首页 > 最新文献

IJC Heart and Vasculature最新文献

英文 中文
Association between inflammatory bowel disease and atrial fibrillation: A systematic review and meta-analysis 炎症性肠病与心房颤动之间的关系:系统回顾与荟萃分析
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 DOI: 10.1016/j.ijcha.2024.101456

Background

Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a prevalent condition associated with chronic noninfectious inflammation of the gastrointestinal tract. It has been hypothesized that chronic inflammation can predispose patients to atrial fibrillation (AF), however, no clear evidence exists to support this.

Methods

A systematic literature search was conducted using major databases aimed at studies focusing on AF development in patients with IBD. Further subgroup analyses were performed for ulcerative colitis (UC) and crohn’s disease (CD). Risk ratios (RR) with their corresponding 95 % confidence intervals (CI) were pooled using a random-effects model in the Review Manager Software. Statistical significance was set at p < 0.05.

Results

Seven studies with 88,893,407 patients were included (1,002,719 and 87, 890, 688 patients in the IBD and non-IBD groups, respectively). IBD patients were at an increased risk of developing AF [RR: 1.52; 95 % CI: 1.19–1.95; p = 0.0009] compared to the non-IBD group. In subgroup analyses, patients with UC were at an increased risk of developing AF [RR: 1.29; 95 % CI: 1.08–1.53; p = 0.004], as were CD patients [RR: 1.30; 95 % CI: 1.07–1.58; p = 0.008] compared to the non-UC and non-CD groups, respectively.

Conclusion

Patients with IBD are at nearly 1.5 times the risk of developing AF compared to the non-IBD population. Our meta-analysis was limited by heterogeneity among the studies, highlighting the importance of further large-scale prospective studies to establish more robust evidence.

背景炎症性肠病(IBD),包括克罗恩病(CD)和溃疡性结肠炎(UC),是一种与胃肠道慢性非感染性炎症有关的流行病。有人假设慢性炎症会使患者易患心房颤动(AF),但目前还没有明确的证据支持这一观点。方法:我们使用主要数据库对有关 IBD 患者心房颤动发展的研究进行了系统的文献检索。对溃疡性结肠炎(UC)和克罗恩病(CD)进行了进一步的亚组分析。使用Review Manager软件中的随机效应模型对风险比(RR)及其相应的95%置信区间(CI)进行了汇总。结果共纳入七项研究,88,893,407 名患者(IBD 组和非 IBD 组患者人数分别为 1,002,719 人和 87,890,688 人)。与非 IBD 组相比,IBD 患者罹患房颤的风险更高[RR:1.52;95 % CI:1.19-1.95;P = 0.0009]。在亚组分析中,与非 UC 组和非 CD 组相比,UC 患者罹患房颤的风险增加 [RR:1.29;95 % CI:1.08-1.53;p = 0.004],CD 患者也是如此 [RR:1.30;95 % CI:1.07-1.58;p = 0.008]。我们的荟萃分析因研究间的异质性而受到限制,这凸显了进一步开展大规模前瞻性研究以建立更可靠证据的重要性。
{"title":"Association between inflammatory bowel disease and atrial fibrillation: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.ijcha.2024.101456","DOIUrl":"10.1016/j.ijcha.2024.101456","url":null,"abstract":"<div><h3>Background</h3><p>Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a prevalent condition associated with chronic noninfectious inflammation of the gastrointestinal tract. It has been hypothesized that chronic inflammation can predispose patients to atrial fibrillation (AF), however, no clear evidence exists to support this.</p></div><div><h3>Methods</h3><p>A systematic literature search was conducted using major databases aimed at studies focusing on AF development in patients with IBD. Further subgroup analyses were performed for ulcerative colitis (UC) and crohn’s disease (CD). Risk ratios (RR) with their corresponding 95 % confidence intervals (CI) were pooled using a random-effects model in the Review Manager Software. Statistical significance was set at p &lt; 0.05.</p></div><div><h3>Results</h3><p>Seven studies with 88,893,407 patients were included (1,002,719 and 87, 890, 688 patients in the IBD and non-IBD groups, respectively). IBD patients were at an increased risk of developing AF [RR: 1.52; 95 % CI: 1.19–1.95; p = 0.0009] compared to the non-IBD group. In subgroup analyses, patients with UC were at an increased risk of developing AF [RR: 1.29; 95 % CI: 1.08–1.53; p = 0.004], as were CD patients [RR: 1.30; 95 % CI: 1.07–1.58; p = 0.008] compared to the non-UC and non-CD groups, respectively.</p></div><div><h3>Conclusion</h3><p>Patients with IBD are at nearly 1.5 times the risk of developing AF compared to the non-IBD population. Our <em>meta</em>-analysis was limited by heterogeneity among the studies, highlighting the importance of further large-scale prospective studies to establish more robust evidence.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001222/pdfft?md5=38eb2d9d0a7a95e19b1705566daabb90&pid=1-s2.0-S2352906724001222-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951606","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}
引用次数: 0
Pulmonary arterial compliance as a measure of right ventricular loading in mitral regurgitation 肺动脉顺应性作为二尖瓣反流时右心室负荷的测量指标
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 DOI: 10.1016/j.ijcha.2024.101472

Pulmonary hypertension (PH) is a common and prognostically important complication of mitral regurgitation (MR). Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) are traditionally used to diagnose PH, however these indices measure static rather than pulsatile load, leading to an incomplete representation of pulmonary vascular load on the right ventricle (RV). Pulmonary arterial compliance (PAC) is one method for quantifying pulsatile load, and is both a stronger predictor of prognosis in left heart failure, as well as a more sensitive measure of early pulmonary vascular dysfunction than PVR. With the expansion of transcatheter mitral and tricuspid valve therapies, there is renewed interest to more accurately define the load imposed by the pulmonary vasculature on the RV, especially in the early phase, prior to the onset of chronic PH. This review discusses the pathophysiology of pH in left heart failure and MR, the utility of PAC as a measure of RV afterload, and its calculation for clinical use and interpretation, underlining the utility of PAC as an adjunct for assessing pulmonary vascular haemodynamics.

肺动脉高压(PH)是二尖瓣反流(MR)的常见并发症,在预后方面具有重要意义。传统上,平均肺动脉压(mPAP)和肺血管阻力(PVR)被用于诊断肺动脉高压,但这些指标测量的是静态而非搏动负荷,导致肺血管对右心室(RV)的负荷表现不完整。肺动脉顺应性(PAC)是量化搏动负荷的一种方法,它既能更准确地预测左心衰竭的预后,也是比 PVR 更灵敏的早期肺血管功能障碍测量指标。随着经导管二尖瓣和三尖瓣疗法的推广,人们再次对更准确地定义肺血管对左心室施加的负荷产生了兴趣,尤其是在慢性 PH 发病前的早期阶段。这篇综述讨论了左心衰竭和 MR 中 pH 的病理生理学、PAC 作为衡量 RV 后负荷的实用性及其临床使用和解释的计算方法,强调了 PAC 作为评估肺血管血流动力学的辅助方法的实用性。
{"title":"Pulmonary arterial compliance as a measure of right ventricular loading in mitral regurgitation","authors":"","doi":"10.1016/j.ijcha.2024.101472","DOIUrl":"10.1016/j.ijcha.2024.101472","url":null,"abstract":"<div><p>Pulmonary hypertension (PH) is a common and prognostically important complication of mitral regurgitation (MR). Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) are traditionally used to diagnose PH, however these indices measure static rather than pulsatile load, leading to an incomplete representation of pulmonary vascular load on the right ventricle (RV). Pulmonary arterial compliance (PAC) is one method for quantifying pulsatile load, and is both a stronger predictor of prognosis in left heart failure, as well as a more sensitive measure of early pulmonary vascular dysfunction than PVR. With the expansion of transcatheter mitral and tricuspid valve therapies, there is renewed interest to more accurately define the load imposed by the pulmonary vasculature on the RV, especially in the early phase, prior to the onset of chronic PH. This review discusses the pathophysiology of pH in left heart failure and MR, the utility of PAC as a measure of RV afterload, and its calculation for clinical use and interpretation, underlining the utility of PAC as an adjunct for assessing pulmonary vascular haemodynamics.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001386/pdfft?md5=fbead30e3fc2c5d288b84eac0efef2ac&pid=1-s2.0-S2352906724001386-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141954326","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}
引用次数: 0
Artificial intelligence in fetal echocardiography: Recent advances and future prospects 人工智能在胎儿超声心动图中的应用:最新进展与未来展望
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 DOI: 10.1016/j.ijcha.2024.101380

In the past few decades, great progress has been made in prenatal diagnosis of congenital heart disease (CHD). Fetal echocardiography is recognized as the main prenatal screening and diagnostic tool that can accurately detect approximately 85 % of fetal cardiac abnormalities. Evaluation of the fetal heart remains a major challenge in prenatal ultrasound screening and diagnosis due to fetal position, involuntary movement, small and complex fetal cardiac anatomy, maternal abdominal wall conditions, and lack of expertise in fetal echocardiography by some physicians engaged in obstetric ultrasound. Artificial intelligence (AI) can automate and standardize the display of each diagnostic section of the fetal heart and thus contribute to accurate diagnosis, which significantly optimizes the clinical application of fetal echocardiography. In this review, we not only clarify the role of AI but also highlight its significance and future solutions in the field of fetal echocardiography.

过去几十年来,先天性心脏病(CHD)的产前诊断取得了长足的进步。胎儿超声心动图是公认的主要产前筛查和诊断工具,可准确检测出约 85% 的胎儿心脏畸形。由于胎儿位置、不自主运动、胎儿心脏解剖结构小而复杂、母体腹壁情况以及一些从事产科超声的医生缺乏胎儿超声心动图方面的专业知识等原因,对胎儿心脏的评估仍然是产前超声筛查和诊断的一大挑战。人工智能(AI)可实现胎儿心脏各诊断切面显示的自动化和标准化,从而有助于准确诊断,极大地优化了胎儿超声心动图的临床应用。在这篇综述中,我们不仅阐明了人工智能的作用,还强调了其在胎儿超声心动图领域的意义和未来的解决方案。
{"title":"Artificial intelligence in fetal echocardiography: Recent advances and future prospects","authors":"","doi":"10.1016/j.ijcha.2024.101380","DOIUrl":"10.1016/j.ijcha.2024.101380","url":null,"abstract":"<div><p>In the past few decades, great progress has been made in prenatal diagnosis of congenital heart disease (CHD). Fetal echocardiography is recognized as the main prenatal screening and diagnostic tool that can accurately detect approximately 85 % of fetal cardiac abnormalities. Evaluation of the fetal heart remains a major challenge in prenatal ultrasound screening and diagnosis due to fetal position, involuntary movement, small and complex fetal cardiac anatomy, maternal abdominal wall conditions, and lack of expertise in fetal echocardiography by some physicians engaged in obstetric ultrasound. Artificial intelligence (AI) can automate and standardize the display of each diagnostic section of the fetal heart and thus contribute to accurate diagnosis, which significantly optimizes the clinical application of fetal echocardiography. In this review, we not only clarify the role of AI but also highlight its significance and future solutions in the field of fetal echocardiography.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724000460/pdfft?md5=1fdfca50fd9d06aebec66e31f0d29667&pid=1-s2.0-S2352906724000460-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141954672","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}
引用次数: 0
In-hospital pulse pressure variability: A novel marker of cardiovascular risk among patients with coronary artery disease undergoing percutaneous coronary intervention? 院内脉压变异性:接受经皮冠状动脉介入治疗的冠心病患者心血管风险的新标记?
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 DOI: 10.1016/j.ijcha.2024.101445
{"title":"In-hospital pulse pressure variability: A novel marker of cardiovascular risk among patients with coronary artery disease undergoing percutaneous coronary intervention?","authors":"","doi":"10.1016/j.ijcha.2024.101445","DOIUrl":"10.1016/j.ijcha.2024.101445","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001118/pdfft?md5=8d9e5925868ff79ab4c6d1c999d095d9&pid=1-s2.0-S2352906724001118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141393165","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}
引用次数: 0
Characteristics, management and outcome of patients with late-arrival STEMI in the Acute Coronary Syndrome Israeli Surveys (ACSIS) 以色列急性冠状动脉综合征调查(ACSIS)中晚到 STEMI 患者的特征、管理和预后
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 DOI: 10.1016/j.ijcha.2024.101476

Introduction

Patients with ST-elevation myocardial infarction (STEMI) and late arrival (>12 h) after symptom onset, are at high risk for mortality and heart failure and represent a challenge for management. We aimed to define patient characteristics, management, and outcome of late-arrival STEMI in Israel over the last 20 years.

Methods

We analyzed data of late-arrival STEMI (12–48 h and > 48 h) from the biennial acute coronary syndrome Israeli Surveys (ACSIS), as well as time-dependent changes [early (2000–2010) Vs. late (2013–2021) period].

Results

Data regarding time from symptom onset to hospital arrival was available in 6,466 STEMI patients. Of these, 9.6 % arrived 12–48 h and 3 % >48 h from symptom onset. Late-arrival patients were more likely to be older women with diabetes and high GRACE score and less likely to have prior myocardial infarction.

In recent years, 95 % of patients arriving 12–48 h and 96 % of those arriving > 48 h had coronary angiography, as opposed to 75 % and 77 % in the early years (p = 0.007). Percutaneous coronary intervention (PCI) increased from 60 % and 55 % respectively to 85 % (p ≤ 0.001).

TIMI-3 flow after primary PCI was 89–92 %, irrespective of arrival time. Late arrival patients (12–48 h but not > 48 h) who had PCI had better adjusted 1-year survival, HR 0.49 (95 %CI 0.29–0.82), p = 0.01.

Conclusions

Late-arrival STEMI patients have higher risk characteristics. Most late-arrival patients undergo coronary angiography and PCI and have TIMI-3 flow after primary PCI. In patients arriving 12–48 h after symptom onset PCI is associated with better survival.

导言ST段抬高型心肌梗死(STEMI)患者在症状出现后到达医院的时间较晚(12 小时),死亡率和心力衰竭的风险较高,是管理方面的一项挑战。我们分析了两年一次的以色列急性冠状动脉综合征调查(ACSIS)中关于晚到 STEMI(12-48 小时和 48 小时)的数据,以及随时间发生的变化[早期(2000-2010 年)与晚期(2013-2021 年)]。其中,9.6%的患者在症状出现后12-48小时到达医院,3%的患者在症状出现后48小时到达医院。近年来,95%的 12-48 小时内和 96% 的 48 小时内到达医院的患者进行了冠状动脉造影,而早年分别为 75% 和 77%(P = 0.007)。经皮冠状动脉介入治疗(PCI)的比例分别从 60% 和 55% 增加到 85%(p ≤ 0.001)。晚到的 STEMI 患者(12-48 小时,但不包括 48 小时)接受 PCI 治疗的调整后 1 年生存率更高,HR 为 0.49(95 %CI 0.29-0.82),P = 0.01。大多数晚到患者会接受冠状动脉造影和 PCI,初级 PCI 后会出现 TIMI-3 血流。对于症状出现 12-48 小时后到达的患者,PCI 与更好的存活率相关。
{"title":"Characteristics, management and outcome of patients with late-arrival STEMI in the Acute Coronary Syndrome Israeli Surveys (ACSIS)","authors":"","doi":"10.1016/j.ijcha.2024.101476","DOIUrl":"10.1016/j.ijcha.2024.101476","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with ST-elevation myocardial infarction (STEMI) and late arrival (&gt;12 h) after symptom onset, are at high risk for mortality and heart failure and represent a challenge for management. We aimed to define patient characteristics, management, and outcome of late-arrival STEMI in Israel over the last 20 years.</p></div><div><h3>Methods</h3><p>We analyzed data of late-arrival STEMI (12–48 h and &gt; 48 h) from the biennial acute coronary syndrome Israeli Surveys (ACSIS), as well as time-dependent changes [early (2000–2010) Vs. late (2013–2021) period].</p></div><div><h3>Results</h3><p>Data regarding time from symptom onset to hospital arrival was available in 6,466 STEMI patients. Of these, 9.6 % arrived 12–48 h and 3 % &gt;48 h from symptom onset. Late-arrival patients were more likely to be older women with diabetes and high GRACE score and less likely to have prior myocardial infarction.</p><p>In recent years, 95 % of patients arriving 12–48 h and 96 % of those arriving &gt; 48 h had coronary angiography, as opposed to 75 % and 77 % in the early years (p = 0.007). Percutaneous coronary intervention (PCI) increased from 60 % and 55 % respectively to 85 % (p ≤ 0.001).</p><p>TIMI-3 flow after primary PCI was 89–92 %, irrespective of arrival time. Late arrival patients (12–48 h but not &gt; 48 h) who had PCI had better adjusted 1-year survival, HR 0.49 (95 %CI 0.29–0.82), p = 0.01.</p></div><div><h3>Conclusions</h3><p>Late-arrival STEMI patients have higher risk characteristics. Most late-arrival patients undergo coronary angiography and PCI and have TIMI-3 flow after primary PCI. In patients arriving 12–48 h after symptom onset PCI is associated with better survival.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001428/pdfft?md5=6898e320225e03282a991e9029402ac7&pid=1-s2.0-S2352906724001428-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141954671","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}
引用次数: 0
Utilizing omics technologies in the investigation of sepsis-induced cardiomyopathy 利用全息技术研究脓毒症诱发的心肌病
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-07-30 DOI: 10.1016/j.ijcha.2024.101477

Sepsis-induced cardiomyopathy (SIC) is a common and high-mortality complication among critically ill patients. Uncertainties persist regarding the pathogenesis, pathophysiology, and diagnosis of SIC, underscoring the necessity to investigate potential biological mechanisms. With the rise of omics technologies, leveraging their high throughput and big data advantages, a systems biology perspective is employed to study the biological processes of SIC. This approach aids in gaining a better understanding of the disease’s onset, progression, and outcomes, ultimately providing improved guidance for clinical practices. This review summarizes the currently applied omics technologies, omics studies related to SIC, and relevant omics databases.

脓毒症诱发的心肌病(SIC)是重症患者中常见的并发症,死亡率很高。SIC的发病机制、病理生理学和诊断仍存在不确定性,这凸显了研究潜在生物机制的必要性。随着 omics 技术的兴起,利用其高通量和大数据的优势,采用系统生物学的观点来研究 SIC 的生物学过程。这种方法有助于更好地了解疾病的发病、进展和结果,最终为临床实践提供更好的指导。本综述总结了目前应用的 omics 技术、与 SIC 相关的 omics 研究以及相关的 omics 数据库。
{"title":"Utilizing omics technologies in the investigation of sepsis-induced cardiomyopathy","authors":"","doi":"10.1016/j.ijcha.2024.101477","DOIUrl":"10.1016/j.ijcha.2024.101477","url":null,"abstract":"<div><p>Sepsis-induced cardiomyopathy (SIC) is a common and high-mortality complication among critically ill patients. Uncertainties persist regarding the pathogenesis, pathophysiology, and diagnosis of SIC, underscoring the necessity to investigate potential biological mechanisms. With the rise of omics technologies, leveraging their high throughput and big data advantages, a systems biology perspective is employed to study the biological processes of SIC. This approach aids in gaining a better understanding of the disease’s onset, progression, and outcomes, ultimately providing improved guidance for clinical practices. This review summarizes the currently applied omics technologies, omics studies related to SIC, and relevant omics databases.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235290672400143X/pdfft?md5=8e8396e9c5fb6106a6b4f0f586739cf2&pid=1-s2.0-S235290672400143X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962000","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}
引用次数: 0
Association of statins with peak oxygen consumption in 4,941 adults: A cross-sectional study 他汀类药物与 4941 名成年人峰值耗氧量的关系:横断面研究
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-07-20 DOI: 10.1016/j.ijcha.2024.101471

Background and aims

Cardiovascular disease remains a leading cause of mortality, with statins widely used to reduce its risk. Despite extensive research, the nuanced impact of statin therapy on cardiorespiratory fitness, particularly the reduction in peak oxygen consumption (VO2), is still an open question. This study aims to contribute fresh insights to the ongoing discussion, highlighting the unresolved nature of this clinical matter.

Methods

We retrospectively analyzed maximal cardiopulmonary exercise test (CPET) in male and female participants over 18 years of age who were under statins treatment. They were categorized as physically active or inactive according to self-report of physical activity. From 33,804 CPET, 4,941 participants (76 % men, age 42 ± 13 years; and 24 % women, age 41 ± 13 years) were included in the study.

Results

The multivariate linear regression model showed that statins were associated with a significant reduction in VO2 peak (−4.2 [-4.8, −3.5] mL/kg/min, p < 0.01) after adjusting for age, sex, use of beta-blockers, antiarrhythmics, presence of diabetes, and weekly level of physical activity. This reduction in VO2 peak was attenuated in participants with higher weekly physical activity volume (150 to 300 min/week: 3.2 [2.7; 3.7] mL/kg/min; 301 to 600 min/week: 4.5 [3.7; 5.3] mL/kg/min; and > 600 min/week: 6.9 [5.4; 8.4] mL/kg/min, all p < 0.01).

Conclusions

Statin use is associated with a lower VO2 peak in adults. However, this adverse effect appears to be mitigated by engaging in regular physical activity (>150 min/week). Future research should explore the mechanisms behind this interaction and identify optimal exercise regimens for individuals on statin therapy.

背景和目的心血管疾病仍然是导致死亡的主要原因,他汀类药物被广泛用于降低心血管疾病的风险。尽管进行了广泛的研究,但他汀类药物治疗对心肺功能的细微影响,尤其是峰值耗氧量(VO2)的降低,仍是一个未决问题。本研究旨在为正在进行的讨论贡献新的见解,强调这一临床问题的未决性。方法我们回顾性地分析了接受他汀类药物治疗的 18 岁以上男性和女性参与者的最大心肺运动测试(CPET)。根据自我报告的体育锻炼情况,他们被分为体育锻炼活跃和体育锻炼不活跃两类。结果多变量线性回归模型显示,他汀类药物与 VO2 峰值的显著降低有关(-4.2 [-4.8, -3.5] mL/kg/min,p < 0.01),这是在调整了年龄、性别、β-受体阻滞剂和抗心律失常药的使用情况、是否患有糖尿病以及每周体育锻炼水平后得出的结果。在每周运动量较大(150 至 300 分钟/周)的参与者中,VO2 峰值的降低有所减弱:3.2 [2.7; 3.7] mL/kg/min;301 至 600 分钟/周:4.5 [3.7; 5.3] 毫升/千克/分钟;以及 > 600 分钟/周:结论铂的使用与成人较低的 VO2 峰值有关。然而,经常参加体育锻炼(每周 150 分钟)似乎可以减轻这种不利影响。未来的研究应探索这种相互作用背后的机制,并确定他汀类药物治疗者的最佳运动方案。
{"title":"Association of statins with peak oxygen consumption in 4,941 adults: A cross-sectional study","authors":"","doi":"10.1016/j.ijcha.2024.101471","DOIUrl":"10.1016/j.ijcha.2024.101471","url":null,"abstract":"<div><h3>Background and aims</h3><p>Cardiovascular disease remains a leading cause of mortality, with statins widely used to reduce its risk. Despite extensive research, the nuanced impact of statin therapy on cardiorespiratory fitness, particularly the reduction in peak oxygen consumption (VO<sub>2</sub>), is still an open question. This study aims to contribute fresh insights to the ongoing discussion, highlighting the unresolved nature of this clinical matter.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed maximal cardiopulmonary exercise<!--> <!-->test (CPET) in male and female participants over 18 years of age who were under statins treatment. They were categorized as physically active or inactive according to self-report of physical activity. From 33,804 CPET, 4,941 participants (76 % men, age 42 ± 13 years; and 24 % women, age 41 ± 13 years) were included in the study.</p></div><div><h3>Results</h3><p>The multivariate linear regression model showed that statins were associated with a significant reduction in VO<sub>2</sub> peak (−4.2 [-4.8, −3.5] mL/kg/min, p &lt; 0.01) after adjusting for age, sex, use of beta-blockers, antiarrhythmics, presence of diabetes, and weekly level of physical activity. This reduction in VO<sub>2</sub> peak was attenuated in participants with higher weekly physical activity volume (150 to 300 min/week: 3.2 [2.7; 3.7] mL/kg/min; 301 to 600 min/week: 4.5 [3.7; 5.3] mL/kg/min; and &gt; 600 min/week: 6.9 [5.4; 8.4] mL/kg/min, all p &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>Statin use is associated with a lower VO<sub>2</sub> peak in adults. However, this adverse effect appears to be mitigated by engaging in regular physical activity (&gt;150 min/week). Future research should explore the mechanisms behind this interaction and identify optimal exercise regimens for individuals on statin therapy.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001374/pdfft?md5=6e5de663f8fb0e7fc7b66d1aed050221&pid=1-s2.0-S2352906724001374-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141732401","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}
引用次数: 0
Sarcopenia influences usage of reperfusion treatment in patients with pulmonary embolism aged 75 years and older 肌肉疏松症影响 75 岁及以上肺栓塞患者再灌注治疗的使用情况
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-07-19 DOI: 10.1016/j.ijcha.2024.101470

Background

Although pulmonary embolism (PE) and sarcopenia are common diseases, only a few studies have assessed the impact of sarcopenia in PE on usage of reperfusion treatments in PE.

Methods

All hospitalizations of PE patients aged ≥75 years 2005–2020 in Germany were included in this study and stratified for sarcopenia. Impact of sarcopenia on treatment procedures and adverse in-hospital events were investigated.

Results

Overall, 576,364 hospitalizations of PE patients aged ≥75 years (median age 81.0 [78.0–85.0] years; 63.3 % females) were diagnosed in Germany during the observational period 2005–2020. Among these, 2357 (0.4 %) were coded with sarcopenia. PE patients with sarcopenia were in median 2 years older (83.0 [79.0–87.0] vs. 81.0 [78.0–85.0] years, P<0.001) and showed an aggravated comorbidity-profile (Charlson Comorbidity Index 7.00 [5.00–9.00] vs. 6.00 [4.00–7.00], P<0.001). Although signs of hemodynamic compromise such as shock (5.2 % vs. 4.1 %, P=0.005) and tachycardia (4.1 % vs. 2.8 %, P<0.001) were more prevalent in sarcopenic PE patients, systemic thrombolysis (1.9 % vs. 3.5 %, P<0.001) was less often used in these patients. Sarcopenia was independently related to an underuse of systemic thrombolysis (OR 0.537 [95 %CI 0.398–0.725], P<0.001). This underuse might driven by higher rates of bleeding events (gastro-intestinal bleeding: 3.1 % vs. 1.9 %, P<0.001, necessity of transfusion of blood constituents: 18.9 % vs. 11.3 %, P<0.001), but also stroke (5.6 % vs. 3.3 %, P<0.001).

Conclusions

Sarcopenia represents a widely overlooked condition in PE patients. Although sarcopenic PE patients were more often afflicted by hemodynamic compromise, systemic thrombolysis was less often administered. This underuse might be caused by contraindications like bleeding events and stroke.

背景虽然肺栓塞(PE)和肌肉疏松症是常见疾病,但只有少数研究评估了PE患者肌肉疏松症对PE再灌注治疗使用的影响。结果在 2005-2020 年的观察期内,德国共有 576,364 例年龄≥75 岁(中位年龄为 81.0 [78.0-85.0] 岁;63.3% 为女性)的 PE 患者住院治疗。其中,2357 人(0.4%)被编码为肌肉疏松症。患有肌肉疏松症的 PE 患者的年龄中位数为 2 岁(83.0 [79.0-87.0] 岁 vs. 81.0 [78.0-85.0] 岁,P<0.001),且合并症情况更为严重(Charlson 合并症指数为 7.00 [5.00-9.00] vs. 6.00 [4.00-7.00],P<0.001)。虽然休克(5.2% vs. 4.1%,P=0.005)和心动过速(4.1% vs. 2.8%,P<0.001)等血流动力学受损迹象在肌肉疏松型 PE 患者中更为普遍,但这些患者较少使用全身溶栓治疗(1.9% vs. 3.5%,P<0.001)。肌肉疏松症与系统性溶栓的使用不足有独立关系(OR 0.537 [95 %CI 0.398-0.725], P<0.001)。出血事件发生率较高(胃肠道出血:3.1% 对 1.1%)可能是导致系统性溶栓使用不足的原因:3.1%对1.9%,P<0.001;输血成分的必要性:18.9%对11.9%,P<0.001:结论在 PE 患者中,肌肉疏松症是一种被广泛忽视的疾病。尽管肌肉疏松症 PE 患者更常受到血流动力学损害的困扰,但全身溶栓治疗却较少使用。造成这种使用不足的原因可能是出血事件和中风等禁忌症。
{"title":"Sarcopenia influences usage of reperfusion treatment in patients with pulmonary embolism aged 75 years and older","authors":"","doi":"10.1016/j.ijcha.2024.101470","DOIUrl":"10.1016/j.ijcha.2024.101470","url":null,"abstract":"<div><h3>Background</h3><p>Although pulmonary embolism (PE) and sarcopenia are common diseases, only a few studies have assessed the impact of sarcopenia in PE on usage of reperfusion treatments in PE.</p></div><div><h3>Methods</h3><p>All hospitalizations of PE patients aged ≥75 years 2005–2020 in Germany were included in this study and stratified for sarcopenia. Impact of sarcopenia on treatment procedures and adverse in-hospital events were investigated.</p></div><div><h3>Results</h3><p>Overall, 576,364 hospitalizations of PE patients aged ≥75 years (median age 81.0 [78.0–85.0] years; 63.3 % females) were diagnosed in Germany during the observational period 2005–2020. Among these, 2357 (0.4 %) were coded with sarcopenia. PE patients with sarcopenia were in median 2 years older (83.0 [79.0–87.0] vs. 81.0 [78.0–85.0] years, P&lt;0.001) and showed an aggravated comorbidity-profile (Charlson Comorbidity Index 7.00 [5.00–9.00] vs. 6.00 [4.00–7.00], P&lt;0.001). Although signs of hemodynamic compromise such as shock (5.2 % vs. 4.1 %, P=0.005) and tachycardia (4.1 % vs. 2.8 %, P&lt;0.001) were more prevalent in sarcopenic PE patients, systemic thrombolysis (1.9 % vs. 3.5 %, P&lt;0.001) was less often used in these patients. Sarcopenia was independently related to an underuse of systemic thrombolysis (OR 0.537 [95 %CI 0.398–0.725], P&lt;0.001). This underuse might driven by higher rates of bleeding events (gastro-intestinal bleeding: 3.1 % vs. 1.9 %, P&lt;0.001, necessity of transfusion of blood constituents: 18.9 % vs. 11.3 %, P&lt;0.001), but also stroke (5.6 % vs. 3.3 %, P&lt;0.001).</p></div><div><h3>Conclusions</h3><p>Sarcopenia represents a widely overlooked condition in PE patients. Although sarcopenic PE patients were more often afflicted by hemodynamic compromise, systemic thrombolysis was less often administered. This underuse might be caused by contraindications like bleeding events and stroke.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001362/pdfft?md5=b71067434520444a2aba4a45fca25b1d&pid=1-s2.0-S2352906724001362-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728810","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}
引用次数: 0
Correlation between thromboembolic risk and prevalence of coronary artery disease in patients with atrial fibrillation and impaired renal function 心房颤动和肾功能受损患者血栓栓塞风险与冠状动脉疾病患病率之间的相关性
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-07-18 DOI: 10.1016/j.ijcha.2024.101454

Background

Atrial fibrillation (AF) and coronary artery disease (CAD) often co-occur. The prevalence of coincident AF and CAD, the characteristics of such patients, and the correlation with thromboembolic risk in association with renal function are unclear.

Methods and Results

We studied 435 consecutive patients who underwent contrast-enhanced computed tomography (CT) before catheter ablation for AF. Nineteen patients with inconclusive CT underwent coronary angiography for a calcified coronary artery. Overall, 87 of the 435 patients had CAD (20.0 %: paroxysmal AF, 63.9 %; persistent AF, 35.2 %; and longstanding AF, 0.9 %). Of these, 17.9 % were newly diagnosed with CAD. There was a stepwise increase in CAD prevalence according to the CHADS2 score (10.1 % at 0, 20.1 % at 1, 24.7 % at 2, 35.1 % at 3, and 41.7 % at ≥ 4 points). Of note, in patients with low estimated glomerular filtration rate < 50 mL/min/1.73 m2, the CAD prevalence increased for all CHADS2 scores (15.4 % at 0, 40.0 % at 1, 32.4 % at 2, 38.5 % at 3, and 50.0 % at ≥ 4 points).

Conclusions

The prevalence of coexisting CAD increases with the CHADS2 score. This underscores the importance of screening for coexisting CAD in patients who are at high risk for thromboembolic events, particularly in patients with impaired renal function.

背景 心房颤动(AF)和冠状动脉疾病(CAD)经常同时发生。房颤和冠状动脉疾病同时发生的发病率、此类患者的特征以及血栓栓塞风险与肾功能的相关性尚不清楚。方法和结果我们对 435 例连续患者进行了研究,这些患者在房颤导管消融术前接受了造影剂增强计算机断层扫描(CT)。19名CT结果不确定的患者因冠状动脉钙化而接受了冠状动脉造影术。总体而言,435 名患者中有 87 人患有 CAD(20.0%:阵发性房颤,63.9%;持续性房颤,35.2%;长期房颤,0.9%)。其中,17.9%为新诊断出的心血管并发症患者。根据 CHADS2 评分,CAD 患病率呈阶梯式上升(0 分时为 10.1%,1 分时为 20.1%,2 分时为 24.7%,3 分时为 35.1%,≥ 4 分时为 41.7%)。值得注意的是,在估计肾小球滤过率< 50 mL/min/1.73 m2较低的患者中,CADS2 所有评分的患病率均有所增加(0 分时为 15.4%,1 分时为 40.0%,2 分时为 32.4%,3 分时为 38.5%,≥ 4 分时为 50.0%)。这强调了在血栓栓塞事件高危患者中筛查并存的 CAD 的重要性,尤其是在肾功能受损的患者中。
{"title":"Correlation between thromboembolic risk and prevalence of coronary artery disease in patients with atrial fibrillation and impaired renal function","authors":"","doi":"10.1016/j.ijcha.2024.101454","DOIUrl":"10.1016/j.ijcha.2024.101454","url":null,"abstract":"<div><h3>Background</h3><p>Atrial fibrillation (AF) and coronary artery disease (CAD) often co-occur. The prevalence of coincident AF and CAD, the characteristics of such patients, and the correlation with thromboembolic risk in association with renal function are unclear.</p></div><div><h3>Methods and Results</h3><p>We studied 435 consecutive patients who underwent contrast-enhanced computed tomography (CT) before catheter ablation for AF. Nineteen patients with inconclusive CT underwent coronary angiography for a calcified coronary artery. Overall, 87 of the 435 patients had CAD (20.0 %: paroxysmal AF, 63.9 %; persistent AF, 35.2 %; and longstanding AF, 0.9 %). Of these, 17.9 % were newly diagnosed with CAD. There was a stepwise increase in CAD prevalence according to the CHADS<sub>2</sub> score (10.1 % at 0, 20.1 % at 1, 24.7 % at 2, 35.1 % at 3, and 41.7 % at ≥ 4 points). Of note, in patients with low estimated glomerular filtration rate &lt; 50 mL/min/1.73 m<sup>2</sup>, the CAD prevalence increased for all CHADS<sub>2</sub> scores (15.4 % at 0, 40.0 % at 1, 32.4 % at 2, 38.5 % at 3, and 50.0 % at ≥ 4 points).</p></div><div><h3>Conclusions</h3><p>The prevalence of coexisting CAD increases with the CHADS<sub>2</sub> score. This underscores the importance of screening for coexisting CAD in patients who are at high risk for thromboembolic events, particularly in patients with impaired renal function.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001209/pdfft?md5=6423ade43827fb87e206efb27b6a30b0&pid=1-s2.0-S2352906724001209-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638225","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}
引用次数: 0
Recent highlights from the International Journal of Cardiology Heart and Vasculature: Spatiotemporal and functional immunoprofiling and its theranostic potential 国际心脏病学杂志心脏与血管》近期要闻:时空和功能免疫谱分析及其治疗潜力
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-07-17 DOI: 10.1016/j.ijcha.2024.101468
{"title":"Recent highlights from the International Journal of Cardiology Heart and Vasculature: Spatiotemporal and functional immunoprofiling and its theranostic potential","authors":"","doi":"10.1016/j.ijcha.2024.101468","DOIUrl":"10.1016/j.ijcha.2024.101468","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001349/pdfft?md5=e2c25bc858d3bf3fcf03504e703b451f&pid=1-s2.0-S2352906724001349-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638204","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}
引用次数: 0
期刊
IJC Heart and Vasculature
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1