clinical question in pediatric coronary CT - one size doesn't have to fit all.","authors":"V Cuculovic, E Ashworth, F Sheikh, I Castellano, E McDonagh, M Rubens, S Padley, E Nicol, T Semple","doi":"10.1016/j.jcct.2026.02.004","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.02.004","url":null,"abstract":"<p><strong>Purpose: </strong>To compare image quality and radiation dose between pediatric coronary CT protocols.</p><p><strong>Methods: </strong>A retrospective observational study of pediatric coronary CT in children under 2 years old undergoing awake, non-sedated imaging in a pediatric cardiac surgical centre, comparing non-gated high-pitch dual source spiral (ng-FLASH); ECG-gated FLASH (FLASH); single-phase (30 ​% R-R) and multiphase (30-50 ​% R-R) sequential acquisition protocols. Dose metrics (DLP and CTDIvol) were collected and coronary visualisation assessed for the left mainstem (0 ​= ​not visible; 1 ​= ​visible), anterior descending, circumflex and right coronary arteries (0 ​= ​not visible; 1 ​= ​origin only; 2 ​= ​to mid-vessel; 3 ​= ​whole vessel).</p><p><strong>Results: </strong>128 consecutive studies were identified (84 ​ng-FLASH, 23 FLASH, 7 single-phase and 14 multi-phase sequential); median age was 3 months (range 1 day-17 months). Multi-phase sequential scans were the highest dose (median CTDI vol 1.66 ​mGy); cf. single-phase sequential 1.20 ​mGy (p ​= ​1.00); FLASH 0.57 ​mGy (p ​< ​0.001) and ng-FLASH 0.45 ​mGy (p ​< ​0.001). Multi-phase sequential scans had best image quality (median score 8, IQR 1.75) cf. single-phase sequential scans; 6, 5, p ​= ​0.95; FLASH 5, 5, p ​= ​0.15, and ng-FLASH 4, 3, p ​= ​0.001). Multi-phase acquisitions visualised coronaries to at least the mid-portion in 71.4 ​% (vs. 28.6 ​% single-phase sequential, 30.4 ​% FLASH and 13.1 ​% ng-FLASH).</p><p><strong>Conclusions: </strong>Coronary visualisation via CT in under-2 year olds can be achieved at a fraction of the dose expected from retrospective ECG gating, without anaesthesia. Where full coronary visualisation is not the primary aim of the examination, scan protocol can be adjusted accordingly. Stepwise increases in radiation exposure can be added according to level of coronary assessment required.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-enabled cardiac volumetry on non-contrast calcium scoring CT for predicting atrial fibrillation and mortality.","authors":"Jong Eun Lee, Ji-Hoon Jung, Hongmin Oh, Hyo-Jae Lee, June-Goo Lee, Hyun Jung Koo, Joon-Won Kang, Dong Hyun Yang","doi":"10.1016/j.jcct.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.03.009","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of cardiac volumetry derived from non-contrast coronary calcium scoring CT (CSCT) remains uncertain. This study evaluated whether artificial intelligence (AI)-enabled cardiac volumetry from CSCT improves prediction of incident atrial fibrillation (AF) and all-cause mortality.</p><p><strong>Methods: </strong>We analyzed 4402 adults (median age, 55.8 years; 68.6% men) who underwent CSCT at two centers between 2007 and 2014. A deep-learning model automatically quantified four cardiac chamber volumes, left ventricular (LV) mass, and CAC. AI-enabled volumetric measurements were validated against human expert-validated manual measurements using concordance correlation coefficients (CCC) and Spearman correlation. Associations with incident AF and all-cause mortality were evaluated using multivariable Cox regression, and incremental predictive value was assessed using Harrell's C-index, integrated discrimination improvement, and net reclassification improvement.</p><p><strong>Results: </strong>AI-enabled cardiac volumetry showed excellent agreement with manual CSCT measurements (CCC range, 0.80-0.98). During a median follow-up of 14 years, AF occurred in 102 individuals (2.3%), and all-cause mortality occurred in 299 individuals (6.8%). Enlarged left atrial (LA) and right atrial (RA) volumes independently predicted incident AF (hazard ratios [HRs], 7.77 and 9.61; both p ​< ​0.001). Enlarged LA volume and increased LV mass were independently associated with all-cause mortality (HR, 1.61; p ​= ​0.012 and HR, 1.73; p ​= ​0.032, respectively). AI-enabled cardiac volumetry significantly improved discrimination for AF prediction (C-index, 0.74 to 0.83; p ​< ​0.001), whereas its incremental prognostic value for all-cause mortality beyond CAC and clinical variables was modest and not statistically significant.</p><p><strong>Conclusions: </strong>AI-enabled cardiac volumetry from CSCT significantly enhances prediction of incident AF, while its additional value for mortality prediction beyond CAC remains limited.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular extracellular volume on computed tomography is significant predictor of patient prognosis after cardiac resynchronization therapy.","authors":"Katsuya Suzuki, Hiroyuki Takaoka, Ryosuke Irie, Moe Matsumoto, Yusei Nishikawa, Yoshitada Noguchi, Shuhei Aoki, Kazuki Yoshida, Satomi Yashima, Makiko Kinoshita, Haruka Sasaki, Noriko Suzuki-Eguchi, Yusuke Kondo, Yoshio Kobayashi","doi":"10.1016/j.jcct.2026.03.010","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.03.010","url":null,"abstract":"<p><strong>Background: </strong>Cardiac resynchronization therapy (CRT) is useful for patients with severe heart failure (HF); however, almost 30% of patients are non-responders.</p><p><strong>Purpose: </strong>This study aimed to evaluate the utility of left ventricular (LV) extracellular volume (ECV) on computed tomography (CT) for the prediction of prognosis in CRT candidates.</p><p><strong>Methods: </strong>This study included 52 patients who underwent cardiac CT before CRT device implantation between 2008 and 2024. The primary outcomes were cardiac death, hospitalization for HF, and fatal arrhythmia after CRT device implantation. CRT responders were defined as patients who exhibited a 15% or greater reduction in LV end-systolic volume.</p><p><strong>Results: </strong>Nineteen patients (37%) experienced one of the primary outcomes (7 cardiac deaths, 7 fatal arrhythmias, and 5 ​H ​F hospitalizations). LVECV was lower in CRT responders (n ​= ​26) than in the others (n ​= ​23) (36% ​± ​7.6% vs 40% ​± ​6.0%, p ​= ​0.03). LVECV was higher in patients with one of the primary outcomes (n ​= ​19) than the others (n ​= ​33) (42% ​± ​7.5% vs 35% ​± ​5.7%, p ​< ​0.001). Receiver operating characteristic analysis identified 44.03% as the optimal LVECV threshold for predicting primary outcomes. In the Cox proportional hazards model, LVECV was a significant predictor of a primary outcome (hazard ratio, 3.21; 95% confidence interval, 1.08-9.51; p ​= ​0.04). Kaplan-Meier analysis showed that patients with an LVECV ≥44.03% had significantly more primary events than those with lower LVECV (p ​< ​0.01).</p><p><strong>Conclusion: </strong>LVECV on cardiac CT may be useful for predicting CRT response and prognosis.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}