Revista española de cardiología (English ed.)最新文献

{"title":"Sedentariness in the Spanish population: a cross-sectional study for the period 2011 to 2020","authors":"María Fe Montero-Torreiro , Mónica Pérez-Ríos , Cristina Candal-Pedreira , Carla Guerra-Tort , Guadalupe García , Julia Rey-Brandariz","doi":"10.1016/j.rec.2024.07.010","DOIUrl":"10.1016/j.rec.2024.07.010","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 1","pages":"Pages 71-73"},"PeriodicalIF":7.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy in women with genetic variants of dilated cardiomyopathy","authors":"Luis Ruiz-Guerrero , Francisco González-Vílchez","doi":"10.1016/j.rec.2024.06.007","DOIUrl":"10.1016/j.rec.2024.06.007","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 1","pages":"Pages 10-11"},"PeriodicalIF":7.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to Life's Essential 8 is associated with delayed biological aging: a population-based cross-sectional study","authors":"Hongyu Chen ,&nbsp;Haoxian Tang ,&nbsp;Xuan Zhang ,&nbsp;Jingtao Huang ,&nbsp;Nan Luo ,&nbsp;Qingqian Guo ,&nbsp;Xin Wang","doi":"10.1016/j.rec.2024.04.004","DOIUrl":"10.1016/j.rec.2024.04.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The aim of this study was to explore the potential of adhering to the American Heart Association's updated Life's Essential 8 (LE8) scores in delaying biological aging amid growing concerns about aging populations and related diseases.</div></div><div><h3>Methods</h3><div>A total of 18 261 adults (≥ 20 years old) were examined using National Health and Nutrition Examination Survey data from 2005-2010 and 2015-2018. The LE8 includes 8 components, covering health behaviors and factors. Acceleration of biological aging was defined as an excess of biological/phenotypic age over chronological age, assessed by using clinical biomarkers. The association between LE8 score and biological aging was explored through regression analyses.</div></div><div><h3>Results</h3><div>Each 10-point increase in LE8 scores was associated with a 1.19-year decrease in biological age and a 1.63-year decrease in phenotypic age. Individuals with high cardiovascular health (CVH) had a 90% reduction in their risk of accelerated aging based on biological age and an 81% reduction based on phenotypic age compared with individuals with low CVH. Bootstrap-based model estimates and weighted quantile sum regression suggested that health factors, particularly blood glucose, had strong impact on delaying aging. The association between smoking and biological aging seemed to differ depending on the definition of aging used. Among all subgroups, LE8 consistently correlated negatively with biological aging, despite observed interactions. Three sensitivity analyses confirmed the robustness of our conclusions.</div></div><div><h3>Conclusions</h3><div>A higher CVH is associated with a lower risk of biological aging. Maintaining elevated LE8 levels across demographics, regardless of cardiovascular history, is recommended to delay aging and promote healthy aging, with significant implications for primary health care.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 1","pages":"Pages 37-46"},"PeriodicalIF":7.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stasis imaging predicts the risk of cardioembolic events related to acute myocardial infarction: the ISBITAMI study","authors":"Elena Rodríguez-González ,&nbsp;Pablo Martínez-Legazpi ,&nbsp;Teresa Mombiela ,&nbsp;Ana González-Mansilla ,&nbsp;Antonia Delgado-Montero ,&nbsp;Juan A. Guzmán-De-Villoria ,&nbsp;Fernando Díaz-Otero ,&nbsp;Raquel Prieto-Arévalo ,&nbsp;Miriam Juárez ,&nbsp;María del Carmen García del Rey ,&nbsp;Pilar Fernández-García ,&nbsp;Óscar Flores ,&nbsp;Andrea Postigo ,&nbsp;Raquel Yotti ,&nbsp;Manuel García-Villalba ,&nbsp;Francisco Fernández-Avilés ,&nbsp;Juan C. del Álamo ,&nbsp;Javier Bermejo","doi":"10.1016/j.rec.2024.04.007","DOIUrl":"10.1016/j.rec.2024.04.007","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>In the setting of ST-segment elevation myocardial infarction (STEMI), imaging-based biomarkers could be useful for guiding oral anticoagulation to prevent cardioembolism. Our objective was to test the efficacy of intraventricular blood stasis imaging for predicting a composite primary endpoint of cardioembolic risk during the first 6 months after STEMI.</div></div><div><h3>Methods</h3><div>We designed a prospective clinical study, Imaging Silent Brain Infarct in Acute Myocardial Infarction (ISBITAMI), including patients with a first STEMI, an ejection fraction ≤ 45% and without atrial fibrillation to assess the performance of stasis metrics to predict cardioembolism. Patients underwent ultrasound-based stasis imaging at enrollment followed by heart and brain magnetic resonance at 1-week and 6-month visits. From the stasis maps, we calculated the average residence time, <em>R</em>_<em>T</em>, of blood inside the left ventricle and assessed its performance to predict the primary endpoint. The longitudinal strain of the 4 apical segments was quantified by speckle tracking.</div></div><div><h3>Results</h3><div>A total of 66 patients were assigned to the primary endpoint. Of them, 17 patients had 1 or more events: 3 strokes, 5 silent brain infarctions, and 13 mural thromboses. No systemic embolisms were observed. <em>R</em>_<em>T</em> (OR, 3.73; 95%CI, 1.75-7.9; <em>P</em> <!-->&lt;<!--> <!-->.001) and apical strain (OR, 1.47; 95%CI, 1.13-1.92; <em>P</em> <!-->=<!--> <!-->.004) showed complementary prognostic value. The bivariate model showed a c-index<!--> <!-->=<!--> <!-->0.86 (95%CI, 0.73-0.95), a negative predictive value of 1.00 (95%CI, 0.94-1.00), and positive predictive value of 0.45 (95%CI, 0.37-0.77). The results were confirmed in a multiple imputation sensitivity analysis. Conventional ultrasound-based metrics were of limited predictive value.</div></div><div><h3>Conclusions</h3><div>In patients with STEMI and left ventricular systolic dysfunction in sinus rhythm, the risk of cardioembolism may be assessed by echocardiography by combining stasis and strain imaging. Registered at ClinicalTrials.gov (<span><span>NCT02917213</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 1","pages":"Pages 22-33"},"PeriodicalIF":7.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteomic biomarkers for noninvasive left atrial appendage thrombus prediction in patients with atrial fibrillation","authors":"ZhongHui Xie ,&nbsp;Tao Chen ,&nbsp;Xu Lu ,&nbsp;MaoXiang Zhao ,&nbsp;Yating Chen ,&nbsp;XinYan Wang ,&nbsp;Hang Zhou ,&nbsp;Juan Shen ,&nbsp;Jun Guo ,&nbsp;Yang Li","doi":"10.1016/j.rec.2024.04.008","DOIUrl":"10.1016/j.rec.2024.04.008","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The CHA₂DS₂-VASc score, used to assess the risk of left atrial appendage thrombus (LAAT) formation in patients with atrial fibrillation (AF), has limited predictive value. Moreover, transesophageal echocardiography imaging, the gold standard diagnostic method to identify thrombi, is semi-invasive. Consequently, there is a need for alternative and noninvasive diagnostic methods for LAAT risk assessment.</div></div><div><h3>Methods</h3><div>Deep proteomic analysis was conducted in plasma samples from 8 patients with nonvalvular AF, divided into thrombus and control groups (4 patients in each group) based on the presence or absence of LAAT. Biomarkers associated with LAAT were validated using an enzyme-linked immunosorbent assay in a cohort of 179 patients with available clinical, transthoracic, and transesophageal echocardiography data. Predictive models were developed to assess the improvement in LAAT identification.</div></div><div><h3>Results</h3><div>The LAAT group had higher CHA₂DS₂<span>-VASc scores, larger LA diameter, and lower LAA flow velocities. Deep proteomic analysis identified 30 differentially expressed proteins, including myosin light chain 4, prenylcysteine oxidase 1 (PCYOX1), and decorin as potential diagnostic biomarkers of LAAT. The model showed that PCYOX1 and decorin provided an area under the curve (AUC) of 0.970 for LAAT prediction compared with 0.672 in a model including the CHA</span>₂DS₂-VASc score and LAA cauliflower morphology. The incremental value of proteomic biomarkers for LAAT in patients with nonvalvular AF was further confirmed with the net reclassification improvement and integrated discrimination improvement indices.</div></div><div><h3>Conclusions</h3><div>Protein levels of PCYOX1 and decorin improve the predictive performance for LAAT in patients with nonvalvular AF.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 1","pages":"Pages 47-55"},"PeriodicalIF":7.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of bempedoic acid in acute coronary syndrome. Design of the clinical trial ES-BempeDACS","authors":"Sergio Raposeiras-Roubín ,&nbsp;Emad Abu-Assi ,&nbsp;José Ángel Pérez Rivera ,&nbsp;Pablo Jorge Pérez ,&nbsp;Ana Ayesta López ,&nbsp;Ana Viana Tejedor ,&nbsp;Miguel José Corbí Pascual ,&nbsp;Anna Carrasquer ,&nbsp;César Jiménez Méndez ,&nbsp;Cristina González Cambeiro ,&nbsp;Aitor Uribarri González ,&nbsp;Clara Bonanad Lozano ,&nbsp;Marta Marcos Mangas ,&nbsp;Ana Merino-Merino ,&nbsp;Ester Sánchez-Corral ,&nbsp;Isabel Santos-Sánchez ,&nbsp;Lara Aguilar-Iglesias ,&nbsp;Alberto Alen ,&nbsp;José Rozado Castaño ,&nbsp;Ester Mínguez de la Guía ,&nbsp;Albert Ariza-Solé","doi":"10.1016/j.rec.2024.05.017","DOIUrl":"10.1016/j.rec.2024.05.017","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Only about 1 out of every 3 patients with acute myocardial infarction (AMI) achieve low-density lipoprotein cholesterol (LDL-<span>C</span>) values &lt;<!--> <!-->55<!--> <!-->mg/dL in the first year. The present study aims to evaluate the impact of early intensive therapy on lipid control after an AMI.</div></div><div><h3>Methods</h3><div>An independent, prospective, pragmatic, controlled, randomized, open-label, evaluator-blinded clinical trial (PROBE design) will analyze the efficacy and safety of an oral lipid-lowering triple therapy: high-potency statin<!--> <!-->+<!--> <!-->bempedoic acid (BA) 180<!--> <!-->mg<!--> <!-->+<!--> <!-->ezetimibe (EZ) 10<!--> <!-->mg versus current European-based guidelines (high-potency statin<!--> <!-->±<!--> <!-->EZ 10<!--> <!-->mg), in AMI patients. LDL-C will be determined within the first 48<!--> <!-->hours. Patients with LDL-C ≥ 115<!--> <!-->mg/dL (without previous statin therapy), ≥ 100<!--> <!-->mg/dL (with previous low-potency or high-potency statin therapy at submaximal dose), or ≥ 70<!--> <!-->mg/dL (with previous high-potency statin therapy at high dose) will be randomly assigned 1:1 between 24 and 72<!--> <!-->hours post-AMI to the BA/EZ combination or to statin<!--> <!-->±<!--> <!-->EZ, without BA. The primary endpoint is the proportion of patients reaching LDL-C &lt;<!--> <!-->55<!--> <!-->mg/dL at 8 weeks after treatment.</div></div><div><h3>Results</h3><div>The results of this study will provide novel information for post-AMI LDL-C control by evaluating the usefulness of an early intensive lipid-lowering strategy based on triple oral therapy.</div></div><div><h3>Conclusions</h3><div>Early intensive lipid-lowering triple oral therapy vs the treatment recommended by current clinical practice guidelines could facilitate the achievement of optimal LDL-C levels in the first 2 months after AMI (a high-risk period).</div></div><div><h3>Identification number</h3><div>EudraCT 2021-006550-31.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"78 1","pages":"Pages 56-63"},"PeriodicalIF":7.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between autoimmune diseases and all-cause mortality in patients with cardiac arrhythmia.","authors":"Le Li, Lingmin Wu, Zhicheng Hu, Limin Liu, Likun Zhou, Zhuxin Zhang, Minghao Zhao, Yulong Xiong, Zhenhao Zhang, Lihui Zheng, Ligang Ding, Yan Yao","doi":"10.1016/j.rec.2024.12.008","DOIUrl":"10.1016/j.rec.2024.12.008","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Autoimmune diseases (ADs) are associated with an increased risk of developing certain cardiac arrhythmias. However, their prognostic effect in patients with cardiac arrhythmias has not been comprehensively investigated. We aimed to assess the association between ADs and prognosis in this population.</p><p><strong>Methods: </strong>Based on a large retrospective observational cohort, this study included patients with various cardiac arrhythmias, including atrial fibrillation/atrial flutter (AF/AFl), ventricular tachycardia/ventricular fibrillation (VT/VF), and bradyarrhythmias. ADs were considered an exposure factor. The endpoint was all-cause mortality. Cox proportional hazards regression analyses were performed to calculate hazard ratios (HR) and 95% confidence intervals (95%CI) to quantify associations. Propensity score matching was used to mitigate potential confounding bias.</p><p><strong>Results: </strong>The analysis included 14 225 patients (mean age, 73.9±12.5 years, 59.2% women), of whom 4552 (32.0%) died within 1 year of discharge. After adjustment for various covariates, patients with ADs showed a higher risk of mortality in AF/AFl (HR, 1.23; 95%CI, 1.1-1.33; P<.001) and VT/VF (HR, 1.28; 95%CI, 1.02-1.60, P=.032). For bradyarrhythmias, although a potential association was observed, the trend did not reach statistical significance (HR, 1.20; 95%CI, 0.93-1.56; P=.168). The association persisted among multiple sensitivity analyses and remained consistent after adjustment for a wide range of covariates.</p><p><strong>Conclusions: </strong>ADs were significantly associated with an increased risk of all-cause mortality in patients with cardiac arrhythmias, particularly in those with AF/AFl and VT/VF.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frozen elephant trunk rupturing into the false lumen.","authors":"Haochen Wang, Hui Yu, Zhenghua Xiao","doi":"10.1016/j.rec.2024.12.010","DOIUrl":"10.1016/j.rec.2024.12.010","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of aortic valve calcification on TAVI. Should we rethink existing concepts?","authors":"Alberto Alperi, Raquel Del Valle, Pablo Avanzas","doi":"10.1016/j.rec.2024.12.007","DOIUrl":"10.1016/j.rec.2024.12.007","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and design of the beta-blockers in tako-tsubo syndrome study: a randomized clinical trial (β-Tako).","authors":"Fernando Alfonso, Jorge Salamanca, Iván Núñez-Gil, Borja Ibáñez, Juan Sanchis, Manel Sabaté, Maite Velázquez, Sergio Raposeiras-Roubín, Tamara García-Camarero, Paula Antuña, Hernán Mejía, Xavier Carrillo, Irene Buera, Manuel Martínez-Sellés, Juan Manuel Escudier-Villa, Joaquín Sánchez-Prieto, Emilia Blanco Ponce, Gonzalo Cabezón, Covadonga Fernández-Golfín, Domingo Pascual-Figal, Belén Cid, Ana Marcano, Rafael González-Manzanares, Santiago Jiménez-Valero, José Manuel Vázquez, Jorge Sanz-Sánchez, Alberto Cecconi, David Del Val, Francisco Abad-Santos, Filippo Crea","doi":"10.1016/j.rec.2024.12.006","DOIUrl":"10.1016/j.rec.2024.12.006","url":null,"abstract":"<p><strong>Introduction y objectives: </strong>Tako-tsubo syndrome (TTS) is a cardiac condition that mimics acute coronary syndrome, characterized by transient left ventricular dysfunction in the absence of culprit coronary artery stenosis. Although its etiology remains unknown, reversible microvascular dysfunction secondary to an adrenergic surge is thought to play a role. Treatment is empirical, although most patients receive beta-blockers (BB) in clinical practice. The Beta-blockers in Tako-tsubo Syndrome study (β-Tako), is an academic, multicenter, pragmatic, prospective randomized open-label trial with blinded endpoint evaluation that aims to assess the efficacy and safety of BB in patients with TTS.</p><p><strong>Methods: </strong>The diagnosis of TTS will be confirmed by invasive coronary angiography and serial echocardiographic assessments. Two hundred patients with TTS will be randomized (1:1) to BB (n=100) or no BB (n=100). BB with alpha or nitric oxide release activity will be used in the treatment arm.</p><p><strong>Results: </strong>The primary efficacy endpoint is the comparison of the wall motion score index by echocardiography at 7 days, analyzed by an independent core laboratory. Changes in left ventricular ejection fraction and global longitudinal strain will also be evaluated. A composite clinical endpoint (death, stroke, admission for recurrent TTS, acute coronary syndrome, heart failure, or atrial fibrillation) at 1 year will be assessed by an independent clinical events committee. Several predefined substudies will be conducted to examine clinical, imaging, biomarker, pharmacogenetic, inflammatory, messenger ribonucleic acids, and quality-of-life parameters.</p><p><strong>Conclusions: </strong>The β-Tako trial will generate robust scientific evidence to address unmet clinical needs and inform clinical and treatment decisions in this uniquely challenging clinical entity. The study has been registered (EU-CT number: 2023-510213-25-01, ClinicalTrials.gov Identifier, NCT06509074.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}