European heart journal. Imaging methods and practice最新文献

{"title":"Myocardial active strain energy density and contractance: novel prognostic tools for left ventricular function and cardiovascular risk.","authors":"David H MacIver, Henggui Zhang, David Oxborough, Steffen E Petersen, Nay Aung","doi":"10.1093/ehjimp/qyaf105","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf105","url":null,"abstract":"<p><p>Myocardial active strain energy density (MASED), also known as contractance, is a novel measure of myocardial contractile function, defined by the area within the stress-strain loop; it quantifies the energy per unit volume of myocardium used to perform work. MASED applies the principle of strain energy density, which is grounded in engineering science, to cardiac tissue. Using cardiovascular magnetic resonance imaging, we demonstrate that global longitudinal active strain energy density (GLASED), a subtype of MASED, provides superior predictive value compared to conventional metrics such as ejection fraction and global longitudinal strain in predicting mortality among patients with hypertensive heart disease, dilated cardiomyopathy, and amyloid heart disease (<i>n</i> = 183). In a large community-based cohort (<i>n</i> = 44 957), GLASED was the strongest independent predictor of all-cause mortality and major adverse cardiovascular events among 23 left ventricular structural and functional metrics. Echocardiographic assessment of GLASED further revealed significant associations with age and sex in healthy individuals. These findings indicate that MASED, and specifically GLASED, provide a more accurate and mechanistically grounded assessment of left ventricular performance and cardiovascular risk than established measures. In clinical practice, MASED has the potential to enhance risk stratification, guide heart failure management, and differentiate pathological from physiological hypertrophy. Prospective prognostic studies in wider disease populations are warranted to validate its clinical utility.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 4","pages":"qyaf105"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low peak oxygen uptake in relation to total heart volume as an early marker of sub-clinical diastolic dysfunction.","authors":"Katarina Steding-Ehrenborg, Anders Nelsson, Henrik Engblom, Ellen Ostenfeld, Per M Arvidsson, Martin Magnusson, J Gustav Smith, Håkan Arheden","doi":"10.1093/ehjimp/qyaf115","DOIUrl":"10.1093/ehjimp/qyaf115","url":null,"abstract":"<p><strong>Aims: </strong>Peak oxygen uptake (VO₂peak) is closely related to total heart volume (THV) in healthy individuals. This study aimed to investigate (i) the association between VO₂peak and THV in subjects with sub-clinical diastolic dysfunction, athletes, healthy controls, and patients with established heart failure with and without preserved ejection fraction (HFpEF and HFrEF), and (ii) whether VO₂peak/THV-index can distinguish between subjects with sub-clinical diastolic dysfunction, HFpEF, HFrEF, and healthy controls.</p><p><strong>Methods and results: </strong>Seventy participants were included: 15 with sub-clinical diastolic dysfunction (defined as showing only 1-2 echocardiographic signs of diastolic dysfunction, not meeting clinical diagnostic criteria), 10 athletes, 15 healthy controls, and 30 heart failure patients (15 HFpEF and 15 HFrEF). VO₂peak was assessed by cardiopulmonary exercise testing and THV by cardiovascular magnetic resonance imaging. In sub-clinical diastolic dysfunction, THV was a weak determinant of VO₂peak (<i>R</i> ² = 0.41, <i>P</i> = 0.01), and even weaker in heart failure (<i>R</i> ² = 0.16, <i>P</i> = 0.03). However, THV strongly predicted VO₂peak in athletes and controls combined (<i>R</i> ² = 0.87, <i>P</i> < 0.0001). VO₂peak/THV did not distinguish healthy controls from sub-clinical diastolic dysfunction but could reliably discriminate between healthy controls and patients with heart failure.</p><p><strong>Conclusion: </strong>Subjects with sub-clinical diastolic dysfunction may have an altered relationship between VO₂peak and THV, approaching that of patients with established heart failure. Thus, this proof-of-concept study indicates that sub-clinical diastolic dysfunction constitutes a group of patients that may be of interest to follow over time to prevent continued deterioration of cardiac function. Furthermore, the VO₂peak/THV ratio can be used to distinguish between healthy controls and overt heart failure.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf115"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of superb microvascular imaging in cardiac metastasis.","authors":"Yuta Torii, Madoka Sano, Hideyuki Hayashi, Aoi Hamano, Yutaka Furukawa","doi":"10.1093/ehjimp/qyaf114","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf114","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf114"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of left ventricular global longitudinal strain across acquisition and analysis techniques: a prospective comparative study.","authors":"FeiFei Gong, Nausheen Akhter, Inga Vaitenas, Bernadette Wodzinski, Nicola Lancki, Leah J Welty, Kameswari Maganti","doi":"10.1093/ehjimp/qyaf101","DOIUrl":"10.1093/ehjimp/qyaf101","url":null,"abstract":"<p><strong>Aims: </strong>Left ventricular (LV) global longitudinal strain (GLS) is a sensitive marker for detection of subclinical LV systolic dysfunction, but variability in acquisition and analysis may limit its clinical utility. We studied the accuracy, variability, and correlation of LV GLS across different 2D and 3D echocardiographic acquisition methods and post-processing platforms.</p><p><strong>Methods and results: </strong>In this prospective study, we analyzed 254 consecutive patients (mean age 55 ± 16 years, 60% female) undergoing clinically indicated echo. GLS was measured using multiple 2D acquisition methods (three beats and single beat) and 3D. Analyses were performed using both vendor-specific (EchoPac) and vendor-neutral (TomTec-Arena) software. Correlations and agreement between methods were assessed using Pearson correlation, intraclass correlation coefficients (ICCs), and Bland-Altman analyses.GLS values were highly consistent across the acquisition methods and between software platforms. Mean GLS values were -19.4 ± 3.3 (2D-A), -19.2 ± 3.3 (2D-B), -19.1 ± 3.5 (3P), and -14.8 ± 4.1 (3D). Intra- and interobserver variability for 2D GLS was low (ICC >0.9), indicating excellent reproducibility. However, 3D GLS values were significantly lower than 2D (mean difference -4.3%), with only moderate correlation (<i>r</i> = 0.66), suggesting that 2D and 3D GLS values are not interchangeable.</p><p><strong>Conclusion: </strong>The LV GLS is a reliable method for assessment of LV function with strong reproducibility across differing acquisition and analysis methods. However, 3D GLS is consistently lower and should not be used interchangeably with 2D measurements. These findings underscore the need for ongoing standardization and caution in comparing GLS values across 2D and 3D methods.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf101"},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of music as an adjunct to sedation in patients undergoing transoesophageal echocardiography.","authors":"Amanda de Vasconcelos Eng, João Afonso Astolfi Martins, Edgar Bezerra Lira Filho, Claudio Henrique Fischer, Claudia Gianini Monaco, Alessandra Joslin Oliveira, Fernando Rodrigues da Camara Oliveira, Marcelo Luiz Campos Vieira, Samira Saady Morhy, Ana Clara Tude Rodrigues","doi":"10.1093/ehjimp/qyaf084","DOIUrl":"10.1093/ehjimp/qyaf084","url":null,"abstract":"<p><strong>Aims: </strong>Transoesophageal echocardiography (TEE) is widely used for cardiac assessment and requires moderate sedation due to its semi-invasive nature, carrying potential risks. Music is a non-pharmacological strategy shown to reduce anxiety in various clinical settings. We prospectively investigated whether music could reduce anxiety and/or sedation dosage in patients undergoing TEE.</p><p><strong>Methods and results: </strong>Sixty-three patients (>18 years) referred for TEE were randomized into a music group (<i>n</i> = 31) or control group (<i>n</i> = 32). All completed an anxiety questionnaire and had haemodynamic parameters (blood pressure, heart rate, oxygen saturation) assessed prior to transthoracic echocardiography (TTE). Music was played before TTE and continued throughout TEE in the intervention group. Anxiety and haemodynamic measurements were repeated after TTE, before sedation. Groups were compared for baseline characteristics, anxiety levels, haemodynamic changes, and midazolam dosage. There was no difference between the groups regarding age or sex; control group had more comorbidities. Anxiety levels did not differ between groups at baseline or pre-sedation (<i>P</i> > 0.05). A significant reduction over time was observed only in the music group (<i>P</i> = 0.032 vs. <i>P</i> = 0.069), but group-by-time interaction was not significant (<i>P</i> = 0.347). Regarding anxiety level, it decreased in both groups, more markedly in the music group (<i>P</i> < 0.008 vs. <i>P</i> = 0.04). Diastolic blood pressure also decreased after music exposure (<i>P</i> = 0.024). Midazolam dosage did not differ between groups but was inversely correlated with age.</p><p><strong>Conclusion: </strong>Although music did not reduce sedation requirements, it significantly decreased anxiety levels and blood pressure; music may be a valuable adjunct to sedation in patients undergoing TEE.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf084"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What role for cardiac imaging in chronic coronary syndromes: review of the literature in light of the latest recommendations.","authors":"David Sulman, Stéphane Manzo-Silberman","doi":"10.1093/ehjimp/qyaf112","DOIUrl":"10.1093/ehjimp/qyaf112","url":null,"abstract":"<p><p>The 2019 ESC guidelines redefined stable coronary artery disease as chronic coronary syndrome (CCS), highlighting the dynamic nature of this disease. This condition is characterized by the gradual accumulation of atherosclerotic plaques in the epicardial coronary arteries. CCS can result in myocardial ischaemia due to supply-demand mismatch, often triggered by physical or emotional stress. The clinical course may be abruptly interrupted by plaque rupture or erosion, leading to acute coronary syndromes. Revolutionary advances in non-invasive imaging have transformed the chronic coronary syndrome diagnosis algorithm and management. Coronary computed tomography angiography provides detailed anatomical insights, identifying high-risk plaques with features like low attenuation and positive remodelling, as evidenced by SCOT-HEART, which reported reduced coronary events (HR: 0.59, <i>P</i> = 0.004). Stress echocardiography may detect ischaemia-induced wall motion abnormalities (sensitivity, 85-95%), while cardiovascular magnetic resonance is paramount in functional assessment, offering 81-86% sensitivity/specificity and detecting microvascular dysfunction via perfusion and late gadolinium enhancement. Nuclear imaging (SPECT/PET) enhances ischaemia detection, with PET's myocardial flow reserve improving prognostic accuracy (sensitivity 90%, specificity 88%). AI-driven innovations, such as CT-derived fractional flow reserve, automate plaque quantification and may reduce in the future unnecessary invasive angiographies by 19-25% (<i>P</i> = 0.01), while dynamic CT myocardial perfusion integrates anatomical and hemodynamic data, boosting diagnostic accuracy (87%). These advancements enable precise risk stratification and a personalized multimodal imaging approach, based on pre-test likelihood. It also increases the risk of unsustainable costs for society, repeated radiation exposure throughout a patient's life, and raises the question of actual limited benefits from revascularization in low-risk patients.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf112"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readability of patient education materials on cardiac magnetic resonance imaging.","authors":"Albert Dayor Piersson, Bismark Ofori-Manteaw, Hanifatu Napari Mumuni, Klenam Dzefi-Tettey","doi":"10.1093/ehjimp/qyaf111","DOIUrl":"10.1093/ehjimp/qyaf111","url":null,"abstract":"<p><strong>Aims: </strong>We assessed the readability level of online patient education materials (PEMs) for cardiac MRI (CMRI) to determine whether they meet the standard health literacy needs as determined by the US National Institutes of Health and the American Medical Association guidelines.</p><p><strong>Methods and results: </strong>We evaluated the readability of CMRI PEMs from 5 websites using the Flesch-Kincaid Reading Ease (FKRE), Flesch-Kincaid grade level (FKGL), Gunning-Fog Index (GFI), Simple Measure of Gobbledygook index (SMOGI), Coleman-Liau Index (CLI), and Automated Readability Index (ARI). PEMs on the British Heart Foundation (BHF) website yielded the highest mean FKRE score, while the RadiologyInfo.org (RadInfo) website yielded the highest mean score on the CLI compared to all the other websites. Statistical analysis of individual predictors revealed that average words per sentence (<i>P</i> < 0.001) and average syllables per word (<i>P</i> < 0.001) were strong determinants of FKRE for the RadInfo PEMs. In contrast, sentences (<i>P</i> = 0.044), words (<i>P</i> = 0.046), average words per sentence (<i>P</i> = <0.001), and average syllables per word (<i>P</i> = <0.001) were significant predictors of FKRE for the InsideRadiology (InsRad) PEMs. The sensitivity analysis consistently confirmed the robustness and primary influence of average words per sentence and average syllables per word.</p><p><strong>Conclusion: </strong>The BHF and American Heart Association emphasize accessible CMRI communication, whereas RadInfo, InsRad, and the European Society of Cardiology PEMs may be less suitable for low-health-literacy audiences. Strategies aimed at enhancing the comprehensibility of patient education materials should primarily focus on reducing the average complexity of words and shortening average sentence lengths.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf111"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: A deep learning model for classifying left ventricular enlargement for both transthoracic echocardiograms and handheld cardiac ultrasound.","authors":"","doi":"10.1093/ehjimp/qyaf104","DOIUrl":"10.1093/ehjimp/qyaf104","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjimp/qyaf049.].</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf104"},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speckle tracking echocardiography for prediction of arrhythmias in idiopathic ventricular fibrillation.","authors":"Rasmus B Dinesen, Ulrik Christian G Winsløw, Michael Vinther, Berit Th Philbert, Tor Biering-Sørensen, Niels Stampe, Bo G Winkel, Jacob Tfelt-Hansen, Niels Risum","doi":"10.1093/ehjimp/qyaf099","DOIUrl":"10.1093/ehjimp/qyaf099","url":null,"abstract":"<p><strong>Aims: </strong>Individuals experiencing a sudden cardiac arrest with ventricular fibrillation and no identifiable cause are diagnosed with idiopathic ventricular fibrillations (IVFs). 2D speckle tracking echocardiography (2DSTE) has been able to detect differences between IVF patients and controls. However, the association between these differences and the risk of ventricular arrhythmias (VAs) remains unknown.This study aimed to investigate whether parameters derived from myocardial deformation analysis using 2DSTE are associated with the recurrence of VA in IVF patients.</p><p><strong>Methods and results: </strong>This single-centre, cross-sectional study enrolled IVF patients treated with an implantable cardioverter defibrillator. IVF patients were compared with healthy sex- and age-matched controls. Furthermore, IVF patients were categorized into two groups (IVF patients with or without recurrent VA) based on the recurrence of VA over a 5-year follow-up period. Left ventricular global longitudinal strain (LVGLS) and left ventricular mechanical dispersion (LVMD) were investigated using 2DSTE and compared across all groups. Fifty-six IVF patients, males 39 (69.9%), age 49 ± 15 years, and 55 controls were included. IVF patients showed significantly increased LVMD (35.78 ± 13.4 ms vs. 31.0 ± 9.8 ms; <i>P</i> = 0.03) and decreased LVGLS (-18.8% ± 3.0% vs. -20.5% ± 2.7%; <i>P</i> < 0.01) compared with controls. IVF patients with recurrent VA had significantly increased LVMD compared with IVF patients without recurrent VA (43.63 ± 13.63 vs. 33.16 ± 12.45; <i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>IVF patients had an increased LVMD and decreased LVGLS compared with healthy controls. Increased LVMD was significantly associated with recurrent VA in IVF patients suggesting a potential clinical value in risk stratification of VA recurrency in IVF patients.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf099"},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aorta unveiled: the crucial role of imaging in diagnosing and managing aortic disease-a review.","authors":"Jean-Baptiste Ricco, Aurélien Hostalrich, Xavier Chaufour","doi":"10.1093/ehjimp/qyaf108","DOIUrl":"10.1093/ehjimp/qyaf108","url":null,"abstract":"<p><p>Aortic diseases, including aneurysmal and occlusive pathologies of the thoracic and abdominal aorta, represent a significant source of cardiovascular morbidity and mortality. This narrative review explores the role of modern and emerging imaging modalities in the management of aortic disease and highlights the pivotal roles of computed tomography angiography (CTA), magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS). CTA remains the cornerstone for evaluating aneurysms, dissections, and traumatic injuries, offering high spatial resolution, rapid acquisition, and detailed anatomical assessment. MRI, particularly with advanced sequences such as 4D flow, provides comprehensive multiparametric evaluation without radiation exposure, making it ideal for younger patients and those requiring repeat imaging. Positron emission tomography (PET), especially when integrated with CTA or MRI, enables metabolic characterization of inflammation and infection in aortic walls. Ultrasound, particularly CEUS, remains indispensable in abdominal aortic aneurysm (AAA) screening and post-endovascular aortic aneurysm repair (EVAR) surveillance, especially in patients with renal impairment. Emerging technologies, including hybrid imaging, radiomics, and artificial intelligence (AI) are reshaping the landscape of aortic diagnostics. These innovations enhance detection of subtle imaging features, automate measurements, and may enable prediction of disease progression or complications.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf108"},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}