European heart journal. Imaging methods and practice最新文献

{"title":"Glucose and insulin actions after glucose loading on myocardial glucose metabolism in pulmonary hypertension.","authors":"Yuki Koga, Nobuhiro Tahara, Yoichi Sugiyama, Shoko Maeda-Ogata, Atsuko Tahara, Munehisa Bekki, Akihiro Honda, Sachiyo Igata, Shuichi Tanoue, Yoshihiro Fukumoto","doi":"10.1093/ehjimp/qyaf044","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf044","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf044"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004297","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":"Factors affecting the performance of a novel artificial intelligence-based coronary computed tomography-derived ischaemia algorithm.","authors":"Peerapon Kiatkittikul, Teemu Maaniitty, Sarah Bär, Takeru Nabeta, Jeroen J Bax, Antti Saraste, Juhani Knuuti","doi":"10.1093/ehjimp/qyaf033","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf033","url":null,"abstract":"<p><strong>Aims: </strong>AI-QCT_ischaemia is an FDA-cleared novel artificial intelligence-guided method that utilizes features from coronary computed tomography angiography (CCTA) to predict myocardial ischaemia.</p><p><strong>Objective: </strong>To identify factors associated with discrepancy between AI-QCT_ischaemia and positron emission tomography (PET) perfusion.</p><p><strong>Methods and results: </strong>Six hundred and sixty-two patients with suspected obstructive coronary artery disease (CAD) on CCTA and undergoing [¹⁵O]H₂O PET were analysed using AI-QCT_ischaemia. Multivariable logistic regression identified factors associated with discrepancy. Perfusion homogeneity was measured by relative flow reserve. A total of 209 (32%) patients showed discrepancies: 62 (9%) exhibited normal AI-QCT_ischaemia but abnormal perfusion (false negative AI-QCT_ischaemia), whereas 147 (22%) had abnormal AI-QCT_ischaemia despite normal perfusion (false positive AI-QCT_ischaemia). False positive AI-QCT_ischaemia patients (vs. true positive) were more often females, older, with less typical angina, and less advanced CAD. In multivariable analysis, typical angina [OR 95% CI: 1.796 (1.015-3.179), <i>P</i> = 0.044], diameter stenosis per 1% increase [1.058 (1.036-1.080), <i>P</i> < 0.001], and percent atheroma volume per 1% increase [1.103 (1.051-1.158), <i>P</i> < 0.001] significantly predicted true positive, while age was inversely associated [0.955 (0.923-0.989), <i>P</i> = 0.010]. False-negative AI-QCT_ischaemia patients (vs. true negative) were more often males, smokers, with less good CCTA image quality, and more advanced CAD. However, none was significant in multivariable analysis. Furthermore, false-negative AI-QCT_ischaemia showed more homogenously reduced perfusion by relative flow reserve compared to true positive (median ± IQR: 0.68 ± 0.15 vs. 0.56 ± 0.23, <i>P</i> < 0.001) and 21 (34%) of false negative showed globally reduced perfusion.</p><p><strong>Conclusion: </strong>For abnormal AI-QCT_ischaemia, younger age, typical angina, more severe stenosis, and more extensive atherosclerosis predicted abnormal PET perfusion. With false negative AI-QCT_ischaemia, perfusion abnormalities were partly explained by microvascular disease.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 4","pages":"qyaf033"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056736","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":"Coronary inflammation and AI-Risk scores from cardiovascular computed tomography: impact on risk prediction and clinical management in a real-world setting.","authors":"John A Henry, Susannah M Black, Oliver G J Mitchell, Edward Richardson, Cameron Watson, Chris Hare, Pierre Le Page, Andrew R J Mitchell","doi":"10.1093/ehjimp/qyaf031","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf031","url":null,"abstract":"<p><strong>Aims: </strong>Coronary computed tomography angiography (CCTA) is the primary investigation for stable chest pain. Despite approximately 80% of individuals undergoing CCTA not having obstructive coronary disease, this group contributes to two-thirds of major adverse cardiovascular events. Assessment of coronary inflammation using perivascular fat attenuation index (FAI) and AI-derived risk scores (AI-Risk) has demonstrated enhanced risk prediction beyond traditional clinical and CCTA parameters. We aimed to assess if FAI and AI-Risk alter risk prediction and clinical management in a real-world setting.</p><p><strong>Methods and results: </strong>Consecutive patients undergoing CCTA with FAI calculation and AI-Risk (CaRi-Heart®) at a single centre over a 3-year period were recruited. Conventional risk scores for non-fatal and fatal myocardial infarctions (QRISK3 and SCORE, respectively) were compared with AI-Risk. Clinical management decisions based on risk factors and CCTA results were recorded. FAI and AI-Risk scores were then provided and the resultant clinical management decision recorded. One hundred and sixty-four patients were included in the study (<i>n</i> = 164, male 78%, 56 years). Forty-eight per cent of the patients had no evidence of coronary artery disease (CAD) on CCTA, with 41% having non-obstructive CAD and 10% with potentially obstructive CAD. AI-Risk reclassified risk in 58% and 43% of patients compared with QRISK3 and SCORE, respectively. Clinical management was changed in 33% of patients following AI-Risk analysis.</p><p><strong>Conclusion: </strong>FAI and AI-Risk scores in a real-world setting changed risk prediction in around half of individuals and changed clinical management in around a third.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 4","pages":"qyaf031"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056734","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":"Current trends and challenges in the clinical use of cardiovascular magnetic resonance: a survey from the Italian Society of Cardiology.","authors":"Lorenzo Monti, Fabrizio Ricci, Andrea Baggiano, Andrea Barison, Nazario Carrabba, Stefano Figliozzi, Patrizia Pedrotti, Camilla Torlasco, Erika Tempo, Alessandro Giaj Levra, Stefania Paolillo, Gianfranco Sinagra, Pasquale Perrone Filardi, Ciro Indolfi, Santo Dellegrottaglie","doi":"10.1093/ehjimp/qyaf046","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf046","url":null,"abstract":"<p><strong>Aims: </strong>Challenges related to the use of cardiovascular magnetic resonance (CMR) remain a key issue to secure its full clinical impact. This survey aimed to assess the awareness of CMR clinical utility and to collect data on its local usage levels, operational barriers, and report efficacy, with the goal of identifying key obstacles to its effective implementation across Italy.</p><p><strong>Methods and results: </strong>The CMR Working Group of the Italian Society of Cardiology promoted an online survey targeting Italian physicians involved in direct care of patients with cardiovascular disease. The questionnaire was completed by 709 physicians, mostly working in public or university hospitals (75%); 27% were medical residents. Cardiomyopathies and myocarditis were identified as the most established clinical indications for CMR. 79% of respondents perceived underutilisation of CMR in their local settings, with waiting times exceeding 3 months in 42% of cases. Public hospitals were reported as the primary providers of CMR services (41%), with the majority of CMR reports signed exclusively by radiologists. Obstacles in obtaining clinically useful and effective CMR exams were frequent, with 69% of respondents often encountering issues. Need for an expert second opinion was reported by 27% of participants either often or always. Stress CMR was reported of limited access or unavailable by 79% of respondents.</p><p><strong>Conclusion: </strong>CMR is highly regarded for its clinical utility but underutilized due to operational barriers, mainly long waiting times and lack of specific competence. Perceived inadequacy in report quality is common and contributes to a consistent rate of second-opinion requests.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf046"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040538","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":"Patient centric performance and interpretation of SPECT and SPECT/CT myocardial perfusion imaging: a clinical consensus statement of the European Association of Cardiovascular Imaging of the ESC.","authors":"Bryan Abadie, Riccardo Liga, Ronny Buechel, Andreas A Giannopoulos, María Nazarena Pizzi, Albert Roque, Ricardo Geronazzo, Fabien Hyafil, Juhani Knuuti, Antti Saraste, Riemer Slart, Paul Cremer, Richard Weinberg, Maria João Vidigal Ferreira, Alessia Gimelli, Wael Jaber","doi":"10.1093/ehjimp/qyaf043","DOIUrl":"10.1093/ehjimp/qyaf043","url":null,"abstract":"<p><p>The non-invasive assessment of ischaemic heart disease with myocardial perfusion imaging remains an integral part of modern cardiology. This modality has been used for decades, but improving technology has maintained its relevance today. This document describes the fundamentals of single-photon emission computed tomography, including stress protocols, tracer pharmacodynamics, camera settings and capabilities, post-acquisition processing, and clinical translation in an easy to read and highly pictorial manner to be applicable to not only healthcare providers of all levels, but patients as well.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf043"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129943","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":"Primary mitral regurgitation, surgery in the transcatheter era: when the neighbourhood becomes noisy: a state-of-art review.","authors":"Edoardo Zancanaro, Julia Grapsa, Karl Patrick Kresoja, Guido Ascione, Kabir Sethi, Sebastian Rosch, Davide Carino, Daniel Sebastian Dohle, Michele Di Mauro, Ralph Stephan von Bardeleben, Hendrik Treede, Philipp Lurz, Roberto Lorusso","doi":"10.1093/ehjimp/qyaf041","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf041","url":null,"abstract":"<p><p>Primary mitral regurgitation is a valvular heart disorder that found to be treated with surgery that has been the gold standard for decades with different techniques to approach this pathology. In the last decade, Transcatheter Edge-to-Edge Repair emerged as a valid option for this type of pathology, in case of surgical unsuitability. Others device emerged as well leaving less remark compared with Transcatheter Edge-to-Edge Repair. The article analyse the old and new frontiers as well as the controversies of this phenotype.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf041"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035435","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":"Quantification of carotid artery plaque and peri-vascular adipose tissue attenuation on computed tomography.","authors":"Beth Whittington, Viswan Thiagarajah, Evangelos Tzolos, Jakub Kaczynski, Caelan Taggart, Alex Vesey, Damini Dey, Rachael O Forsythe, Andrew Tambyraja, Edwin J R van Beek, Marc R Dweck, David E Newby, Michelle C Williams","doi":"10.1093/ehjimp/qyaf040","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf040","url":null,"abstract":"<p><strong>Aims: </strong>Quantitative assessment of carotid artery plaque on computed tomography (CT) may identify high-risk phenotypes associated with culprit lesions and subsequent ischaemic stroke or transient ischaemic attack.</p><p><strong>Methods and results: </strong>Carotid CT angiography was performed in 48 patients with acute ischaemic stroke or transient ischaemic attack within 21 days. Quantitative plaque assessment was performed in the proximal 6 cm of the internal and external carotid artery, distal 6 cm of the common carotid artery, and residual common carotid artery. Semi-automated quantification included assessment of non-calcified, calcified, low-attenuation, and total plaque, area and diameter stenosis, and peri-vascular adipose tissue attenuation. In 48 patients (mean age 71 ± 11 years, 67% male), 96 vessels were assessed with 30 (31%) identified as culprit vessels. Culprit internal carotid arteries had greater area [83 (65, 94) vs. 64 (55, 77)%] and diameter [56 (39, 74) vs. 32 (21, 48)%] stenosis and more non-calcified [563 (413, 965) vs. 428 (283 649) mm³, <i>P</i> = 0.04], low-attenuation [33.7 (6.9, 72.4) vs. 16.3 (3.35, 54.3) mm³, <i>P</i> = 0.01], and total [699 (455, 1057) vs. 492 (311, 809), <i>P</i> = 0.04] plaque. There was no difference in calcified plaque or peri-vascular adipose tissue attenuation between culprit and non-culprit internal carotid arteries. There were no differences in quantitative plaque or peri-vascular adipose tissue attenuation in the external carotid artery or common carotid artery.</p><p><strong>Conclusion: </strong>Carotid atherosclerotic plaque characteristics are the principal features associated with culprit plaques with little or no demonstrable relationship with calcified plaque or increased peri-vascular adipose tissue attenuation.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf040"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034778","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":"How to behave with paediatric myocarditis: imaging methods and clinical considerations.","authors":"Rosalba De Sarro, Nunzia Borrelli, Giulia Pelaia, Alessia Mendicino, Sara Moscatelli, Isabella Leo, Giulia La Vecchia, Giuseppe Mazza, Lucy Castaldo, Antonio Strangio, Martina Avesani, Salvatore De Rosa, Daniele Torella, Giovanni Di Salvo, Jolanda Sabatino","doi":"10.1093/ehjimp/qyaf025","DOIUrl":"10.1093/ehjimp/qyaf025","url":null,"abstract":"<p><p>Paediatric myocarditis is a challenging and heterogeneous condition, with varied clinical presentations ranging from mild symptoms to life-threatening complications such as heart failure, arrhythmias, and sudden cardiac death. Effective management hinges on early diagnosis, appropriate treatment, and ongoing monitoring, which can be significantly enhanced through multimodal imaging techniques. This review emphasizes the crucial role of advanced imaging in the diagnosis, prognostication, and management of paediatric myocarditis. While traditional echocardiography remains the first-line imaging tool, it is often insufficient in detecting subtle myocardial changes and it does not allow the identification of myocardial inflammation and fibrosis, particularly in cases with preserved left ventricular function. Recent advancements, including speckle-tracking echocardiography, provide enhanced sensitivity for detecting early signs of myocardial dysfunction, even in the absence of overt abnormalities. Cardiovascular magnetic resonance (CMR) has emerged as a cornerstone in the non-invasive evaluation of myocarditis, offering unparalleled tissue characterization. Indeed, CMR provides critical insights into myocardial oedema, necrosis, and fibrosis, which are essential for confirming the diagnosis, stratifying prognosis, and guiding therapy. Parametric mapping techniques allow for highly accurate detection of myocardial fibrosis (native T1 mapping) and inflammation (T2 mapping), even in the absence of gadolinium contrast, making it particularly valuable in paediatric patients. In conclusion, multimodality imaging, integrating echocardiography and CMR, allows for a comprehensive understanding of disease severity, guiding treatment decisions and optimizing long-term outcomes. This review underscores the importance of a tailored, imaging-driven approach to managing paediatric myocarditis, ensuring the best possible care for this special population.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf025"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797535","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":"Familial non-inflammatory, non-atherosclerotic vasculopathy presented with acute coronary syndrome.","authors":"Hikaru Masuda, Riku Arai, Yuki Nakajima, Yutaka Koyama, Nobuhiro Murata, Yasuo Okumura, Masashi Tanaka, Hiroyuki Hao","doi":"10.1093/ehjimp/qyaf039","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf039","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf039"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035587","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":"High-resolution automated free-breathing coronary magnetic resonance angiography in comparison with coronary computed tomography angiography.","authors":"Gregory Wood, Alexandra Uglebjerg Pedersen, Bjarne Linde Nørgaard, Christian Alcaraz Frederiksen, Jesper Møller Jensen, Karl-Philipp Kunze, Radhouene Neji, Jens Wetzl, Claudia Prieto, René M Botnar, Won Yong Kim","doi":"10.1093/ehjimp/qyaf037","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf037","url":null,"abstract":"<p><strong>Aims: </strong>Clinical implementation of coronary magnetic resonance angiography (CMRA) is limited due to variability in image quality. A protocol utilizing an image navigator (iNAV) integrated with automated scan planning has been developed to facilitate consistent diagnostic image quality. The aim of this study was to evaluate the agreement of automated iNAV CMRA compared with coronary computed tomography angiography (CCTA) using Coronary Artery Disease-Reporting and Data System (CAD-RADS) to classify coronary artery disease (CAD).</p><p><strong>Methods and results: </strong>Ninety-five individuals underwent automated iNAV CMRA at a resolution of 0.7 mm³ with a deep learning-assisted automated scan planning and trigger-delay detection protocol. CMRA and CCTA data sets were analysed using CAD-RADS to classify the per-patient severity of CAD. Additionally, the accuracy of both imaging modalities in predicting referral for invasive coronary angiography (ICA) and coronary revascularization was assessed. CMRA classification for CAD-RADS ≥ 1, ≥2, ≥3, and ≥4 agreed with CCTA for 80%, 73%, 63%, and 70% of cases, respectively. The area under the receiver operating characteristic curves with CAD-RADS ≥ 4 and ≥3 for CMRA and CCTA were comparable in predicting ICA referral (0.75 vs. 0.70, <i>P</i> = 0.687, and 0.70 vs. 0.70, <i>P</i> = 0.945) and revascularization (0.72 vs. 0.74, <i>P</i> = 0.811, and 0.68 vs. 0.76, <i>P</i> = 0.089).</p><p><strong>Conclusion: </strong>A novel automated iNAV CMRA protocol was implemented, investigating individuals at risk of CAD. Using the CAD-RADS classification, there was moderate to good agreement between CMRA and CCTA. In patients with CAD-RADS ≥ 4 and ≥3, CMRA was as effective as CCTA in predicting ICA referral and revascularization.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf037"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049422","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}