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Prognostic value of combining cardiac myosin-binding protein C and N-terminal pro-B-type natriuretic peptide in patients without acute coronary syndrome treated at medical cardiac intensive care units.
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-04 DOI: 10.1007/s00380-024-02492-5
Hideto Nishimura, Junnichi Ishii, Hiroshi Takahashi, Yuya Ishihara, Kazuhiro Nakamura, Fumihiko Kitagawa, Eirin Sakaguchi, Yuko Sasaki, Hideki Kawai, Takashi Muramatsu, Masahide Harada, Akira Yamada, Sadako Tanizawa-Motoyama, Hiroyuki Naruse, Masayoshi Sarai, Masanobu Yanase, Hideki Ishii, Eiichi Watanabe, Yukio Ozaki, Hideo Izawa

We investigated the prognostic value of cardiac myosin-binding protein C (cMyC), a novel cardiospecific marker, both independently and in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP), for predicting 6-month all-cause mortality in patients without acute coronary syndrome (ACS) treated at medical (nonsurgical) cardiac intensive care units (CICUs). Admission levels of cMyC, high-sensitivity cardiac troponin T (hs-cTnT), and NT-proBNP were measured in 1032 consecutive patients (mean age; 70 years) without ACS hospitalized acutely in medical CICUs for the treatment of cardiovascular disease. Serum cMyC was closely correlated with hs-cTnT and moderately with NT-proBNP (r = 0.92 and r = 0.49, respectively, p < 0.0001). During the 6-month follow-up period after admission, there were 109 (10.6%) all-cause deaths, including 72 cardiovascular deaths. Both cMyC and NT-proBNP were independent predictors of 6-month all-cause mortality (all p < 0.05). Combining cMyC and NT-proBNP with a baseline model of established risk factors improved patient classification and discrimination beyond any single biomarker (all p < 0.05) or the baseline model alone (both p < 0.0001). Moreover, patients were divided into nine groups using cMyC and NT-proBNP tertiles, and the adjusted hazard ratio (95% confidence interval) for 6-month all-cause mortality in patients with both biomarkers in the highest vs. lowest tertile was 9.67 (2.65-35.2). When cMyC was replaced with hs-cTnT, similar results were observed for hs-cTnT. In addition, the C-indices for addition of cMyC or hs-cTnT to the baseline model were similar (0.798 vs. 0.800, p = 0.94). In conclusion, similar to hs-cTnT, cMyC at admission may be a potent, independent predictor of 6-month all-cause mortality in patients without ACS treated at medical CICUs, and their prognostic abilities may be comparable. Combining cMyC or hs-cTnT with NT-proBNP may substantially improve early risk stratification of this population.

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引用次数: 0
Association of aerobic exercise habits with higher albumin-globulin ratio and lower cellular immune-inflammatory markers: implication of the preventive effect of aerobic exercise on atherosclerotic cardiovascular disease.
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-03 DOI: 10.1007/s00380-024-02490-7
Shigemasa Tani, Kazuhiro Imatake, Yasuyuki Suzuki, Tsukasa Yagi, Atsuhiko Takahashi

Aerobic exercise habits have shown promising potential in reducing inflammation. Several studies have suggested that a higher albumin-globulin ratio (AGR), a key indicator of the immune-inflammatory response, could potentially suppress the progression of atherosclerosis. In this study, we investigated the relationship between aerobic exercise and atherosclerotic cardiovascular disease (ASCVD) predictors, specifically, AGR and cellular immune-inflammatory markers. We conducted a cross-sectional study involving 8381 participants (average age, 46.7 ± 13.0 years; 59% men) with no history of ASCVD registered at the Health Planning Center, Nihon University Hospital between 2019 and 2020. We defined aerobic exercise habits as 30 min of sweating at least twice a week for over a year, per the guideline for conducting specific health examinations according to Japan's Ministry of Health, Labour and Welfare. Participants who engaged in habitual aerobic exercise (n = 2159) had a significantly higher AGR than those who did not (n = 6220) [1.70 (1.55/1.86) vs. 1.67 (1.53/1.84), P < 0.0001]. Cellular immune-inflammatory markers, including neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and systemic immune-inflammation index (neutrophil/lymphocyte × platelet count), were significantly lower in participants who engaged in habitual aerobic exercise than in those who did not (all P < 0.0001). Furthermore, lower cellular immune-inflammatory markers were associated with a higher AGR. Causal mediation analysis revealed that cellular immune-inflammatory markers partially mediated the association between aerobic exercise and AGR. In conclusion, aerobic exercise habits may be associated with a higher AGR and lower cellular immune-inflammatory markers. Moreover, the lower immune-inflammatory response related to aerobic exercise may partially mediate the higher AGR. These associations may explain the attenuating effects of aerobic exercise on the risk of ASCVD.

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引用次数: 0
How to predict the presence of cardiac amyloidosis in patients with atrial fibrillation.
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-02 DOI: 10.1007/s00380-024-02501-7
Naoya Kataoka, Teruhiko Imamura
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引用次数: 0
Elevated arginine vasopressin levels surrogate acute lung injury in acute decompensated heart failure. 精氨酸加压素水平升高可替代急性失代偿性心力衰竭的急性肺损伤。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-06-11 DOI: 10.1007/s00380-024-02429-y
Shuichi Kitada, Yu Kawada, Kosuke Nakasuka, Tatsuya Mizoguchi, Junki Yamamoto, Masashi Yokoi, Tsuyoshi Ito, Toshihiko Goto, Shohei Kikuchi, Yoshihiro Seo

Activated arginine vasopressin (AVP) pathway worsens congestion in heart failure (HF), but its potential to relieve pulmonary congestion is also reported. The pathophysiological role and prognostic utility of AVP elevation in acute decompensated HF (ADHF) are poorly understood. We prospectively enrolled 52 hospitalized patients for ADHF to investigate the association between acute lung injury (ALI) in ADHF and AVP levels on admission. ALI was defined as respiratory failure leading to death, or requiring a respirator or a more than 12-h non-invasive intermittent positive pressure ventilation (NIPPV) support. In addition, we investigated the prognostic value of AVP levels on admission for cardiovascular death or recurrence of ADHF after discharge. ALI was documented in 7 patients (13.5%) during a median hospital stay of 14 days. And the patients with ALI demonstrated significantly higher AVP levels than those without (32.5 ± 21.6 vs. 6.4 ± 8.7 pg/ml, p = 0.018). Besides, the patients with ALI demonstrated significantly higher heart rates (HR) and lower E/e' on admission (HR: 127 ± 24 vs. 97 ± 28 bpm; E/e': 10.6 ± 3.7 vs. 17.4 ± 6.2, all p < 0.05, respectively). Of note, significant hemodilution assessed by hemoglobin and hematocrit values were observed in the patients with ALI 48 h after admission. A receiver operating characteristic curve analysis showed that higher than 7.2 pg/ml surrogate ALI in ADHF (AUC: 0.897, p = 0.001, Sensitivity: 85.7%, and Specificity: 77.8%). In contrast, increased AVP levels on admission could not predict cardiovascular events after discharge. Elevated AVP levels on admission are associated with ALI in ADHF but not cardiovascular events after discharge.

精氨酸血管加压素(AVP)通路的激活会加重心力衰竭(HF)的充血,但也有报道称其具有缓解肺充血的潜力。人们对急性失代偿性心力衰竭(ADHF)中 AVP 升高的病理生理学作用和预后效用知之甚少。我们对 52 名因 ADHF 住院的患者进行了前瞻性研究,以探讨 ADHF 急性肺损伤(ALI)与入院时 AVP 水平之间的关系。ALI的定义是导致死亡的呼吸衰竭,或需要呼吸机或超过12小时的无创间歇正压通气(NIPPV)支持。此外,我们还研究了入院时 AVP 水平对心血管死亡或出院后 ADHF 复发的预后价值。中位住院时间为 14 天的患者中有 7 人(13.5%)出现了 ALI。ALI患者的AVP水平明显高于非ALI患者(32.5 ± 21.6 vs. 6.4 ± 8.7 pg/ml,p = 0.018)。此外,ALI 患者入院时的心率(HR)明显较高,E/e'明显较低(HR:127 ± 24 vs. 97 ± 28 bpm;E/e':10.6 ± 3.7 vs. 17.4 ± 6.2,均 p = 0.018)。
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引用次数: 0
Balloon-expandable cobalt chromium stent versus self-expandable nitinol stent for the Atherosclerotic Iliac Arterial Disease (SENS-ILIAC Trial) Trial: a randomized controlled trial. 动脉粥样硬化性髂动脉疾病球囊扩张型钴铬支架与自扩张型镍钛诺支架对比试验(SENS-ILIAC 试验):随机对照试验。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-07-02 DOI: 10.1007/s00380-024-02431-4
Woong Gil Choi, Seung-Woon Rha, Byoung Geol Choi, Soohyung Park, Ji Bak Kim, Dong Oh Kang, Cheol Ung Choi, Yong Sung Seo, Yoon Hyung Cho, Sang Ho Park, Seung Jin Lee, Young Guk Ko, Ae-Young Her, Sang Min Kim, Ki Chang Kim, Jang Hyun Cho, Won Yu Kang, Joo Han Kim, Min Woong Kim, Do Hoi Kim, Jang Ho Bae, Ji Hoon Ahn, Sang Cheol Jo, Jae Bin Seo, Woo Young Jung, Sang Min Park

Iliac artery angioplasty with stenting is an effective alternative treatment modality for aortoiliac occlusive diseases. Few randomized controlled trials have compared the efficacy and safety between self-expandable stent (SES) and balloon-expandable stent (BES) in atherosclerotic iliac artery disease. In this randomized, multicenter study, patients with common or external iliac artery occlusive disease were randomly assigned in a 1:1 ratio to either BES or SES. The primary end point was the 1-year clinical patency, defined as freedom from any surgical or percutaneous intervention due to restenosis of the target lesion after the index procedure. The secondary end point was a composite event from major adverse clinical events at 1 year. A total of 201 patients were enrolled from 17 major cardiovascular intervention centers in South Korea. The mean age of the enrolled patients was 66.8 ± 8.5 years and 86.2% of the participants were male. The frequency of critical limb ischemia was 15.4%, and the most common target lesion was in the common iliac artery (75.1%). As the primary end point, the 1-year clinical patency as primary end point was 99% in the BES group and 99% in the SES group (p > 0.99). The rate of repeat revascularization at 1 year was 7.8% in the BES group and 7.0% in the SES group (p = 0.985; confidence interval, 1.011 [0.341-2.995]). In our randomized study, the treatment of iliac artery occlusive disease with self-expandable versus balloon-expandable stent was comparable in 12-month clinical outcomes without differences in the procedural success or geographic miss rate regardless of the deployment method in the distal aortoiliac occlusive lesion (ClinicalTrials.gov, NCT01834495).

髂动脉支架成形术是治疗主动脉髂动脉闭塞性疾病的有效替代方法。很少有随机对照试验比较自膨胀支架(SES)和球囊膨胀支架(BES)对动脉粥样硬化性髂动脉疾病的疗效和安全性。在这项多中心随机研究中,髂总动脉或髂外动脉闭塞性疾病患者按 1:1 的比例被随机分配到 BES 或 SES。主要终点是 1 年的临床通畅率,即在指数手术后因目标病变再狭窄而未接受任何手术或经皮介入治疗。次要终点是1年后主要临床不良事件的综合结果。韩国 17 家主要心血管介入中心共招募了 201 名患者。入选患者的平均年龄为(66.8 ± 8.5)岁,86.2%为男性。临界肢体缺血发生率为15.4%,最常见的靶病变位于髂总动脉(75.1%)。作为主要终点,BES 组的 1 年临床通畅率为 99%,SES 组为 99%(P > 0.99)。1 年后重复血管再通率,BES 组为 7.8%,SES 组为 7.0%(P = 0.985;置信区间为 1.011 [0.341-2.995])。在我们的随机研究中,使用自膨胀支架与球囊膨胀支架治疗髂动脉闭塞性疾病,无论在髂主动脉远端闭塞病变中采用哪种部署方法,12 个月的临床结果都相当,在程序成功率或地理漏失率方面没有差异(ClinicalTrials.gov,NCT01834495)。
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引用次数: 0
Impact of polyvascular disease severity on acute heart failure prognosis.
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 DOI: 10.1007/s00380-024-02496-1
Marlon V Gatuz, Rami Abu-Fanne, Dmitry Abramov, Mamas A Mamas, Ariel Roguin, Ofer Kobo

Polyvascular disease, is a prevalent comorbidity among patients with acute heart failure (AHF). Previous research has shown that polyvascular disease is a poor prognostic factor in patients with heart failure. However, data on the relationship between the extent of vascular disease involvement and outcomes in AHF patients are limited. Using the National Inpatient Sample from 2016 to 2019, adult patients with AHF were stratified by number of diseased vascular beds and into heart failure with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). The study assessed in-hospital major adverse cardiovascular and cerebrovascular events (MACCE), mortality, cerebrovascular accident (CVA), and major bleeding. Multivariable regression models examined the association between outcomes and number of diseased vascular beds. This analysis included 652,710 patients hospitalized with AHF, of which 42.2% had disease of 1 vascular site and 57.8% had polyvascular disease. As the number of involved vascular beds increased, AHF patients tended to be older and with higher comorbidity burden. The mean length of stay and total hospital charge increased with a greater number of diseased vascular beds (p < 0.001). Moreover, the adjusted odds of MACCE, all-cause mortality, CVA, and major bleeding showed a significant increase with a greater number of diseased vascular beds (p trend < 0.001) with similar trends for patients with HFrEF and HFpEF. The extent of polyvascular disease involvement is associated with higher in-hospital adverse event rates in AHF patients. These findings highlight the importance of comprehensive vascular assessment and targeted interventions to improve outcomes in this high-risk population.

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引用次数: 0
Association between preprocedural thromboembolic and bleeding events under oral anticoagulation therapy and mid-term outcomes after percutaneous left atrial appendage closure. 口服抗凝疗法下术前血栓栓塞和出血事件与经皮左房阑尾闭合术后中期预后之间的关系。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-06-05 DOI: 10.1007/s00380-024-02427-0
Hironobu Sumiyoshi, Mikitaka Fujita, Naoki Nishiura, Kazunori Mushiake, Ryuki Chatani, Sachiyo Ono, Hiroshi Tasaka, Takeshi Maruo, Kazushige Kadota, Shunsuke Kubo

Currently, no consensus has been established on the most effective antithrombotic therapy to prevent thromboembolic and bleeding events in patients undergoing percutaneous left atrial appendage closure (LAAC) with preprocedural thromboembolic or bleeding events under oral anticoagulation (OAC) therapy. We retrospectively investigated the incidence of device-related thrombosis (DRT), thromboembolic events, and bleeding events in patients who underwent LAAC from September 2019 to October 2022. After categorizing patients into three groups based on preprocedural thromboembolic or bleeding events under OAC therapy, we compared the incidence of DRT and prognosis according to the postprocedural antithrombotic therapy. In patients who received the conventional antithrombotic therapy (OAC with and without single antiplatelet therapy for 45 days after LAAC and dual-antiplatelet therapy from 45 days to 6 months followed by single antiplatelet therapy), preprocedural thromboembolic events despite OAC were independently associated with DRT or postprocedural thromboembolic events at the 3 year follow-up (hazard ratio [HR] 4.55; 95% confidence interval [CI] 1.32-15.6; P = 0.016), whereas preprocedural bleeding events were independently associated with postprocedural bleeding events (HR 8.01, 95% CI 1.45-58.3; P = 0.036). Continuation of OAC for 12 months among patients who developed preprocedural thromboembolic events during OAC significantly decreased the incidence of DRT or postoperative thromboembolic events (P = 0.002) with no increase in the bleeding events (P = 0.522). Preprocedural thromboembolic and bleeding events can predict adverse events after LAAC with the conventional antiplatelet-based antithrombotic therapy. Patients who develop thromboembolic events under continuous OAC may benefit from continuous OAC for 1 year after LAAC.

目前,对于接受经皮左心房阑尾封堵术(LAAC)、术前血栓栓塞或出血事件、口服抗凝药(OAC)治疗的患者,预防血栓栓塞和出血事件的最有效抗血栓疗法尚未达成共识。我们回顾性调查了2019年9月至2022年10月期间接受LAAC手术的患者中设备相关血栓形成(DRT)、血栓栓塞事件和出血事件的发生率。根据患者术前接受 OAC 治疗时发生的血栓栓塞或出血事件将其分为三组,然后根据术后抗血栓治疗情况比较了 DRT 的发生率和预后。在接受常规抗血栓治疗(LAAC 术后 45 天内接受或不接受单一抗血小板治疗的 OAC,以及 45 天至 6 个月内接受单一抗血小板治疗的双抗血小板治疗)的患者中,尽管接受了 OAC,但术前血栓栓塞事件与 3 年随访时的 DRT 或术后血栓栓塞事件独立相关(危险比 [HR] 4.55;95% 置信区间 [CI] 1.32-15.6;P = 0.016),而术前出血事件与术后出血事件独立相关(HR 8.01,95% CI 1.45-58.3;P = 0.036)。在 OAC 期间发生术前血栓栓塞事件的患者中,继续使用 OAC 12 个月可显著降低 DRT 或术后血栓栓塞事件的发生率(P = 0.002),而出血事件不会增加(P = 0.522)。术前血栓栓塞和出血事件可以预测使用传统抗血小板抗血栓疗法进行 LAAC 后的不良事件。在连续 OAC 治疗下发生血栓栓塞事件的患者可能会从 LAAC 术后 1 年的连续 OAC 治疗中获益。
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引用次数: 0
Clinical impact of Academic Research Consortium for High Bleeding-Risk scores on clinical outcomes in patients with stable coronary artery disease undergoing percutaneous coronary intervention. 高出血风险学术研究联盟评分对接受经皮冠状动脉介入治疗的稳定型冠心病患者临床预后的临床影响。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-06-06 DOI: 10.1007/s00380-024-02428-z
Hirokazu Shimono, Akihiro Tokushige, Daisuke Kanda, Ayaka Ohno, Ryo Arikawa, Hideto Chaen, Hideki Okui, Naoya Oketani, Mitsuru Ohishi

High bleeding risk (HBR), as defined by the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria, has been recently reported to be associated with an increased risk of major bleeding events and cardiovascular events. We investigated the association between the ARC-HBR score and clinical outcomes in patients with stable coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We assessed 328 consecutive patients with stable CAD who underwent PCI between January 2017 and December 2020. We scored the ARC-HBR criteria by assigning 1 point to each major criterion and 0.5 points to each minor criterion. Patients were stratified into low (ARC-HBR score < 1), intermediate (1 ≤ ARC-HBR score < 2), and high (ARC-HBR score ≥ 2) bleeding-risk groups. The primary outcome measure was major adverse cardiovascular events (MACE), defined as a composite of all-cause death, nonfatal myocardial infarction, and nonfatal stroke. We compared the discriminative abilities of the ARC-HBR score with the Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention (TRS2°P) and ARC-HBR score with Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) thrombotic risk score. The mean patient age was 70.1 ± 10.2 years (males, 76.8%). During the median follow-up period of 983 (618-1338) days, 44 patients developed MACE. Kaplan-Meier curves showed that a stepwise significant increase in the cumulative incidence of MACE as the ARC-HBR score increased (log-rank p < 0.001). In the time-dependent receiver-operating characteristic curve analysis for predicting MACE within 2 years, the area under the curve (AUC) of the ARC-HBR score was significantly higher than that of the TRS2°P (AUC: 0.825 vs. 0.725, p value for the difference = 0.023) and similar to that of CREDO-Kyoto thrombotic risk score (AUC: 0.825 vs. 0.813, p value for the difference = 0.627). Conclusions: The ARC-HBR score adequately stratified future risk of MACE in patients with stable CAD who underwent PCI. The ARC-HBR score showed a higher discriminative ability for predicting mid-term MACE than the TRS2°P.

根据高出血风险学术研究联盟(ARC-HBR)标准定义的高出血风险(HBR)最近被报道与大出血事件和心血管事件风险增加有关。我们研究了接受经皮冠状动脉介入治疗(PCI)的稳定型冠状动脉疾病(CAD)患者的 ARC-HBR 评分与临床预后之间的关系。我们对 2017 年 1 月至 2020 年 12 月期间接受 PCI 治疗的 328 名连续稳定型 CAD 患者进行了评估。我们对 ARC-HBR 标准进行了评分,每个主要标准 1 分,每个次要标准 0.5 分。患者被分为低分(ARC-HBR 评分
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引用次数: 0
Letter to the editor "Incremental value of diastolic wall strain in predicting heart failure events in patients with atrial fibrillation''. 致编辑的信 "舒张期室壁应变在预测心房颤动患者心衰事件中的增量价值"。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-07-16 DOI: 10.1007/s00380-024-02442-1
Xiaohong Zhou
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引用次数: 0
Reply to letter to the editor "Incremental value of diastolic wall strain in predicting heart failure events in patients with atrial fibrillation". 回复致编辑的信 "舒张壁应变在预测心房颤动患者心衰事件中的增量价值"。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-07-19 DOI: 10.1007/s00380-024-02443-0
Naoki Taniguchi, Yoko Miyasaka
{"title":"Reply to letter to the editor \"Incremental value of diastolic wall strain in predicting heart failure events in patients with atrial fibrillation\".","authors":"Naoki Taniguchi, Yoko Miyasaka","doi":"10.1007/s00380-024-02443-0","DOIUrl":"10.1007/s00380-024-02443-0","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"1081"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Heart and Vessels
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