Cardiology and cardiovascular medicine最新文献

{"title":"Sacubitril-Valsartan in LVAD Patients: Potentials for the Future?","authors":"Samiullah Arshad, Tayyaba Haq, Dane Stephens, Gaurang N Vaidya","doi":"10.26502/fccm.92920275","DOIUrl":"https://doi.org/10.26502/fccm.92920275","url":null,"abstract":"Beneficial effects of Angiotensin Receptor Neprilysin Inhibitors (ARNIs) in heart failure patients are increasingly being recognized. Current literature on ARNIs among LVAD patients is based on small retrospective studies; however, these reports suggest their acceptable tolerability, effective blood pressure control and improvement in NT-proBNP levels. As we continue to better understand their cardio-protective effects including potential of myocardial recovery their use in patients with LVADs is bound to increase. Side effects that may limit their tolerability include acute kidney injury, hypotension, hyperkalemia and angioedema. Clinical trials are ongoing to assess their safety and tolerability in LVAD patients.","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69346787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Glucose Deficiency with Sodium-Glucose Cotransporter 2 Inhibitors makes a Positive Impact on Heart and Kidney","authors":"Y. Hattori","doi":"10.26502/fccm.92920241","DOIUrl":"https://doi.org/10.26502/fccm.92920241","url":null,"abstract":"Response to Glucose Deficiency with Sodium-Glucose Cotransporter 2 Inhibitors makes a Positive Impact on Heart and Kidney. Cardiology and Medicine 6 16-23. Abstract Animal hibernation is a kind of starvation with some fat reserve. During early stage of starvation, gluconeogenesis, fatty acid oxidation and ketogenesis started in the liver which is a comparable condition in patients who are being treated with sodium-glucose cotransporter 2 inhibitors (SGLT2i). SGLT2i might exert a cardioprotective effect by change in cardiac excitation-contraction coupling as seen in hibernating animals, which prevents calcium overload and energy waste in myocardium. Modestly elevated circulating levels of the ketone β-hydroxybutyrate (βOHB) during treatment with SGLT2i causes different beneficial effects on organs and cells, depending on the succinyl-CoA:3-ketoacid CoA transferase (SCOT) level. In the failing heart, SCOT is highly expressed/up-regulated and thus βOHB may be an energy source apart from fat and glucose oxidation in myocardial mitochondria. On the other hand, SCOT is not highly expressed/down-regulated in the kidney and thus βOHB may translocate into nucleus and cause beneficial effects such as inhibition of inflammation, oxidative stress and fibrosis as an endogenous and specific inhibitor of class I histone deacetylases (HDACs) and the NLRP3 inflammasome. SGLT2i exert a direct renoprotective effect with restoration of tubulo-glomerular feedback and improving renal proximal tubule oxygenation. Other than that, various beneficial effects of SGLT2i might be caused by well-orchestrated pattern of systemic metabolic change against glucose starvation induced by SGLT2i.","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69346135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Diagnosis of Membranous Ventricular Septal Aneurysm Bulging from the Left Ventricle towards Right Atrium in a Fetus with a Tricuspid Atresia– Characteristics and Differential Diagnosis of Membranous Ventricular Septal Aneurysms","authors":"A. Walter, M. Schneider, Bettina Faridi, A. Geipel, U. Gembruch","doi":"10.26502/fccm.92920281","DOIUrl":"https://doi.org/10.26502/fccm.92920281","url":null,"abstract":"Prenatal detection of membranous ventricular septal aneurysm requires clinical, morphological and functional evaluation, as the spectrum of a congenital ventricular out-pouching is vast and complex. Early pediatric cardiological presentation is needed, since clinical course during first year is variable.","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69346342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydroxychloroquine Attenuates Myocardial Ischemic and Post-Ischemic Reperfusion Injury by Inhibiting the Toll-Like Receptor 9 - Type I Interferon Pathway.","authors":"Katherine M Marsh,&nbsp;Radhika Rastogi,&nbsp;Aimee Zhang,&nbsp;Di Wu,&nbsp;Irving L Kron,&nbsp;Zequan Yang","doi":"10.26502/fccm.92920278","DOIUrl":"https://doi.org/10.26502/fccm.92920278","url":null,"abstract":"<p><strong>Background: </strong>We hypothesized that hydroxychloroquine (HCQ) attenuates myocardial ischemia/reperfusion injury (IRI) via TLR9 - type I interferon (IFN-I) pathway inhibition.</p><p><strong>Methods: </strong>The left coronary artery of wild-type (WT) C57BL/6 and congenic TLR9^-/- mice was occluded for 40 minutes, with or without 60 minutes of reperfusion (40'/0' or 40'/60'). Either ODN-2088 or HCQ (TLR9 inhibitors), or ODN-1826 (TLR9 agonist) was administered to determine effect on infarct size (IS). After 40'/0', cardiac perfusate (CP) was collected from harvested hearts and administered to either intact WT mice after 20 minutes of ischemia or isolated splenocytes. Type-I interferon (IFNα and IFNβ) levels were measured in plasma and splenocyte culture supernatant, and levels of damage associated molecular patterns HMGB1 and cell-free DNA (cfDNA) were measured in CP.</p><p><strong>Results: </strong>After 40'/60', WT mice treated with HCQ or ODN-2088 had significantly reduced IS. TLR9^-/- mice and HCQ-treated WT mice undergoing 40'/0' and 40'/60' similarly attenuated IS, with significantly lower IFN-Is in CP after 40'/0' and in plasma after 40'/60'. IS was significantly increased in 40'/0' CP-treated and ODN-1826-treated 20'/60' WT mice. CP-treated WT splenocytes produced significantly higher IFN-I in culture supernatant, which was significantly reduced with HCQ.</p><p><strong>Conclusions: </strong>The TLR9-IFN-I-mediated inflammatory response contributes significantly to both ischemic and post-ischemic myocardial ischemia-reperfusion injury. HMGB1 and cfDNA released from ischemic myocardium activated the intra-myocardial TLR9 - IFN-I inflammatory pathway during ischemia and the extra-myocardial TLR9 - IFN-I inflammatory pathway during reperfusion. Hydroxychloroquine reduces production of IFN-I and attenuates myocardial IRI, likely by inhibiting the TLR9-IFN-I pathway.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":" ","pages":"416-423"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9450995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33458036","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":"Congestive Heart Failure Following COVID-19 Vaccination","authors":"Usha Yendrapalli, H. J. Chen, N. Punnanithinont, Ahmed Elawad","doi":"10.26502/fccm.92920240","DOIUrl":"https://doi.org/10.26502/fccm.92920240","url":null,"abstract":"Failure Following Abstract Myocardial injury following vaccination, particularly coronavirus disease 2019 (COVID-19), smallpox, influenza, hepatitis B has been documented as a rare side effect. In this report, we present a case of congestive heart failure that developed in a healthy male following the BNT162b2 mRNA-Pfizer-BioNTech vaccine. A 47-year-old male developed shortness of breath 5 days after receiving the second dose of Pfizer vaccine presented multiple times to urgent care, primary care physician office, and emergency room and had been misdiagnosed with bronchitis and allergies. Eventually after several weeks he was admitted due to worsening dyspnea and got echocardiography which showed an EF of 15% and cardiac catheterization did not reveal significant obstruction of coronary arteries. He was successfully diuresed and was discharged home symptom-free. We aim to increase awareness of this rare side effect of the COVID mRNA vaccination so that it can be recognized early and treated promptly to avoid complications.","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69346128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Dual Intervention with Vitamin D Supplementation and Voluntary Physical Exercise on Cardiac Remodeling and Function in a Mouse Model of Diet-Induced Type 2 Diabetes","authors":"A. Marziou, Clothilde Philouze, J. Landrier, C. Riva, P. Obert","doi":"10.26502/fccm.92920258","DOIUrl":"https://doi.org/10.26502/fccm.92920258","url":null,"abstract":"Effect of a Dual Intervention with Vitamin D Supplementation and Voluntary Physical Exercise on Cardiac Remodeling and Function in a Mouse Model of Diet-Induced Type 2 Diabetes. Cardiology and Cardiovascular Medicine 6 229-236. Abstract Background and Aims: We have previously demonstrated the cardiac beneficial effects of vitamin D (VD) supplementation. The aim of this study was to evaluate the combined effects of voluntary Physical Exercise (PE) and VD on cardiac remodeling and function in tertiary prevention in a mice model of diet-induced diabetes. Methods and Results: Mice were fed with a high fat and sucrose diet for 10 weeks. Then, they were divided into 4 subgroups for the 15 following weeks: diet, diet/vitamin D, diet/PE and diet/VD/PE. Glucose homeostasis assessment and echocardiography were performed one week before the end of the protocol. Blood samples and hearts were collected at sacrifice. After 25 weeks of diet alone, obese mice displayed diabetes, cardiac concentric hypertrophy combination improved glucose homeostasis and was associated with physiological cardiac remodeling, with however no additional beneficial effect over PE or VD alone on cardiac function. Conclusion: The major finding of the present study is that VD supplementation and PE exert similar cardioprotective effects in diabetic mice, with no major synergistic effect from their combination. Abstract The present study is the first to investigate the combined effects of voluntary PE and VD supplementation on cardiac remodeling and function in tertiary prevention in a rodent model of diet-induced T2D. Numerous studies demonstrated beneficial effects of voluntary PE or exercise training on cardiac function in pharmacological [17] or diet-induced [14] rodent models of diabetes, agreeing with our results. Data regarding the effects of VD are scarce [11]. The salient finding from our study is that VD supplementation exerts similar favorable effects to PE on both regional and global cardiac function while their combination did not yield to additional benefits. Since VD and PE were each other already able to normalize cardiac function, synergic effects were unlikely to be expected. Of note, PE or VD individually prevented the development of HFS-induced pathological cardiac remodeling, in accordance with previous studies [9, 17]. Interestingly, their combination yielded to cardiac hypertrophy, similar in magnitude to that one seen in HFS mice, although physiological. The underlying mechanisms associated with improvements in cardiac remodeling and function consecutive to PE or VD imply very likely favorable changes at both systemic and cardiac levels in signaling pathways related to inflammation and oxidative stress [18] leading to enhancement in cardiac metabolism, calcium handling, apoptosis and fibrosis [19, 20]. Aside, we also demonstrated cardioprotective effects of VD through modulation of cardiac lipotoxicity [11]. Further investigations will be needed to properly charac","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69346536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Surgical Conversion Following Device Embolization During Transcatheter Aortic Valve Implantation: A Case Report","authors":"Barry Misbaou, CHABRY-HUN Yuthiline, M. Gun, Harmouche Majid, Caus Thierry","doi":"10.26502/fccm.92920266","DOIUrl":"https://doi.org/10.26502/fccm.92920266","url":null,"abstract":"Emergency Surgical Conversion Following Device Embolization During Transcatheter Aortic Valve Implantation: A Case Report. Abstract Surgical conversion following embolization of a TAVI device is very rare. We report the case of a 78-year-old woman who underwent a TAVI procedure. This procedure failed due to migration of the prosthesis, which is embedded at the foot of the TABC in the ascending aorta. This patient had an emergency surgical conversion. We want to draw attention to the fact that the management of the TAVI patient by the surgical team in case of conversion should be rapid and the surgical intervention should be short. activation (P wave) to onset of ventricular myocardial activation; mmHg: millimeter of mercury ; B2: the second heart sound; LVH: Left Ventricular Hypertrophy; Segment ST: the ST-segment; V1, V2, V5, V6: the electrodes; Onde T: Twave; Ao : Aorta; Vmax: maximum velocity; IP: Permeability index; LVEF: Left Ventricular Ejection Fraction; MR: Mitral Regurgitation; mm: millimeter; TABC: Brachiocephalic Artery Trunk; ECC: Extracorporel Circulation; mn: minute","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69346652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise in Patients with Chronic Angina Pectoris: Friend or Foe?","authors":"R. Dechend, H. Predel","doi":"10.26502/fccm.92920271","DOIUrl":"https://doi.org/10.26502/fccm.92920271","url":null,"abstract":"Angina pectoris, a constricting pain resulting from inadequate oxygen supply to the heart, typically develops as a consequence of physical exertion or emotional stress in the presence of coronary artery disease (CAD). However, there is also evidence that physical activity is effective in the prevention of CAD and may also prevent angina in the long term. Guideline-based strategies for chronic stable angina aim to reduce symptoms and improve patient prognosis through lifestyle changes and appropriate medications and interventions. Physicians may have uncertainty and concerns around the safety of exercise regimens in patients with chronic angina, a factor complicated by the paucity of data related to this clinical condition. This narrative review discusses the importance of regular physical activity as a key component in the management of patients with stable angina, demonstrating cardioprotective effects in patients with CAD, as well as improving prognosis and physical fitness while maintaining an appropriate risk/benefit ratio. Given these benefits, current guidelines recommend 30–60 minutes of moderate-intensity aerobic activity for at least 5 days/week in patients with chronic coronary syndromes, personalized based on the ‘Frequency, Intensity, Time and Type’ (FITT) principle to derive optimal efficacy with the lowest risk; addition of resistance training 2 days/week can provide further benefits. We also highlight the importance of complementing pharmacological options with regular physical exercise in patients with stable angina, and how web-based technologies can help to overcome some of the barriers to exercise training and challenges associated with implementing cardiac rehabilitation programmes during the COVID-19 pandemic.","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69346719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Results after Exclusion of Popliteal Aneurysms with an Endoprosthesis.","authors":"Elias Noory,&nbsp;Tanja Böhme,&nbsp;Ulrich Beschorner,&nbsp;Börries Jacques,&nbsp;Karlheinz Bürgelin,&nbsp;Christina Zürn,&nbsp;Thomas Zeller","doi":"10.26502/fccm.92920298","DOIUrl":"https://doi.org/10.26502/fccm.92920298","url":null,"abstract":"Objectives: To evaluate safety and efficacy of endoprosthesis implantation for the exclusion of popliteal artery aneurysm (PAA). Methods: Elective asymptomatic patients with aneurysm > 20 mm and symptomatic patients with endovascular therapy of PAA were included. The proportion of patients with critical limb ischemia (presence of rest pain or tissue loss) was high at 32.1%, 21.6% of the patients had acute ischemia with symptoms persisting shorter than 14 days. The primary study endpoint was the target lesion revascularization (TLR) rate at 12 months. Secondary endpoints included technical success, periinterventional adverse events, primary patency at 6, 12 and 24 months, TLR rate at 24 months, predictors on reintervention, change in in clinical symptoms using the Rutherford-Becker classification (RBC), amputation and mortality rate. One hundred thirty-four patients (68.3±10.6 years, 88.8% male) were treated with a Viabahn® endoprosthesis (W.L. Gore & Associates Inc., Flagstaff, AZ, USA). Results: The average aneurysm diameter was 2.5±0.87 cm. In 41%, occlusion of the aneurysm was present. TLR rate was 31.3% and 38.8% after 12 and 24 months, respectively. Primary patency rates were 69.1%, 52.3% and 42.6% at 6, 12 and 24 months, respectively. Univariate logistic regression analysis revealed age as a predictor of reintervention and in the multivariable analysis it was treatment with lysis. An improvement in RBC was seen at all-time points. Two major amputations (1.5%) were performed and the mortality rate at 24 months was 5.2%. Conclusion: Primary patency rate after endovascular exclusion of PAA is low. However, limb salvage rate is high.","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"6 6","pages":"550-557"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10709582","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":"Patient-Specific Cardiac Magnetic Resonance Feature Tracking Approach for Scar Detection in Concomitant Ischemic and Non-Ischemic Heart Disease.","authors":"Malgorzata Polacin,&nbsp;Tobias Hünermund,&nbsp;Oliver Müggler,&nbsp;Hatem Alkadhi,&nbsp;Sebastian Kozerke,&nbsp;Robert Manka","doi":"10.26502/fccm.92920297","DOIUrl":"https://doi.org/10.26502/fccm.92920297","url":null,"abstract":"<p><strong>Aim: </strong>This study investigated a patient-specific approach of using cardiac magnetic resonance (CMR) feature tracking for scar detection in a heterogenous patient group with chronic ischemic and non-ischemic heart disease.</p><p><strong>Methods: </strong>CMR exams of 89 patients with concomitant chronic ischemic and non-ischemic heart disease (IHD+) as well as 65 patients with ischemic scars only (IHD) were retrospectively evaluated. In all patients, global (GCS) and segmental circumferential strain (SCS) was derived from native cine images using a dedicated software (Segment CMR, Medviso). After calculation of patient-specific median GCS (GCS_median), segmental values from GCS_median percentage plots were correlated with corresponding myocardial segments in late gadolinium enhancement (LGE).</p><p><strong>Results: </strong>Overall GCS ranged between -3.5% to -19.8% and average GCS was lower in IHD+ than in IHD (p <0.05). In IHD, 19% of all myocardial segments were infarcted, in IHD+ 16.6%. Additionally, non-ischemic LGE was present in 6.7% of segments in IHD+. Correlation of GCS_median percentage plots with corresponding LGE showed that presence of ischemic scar tissue in a myocardial segment was very likely below a cut-off of 39.5% GCS_median (87.5% sensitivity, 86.3% specificity, AUC 0.907, 95% CI 0.875-0.938, p < 0.05).</p><p><strong>Conclusion: </strong>In patient-specific GCS_median percentage plots calculated from native cine images, ischemic scar tissue can be suspected in myocardial segments below the threshold of 40% GCS_median (sensitivity 88%, specificity 86%), even in a heterogenous patient cohort with ischemic and non-ischemic heart disease.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"6 6","pages":"542-549"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10788595","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}