Lorenzo Serio, Riccardo Beccari, Stefano Nistri, Antonella Cecchetto, Gianni Pedrizzetti, Donato Mele
{"title":"Intracardiac flow dynamics in mitral regurgitation: state of the art.","authors":"Lorenzo Serio, Riccardo Beccari, Stefano Nistri, Antonella Cecchetto, Gianni Pedrizzetti, Donato Mele","doi":"10.1093/ehjimp/qyaf022","DOIUrl":"10.1093/ehjimp/qyaf022","url":null,"abstract":"<p><p>Intracardiac flow dynamics is a complex phenomenon interrelated with cardiac mechanics. Today, it can be evaluated non-invasively using various imaging modalities, including echocardiography, magnetic resonance imaging, and computed tomography. This review explores the effects of mitral regurgitation on blood flow dynamics inside the left ventricular and atrial cavities and emphasizes the disruption of normal flow dynamics caused by mitral regurgitation, leading to turbulent flow and increased energy dissipation. It further examines the consequences of mitral valve repair and replacement, noting that, while repair generally improves intracardiac flow dynamics compared with replacement, residual flow disturbances may persist. Finally, the implications of abnormal intracardiac vorticity on left ventricular wall stress, myocardial remodelling, and thromboembolic risk are discussed.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf022"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627314","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}
Axel Abel Rodriguez-Mendez, Hugo Gerardo Rodriguez-Zanella, Ana Maria Coeto-Cano, David Jacobo Sanchez-Amaya, Daniel Manzur-Sandoval
{"title":"Recurrent locally uncontrolled infection in endocarditis, a fearful complication.","authors":"Axel Abel Rodriguez-Mendez, Hugo Gerardo Rodriguez-Zanella, Ana Maria Coeto-Cano, David Jacobo Sanchez-Amaya, Daniel Manzur-Sandoval","doi":"10.1093/ehjimp/qyae117","DOIUrl":"https://doi.org/10.1093/ehjimp/qyae117","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyae117"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451361","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}
Eric Saloux, Christophe Simard, Pauline Ruello, Adrien Lemaitre, Amir Hodzic, Alexandre Lebrun, Pierre-Antoine Dupont, Christophe Tribouilloy, Hélène Eltchaninoff, Morgane Le Garec, Christophe Fraschini, Vladimir Saplacan, Alain Manrique
{"title":"Impact of loading, heart rate, and short episodes of ischaemia on myocardial stiffness assessed using shear wave elastography in an open-chest animal model.","authors":"Eric Saloux, Christophe Simard, Pauline Ruello, Adrien Lemaitre, Amir Hodzic, Alexandre Lebrun, Pierre-Antoine Dupont, Christophe Tribouilloy, Hélène Eltchaninoff, Morgane Le Garec, Christophe Fraschini, Vladimir Saplacan, Alain Manrique","doi":"10.1093/ehjimp/qyaf015","DOIUrl":"10.1093/ehjimp/qyaf015","url":null,"abstract":"<p><strong>Aims: </strong>Shear wave elastography (SWE) is a new promising ultrasound modality that enables non-invasive measurement of the dynamic myocardial stiffness. The impact of varying physiological conditions on SWE measurement of left ventricular (LV) myocardial stiffness remains poorly investigated.</p><p><strong>Methods and results: </strong>Nineteen sheep were evaluated during open-chest surgery. Epicardial multiframe SWE acquisitions were performed in short-axis view simultaneously with haemodynamic acquisitions during inferior vena cava occlusion, aortic clamping, atrial pacing, and ischaemia-reperfusion. The cyclic variation in the median value of LV myocardial stiffness ranged from 1.1 m/s in diastole (C<sub>min</sub>) to 2.4 m/s in systole (C<sub>max</sub>). At steady state, intra-animal reproducibility was good for C<sub>min</sub> [intraclass correlation coefficient ICC = 0.77 (0.54, 0.90), <i>P</i> < 0.001] and C<sub>max</sub> [ICC = 0.92 (0.84, 0.96), <i>P</i> < 0.001]. C<sub>min</sub> was independent of loading conditions, heart rate, and short 15-minute episodes of ischaemia and reperfusion. C<sub>max</sub> was independent of loading conditions and moderate increase in heart rate but decreased significantly during ischaemia and reperfusion. Compared with baseline, percentage changes in C<sub>max</sub> was correlated to percentage changes in dP/dt<sub>max</sub> (<i>R</i> = 0.47, <i>P</i> = 0.001) and in LV systolic pressure (<i>R</i> = 0.35, <i>P</i> = 0.013) and SW (<i>R</i> = 0.31, <i>P</i> = 0.026).</p><p><strong>Conclusion: </strong>In this study, LV diastolic myocardial stiffness C<sub>min</sub> assessed using SWE demonstrated the characteristics of a potentially useful clinical marker of LV diastolic function linked to the intrinsic elastic properties of the myocardium, whereas C<sub>max</sub> was an indicator of LV contractility.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf015"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560312","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}
Stefano Figliozzi, Erika Hutt, Alessia Gimelli, Wael A Jaber
{"title":"Cardiac imaging highlights from European Society of Cardiology 2024: the future is within our grasp!","authors":"Stefano Figliozzi, Erika Hutt, Alessia Gimelli, Wael A Jaber","doi":"10.1093/ehjimp/qyaf009","DOIUrl":"10.1093/ehjimp/qyaf009","url":null,"abstract":"<p><p>The European Society of Cardiology has held its annual Congress in London, UK, from 30 August to 2 September 2024. With a total of 31 800 participants, 5400 faculty and presenters, and many National Cardiac Societies and industry partners, the Congress has taken an enormous step forward to present and discuss the latest advances in cardiovascular medicine. The sizable intercontinental reach was proved by the fact that 5 of the 10 top countries, in terms of submission of abstracts, were from outside Europe: China, the USA, Japan, Korea, and Australia. This brought a great impetus for international collaboration and exchange of views, learning from different perspectives. Specifically, the field of cardiovascular imaging has been in the spotlight, remarking its growing, central, and transversal role in modern cardiovascular medicine. In this communication, we offer a summary of some notable advances in research, either in terms of novelty or clinical applicability, within the realm of four imaging modalities: echocardiography, cardiovascular magnetic resonance, computed tomography, and nuclear imaging.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf009"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257743","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}
Benedetta Grossi, Giulia Luraghi, Sara Barati, Chiara Forte, Luca Gerosa, Ottavia Cozzi, Fabrizio D'Ascenzo, Gianluigi Condorelli, Francesco Migliavacca, Giulio Stefanini
{"title":"The impact of bicuspid valve morphology on the selection of transcatheter aortic valve implantation devices: an <i>in silico</i> study.","authors":"Benedetta Grossi, Giulia Luraghi, Sara Barati, Chiara Forte, Luca Gerosa, Ottavia Cozzi, Fabrizio D'Ascenzo, Gianluigi Condorelli, Francesco Migliavacca, Giulio Stefanini","doi":"10.1093/ehjimp/qyaf018","DOIUrl":"10.1093/ehjimp/qyaf018","url":null,"abstract":"<p><strong>Aims: </strong>Bicuspid aortic valve (BAV) represents a challenge for transcatheter aortic valve implantation (TAVI). Few data are reported about the procedural implications of BAV using different self-expandable devices. The aim of this study is to investigate how BAV and tricuspid aortic valve (TAV) morphologies influence device selection and their impact on the potential development of post-operative conduction disturbances, using a novel <i>in silico</i> approach.</p><p><strong>Methods and results: </strong>Five patients with BAV undergoing TAVI were enrolled. TAVs were virtually modelled within each BAV patient-specific anatomy, resulting in 10 virtual patients. Acurate Neo2 and Evolut R implantations were subsequently simulated across all cases. Post-implantation stresses exerted on both the stent and aortic root were measured, allowing a comparative analysis of the impact of the two valve morphologies. Comparing stent stresses between BAV and TAV configurations, the stress gap increased by 21.96 ± 5.35% (<i>P</i> = 0.01) in Acurate Neo2 cases (<i>n</i> = 6) compared with Evolut R cases (<i>n</i> = 4). The analysis of aortic root stresses showed no significant differences between BAV (<i>n</i> = 5) and TAV (<i>n</i> = 5) configurations, with a mean stress difference of 5.1 ± 8.17% (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Our patient-specific model shows that high radial force devices, such as Evolut R, demonstrate consistent expansion regardless of valve morphology, without increasing the risk of post-implantation conduction disturbances, hence resulting more suitable for BAV cases. Incorporating this methodology into pre-operative planning could support clinicians in selecting the most suitable device with a patient-specific approach.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf018"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560340","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}
Pruthvi C Revaiah, Kotaro Miyashita, Tsung-Ying Tsai, Retesh Bajaj, Nozomi Kotoku, Akihiro Tobe, Takashi Muramatsu, Kengo Tanabe, Ken Kozuma, Yukio Ozaki, Scot Garg, Shengxian Tu, Jouke Dijkstra, Christos V Bourantas, Yoshinobu Onuma, Patrick W Serruys
{"title":"Segmental post-percutaneous coronary intervention physiological gradients using ultrasonic or optical flow ratio: insights from ASET JAPAN study.","authors":"Pruthvi C Revaiah, Kotaro Miyashita, Tsung-Ying Tsai, Retesh Bajaj, Nozomi Kotoku, Akihiro Tobe, Takashi Muramatsu, Kengo Tanabe, Ken Kozuma, Yukio Ozaki, Scot Garg, Shengxian Tu, Jouke Dijkstra, Christos V Bourantas, Yoshinobu Onuma, Patrick W Serruys","doi":"10.1093/ehjimp/qyaf017","DOIUrl":"10.1093/ehjimp/qyaf017","url":null,"abstract":"<p><strong>Aims: </strong>Segmental pressure gradients post-percutaneous coronary intervention (PCI) can detect residual disease and optimization targets. Ultrasonic flow ratio (UFR) or optical flow ratio (OFR) offer simultaneous physiological and morphological assessment using a single imaging catheter. This study evaluated the utility of UFR and OFR in identifying residual disease post-PCI.</p><p><strong>Methods and results: </strong>The study include patients from the Acetyl Salicylic Elimination Trial JAPAN Pilot study with complete intravascular imaging pullback data, where UFR or OFR was obtained post-PCI. Anatomical focal lesions distal and proximal to the stent were analysed in segments ≥5 mm long. UFR or OFR virtual pullback curves assessed intra-stent pressure gradients, defining physiological focal or diffuse by segmental pressure drops ≥0.05 over lengths <10 or ≥10 mm, respectively. The median post-PCI UFR/OFR was 0.93 (0.88-0.96) with 35.4% (69/195) vessels having a UFR/OFR < 0.91. There were significantly more focal lesions, both anatomical and physiological, proximal and distal to the stent in vessels with UFR/OFR < 0.91 compared with those ≥0.91. Agreement between anatomical and physiological focal lesions was moderate proximally (kappa = 0.553, <i>P</i> < 0.001) and fair distally (kappa = 0.219, <i>P</i> = 0.002). The in-stent gradient poorly predicted significant stent under-expansion. However, the virtual fractional flow reserve gradient performed well in detecting proximal or distal focal disease (area under the curve = 0.835 and 0.877, respectively).</p><p><strong>Conclusion: </strong>UFR/OFR effectively identifies sub-optimal vessel physiology post-PCI and locates precise anatomical issues, validated by intravascular imaging.</p><p><strong>Trial registration: </strong>The ASET JAPAN ClinicalTrials.gov reference: NCT05117866.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf017"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461478","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":"Prediction of tricuspid regurgitation regression after mitral valve transcatheter edge-to-edge repair using three-dimensional transoesophageal echocardiography.","authors":"Makoto Takeuchi, Hiroto Utsunomiya, Kiyotaka Tohgi, Ayano Hamada, Yohei Hyodo, Akane Tsuchiya, Atsuo Mogami, Hajime Takemoto, Kanako Izumi, Kosuke Takahari, Yusuke Ueda, Kiho Itakura, Hiroki Ikenaga, Yukiko Nakano","doi":"10.1093/ehjimp/qyaf016","DOIUrl":"10.1093/ehjimp/qyaf016","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to identify three-dimensional echocardiographic predictors of tricuspid regurgitation (TR) regression in patients with functional TR of moderate or greater severity undergoing mitral valve transcatheter edge-to-edge repair to optimize patient selection and improve clinical outcomes.</p><p><strong>Methods and results: </strong>This retrospective study analysed 61 patients (mean age 81.3 ± 7.6 years; 55.7% males) who underwent mitral valve transcatheter edge-to-edge repair. Two-dimensional transthoracic echocardiography was performed pre- and 1-month post-procedurally, while three-dimensional transoesophageal echocardiography was performed pre-procedurally. We collected data on clinical variables, medications, and detailed echocardiographic measurements to evaluate procedural outcomes. Tricuspid regurgitation severity was semiquantitatively assessed and categorized. At the 1-month follow-up, TR severity had regressed in 43% of patients. A lower prevalence of atrial fibrillation, smaller left atrial volume index, and smaller right atrial area were significantly associated with TR regression. Multivariate analysis revealed the tricuspid valve annulus perimeter, area, and area change as significant predictors of post-procedure TR regression; tricuspid valve annulus perimeter was the strongest predictor among the three indicators [area under the receiver operating characteristic curve, 0.84 (95% confidence interval: 0.75-0.94), <i>P</i> < 0.001]. Receiver operating characteristic curve analysis indicated that tricuspid valve annulus perimeter cut-off of ≤13.75 cm was the best predictor of post-procedure TR regression. Additionally, tricuspid valve annulus area ≤13.55 cm² and annulus area change ≥17.5% were predictors of post-procedure TR regression.</p><p><strong>Conclusion: </strong>In patients with relatively severe mitral regurgitation with a non-dilated tricuspid annulus and significant change in tricuspid valve annulus area, mitral valve transcatheter edge-to-edge repair may lead to TR regression.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf016"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401128","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}
Francesca Calicchio, Elizabeth Epstein, Melinda Boussoussou, Borbála Vattay, Alexander van Rosendael, Shawn Newlander, Márton Kolossváry, Bálint Szilveszter, Pál Maurovich-Horvat, Hugo Marques, Elliot McVeigh, George Wesbey
{"title":"Impact of technical, patient-related and measurement variables on serial Hounsfield unit-based quantitative coronary plaque analysis in computed tomography: time for a new chapter.","authors":"Francesca Calicchio, Elizabeth Epstein, Melinda Boussoussou, Borbála Vattay, Alexander van Rosendael, Shawn Newlander, Márton Kolossváry, Bálint Szilveszter, Pál Maurovich-Horvat, Hugo Marques, Elliot McVeigh, George Wesbey","doi":"10.1093/ehjimp/qyaf014","DOIUrl":"10.1093/ehjimp/qyaf014","url":null,"abstract":"<p><p>This review article explores the challenges and controversies involved in accurately identifying and reliably quantifying coronary plaque over time through coronary computed tomography angiography (CCTA), particularly focusing on lipid-rich, low-attenuation plaques. It highlights significant variability in lipid-rich plaque measurements across studies, questioning their reliability for tracking biological plaque transformation in clinical practice. To address this issue, the review article proposes suggestions for serial CCTA plaque measurements, aiming for realistic goals for reproducible and meaningful serial plaque CCTA imaging. It also emphasizes the necessity of standardized, validated methods for quantitative plaque analysis and underscores the potential of phantom-based calibration to improve the reliability and consistency of serial plaque measurements in clinical practice.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf014"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598695","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}
Michelle C Williams, Jacqueline A L MacArthur, Ross Forsyth, Steffen E Petersen
{"title":"New ways to use imaging data in cardiovascular research: survey of opinions on federated learning and synthetic data.","authors":"Michelle C Williams, Jacqueline A L MacArthur, Ross Forsyth, Steffen E Petersen","doi":"10.1093/ehjimp/qyaf012","DOIUrl":"10.1093/ehjimp/qyaf012","url":null,"abstract":"<p><strong>Aims: </strong>Federated learning and the creation of synthetic data are emerging tools, which may enhance the use of imaging data in cardiovascular research. This study sought to understand the perspectives of cardiovascular imaging researchers on the potential benefits and challenges associated with these technologies.</p><p><strong>Methods and results: </strong>The British Heart Foundation Data Science Centre conducted a series of online surveys and a virtual workshop to gather insights from stakeholders involved in cardiovascular imaging research about federated learning and synthetic data generation. The federated learning survey included 67 respondents: 18% (<i>n</i> = 12) were currently using federated learning, 4% (<i>n</i> = 3) had previously used it, 31% (<i>n</i> = 21) were planning to use it, and 46% (<i>n</i> = 31) were neither using nor planning to use it. Highlighted benefits included data privacy and enhanced collaboration, while challenges included data heterogeneity and technical complexity. The synthetic data survey had 22 respondents: 50% (<i>n</i> = 11) were currently using synthetic imaging data, 36% (<i>n</i> = 8) expressed interest in using it, and 14% (<i>n</i> = 3) thought it should not be used. Amongst the respondents, 50% had created synthetic imaging data and 45% had used it in cardiovascular research. Advantages cited included privacy preservation, increased dataset size and diversity, improved data access, and reduced administrative burden. Concerns included potential biases, trust issues, privacy concerns, and the fact that the images were not real and may have limited diversity or quality.</p><p><strong>Conclusion: </strong>Federated learning and synthetic data offer opportunities for advancing cardiovascular imaging research by addressing data privacy concerns and expanding data availability. However, challenges must be addressed to realize their full potential.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf012"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598714","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}