Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir最新文献

{"title":"Endothelin-Dependent Myocardial Dysfunction in an Experimental Endotoxic Shock Model.","authors":"Mustafa Boz, Alper Bektaş İskit","doi":"10.5543/tkda.2026.27303","DOIUrl":"10.5543/tkda.2026.27303","url":null,"abstract":"<p><strong>Objective: </strong>Impaired myocardial contractility is a major contributor to cardiovascular failure during septic shock; however, the underlying mechanisms remain incompletely understood. This study investigated the roles of endothelin and nitric oxide (NO) in cardiac dysfunction using the endothelin receptor antagonist tezosentan and nitric oxide synthase (NOS) inhibitors in an experimental model of endotoxic shock.</p><p><strong>Method: </strong>Endotoxic shock was induced in rats via intraperitoneal injection of lipopolysaccharide (LPS, 1 mg/kg). Hearts were isolated four hours after LPS or saline administration and perfused using a Langendorff apparatus. Myocardial contractility, coronary perfusion pressure, and heart rate were recorded. The effects of tezosentan and NOS inhibitors (Nω-nitro-L-arginine methyl ester [L-NAME], aminoguanidine, and S-methylisothiourea sulfate [AETU]) were assessed by adding these agents to the perfusate. In parallel, atrial and papillary muscle contractility and spontaneous beating rates were evaluated using isolated tissue preparations in in vitro organ bath studies.</p><p><strong>Results: </strong>Baseline myocardial contractility was significantly reduced in LPS-treated perfused hearts compared with controls (3.03 +- 0.25 vs. 4.94 +- 0.39 g, P < 0.05), whereas no significant differences were observed in isolated atrial or papillary muscle preparations. Coronary perfusion pressure was significantly increased in the LPS group (101 +- 6 vs. 79 +- 6 mmHg, P < 0.05). Tezosentan significantly attenuated the LPS-induced reduction in myocardial contractility but did not affect the increase in perfusion pressure. None of the NOS inhibitors altered myocardial contractility or perfusion pressure in LPS-treated hearts.</p><p><strong>Conclusion: </strong>Myocardial contractility impairment in experimental endotoxic shock occurs only in the presence of an intact coronary vasculature and is prevented by endothelin receptor blockade. These findings suggest that vascular endothelium-derived endothelin plays a key role in myocardial depression during endotoxic shock, whereas nitric oxide appears to have a limited contribution in this model.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"513-518"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378989","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":"Subclinical Cardiac Dysfunction in Children with Iron Deficiency Anemia Assessed by Tissue Doppler and Speckle-Tracking Echocardiography.","authors":"Betül Pehlivan Zorlu, İbrahim İlker Çetin, Emine Azak, Hazım Alper Gürsü, Utku Pamuk, Namık Yaşar Özbek","doi":"10.5543/tkda.2026.21477","DOIUrl":"10.5543/tkda.2026.21477","url":null,"abstract":"<p><strong>Objective: </strong>Iron deficiency is the leading cause of anemia in childhood and may induce cardiovascular adaptations, including increased heart rate, elevated cardiac output, plasma volume expansion, and myocardial remodeling. Beyond hematologic consequences, reduced iron availability may also affect myocardial structure and function. This study aimed to assess biventricular function in children with iron deficiency anemia using two-dimensional speckle-tracking echocardiography.</p><p><strong>Method: </strong>This prospective case-control study included pre- and post-treatment evaluations. Forty children with iron deficiency anemia and 29 healthy controls were enrolled. Of the 40 patients, 24 were re-evaluated after treatment. Tissue Doppler imaging was used to measure myocardial velocities, isovolumic contraction time, isovolumic relaxation time, and ejection time at the interventricular septum and the basal segments of both ventricles. Speckle-tracking echocardiography was used to assess left ventricular longitudinal strain (LS) and strain rate, left ventricular circumferential strain and strain rate, as well as right ventricular global longitudinal strain and strain rate.</p><p><strong>Results: </strong>Left and right ventricular LS values improved following treatment, indicating recovery of myocardial function. Tissue Doppler parameters also demonstrated improvement in both systolic and diastolic function.</p><p><strong>Conclusion: </strong>Although significant improvement was observed after treatment, some echocardiographic parameters did not fully normalize, suggesting that subtle myocardial alterations may persist. These findings should be interpreted with caution due to the relatively small sample size and the predominance of mild-to-moderate anemia in the study population. Children with iron deficiency anemia may benefit from longer-term follow-up and post-treatment evaluation.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"480-486"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379037","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":"Transient Receptor Potential Channel Signaling in Hypertension: Mechanisms, Translation, and Therapeutic Targeting.","authors":"Algül Dilara Dokumacı, Belgin Alaşehirli, Akif Serhat Balcıoğlu","doi":"10.5543/tkda.2026.34864","DOIUrl":"10.5543/tkda.2026.34864","url":null,"abstract":"<p><p>Arterial hypertension (HT) is a major risk factor in the pathogenesis of cardiovascular diseases and has a high prevalence. The pathogenesis of primary HT, which accounts for the majority of HT cases, has not been fully elucidated; therefore, effective treatment targets remain an important area of research. Transient receptor potential (TRP) channels represent a distinct class of cation channels that play a pivotal role in signal transduction by altering membrane potential or intracellular Ca2+ concentration. Based on sequence similarity, TRP channels are classified into six subfamilies: TRP canonical (TRPC), TRP melastatin (TRPM), TRP vanilloid (TRPV), TRP mucolipin (TRPML), TRP ankyrin (TRPA), and TRP polycystin (TRPP). These channels exhibit broad expression across diverse tissues and cell types and play critical roles in numerous pathophysiological processes through the regulation of ion concentrations (Ca2+, Mg2+, Na+, and K+) and the modulation of intracellular signal transduction pathways. Research involving human subjects, as well as experimental models, highlights the essential role of TRP channels in maintaining vascular homeostasis and regulating blood pressure. TRP channels, particularly TRPCs, have gained increasing attention for their role in resistant HT, a condition in which blood pressure remains uncontrolled despite the use of multiple antihypertensive drugs. Additionally, these channels have been identified as central mediators of inflammation and oxidative stress, processes that are pivotal in the pathogenesis of cardiovascular disorders, including HT. This review summarizes current evidence on TRPC, TRPV, and TRPM channels in HT, highlighting emerging translational findings and potential therapeutic implications.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"463-470"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648075","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":"The Effect of Predilatation on Procedural Outcomes in Patients Undergoing Saphenous Vein Graft Percutaneous Coronary Intervention for Acute Coronary Syndrome.","authors":"Mustafa Berat Dumlu, Mehmet Şahinbaş, Gülaçan Tekin, Anıl Şahin, Yücel Kanal, Nurcansu Oğrak Dumlu","doi":"10.5543/tkda.2026.99740","DOIUrl":"10.5543/tkda.2026.99740","url":null,"abstract":"<p><strong>Objective: </strong>Percutaneous coronary interventions (PCI) of saphenous vein grafts (SVG) are technically challenging due to friable plaques, high thrombus burden, and the risk of distal embolization. The impact of balloon predilatation on outcomes in patients presenting with acute coronary syndrome (ACS) remains unclear. This study aimed to evaluate the effect of predilatation in patients undergoing SVG PCI.</p><p><strong>Method: </strong>In this single-center retrospective study, 202 patients with ACS and prior coronary artery bypass graft (CABG) surgery who underwent PCI to an SVG between 2007 and 2024 were analyzed. Patients were categorized according to whether predilatation was performed before stent implantation (predilatation group, n = 112; no predilatation group, n = 90). Coronary flow was assessed using the Thrombolysis in Myocardial Infarction (TIMI) classification. Logistic regression analysis was performed to identify independent predictors of inadequate post-procedural flow (TIMI < 3).</p><p><strong>Results: </strong>Baseline demographic and clinical characteristics were comparable between the groups. Post-procedural TIMI 3 flow was achieved in 69.6% of the predilatation group and 55.6% of the non-predilatation group (P = 0.039). Predilatation (odds ratio [OR] = 0.51, P = 0.030) and the use of glycoprotein IIb/IIIa inhibitors (OR = 0.39, P = 0.003) were independently associated with a lower risk of inadequate flow. ST-segment elevation myocardial infarction (STEMI) was associated with a higher risk of inadequate TIMI flow (OR = 2.37, P = 0.039). Lipid parameters and statin use were not associated with TIMI flow outcomes.</p><p><strong>Conclusion: </strong>In patients with ACS undergoing SVG PCI, predilatation before stent implantation was associated with improved reperfusion, as reflected by higher rates of post-procedural TIMI 3 flow. The use of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors was associated with additional protection. Larger prospective studies are warranted.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"487-495"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725343","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":"The Efficacy of Sacubitril/Valsartan in the Treatment of Peripartum Cardiomyopathy: A Retrospective Analysis of Four Cases.","authors":"Seçkin Dereli, Osman Eren Kır, Fatma Demirci","doi":"10.5543/tkda.2025.33506","DOIUrl":"10.5543/tkda.2025.33506","url":null,"abstract":"<p><p>Peripartum cardiomyopathy (PPCM) is a rare form of cardiomyopathy that develops in the last months of pregnancy or during the postpartum period and is characterized by a decrease in left ventricular ejection fraction below 45%. The diagnosis and management of PPCM can be difficult because the symptoms of the disease may be confused with normal pregnancy symptoms. This requires physicians to maintain a high level of clinical suspicion. PPCM can be fatal if not correctly diagnosed and treated. In this case series, we describe the clinical course of four PPCM patients treated with sacubitril/valsartan (S/V) in addition to standard therapy. In these patients, S/V therapy was associated with improvements in left ventricular function. By the end of the first month, all patients demonstrated recovery of ejection fraction above 50% and were classified as New York Heart Association (NYHA) class I. These preliminary observations suggest that S/V may represent a potential treatment option for PPCM, although confirmation in larger studies is required. Although data on the use of S/V in PPCM remain limited, our case series provides preliminary insights that warrant further investigation. PPCM can lead to permanent cardiac damage and other severe complications if not properly managed. The management of PPCM requires a multidisciplinary approach, emphasizing the importance of timely intervention. Our observations indicate that S/V could be considered a possible therapeutic option, but confirmation in larger cohorts is needed.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"519-523"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544012","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":"Structural and Functional Cardiac Reverse Remodeling After Bariatric Surgery: A Prospective Comparison of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass.","authors":"Kareem Ali Maher, Reda Nabil Dawoud, Osama Abouelfetouh Elshaer, Ramy Magdy Elgamal, Mohamed Shokry Fahmy, Ezz Eldin Ebrahim Gaber, Dina Ahmed Muhammad Abdelmoneim, Mohamed Elsayed Abdelfattah, Reda Biomy, Wael Anwar Hassib","doi":"10.5543/tkda.2026.23796","DOIUrl":"10.5543/tkda.2026.23796","url":null,"abstract":"<p><strong>Objective: </strong>Obesity is associated with characteristic cardiac remodeling, including left ventricular (LV) hypertrophy, concentric geometry, and subclinical myocardial dysfunction. Bariatric surgery induces reverse cardiac remodeling; however, it remains unclear whether structural and functional recovery differ between sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), and to what extent these changes are driven by weight loss versus metabolic and inflammatory mechanisms.</p><p><strong>Method: </strong>In this prospective observational cohort study, 100 adults with severe obesity (body mass index [BMI] > 35 kg/m²) undergoing primary bariatric surgery (SG, n = 50; RYGB, n = 50) were evaluated at baseline and six months postoperatively. Clinical, metabolic, inflammatory, and echocardiographic parameters-including left ventricular mass index (LVMI), epicardial adipose tissue (EAT) thickness, diastolic function, and global longitudinal strain (GLS)-were assessed using standardized transthoracic echocardiography with speckle-tracking analysis. Multivariable regression identified independent predictors of structural (ΔLVMI) and functional (ΔGLS) improvement.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups (mean age 35.9 years; 67% female; BMI 47.1 kg/m²). Both procedures resulted in significant improvements in anthropometric, metabolic, inflammatory, and cardiac parameters. RYGB was associated with greater reductions in BMI (-10.74 +- 2.42 vs. -9.32 +- 2.42 kg/m²; P = 0.004), glycated hemoglobin (HbA1c) (median -1.40% vs. -0.90%; P = 0.007), and C-reactive protein (CRP) (P = 0.029). Structural reverse remodeling was more pronounced following RYGB, with greater reductions in LVMI (median -12.0 vs. -6.5 g/m²·⁷; P < 0.001) and EAT thickness (-1.20 vs. -0.70 mm; P = 0.014). GLS improved in both groups (-2.33% vs. -1.40%; P = 0.031). However, multivariable analysis demonstrated that improvement in GLS was independently associated with baseline GLS, reduction in LV mass, and improvements in HbA1c and CRP, rather than the type of surgical procedure.</p><p><strong>Conclusion: </strong>Bariatric surgery leads to significant reverse cardiac remodeling in patients with severe obesity. RYGB is associated with greater structural regression, whereas improvement in myocardial deformation appears to be primarily driven by metabolic improvement and inflammatory changes rather than surgical technique. These findings suggest that cardiac recovery reflects an integrated process involving structural, metabolic, and inflammatory restoration beyond weight loss alone.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"471-479"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793650","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":"Pacemaker Pocket Infection with Generator Migration and Extrusion from the Left Mammary Areola.","authors":"Uğur Canpolat, Ahmet Hakan Ateş","doi":"10.5543/tkda.2026.69037","DOIUrl":"10.5543/tkda.2026.69037","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"530-531"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694526","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":"Reply to the Letter to the Editor: 'Stress Hyperglycemia Ratio Is Associated with Intracardiac Thrombus in Acute Ischemic Stroke'.","authors":"Vedat Cicek, Almina Erdem, Ezgi Hasret Hasret Kozan Çıkırıkçı, İrem Yılmaz, Elif Günhan, Emrecan Uygun, Salih Karaismail, Mehmet Uzun, Mert İlker Hayıroğlu, Ahmet Lütfullah Orhan, Tufan Çınar","doi":"10.5543/tkda.2026.67374","DOIUrl":"10.5543/tkda.2026.67374","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"536-537"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709273","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":"Quality of Life Outcomes in Patients with Pulmonary Hypertension Receiving Prostacyclin Therapy: Impact of Anxiety, Depression, Sociodemographic Characteristics, and Treatment-Related Factors.","authors":"Fatma Yıldırım, Elif Ok, Vesile Ünver, Dilek Sezgin, Halil Ataş, Betül Şentürk Saraç","doi":"10.5543/tkda.2026.01628","DOIUrl":"10.5543/tkda.2026.01628","url":null,"abstract":"<p><strong>Objective: </strong>Despite advances in prostacyclin therapy, pulmonary hypertension (PH) continues to impair patients' quality of life (QoL). This study aimed to identify the clinical and psychological factors associated with QoL in patients receiving prostacyclin therapy.</p><p><strong>Method: </strong>This cross-sectional study was conducted between July 2023 and September 2024 and included 58 patients with PH receiving prostacyclin therapy. Data were collected using a structured questionnaire assessing sociodemographic and disease-related characteristics. Symptom severity, anxiety, depression, and QoL were evaluated using the Pulmonary Arterial Hypertension Symptom Scale (PAHSS), the Hospital Anxiety and Depression Scale (HADS), and the EmPHasis-10 Questionnaire.</p><p><strong>Results: </strong>The mean age of the patients was 48.89 +- 16.17 years, and 69% were female. Overall, 69% had at least one chronic comorbidity, 19% required continuous oxygen therapy, and the mean disease duration was 7.45 +- 6.84 years. The average duration of prostacyclin therapy was 28.03 +- 34.21 months. Mean scores were 71.52 +- 36.40 for PAHSS, 8.70 +- 5.23 for HADS-Anxiety, 7.82 +- 5.32 for HADS-Depression, and 30.05 +- 14.92 for EmPHasis-10. EmPHasis-10 scores showed moderate correlations with PAHSS, HADS-Anxiety, HADS-Depression, and 6-minute walk test (6MWT) scores. In multivariate analysis, age, PAHSS score, anxiety, depression, and vomiting explained 80% of the variance in EmPHasis-10 scores.</p><p><strong>Conclusion: </strong>QoL was substantially impaired in patients with PH receiving prostacyclin therapy and was influenced by age, symptom severity, anxiety, depression, and vomiting.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"503-512"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427724","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":"A Tortuous 'Corkscrew' Aortic Arch Mimicking Coarctation: A Diagnostic Pitfall in Multimodality Imaging.","authors":"Aslıhan Karaman, Selman Gökalp, Alper Güzeltaş","doi":"10.5543/tkda.2026.29562","DOIUrl":"10.5543/tkda.2026.29562","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"528-529"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709268","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}