Cardio-oncology最新文献

{"title":"Dynamics of SERPINA3 in response to anthracycline treatment and cardiovascular dysfunction.","authors":"Hanne M Boen, Lobke L Pype, Konstantinos Papadimitriou, Sevilay Altintas, Laure-Anne Teuwen, Sébastien Anguille, Kirsten Saevels, Anke Verlinden, Leen Delrue, Ward A Heggermont, Matthias Bosman, Pieter-Jan Guns, Hein Heidbuchel, Caroline M Van De Heyning, Emeline M Van Craenenbroeck, Constantijn Franssen","doi":"10.1186/s40959-025-00324-7","DOIUrl":"10.1186/s40959-025-00324-7","url":null,"abstract":"<p><strong>Background: </strong>SERPINA3 recently emerged as potential prognostic biomarker in heart failure. In a population of cancer survivors with cancer therapy-related cardiac dysfunction (CTRCD) circulating SERPINA3 was elevated compared to age-matched controls. We aimed to assess the longitudinal dynamics of circulating SERPINA3 levels in patients with cancer treated with anthracycline chemotherapy (AnC) and its relation to CTRCD.</p><p><strong>Methods: </strong>In this single centre cohort study, 55 patients with cancer scheduled for AnC were prospectively enrolled. Cardiac evaluation (echocardiography, high-sensitive cardiac troponin I and NT-proBNP) was performed and SERPINA3 levels in plasma were assessed at 4 timepoints: before chemotherapy, directly after the end of chemotherapy, three months and twelve months after the end of chemotherapy.</p><p><strong>Results: </strong>Forty-two out of 55 patients (76.4%) developed CTRCD within 1 year after end of treatment. CTRCD was mild in 32 and moderate in 10 patients, defined as a change in cardiac biomarkers or GLS and LVEF decline < 50% respectively. Overall, median SERPINA3 levels decreased from baseline to three months after AnC (215.7 [62.0-984.0] to 176.9 [94.7-678.0] µg/ml, p = 0.031). This decrease was most prominent in patients without CTRCD (30.8% decrease, p = 0.007), followed by mild CTRCD (9.0% decrease, p = 0.022), while patients with moderate CTRCD did not show a reduction in SERPINA3 (5.1% increase, p = 0.987). SERPINA3 values at three months after AnC were positively correlated with NT-proBNP (r = 0.47, p = 0.002). Several malignancy, treatment and patient characteristics were associated with higher SERPINA3 values.</p><p><strong>Conclusion: </strong>Circulating SERPINA3 levels show dynamic changes in a population of patients with cancer, with an overall decrease following AnC. However, in patients that developed moderate CTRCD, SERPINA3 levels remained elevated. The potential of SERPINA3 dynamics as a biomarker for CTRCD, deserves validation in larger cohorts.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"27"},"PeriodicalIF":3.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633750","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":"Incidence and survival outcomes of myocarditis and pericardial diseases associated with immune checkpoint inhibitor therapy.","authors":"Aya F Ozaki, Michael Sayer, Hirofumi Hamano, Misako Nagasaka, Benjamin J Lee, Jean Doh, Ali Naqvi, Nareh Nowrouzi, Yoshito Zamami, Pranav M Patel","doi":"10.1186/s40959-025-00300-1","DOIUrl":"10.1186/s40959-025-00300-1","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitor(ICI) induced cardiac immune related adverse events are challenging to study; Leveraging large data bases like TriNetX global health network may provide needed insights.</p><p><strong>Methods: </strong>We performed a retrospective cohort study including patients diagnosed neoplasm and 18 and older when receiving ICI therapy from 1/1/2011 to 12/31/2022. Queried ICD 9/10 codes identified patients experiencing myocarditis, pericarditis, pericardial effusion, and cardiac tamponade within 1 year of ICI initiation. Survival analyses compared one-year overall survival (OS) of patients experiencing cardiac irAEs against propensity score matched populations not experiencing them.</p><p><strong>Results: </strong>In 88,928 identified ICI patients, the incidence of myocarditis(0.48%), pericarditis(0.22%), and cardiac tamponade(0.47%) were less than 1% while pericardial effusion occurred in 4.71% of patients. Hazard ratios (HRs) were significantly higher in all cardiac irAE groups: myocarditis (HR:1.26, 95% CI:1.04-1.54, p = 0.02), pericarditis (HR:1.36, 95% CI:1.02-1.82, p = 0.04), pericardial effusion (HR:1.49, 95% CI:1.39-1.59, p < 0.0001), cardiac tamponade (HR:2.15, 95% CI:1.79-2.57, p < 0.0001), and overall pericardial disease (HR:1.46, 95% CI:1.37-1.56, p < 0.0001). There was no significant difference in OS between myocarditis and pericarditis or overall pericardial diseases.</p><p><strong>Discussion/conclusion: </strong>Utilizing a uniquely large cohort of ICI patients, this study further shows the rarity of cardiac inflammatory irAEs and highlights their significant impact on patient survival.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"26"},"PeriodicalIF":3.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566253","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":"Is the pendulum slowly starting to swing back?","authors":"Michael S Ewer, Jay Herson","doi":"10.1186/s40959-025-00321-w","DOIUrl":"10.1186/s40959-025-00321-w","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"25"},"PeriodicalIF":3.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522681","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":"Exercise and cardiovascular health among breast cancer survivors: a scoping review of current observational evidence.","authors":"Oliver W A Wilson, Kaitlyn M Wojcik, Camryn M Cohen, Dalya Kamil, Gisela Butera, Charles E Matthews, Christina M Dieli-Conwright, Jinani Jayasekera","doi":"10.1186/s40959-025-00310-z","DOIUrl":"10.1186/s40959-025-00310-z","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer survivors are at increased risk of cardiovascular events due to the cardiotoxic effects of cancer treatment. Exercise participation can lower the risk of various adverse cardiovascular health outcomes. However, most breast cancer survivors do not meet exercise guidelines.</p><p><strong>Objectives: </strong>To map and critically evaluate the observational literature describing the direction and strength of the relationship between post-diagnosis leisure-time exercise (aerobic and muscle-strengthening) and cardiovascular health (cardiovascular disease, cardiac function, and related physiological risk factors) among diverse breast cancer survivors; and identify variations in this relationship based on race, ethnicity, and/or socioeconomic status.</p><p><strong>Methods: </strong>Our scoping review was conducted in accordance with established guidelines and frameworks. Seven databases were searched. Participant characteristics, findings regarding the relationship between exercise and cardiovascular health, and any variations in this relationship were extracted. Article quality was appraised using the Mixed Methods Appraisal Tool.</p><p><strong>Results: </strong>Fourteen sources were identified, and study quality varied. Two adjusted analyses found aerobic exercise may lower the risk of cardiovascular disease. There was limited data found on the direction and strength of an adjusted relationship between exercise (aerobic or muscle-strengthening) and other cardiovascular outcomes or possible variations in the relationship across racial, ethnic, or socioeconomic groups.</p><p><strong>Conclusion: </strong>Findings highlight a considerable gap in knowledge regarding the relationship between exercise and cardiovascular health among diverse breast cancer survivors. Further longitudinal observational research is needed to better establish the direction and strength of this relationship, and how it differs based on race, ethnicity, or socioeconomic status.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"24"},"PeriodicalIF":3.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514819","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":"Survivorship clinic attendance improves completion but not timeliness of cardiac surveillance post anthracyclines.","authors":"Zac Forbes, Tegan Dunmall, Amanda Tey, Dominic Culligan, Pasquale L Fedele","doi":"10.1186/s40959-025-00316-7","DOIUrl":"10.1186/s40959-025-00316-7","url":null,"abstract":"<p><strong>Background: </strong>Anthracycline induced cardiomyopathy (AIC) is an important complication of cancer management. Recent findings showed that with early identification and intervention, AIC may be fully or partially reversible. European society of cardiology (ESC) guidelines recommend a risk-stratified monitoring approach, including transthoracic echocardiogram (TTE) for all patients within 12 months post-treatment.</p><p><strong>Aim: </strong>Investigate the impact of a survivorship clinic on TTE follow up for AIC.</p><p><strong>Methods: </strong>Over a 5 year span, 235 patients with haematological malignancies received anthracycline chemotherapy ≥ 250mg/m². The electronic medical records of these patients were reviewed. TTE outcomes were compared between survivorship and non-survivorship patients.</p><p><strong>Results: </strong>Survivorship patients received TTE in 88.6% of cases, whereas non-survivorship patients received TTE in 30.9% of cases. In survivorship patients, TTE was indicated for asymptomatic screening in 92.3% of cases. In non-survivorship patients the majority of TTE were for symptom investigation (78.0%). Chi-squared analysis found these results to be statistically significant (p value < 0.05).</p><p><strong>Discussion: </strong>Survivorship patients are nearly three times more likely to receive TTE monitoring for AIC. However, due to delayed clinic referral/attendance, only 36.4% received TTE within 1 year of treatment completion, in line with ESC guidelines.</p><p><strong>Conclusion: </strong>Survivorship clinics improve TTE monitoring for AIC, allowing early identification and potential intervention. However, reliance on this model alone may risk inadequate surveillance for patients who do not attend and delays in referral/attendance may impact monitoring timeliness.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"22"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499504","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":"Incidence and risk factors of trastuzumab-induced cardiac dysfunction in a predominantly Hispanic South Texas population: a descriptive study.","authors":"Aditi Sharma, Maria E Fierro, Samuel Governor, Aishwarya Kothare, Stella Pak, Karen Liu, Zuha Alam, Prince Otchere","doi":"10.1186/s40959-025-00319-4","DOIUrl":"10.1186/s40959-025-00319-4","url":null,"abstract":"<p><strong>Background: </strong>Trastuzumab, a monoclonal antibody against human epidermal growth factor receptor 2 (HER2), is often the first line treatment for HER2 positive breast cancer. Although trastuzumab is effective, it has cardiotoxic effects and therefore requires cardiotoxicity monitoring via serial transthoracic echocardiograms (TTEs). We aimed to evaluate risk factors for trastuzumab related cardiac dysfunction in a South Texas population that is uniquely a majority Hispanic population.</p><p><strong>Methods: </strong>A retrospective study was conducted of female patients with HER2-positive breast cancer who received trastuzumab treatment from 2015 to 2021. A total of 180 patients were identified. Patients without a baseline TTE and a baseline left ventricle ejection fraction (LVEF) less than 53% were excluded. The final sample size included 132 patients. Cardiac dysfunction was defined as a drop in LVEF by more than 10% to less than 53% during the 1-year study period.</p><p><strong>Results: </strong>The incidence of cardiac dysfunction was 6% in the study population. Hispanic/Latino patients composed 58% of the study population and represented 50% of patients who experienced cardiotoxicity. Of the patients who developed cardiotoxicity, 50% had hypertension, 25% had hyperlipidemia, 12.5% had type 2 diabetes mellitus, and 12.5% had previous coronary artery bypass grafts. A total of 12.5% had a history of radiation, 25% had a history of anthracycline therapy, 37.5% were former smokers, and 25% were former alcohol users.</p><p><strong>Conclusions: </strong>The incidence of trastuzumab-related cardiotoxicity in this Hispanic/Latino majority-minority population was 6%, which is surprisingly lower than the 9% cardiotoxicity rate observed in a predominantly white population in a previous study by Otchere et al., in 2023. Further studies are needed to determine the factors contributing to the reduced cardiotoxicity rate observed in this Hispanic population.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"23"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499503","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":"Cancer and myocardial injury in patients with suspected acute coronary syndrome.","authors":"Marta Sabaté-Tormos, Alfredo Bardají, Oscar M Peiró, Anna Carrasquer, German Cediel, Jose Luis Ferreiro","doi":"10.1186/s40959-025-00320-x","DOIUrl":"10.1186/s40959-025-00320-x","url":null,"abstract":"<p><strong>Background: </strong>Cancer and cardiovascular diseases are the leading causes of mortality worldwide, as they share common risk factors and exacerbate cardiovascular outcomes when they coexist. This study aimed to assess the clinical characteristics and cardiovascular outcomes of patients with a history of cancer and myocardial injury (MI) presenting with suspected acute coronary syndrome (ACS) in an emergency setting.</p><p><strong>Methods: </strong>This retrospective cohort study included 3,626 patients admitted to the emergency department with suspected ACS between 2012 and 2013. Patients were categorized on the basis of their cancer history and the presence of MI. Clinical variables and the associations between cancer history and MI with all-cause mortality were analyzed over a four-year follow-up period via univariate and multivariate Cox regression models.</p><p><strong>Results: </strong>Of the cohort, 10.6% (n = 384) had a history of cancer. Compared with other groups, cancer patients with MI were older, had more comorbidities, and presented a higher incidence of type 2 myocardial infarction (T2MI). At the four-year follow-up, all-cause mortality was significantly greater among cancer patients with MI (68.8%) than among cancer patients without MI (32.4%) and noncancer patients with or without MI (42.5% vs. 11.3%, respectively). Multivariate analysis identified cancer patients, particularly those with MI, as independent predictors of mortality.</p><p><strong>Conclusions: </strong>Patients who present to emergency departments with suspected ACS, a history of cancer, or the presence of MI face greater cardiovascular risk and mortality than other patients do. The higher prevalence of T2MI in this population underscores the need for tailored management strategies.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"21"},"PeriodicalIF":3.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476387","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":"Percutaneous coronary intervention-lobectomy for Lung Cancer hybrid surgery: an initial case series.","authors":"Jing Zeng, Junyi Yu, Qiao Mei, Ye Yuan, Taiming Zhang, Longyong Mei, Lingling Huang, Yijie Hu, Bo Deng, Gengze Wu, Chunyu Zeng","doi":"10.1186/s40959-025-00317-6","DOIUrl":"10.1186/s40959-025-00317-6","url":null,"abstract":"<p><strong>Background: </strong>For patients diagnosed with both lung cancer and severe coronary heart disease (CHD), the conflict between revascularization and lung cancer surgery remains to be settled to balance how to attenuate the cardiovascular risk for lung surgery and shorten the waiting time of anti-platelet therapy after revascularization. This study presents the percutaneous coronary intervention (PCI)-lobectomy for lung cancer hybrid surgery (PLHS), and its antithrombotic therapeutic strategy.</p><p><strong>Methods: </strong>From October 2020 to June 2023, 14 patients, with unstable angina and resectable lung cancer received PLHS. All procedures were performed in a hybrid operating room. Drug-eluting stents (DES) were implanted during PCI. Lobectomy was carried out within one hour after PCI.</p><p><strong>Results: </strong>Procedural success was 100%. All the patients subjected to PLHS were alive after 12 months of follow-up; 2 patients (14.29%) died due to distant metastasis within 12-24 months post-PLHS. There were no intraoperative complications, or 30-day- and 3-month-mortality. Except for one patient who suffered pneumothorax, no other postoperative complications, including severe bleeding, or in-stent restenosis, occurred in the 31.7 ± 10.9 months follow-up.</p><p><strong>Conclusions: </strong>PLHS is a feasible and potentially safe option for patients with both lung cancer and severe CHD.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"20"},"PeriodicalIF":3.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476454","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":"TAVR in cancer patients: outcomes in survivors with radiation and active cancer.","authors":"Umesh C Sharma, Saraswati Pokharel","doi":"10.1186/s40959-025-00301-0","DOIUrl":"10.1186/s40959-025-00301-0","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"19"},"PeriodicalIF":3.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425016","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":"Macrotroponin interference and association with cardiotoxicity in patients receiving cardiotoxic breast cancer therapy: a pilot study.","authors":"Andrea Soosaipillai, Inbar Nardi-Agmon, Davor Brinc, Anselmo Fabros, Peter A Kavsak, Paaladinesh Thavendiranathan, Ashley Di Meo","doi":"10.1186/s40959-025-00314-9","DOIUrl":"10.1186/s40959-025-00314-9","url":null,"abstract":"<p><strong>Background: </strong>Cancer therapy-related cardiac dysfunction (CTRCD) is an important adverse effect in patients receiving potential cardiotoxic cancer therapies. Interpretation of cardiac troponin results can be affected by presence of macrotroponin, which can complicate CTRCD assessment. We aimed to assess whether macrotroponin is detectable in women with ERBB2 + breast cancer receiving sequential therapy with anthracyclines and trastuzumab.</p><p><strong>Methods: </strong>A total of 20 serum samples from 12 ERBB2 + breast cancer patients (median age: 55 years, range: 30-69 years) who exhibited a significant increase in high-sensitivity cardiac troponin I (hs-cTnI) from baseline to post-anthracycline (~ 2 months after therapy initiation) and/or 3-months into trastuzumab therapy (~ 5 months after therapy initiation) and/or who had at least one hs-cTnI value above the female-specific 99th percentile (hs-cTnI > 16 ng/L) and had available banked blood for analysis were included in this pilot study. Samples were analyzed using the Abbott STAT High-Sensitive Troponin-I and Roche Elecsys Troponin T hs STAT assays. Macrotroponin was detected by treating the sample with protein G and re-measuring hs-cTn. Macrotroponin presence was defined as a hs-cTnI or hs-cTnT recovery of < 40% or 85%, respectively.</p><p><strong>Results: </strong>Macrotroponin was not identified after anthracycline treatment but was present in four patients 3-months into trastuzumab therapy, two of which had hs-cTnI concentrations above the 99th percentile. None of these patients exhibited a significant reduction in LVEF and/or GLS despite having significant elevations in hs-cTnI.</p><p><strong>Conclusions: </strong>Clinicians should be cautious of benign hs-cTn elevations resulting from macrotroponin presence, as it can complicate CTRCD assessment.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"18"},"PeriodicalIF":3.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425015","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}