{"title":"Evaluation of Outcomes of Pregnancy in Women with Eisenmenger Syndrome: Is There Any Prognostic Criterion?","authors":"Dilek Çiçek Yılmaz, Gülten Taçoy","doi":"10.5543/tkda.2024.40963","DOIUrl":"https://doi.org/10.5543/tkda.2024.40963","url":null,"abstract":"<p><strong>Objective: </strong>Pregnancy in women with Eisenmenger syndrome (ES) presents very high morbidity and mortality rates for both the mother and fetus. In this study, we aimed to evaluate the outcomes of pregnancies affected by ES.</p><p><strong>Methods: </strong>This retrospective cohort study reviewed pregnancies in women with ES at two university hospitals over the past 10 years. The primary outcomes examined were maternal, perinatal, and pregnancy-related outcomes in women with ES.</p><p><strong>Results: </strong>The study enrolled eight pregnant women diagnosed with ES. The average maternal age was 26.7 years (range 21-36 years). The causes of ES included ventricular septal defect (five patients), patent ductus arteriosus (two patients), and atrial septal defect (one patient). Four patients had been diagnosed with ES before pregnancy. Two patients died in this group; one developed right heart failure in the third trimester and unfortunately died immediately after delivery due to cardiogenic shock, and another died on the 10th postpartum day from sudden cardiac arrest despite having had a successful delivery. Four patients were diagnosed with ES during the postpartum period; none in this group died, and there were no cases of fetal mortality. We could not identify any clinical or echocardiographic predictors for postpartum mortality. The two deceased patients showed tendencies of severe right heart failure and lower oxygen saturation during the third trimester and before delivery.</p><p><strong>Conclusion: </strong>Despite advanced obstetric care and targeted treatments for pulmonary arterial hypertension, maternal mortality is still unacceptably high in patients with ES. No significant predictors of maternal mortality were identified.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"52 7","pages":"492-498"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484712","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}
Sedat Taş, Kemal Sarsmaz, Hayrunnisa Yeşil Sarsmaz, Seren Gülşen Gürgen, Ümmü Taş, Mehmet Eyüboğlu, Zeki Arı
{"title":"[The Relationship between Serum Neuropeptide FFR2, Serum Smoothelin and Pregnancy Outcomes in Pregnant Women with Gestational Hypertension].","authors":"Sedat Taş, Kemal Sarsmaz, Hayrunnisa Yeşil Sarsmaz, Seren Gülşen Gürgen, Ümmü Taş, Mehmet Eyüboğlu, Zeki Arı","doi":"10.5543/tkda.2024.10241","DOIUrl":"https://doi.org/10.5543/tkda.2024.10241","url":null,"abstract":"<p><strong>Objective: </strong>Gestational hypetension is a major public health concern due to its links with cardiovascular disease, stroke and neonatal morbidity and mortality. Timely diagnosis and effective management of gestational hypertension are essential for both maternal and neonatal health. Neuropeptide FF Receptor 2 (NPFFR2) is a protein secreted by the brain and placenta, involved in pain regulation, water balance, and the modulation of cardiovascular effects. This study aims to conduct a comparative analysis of NPFFR2, smoothelin (SMTH), echocardiographic results and pregnancy outcomes in pregnant women with and without gestational hypertension.</p><p><strong>Method: </strong>This study included 78 pregnant participants, which were grouped into women with gestational hypertension (n = 39) and those without gestational hypetension (n = 39). The gestational hypertension population was classified into two groups, i.e., dipper and non-dipper groups, based on the 24-hour ambulatory blood pressure monitoring results. Smoothelin and NPFFR2 analyses were performed using the blood samples and placental tissue samples collected from all participants, along with echocardiography and 24-hour ambulatory blood pressure monitoring.</p><p><strong>Results: </strong>The study group comprised 78 pregnant women with a mean age of 28.8 years and mean gestational age of 27.7 weeks. The gestational hypertension group had a significantly higher NPFFR2 levels, lower SMTH levels and gestational age at birth and higher all 24-hour ambulatory blood pressure monitoring findings. The left atrial-to-aortic ratio and Tricuspid annular plane systolic excursion (TAPSE) were significantly higher in GİH group than in the control group. NPFFR2 and gestational age at birth were found to be independently associated with neonatal intensive care unit admission.</p><p><strong>Conclusion: </strong>Serum NPFFR2 levels were increased in women with gestational hypertension, SMTH levels were decreased, and pregnancy prognosis was found to be associated with NPFFR2 levels.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"52 7","pages":"510-518"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484806","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":"Determinant Role of Toll-like Receptor 4 (TLR4) on Angiotensin II in Isolated Umbilical Arteries from Normal and Gestational Diabetes Pregnant Women.","authors":"Esra Büyük Gezer, Ayşe Saide Şahin","doi":"10.5543/tkda.2024.00273","DOIUrl":"https://doi.org/10.5543/tkda.2024.00273","url":null,"abstract":"<p><strong>Objective: </strong>Gestational diabetes mellitus (GDM) is a common condition that occurs during pregnancy and results in cesarean section, pre-eclampsia, and neonatal morbidity. Angiotensin II is a potent vasoconstrictor and an important determinant of uteroplacental perfusion. Toll-like receptor 4 (TLR4) was found to contribute to diabetes progression. This study aimed to determine how TLR4 activation affects the contraction mediated by angiotensin II type 1 receptor in the isolated umbilical arteries of normal and GDM women.</p><p><strong>Methods: </strong>Angiotensin II was applied with either a TLR4 agonist or TLR4 antagonists to isolated arteries from normal and GDM umbilical cords. The changes in the angiotensin II response were expressed as the maximal contraction percentage and pD2 values. The mRNA expression levels of TLR4 and angiotensin II type 1 receptor gene were measured via quantitative real-time polymerase chain reaction analysis.</p><p><strong>Results: </strong>This study displayed an increased sensitivity to angiotensin II in the arteries of the GDM group compared with the normal group. The TLR4 agonist showed a synergistic effect with angiotensin II, while the TLR4 antagonists were not strongly determinant. In the GDM group, the TLR4 mRNA level is slightly higher than in the normal pregnancy group; however, no statistical difference was noted.</p><p><strong>Conclusion: </strong>Toll-like receptor 4 may determine the vasoconstrictive effect of angiotensin II in normal and GDM umbilical arteries. Some studies showed a similar interaction as supportive. However, comprehensive animal and/or human studies are promising.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"52 7","pages":"486-491"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484710","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}
Gamze Babur Güler, Mustafa Ozan Gürsoy, Türkan Seda Tan Kürklü, Selcen Yakar Tülüce, Pelin Karaca Özer, Dilay Karabulut, Suzan Hatipoğlu, Ahmet Barutçu, Alev Kılıçgedik, Arda Güler, Begüm Uygur, Cemil İzgi, Cennet Yıldız, Dilek Çiçek Yılmaz, Duygu Genç Albayrak, Duygu İnan, Ebru Özpelit, Elif Eroğlu Büyüköner, Elif Güçlü, Fahriye Vatansever Ağca, Feyza Çağlıyan, Filiz Akyıldız Akçay, Gökhan Kahveci, Hülya Gamze Çelik, İbrahim Altun, İlknur Altun, İrem Dinçer, İrem Türkmen, Kardelen Ohtaroğlu Tokdil, Mehmet Arslan, Mehmet Karacan, Müge Akbulut, Nazlı Turan Şerifler, Omaç Tüfekçioğlu, Özden Seçkin Göbüt, Özlem Yıldırımtürk, Rezzan Deniz Acar, Saide Aytekin, Selin Yöndem, Sena Sert Şekerci, Serkan Ünlü, Songül Üstündağ, Uğur Karagöz, Zeynep Kumral, Zübeyde Bayram
{"title":"Multimodality Imaging in Cardiomyopathies.","authors":"Gamze Babur Güler, Mustafa Ozan Gürsoy, Türkan Seda Tan Kürklü, Selcen Yakar Tülüce, Pelin Karaca Özer, Dilay Karabulut, Suzan Hatipoğlu, Ahmet Barutçu, Alev Kılıçgedik, Arda Güler, Begüm Uygur, Cemil İzgi, Cennet Yıldız, Dilek Çiçek Yılmaz, Duygu Genç Albayrak, Duygu İnan, Ebru Özpelit, Elif Eroğlu Büyüköner, Elif Güçlü, Fahriye Vatansever Ağca, Feyza Çağlıyan, Filiz Akyıldız Akçay, Gökhan Kahveci, Hülya Gamze Çelik, İbrahim Altun, İlknur Altun, İrem Dinçer, İrem Türkmen, Kardelen Ohtaroğlu Tokdil, Mehmet Arslan, Mehmet Karacan, Müge Akbulut, Nazlı Turan Şerifler, Omaç Tüfekçioğlu, Özden Seçkin Göbüt, Özlem Yıldırımtürk, Rezzan Deniz Acar, Saide Aytekin, Selin Yöndem, Sena Sert Şekerci, Serkan Ünlü, Songül Üstündağ, Uğur Karagöz, Zeynep Kumral, Zübeyde Bayram","doi":"10.5543/tkda.2024.13636","DOIUrl":"https://doi.org/10.5543/tkda.2024.13636","url":null,"abstract":"<p><p>Cardiomyopathy, which is shortly defined as a disease of the myocardium, has a broad definition that includes many different diagnoses. Recent advances in cardiac imaging techniques, including basic and advanced echocardiography, computed tomography, nuclear medicine, and cardiac magnetic resonance, allow for a more accurate evaluation of volumes and thickness of cardiac chambers, systolic and diastolic function of the ventricules, and tissue structure. Multimodality imaging often provides the first clinical suspicion for specific etiologies, especially when the medical and family history is unclear, by identification of red flags of underlying systemic diseases. In this review, we aimed to evaluate the role of multimodality imaging in diagnosis of cardiomyopathies with key images and discussed the effects of genetics on the diagnostic, prognostic, and therapeutic guidance of cardiomyopathies.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"52 Suppl. 1","pages":"1-206"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585416","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}
Büşra Özyeşil, Muhammed Fatih Kaleli, Ahmet Lütfü Sertdemir, Mehmet Akif Düzenli
{"title":"Uncomplicated Pregnancy with Residual Tetralogy of Fallot Post-Surgery.","authors":"Büşra Özyeşil, Muhammed Fatih Kaleli, Ahmet Lütfü Sertdemir, Mehmet Akif Düzenli","doi":"10.5543/tkda.2024.94145","DOIUrl":"https://doi.org/10.5543/tkda.2024.94145","url":null,"abstract":"<p><p>The most common cyanotic congenital heart disease (CHD) in adults is Tetralogy of Fallot (TOF), accounting for 10% of congenital heart anomalies and 75% of cyanotic CHD cases. It is a congenital heart disease that most often requires surgical correction within the first year of life. Corrective surgical treatment for TOF began in the 20th century, starting with a temporary shunt procedure and advancing to primary surgical repair. The current approach in infants often involves valve-sparing techniques. Following corrective surgery, more than 85% of patients with TOF can survive into adulthood. Without repair, however, patients with TOF rarely reach adulthood, and the prognosis for pregnant women with CHD is poor. Congenital heart disease is one of the leading causes of indirect maternal deaths. The literature indicates that pregnant patients with corrected TOF still face a higher risk compared to otherwise healthy women. According to the modified World Health Organization maternal cardiovascular risk classification, patients with repaired TOF have a mild risk of mortality and a moderate risk of morbidity, with the risk of maternal cardiac events ranging from 5.7% to 10.5%. Cardiac evaluations should be performed at least once during each trimester of pregnancy. In this case report, we discuss the pregnancy and successful, uncomplicated birth of a woman with TOF who underwent corrective surgery in childhood.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"52 7","pages":"532-535"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484717","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}
Gülten Taçoy, Deniz Karçaaltıncaba, Sedat Türkoğlu
{"title":"Cardiovascular Diseases During Pregnancy.","authors":"Gülten Taçoy, Deniz Karçaaltıncaba, Sedat Türkoğlu","doi":"10.5543/tkda.2024.06228","DOIUrl":"https://doi.org/10.5543/tkda.2024.06228","url":null,"abstract":"<p><p>Pregnancy-associated hemodynamic changes may cause severe complications in patients with cardiovascular diseases. It may also reveal previously undiagnosed conditions or worsen existing ones. To prevent maternal and fetal complications during pregnancy, a thorough evaluation of the pregnant woman's cardiac history, symptoms, functional capacity, and physical examination should be conducted, in line with current risk classification systems. In this case series, we present the course of pregnancy in four patients with severe cardiac pathology.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"52 7","pages":"536-540"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484709","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":"Pregnancy in a Rare and Acquired Mitral Stenosis Different from Rheumatic Mitral Involvement: Mitral Ring Mismatch.","authors":"Sezgin Atmaca, Arda Güler, İrem Türkmen, Hasan Şahin, Gamze Babur Güler","doi":"10.5543/tkda.2024.39887","DOIUrl":"https://doi.org/10.5543/tkda.2024.39887","url":null,"abstract":"<p><p>There is an increasing incidence of diagnosing both congenital and acquired heart valve diseases in women during pregnancy. Factors such as elevated rates of pregnancy, older maternal age, and coexisting conditions like diabetes, hypertension, and obesity contribute significantly to the symptomatic manifestation and detection of valvular heart diseases in women planning for pregnancy. Pregnancy induces cardiovascular changes across the maternal physiology, posing a heightened risk of morbidity and mortality, especially in women afflicted with valvular heart diseases. In this article, we present a case of a 25-year-old patient who underwent mitral ring annuloplasty surgery at the age of 9. Her echocardiography revealed a mismatch of the mitral ring during a follow-up examination at the age of 20. Despite neglecting further follow-ups, the patient became pregnant and presented to us at the 6th week of pregnancy. She underwent evaluations at the 6th, 10th, and 22nd weeks of pregnancy, as well as before delivery. Following the resumption of follow-up appointments, intervention planning was initiated during the postpartum period. This case exemplifies successful management, resulting in a healthy delivery after navigating through the pregnancy.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"52 7","pages":"527-531"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484714","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":"Cardiac Diagnoses in Obstetric Patients: An Observational Trimester-Based Analysis from Patients Undergoing Cardiology Consultations.","authors":"Zeynettin Kaya, Fuat Polat","doi":"10.5543/tkda.2024.71248","DOIUrl":"https://doi.org/10.5543/tkda.2024.71248","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to evaluate the frequency of cardiac complaints and diagnosed cardiovascular diseases across trimesters in pregnant women referred for cardiology consultations.</p><p><strong>Methods: </strong>This retrospective observational study was conducted at a second-level state hospital. Pregnant women referred to the cardiology clinic between September 2020 and March 2022 were included. Data collected included demographic information, clinical presentations, trimester of pregnancy, blood pressure, heart rate, anemia status, electrocardiography (ECG), and echocardiographic findings. Cardiac diagnoses were based on clinical evaluation, ECG, and echocardiographic findings.</p><p><strong>Results: </strong>A total of 658 pregnant women were included, with a mean age of 28.18 (± 4.28) years. Most consultations occurred in the third trimester (49.1%). Primary reasons for consultation were palpitations (48%), chest pain (21.3%), leg edema (13.1%), and high blood pressure (11.6%). Anemia was present in 28.7% of the women, and 20.2% had hypertension (HT). Significant differences across trimesters included higher rates of chest pain and presyncope/syncope in the first trimester, and higher rates of palpitations and anemia in the second and third trimesters. The most common cardiac diagnoses were arrhythmias (16.6%), high blood pressure (15.2%), and mitral regurgitation (MR) (12.5%). Hypertension was most frequently diagnosed in the second trimester (P = 0.04). Infective endocarditis, myocarditis, and pericarditis were more common in the third trimester.</p><p><strong>Conclusion: </strong>Cardiac consultations are most frequent in the third trimester, with palpitations, chest pain, and high blood pressure being the most common complaints. Hypertension and MR are the most common cardiac diagnoses. Early and ongoing cardiologic assessment during pregnancy is crucial for managing cardiovascular risks.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"52 7","pages":"499-509"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484708","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":"[Comparison of Serum Spexin Level and its Relationship with Echocardiographic Findings in Prediabetic Patients with and without Hypertension].","authors":"Sedat Taş, Ümmü Taş, Tuncay Küme","doi":"10.5543/tkda.2024.03078","DOIUrl":"10.5543/tkda.2024.03078","url":null,"abstract":"<p><strong>Objective: </strong>Prediabetes mellitus, hypertension, and their frequent coexistence are risk factors for macrovascular and cardiovascular complications. In this study we aimed to determine the relationship between spexin levels and echocardiographic findings and hypertension in prediabetic patients.</p><p><strong>Methods: </strong>This study included 118 adult patients diagnosed with prediabetes mellitus who presented to outpatient clinics between April 2021 and January 2022. The patients were grouped into prediabetic patients with hypertension (n = 58) and those without hypertension (n = 60). The hypertension group was further divided into dipper and non-dipper groups according to the 24-hour ambulatory blood pressure monitoring. Blood samples were collected from all patients and echocardiography was performed. Spexin levels were measured by ELISA. Serum spexin levels, echocardiographic and ambulatory blood pressure monitoring findings were compared between the groups.</p><p><strong>Results: </strong>The hypertension and non-dipper groups had significantly lower spexin levels and higher left atrial volume index, E/Em index, and interventricular septum and posterior wall thicknesses. Spexin levels were negatively correlated with body mass index (r = -0.298, P < 0.001), nighttime systolic blood pressure (r = -0.264, P = 0.006), nighttime diastolic blood pressure (r =-.255, P = 0.005), left atrial volume index (r =-.238, P = 0.009), E/Em (r =-.214,P = 0.020), and low-density lipoprotein cholesterol (r = -.243, P = 0.008). Obesity, overweight and spexin <780 pg/mL were independently associated with hypertension.</p><p><strong>Conclusion: </strong>Circulating spexin levels were lower in prediabetic patients with overall hypertension and in non-dipper patients, and were associated with echocardiographic and lipid parameters. The cut-off value of spexin identified in our study may be a useful indicator for hypertension detection and raise clinicians' awareness about evaluating prediabetic patients for hypertension.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"52 6","pages":"400-410"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121483","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}