Cardiology and Therapy最新文献

{"title":"Leadless Cardiac Pacing: New Horizons.","authors":"Katarzyna Malaczynska-Rajpold, Mark Elliot, Nadeev Wijesuriya, Vishal Mehta, Tom Wong, Christopher Aldo Rinaldi, Jonathan M Behar","doi":"10.1007/s40119-022-00288-0","DOIUrl":"10.1007/s40119-022-00288-0","url":null,"abstract":"<p><p>Since the introduction of transvenous cardiac pacing leads, pacemaker system design has remained similar for several decades. Progressive miniaturisation of electronic circuitry and batteries has enabled a smaller, single pacing unit comprising the intracardiac electrodes, generator and computer. This review explores the development of leadless pacing, the clinical trials comparing leadless to transvenous pacing in addition to the future developments of multi-chamber leadless pacing.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"12 1","pages":"21-33"},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/0d/40119_2022_Article_288.PMC9986180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752405","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":"Colchicine in the Management of Acute Coronary Syndrome: A Meta-analysis.","authors":"Jason Nogic,&nbsp;Ojas Mehta,&nbsp;David Tong,&nbsp;Adam J Brown,&nbsp;Jamie Layland","doi":"10.1007/s40119-022-00298-y","DOIUrl":"https://doi.org/10.1007/s40119-022-00298-y","url":null,"abstract":"<p><strong>Introduction: </strong>Colchicine, thought to exert its effect via reduction of inflammation, has recently been studied in patients following acute coronary syndromes (ACS). We performed a meta-analysis of all available randomized controlled trials (RCTs) in this high-risk cohort, evaluating efficacy and safety.</p><p><strong>Methods: </strong>MEDLINE, PubMed, EMBASE, clinical trial registries, and select conference proceedings were searched for RCTs comparing colchicine to placebo in patients following ACS. The primary outcome was trial-defined major adverse cardiovascular events (MACE). Secondary endpoints included stroke, myocardial infarction (MI), all-cause and cardiovascular death, and urgent revascularization. Analysis was performed at the longest available clinical follow-up.</p><p><strong>Results: </strong>Two RCTs with a pooled sample size of 5540 patients with 2778 (50.1%) receiving colchicine and 2762 (49.9%) placebo were included. In order to maximize consistency, composite efficacy endpoints between trials were modified. Compared to placebo, patients receiving colchicine had reduction in study-defined composite endpoint (5.5% vs. 7.6%) OR 0.67 (95% CI 0.46-0.98, p = 0.04, I² = 46%). Similarly, there was a significant reduction in cerebrovascular accidents (OR 0.31, 95% CI 0.14-0.69, p = 0.004, I² = 0%) and repeat revascularization OR 0.36 (95% CI 0.14-0.90, p = 0.03, I² = 54%). There was no difference between cardiovascular death (OR 0.92, 95% CI 0.52-1.62, p = 0.78, I² = 0%), non-cardiovascular death OR 1.27 (95% CI 0.72-2.24, p = 0.41, I² = 0%), MI at longest available follow-up OR 0.89 (95% CI 0.67-1.17, p = 0.39, I² = 0%) or resuscitated cardiac arrest OR 0.88 (95% CI 0.32-2.43, p = 0.81, I² = 0%) in those receiving colchicine.</p><p><strong>Conclusions: </strong>These data suggest colchicine, in addition to guideline-directed medical therapy following acute coronary syndrome reduces MACE, cerebrovascular accidents, and rates of urgent revascularization at 2 years of follow-up.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"12 1","pages":"171-181"},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/e4/40119_2022_Article_298.PMC9986187.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9755368","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":"Hyperkalemia: Prevalence, Predictors and Emerging Treatments.","authors":"Natasha L Larivée, Jacob B Michaud, Keigan M More, Jo-Anne Wilson, Karthik K Tennankore","doi":"10.1007/s40119-022-00289-z","DOIUrl":"10.1007/s40119-022-00289-z","url":null,"abstract":"<p><p>It is well established that an elevated potassium level (hyperkalemia) is associated with a risk of adverse events including morbidity, mortality and healthcare system cost. Hyperkalemia is commonly encountered in many chronic conditions including kidney disease, diabetes and heart failure. Furthermore, hyperkalemia may result from the use of renin-angiotensin-aldosterone system inhibitors (RAASi), which are disease-modifying treatments for these conditions. Therefore, balancing the benefits of optimizing treatment with RAASi while mitigating hyperkalemia is crucial to ensure patients are optimally treated. In this review, we will briefly discuss the definition, causes, epidemiology and consequences of hyperkalemia. The majority of the review will be focused on management of hyperkalemia in the acute and chronic setting, emphasizing contemporary approaches and evolving data on the relevance of dietary restriction and the use of novel potassium binders.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"12 1","pages":"35-63"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/74/40119_2022_Article_289.PMC9742042.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10835776","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":"Application of Single-Cell Genomics in Cardiovascular Research.","authors":"Xuejing Yu,&nbsp;Xianggui Yang,&nbsp;Jinjin Cao","doi":"10.1007/s40119-023-00303-y","DOIUrl":"https://doi.org/10.1007/s40119-023-00303-y","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs) are the leading cause of death in the global world. The emergence of single-cell technologies has greatly facilitated the research on CVDs. Currently, those single-cell technologies have been widely applied in atherosclerosis, myocardial infarction, cardiac ischemia-reperfusion injury, arrhythmia, hypertrophy cardiomyopathy, and heart failure, which are extremely helpful in elucidating the underlying mechanisms of CVDs from physiological and pathological perspectives at DNA, RNA, protein, post-transcriptional, post-translational, and metabolite levels. In this review, we would like to briefly introduce the current single-cell technologies, and will focus on the utilization of single-cell genomics in various heart diseases. Single-cell technologies have great potential in exploration of CVDs, and widespread application of single-cell genomics will promote the understanding and therapeutic treatments for CVDs.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"12 1","pages":"101-125"},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/8e/40119_2023_Article_303.PMC9986177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9753730","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":"The Use of Midodrine as an Adjunctive Therapy to Liberate Patients from Intravenous Vasopressors: A Systematic Review and Meta-analysis of Randomized Controlled Studies.","authors":"Mohamed Hamed,&nbsp;Sheref A Elseidy,&nbsp;Ahmed Elkheshen,&nbsp;Jamal Maher,&nbsp;Adel Elmoghrabi,&nbsp;Ahmed Zaghloul,&nbsp;Andrew Panakos,&nbsp;Sidakpal Panaich,&nbsp;Marwan Saad,&nbsp;Ayman Elbadawi","doi":"10.1007/s40119-023-00301-0","DOIUrl":"https://doi.org/10.1007/s40119-023-00301-0","url":null,"abstract":"<p><strong>Background: </strong>Studies evaluating the role of midodrine as an adjunctive therapy to liberate patients with shock from intravenous (IV) vasopressors have yielded mixed results. The aim of our study was to evaluate the efficacy and safety of midodrine as an adjunctive therapy to liberate patients with shock from IV vasopressors.</p><p><strong>Methods: </strong>Electronic searches of the MEDLINE, EMBASE, and Cochrane databases through April 2022 for randomized controlled trials (RCTs) that evaluated the use of midodrine versus control in patients with shock and a low dose of IV vasopressors. The primary outcome was total IV vasopressor time, while the secondary outcomes included time-to-IV vasopressor discontinuation, IV vasopressor restart, intensive care unit (ICU) length of stay (LOS), hospital LOS, and incidence of bradycardia.</p><p><strong>Results: </strong>The final analysis included four RCTs with a total of 314 patients: 158 in the midodrine group and 156 in the control group, with a weighted mean age of 64 years (54.2% men). There was no significant difference in the total IV vasopressor time between the midodrine and control groups (standardized mean difference [SMD] - 0.53; 95% confidence interval [CI] - 1.38 to 0.32, p = 0.22; I² = 92%). Also, there were no significant differences between the two groups in the time-to-IV vasopressor discontinuation (SMD - 0.05; 95% CI - 0.57 to 0.47, p = 0.09), IV vasopressor restart (19.3 vs. 28.3%; risk ratio [RR] 0.74; 95% 0.25-2.20, p = 0.59), ICU LOS (SMD - 0.49; 95% CI - 1.30 to 0.33, p = 0.24), and hospital LOS (SMD 0.01; 95% CI - 0.27 to 0.29, p = 0.92). However, compared with the control group, the midodrine group had a higher risk of bradycardia (15.3 vs. 2.1% RR 5.56; 95% CI 1.54-20.05, p = 0.01).</p><p><strong>Conclusions: </strong>Among patients with vasopressor-dependent shock, midodrine was not associated with early liberation of vasopressor support or shorter ICU or hospital length of stay. Adding midodrine increased the risk of bradycardia. Further large RCTs are needed to better evaluate the efficacy and safety of midodrine in liberating patients from IV vasopressors.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"12 1","pages":"185-195"},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/da/40119_2023_Article_301.PMC9986154.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809384","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: Colchicine in the Management of Acute Coronary Syndrome: A Meta-analysis.","authors":"Jason Nogic,&nbsp;Ojas Mehta,&nbsp;David Tong,&nbsp;Adam J Brown,&nbsp;Jamie Layland","doi":"10.1007/s40119-023-00306-9","DOIUrl":"https://doi.org/10.1007/s40119-023-00306-9","url":null,"abstract":"","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"12 1","pages":"183-184"},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/ec/40119_2023_Article_306.PMC9986169.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9111434","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":"Communicating Cardiac Pathology and Procedures: Patient and Medical Perspective.","authors":"Armaun D Rouhi,&nbsp;Jason J Han","doi":"10.1007/s40119-023-00302-z","DOIUrl":"https://doi.org/10.1007/s40119-023-00302-z","url":null,"abstract":"<p><p>This article, co-authored by a family member of a patient with atrial fibrillation and a cardiothoracic surgeon, discusses the challenges of communicating cardiac diagnoses and treatment options from both the patient and clinician perspective.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"12 1","pages":"7-10"},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/5f/40119_2023_Article_302.PMC9986157.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752437","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":"Targeted Temperature Management in Cardiac Arrest: An Updated Narrative Review.","authors":"Agastya D Belur,&nbsp;Yub Raj Sedhai,&nbsp;Alexander G Truesdell,&nbsp;Ashish K Khanna,&nbsp;Joseph D Mishkin,&nbsp;P Matthew Belford,&nbsp;David X Zhao,&nbsp;Saraschandra Vallabhajosyula","doi":"10.1007/s40119-022-00292-4","DOIUrl":"https://doi.org/10.1007/s40119-022-00292-4","url":null,"abstract":"<p><p>The established benefits of cooling along with development of sophisticated methods to safely and precisely induce, maintain, monitor, and reverse hypothermia have led to the development of targeted temperature management (TTM). Early trials in human subjects showed that hypothermia conferred better neurological outcomes when compared to normothermia among survivors of cardiac arrest, leading to guidelines recommending targeted hypothermia in this patient population. Multiple studies have sought to explore and compare the benefit of hypothermia in various subgroups of patients, such as survivors of out-of-hospital cardiac arrest versus in-hospital cardiac arrest, and survivors of an initial shockable versus non-shockable rhythm. Larger and more recent trials have shown no statistically significant difference in neurological outcomes between patients with targeted hypothermia and targeted normothermia; further, aggressive cooling is associated with a higher incidence of multiple systemic complications. Based on this data, temporal trends have leaned towards using a lenient temperature target in more recent times. Current guidelines recommend selecting and maintaining a constant target temperature between 32 and 36 °C for those patients in whom TTM is used (strong recommendation, moderate-quality evidence), as soon as possible after return of spontaneous circulation is achieved and airway, breathing (including mechanical ventilation), and circulation are stabilized. The comparative benefit of lower (32-34 °C) versus higher (36 °C) temperatures remains unknown, and further research may help elucidate this. Any survivor of cardiac arrest who is comatose (defined as unarousable unresponsiveness to external stimuli) should be considered as a candidate for TTM regardless of the initial presenting rhythm, and the decision to opt for targeted hypothermia versus targeted normothermia should be made on a case-by-case basis.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"12 1","pages":"65-84"},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/d1/40119_2022_Article_292.PMC9986171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9753237","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":"Detection and Diagnosis of Cardiac Amyloidosis in Egypt.","authors":"Mohamed Abdelghany,&nbsp;Magdy Abdelhamid,&nbsp;Adel Allam,&nbsp;Adel El Etriby,&nbsp;Sherif Hafez,&nbsp;Hany Ragy,&nbsp;Mohamed Sobhy","doi":"10.1007/s40119-022-00299-x","DOIUrl":"https://doi.org/10.1007/s40119-022-00299-x","url":null,"abstract":"<p><p>Cardiac amyloidosis is a life-threatening disease that occurs when amyloid proteins, most commonly immunoglobulin light chain or transthyretin, mutate or become unstable, misfold, deposit as amyloid fibrils, and accumulate in the myocardium. Early diagnosis of cardiac amyloidosis is hindered by insufficient awareness, specifically regarding clinical red flags and diagnostic pathways. Cardiac amyloidosis diagnosis comprises two important phases, clinical suspicion (phase one) followed by definitive diagnosis (phase two). Each phase is associated with specific clinical techniques. For example, clinical features, electrocardiography, echocardiography, and cardiac magnetic resonance imaging serve to raise suspicion of cardiac amyloidosis and facilitate early diagnosis, whereas laboratory tests (i.e., blood or urine electrophoresis with immunofixation), biopsy, scintigraphy-based nuclear imaging, and genetic testing provide a definitive diagnosis of cardiac amyloidosis. In Egypt, both the lack of cardiac amyloidosis awareness amongst healthcare providers and the unavailability of clinical expertise for the use of diagnostic techniques must be overcome to improve the prognosis of cardiac amyloidosis in the region. Previously published diagnostic algorithms for cardiac amyloidosis have amalgamated techniques that can raise clinical suspicions of cardiac amyloidosis with those that definitively diagnose cardiac amyloidosis. Though such algorithms have been successful in developed countries, diagnostic tools like echocardiography, scintigraphy, and cardiac magnetic resonance imaging are not ubiquitously available across Egyptian facilities. This review presents the current state of knowledge regarding cardiac amyloidosis in Egypt and outlines a new diagnostic algorithm which leverages regional nuclear imaging expertise. Importantly, the proposed diagnostic algorithm guides accurate amyloid-typing to mitigate misdiagnosis and erroneous treatment selection and improve the cardiac amyloidosis diagnostic accuracy in Egypt.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"12 1","pages":"197-213"},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/fb/40119_2022_Article_299.PMC9986164.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9755367","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":"Impact of Cardiovascular Risk Factors on Arterial Stiffness in a Countryside Area of Switzerland: Insights from the Swiss Longitudinal Cohort Study.","authors":"Lucrezia Pusterla,&nbsp;Dragana Radovanovic,&nbsp;Franco Muggli,&nbsp;Paul Erne,&nbsp;Andreas W Schoenenberger,&nbsp;Renate Schoenenberger-Berzins,&nbsp;Gianfranco Parati,&nbsp;Paolo Suter,&nbsp;Sebastiano A G Lava,&nbsp;Augusto Gallino,&nbsp;Mario G Bianchetti","doi":"10.1007/s40119-022-00280-8","DOIUrl":"10.1007/s40119-022-00280-8","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease is the leading cause of morbidity and mortality. Besides traditional cardiovascular risk factors, arterial stiffness is a recognized predictor of cardiovascular risk.</p><p><strong>Methods: </strong>We investigated the relationship between traditional cardiovascular risk factors, sex, and aortic pulse wave velocity in subjects living in a countryside area of Southern Switzerland. For this aim, we performed a cross-sectional analysis of data from adult participants of the Swiss Longitudinal Cohort Study, which, initiated in 2015, follows health status and disease risk factors in a Swiss countryside cohort at least 6 years of age.</p><p><strong>Results: </strong>A total of 387 people (205 women and 182 men) were included. Hyperlipidemia, overweight, and obesity were more common (p ≤ 0.001) and LDL-cholesterol, triglycerides, and hemoglobin A1c were higher (p < 0.03) in men than women. Systolic and diastolic brachial and aortic blood pressures were higher in men (p < 0.02), whereas aortic pulse wave velocity and aortic pulse pressure were higher in women (p < 0.05). The aortic pulse wave velocity was significantly higher in subjects with hypertension, hyperlipidemia, diabetes, and obesity, and significantly increased with age (p < 0.0001). Multiple linear regression analysis showed a significant correlation between pulse wave velocity and age, female sex, brachial systolic blood pressure, and heart rate (p < 0.005).</p><p><strong>Conclusion: </strong>Also in a countryside area, the aortic pulse wave velocity is higher in subjects with hypertension, hyperlipidemia, diabetes and obesity, and significantly increases with age. Furthermore, with advancing age, aortic pulse wave velocity is higher in women than men.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT02282748.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":"11 4","pages":"545-557"},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/66/40119_2022_Article_280.PMC9652188.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10342040","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}