{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:34:37Z","timestamp":1757702077136,"version":"3.44.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the 6th phase 333 project of Jiangsu Province","award":["2022-2-408"],"award-info":[{"award-number":["2022-2-408"]}]},{"name":"Zhongnanshan Medical Foundation of Guangdong Province","award":["ZNSA 2020017"],"award-info":[{"award-number":["ZNSA 2020017"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Left atrial (LA) localized voltage abnormality displayed by electro-anatomic mapping (EAM) has been established as a surrogate marker of atrial fibrosis (AF) which predicts post-ablation recurrence. This study investigates preoperative predictors of LA voltage abnormalities and assesses their impact on atrial fibrillation recurrence following catheter ablation in patients with paroxysmal atrial fibrillation (PAF).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Forty-four (25.6%) patients had LA voltage abnormality which independently predicted post-ablation recurrence (HR 2.85, 95%CI 1.20\u20136.78, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). Larger left atrial diameter (LAD) (OR 1.24 per 1\u00a0mm, 95%CI 1.02\u20131.50, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) and higher atrial tachyarrhythmia (ATA) burden (OR 1.02 per 1%, 95%CI 1.00\u20131.04, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) independently correlates with LA voltage abnormality with an ideal combined diagnostic efficiency (AUC 0.80, sensitivity 79.3%, specificity 70.7%, 95% CI 0.70\u20130.89, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>LA substrate abnormality, even moderate, is an independent risk factor for PAF post-ablation recurrence which can be predicted pre-procedure by LAD and ATA burden.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s43044-025-00664-w","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T17:47:00Z","timestamp":1753984020000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of left atrial voltage abnormality on ablation outcomes in paroxysmal atrial fibrillation and its pre-procedural predictors: an observational retrospective study"],"prefix":"10.1186","volume":"77","author":[{"given":"Dongsheng","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiushi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaoyuan","family":"Ge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishant","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Di","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0125-3926","authenticated-orcid":false,"given":"Fengxiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"664_CR1","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.jacc.2004.10.035","volume":"45","author":"A Verma","year":"2005","unstructured":"Verma A, Wazni OM, Marrouche NF, Martin DO, Kilicaslan F, Minor S, Schweikert RA, Saliba W, Cummings J, Burkhardt JD, Bhargava M, Belden WA, Abdul-Karim A, Natale A (2005) Pre-existent left atrial scarring in patients undergoing pulmonary vein antrum isolation: an independent predictor of procedural failure. J Am Coll Cardiol 45:285\u2013292","journal-title":"J Am Coll Cardiol"},{"key":"664_CR2","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1111\/jce.13321","volume":"28","author":"K Vlachos","year":"2017","unstructured":"Vlachos K, Efremidis M, Letsas KP, Bazoukis G, Martin R, Kalafateli M, Lioni L, Georgopoulos S, Saplaouras A, Efremidis T, Liu T, Valkanas K, Karamichalakis N, Asvestas D, Sideris A (2017) Low-voltage areas detected by high-density electroanatomical mapping predict recurrence after ablation for paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol 28:1393\u20131402","journal-title":"J Cardiovasc Electrophysiol"},{"key":"664_CR3","doi-asserted-by":"publisher","first-page":"2225","DOI":"10.1016\/j.jacc.2011.05.061","volume":"58","author":"PG Platonov","year":"2011","unstructured":"Platonov PG, Mitrofanova LB, Orshanskaya V, Ho SY (2011) Structural abnormalities in atrial walls are associated with presence and persistency of atrial fibrillation but not with age. J Am Coll Cardiol 58:2225\u20132232","journal-title":"J Am Coll Cardiol"},{"key":"664_CR4","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1093\/europace\/euaa009","volume":"22","author":"A Xintarakou","year":"2020","unstructured":"Xintarakou A, Tzeis S, Psarras S, Asvestas D, Vardas P (2020) Atrial fibrosis as a dominant factor for the development of atrial fibrillation: facts and gaps. Europace 22:342\u2013351","journal-title":"Europace"},{"key":"664_CR5","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1161\/CIRCEP.112.975144","volume":"6","author":"S Verheule","year":"2013","unstructured":"Verheule S, Tuyls E, Gharaviri A, Hulsmans S, van Hunnik A, Kuiper M, Serroyen J, Zeemering S, Kuijpers NH, Schotten U (2013) Loss of continuity in the thin epicardial layer because of endomysial fibrosis increases the complexity of atrial fibrillatory conduction. Circ Arrhythm Electrophysiol 6:202\u2013211","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"664_CR6","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1001\/jama.2014.3","volume":"311","author":"NF Marrouche","year":"2014","unstructured":"Marrouche NF, Wilber D, Hindricks G, Jais P, Akoum N, Marchlinski F, Kholmovski E, Burgon N, Hu N, Mont L, Deneke T, Duytschaever M, Neumann T, Mansour M, Mahnkopf C, Herweg B, Daoud E, Wissner E, Bansmann P, Brachmann J (2014) Association of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibrillation catheter ablation: the DECAAF study. JAMA 311:498\u2013506","journal-title":"JAMA"},{"key":"664_CR7","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.1161\/CIRCULATIONAHA.108.811877","volume":"119","author":"RS Oakes","year":"2009","unstructured":"Oakes RS, Badger TJ, Kholmovski EG, Akoum N, Burgon NS, Fish EN, Blauer JJ, Rao SN, DiBella EV, Segerson NM, Daccarett M, Windfelder J, McGann CJ, Parker D, MacLeod RS, Marrouche NF (2009) Detection and quantification of left atrial structural remodeling with delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation 119:1758\u20131767","journal-title":"Circulation"},{"key":"664_CR8","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1016\/j.jacc.2013.03.081","volume":"62","author":"AS Jadidi","year":"2013","unstructured":"Jadidi AS, Cochet H, Shah AJ, Kim SJ, Duncan E, Miyazaki S, Sermesant M, Lehrmann H, Lederlin M, Linton N, Forclaz A, Nault I, Rivard L, Wright M, Liu X, Scherr D, Wilton SB, Roten L, Pascale P, Derval N, Sacher F, Knecht S, Keyl C, Hocini M, Montaudon M, Laurent F, Ha\u00efssaguerre M, Ja\u00efs P (2013) Inverse relationship between fractionated electrograms and atrial fibrosis in persistent atrial fibrillation: combined magnetic resonance imaging and high-density mapping. J Am Coll Cardiol 62:802\u2013812","journal-title":"J Am Coll Cardiol"},{"key":"664_CR9","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s10840-013-9838-y","volume":"39","author":"Y Lin","year":"2014","unstructured":"Lin Y, Yang B, Garcia FC, Ju W, Zhang F, Chen H, Yu J, Li M, Gu K, Cao K, Callans DJ, Marchlinski FE, Chen M (2014) Comparison of left atrial electrophysiologic abnormalities during sinus rhythm in patients with different type of atrial fibrillation. J Interv Card Electrophysiol 39:57\u201367. https:\/\/doi.org\/10.1007\/s10840-013-9838-y","journal-title":"J Interv Card Electrophysiol"},{"key":"664_CR10","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1111\/pace.13462","volume":"41","author":"W Shen","year":"2018","unstructured":"Shen W, Zhai L, Yang G, Liu H, Chen H, Ju W, Gu K, Li M, Zhang F, Chen M (2018) Efficacy of sole pulmonary vein isolation in patients with nonparoxysmal atrial fibrillation without significant left atrium scar. Pacing Clin Electrophysiol 41:1356\u20131361","journal-title":"Pacing Clin Electrophysiol"},{"key":"664_CR11","doi-asserted-by":"publisher","first-page":"e025697","DOI":"10.1161\/JAHA.121.025697","volume":"11","author":"Y Sagawa","year":"2022","unstructured":"Sagawa Y, Nagata Y, Miwa N, Yamaguchi T, Watanabe K, Kaneko M, Nakamura T, Nozato T, Ashikaga T, Goya M, Sasano T (2022) Alcohol consumption is associated with postablation recurrence but not changes in atrial substrate in patients with atrial fibrillation: insight from a high-density mapping study. J Am Heart Assoc 11:e025697","journal-title":"J Am Heart Assoc"},{"key":"664_CR12","doi-asserted-by":"publisher","first-page":"euae039","DOI":"10.1093\/europace\/euae039","volume":"26","author":"Y Dong","year":"2024","unstructured":"Dong Y, Zhao D, Chen X, Shi L, Chen Q, Zhang H, Yu Y, Ullah I, Kojodjojo P, Zhang F (2024) Role of electroanatomical mapping-guided superior vena cava isolation in paroxysmal atrial fibrillation patients without provoked superior vena cava triggers: a randomized controlled study. Europace 26:euae039. https:\/\/doi.org\/10.1093\/europace\/euae039","journal-title":"Europace"},{"key":"664_CR13","doi-asserted-by":"publisher","first-page":"H1002","DOI":"10.1152\/ajpheart.00252.2005","volume":"289","author":"R Zou","year":"2005","unstructured":"Zou R, Kneller J, Leon LJ, Nattel S (2005) Substrate size as a determinant of fibrillatory activity maintenance in a mathematical model of canine atrium. Am J Physiol Heart Circ Physiol 289:H1002-1012","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"664_CR14","doi-asserted-by":"publisher","first-page":"101979","DOI":"10.1155\/2013\/101979","volume":"2013","author":"W Carver","year":"2013","unstructured":"Carver W, Goldsmith EC (2013) Regulation of tissue fibrosis by the biomechanical environment. Biomed Res Int 2013:101979","journal-title":"Biomed Res Int"},{"key":"664_CR15","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1093\/europace\/euaa071","volume":"22","author":"T Strisciuglio","year":"2020","unstructured":"Strisciuglio T, El Haddad M, Debonnaire P, De Pooter J, Demolder A, Wolf M, Phlips T, Kyriakopoulou M, Almorad A, Knecht S, Tavernier R, Vandekerckhove Y, Duytschaever M (2020) Paroxysmal atrial fibrillation with high vs. low arrhythmia burden: atrial remodelling and ablation outcome. Europace 22:1189\u20131196","journal-title":"Europace"},{"key":"664_CR16","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.1016\/j.hrthm.2015.07.003","volume":"12","author":"J Kosiuk","year":"2015","unstructured":"Kosiuk J, Dinov B, Kornej J, Acou WJ, Sch\u00f6nbauer R, Fiedler L, Buchta P, Myrda K, G\u0105sior M, Polo\u0144ski L, Kircher S, Arya A, Sommer P, Bollmann A, Hindricks G, Rolf S (2015) Prospective, multicenter validation of a clinical risk score for left atrial arrhythmogenic substrate based on voltage analysis: DR-FLASH score. Heart Rhythm 12:2207\u20132212","journal-title":"Heart Rhythm"},{"key":"664_CR17","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1016\/j.hrthm.2015.12.029","volume":"13","author":"M Masuda","year":"2016","unstructured":"Masuda M, Fujita M, Iida O, Okamoto S, Ishihara T, Nanto K, Kanda T, Shiraki T, Sunaga A, Matsuda Y, Uematsu M (2016) Influence of underlying substrate on atrial tachyarrhythmias after pulmonary vein isolation. Heart Rhythm 13:870\u2013878","journal-title":"Heart Rhythm"},{"key":"664_CR18","doi-asserted-by":"publisher","first-page":"2731","DOI":"10.1093\/eurheartj\/eht194","volume":"34","author":"H Kottkamp","year":"2013","unstructured":"Kottkamp H (2013) Human atrial fibrillation substrate: towards a specific fibrotic atrial cardiomyopathy. Eur Heart J 34:2731\u20132738","journal-title":"Eur Heart J"},{"key":"664_CR19","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.amjcard.2018.04.047","volume":"122","author":"M Leung","year":"2018","unstructured":"Leung M, Abou R, van Rosendael PJ, van der Bijl P, van Wijngaarden SE, Regeer MV, Podlesnikar T, Ajmone Marsan N, Leung DY, Delgado V, Bax JJ (2018) Relation of echocardiographic markers of left atrial fibrosis to atrial fibrillation burden. Am J Cardiol 122:584\u2013591","journal-title":"Am J Cardiol"},{"key":"664_CR20","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.hrthm.2015.10.028","volume":"13","author":"TE Walters","year":"2016","unstructured":"Walters TE, Nisbet A, Morris GM, Tan G, Mearns M, Teo E, Lewis N, Ng A, Gould P, Lee G, Joseph S, Morton JB, Zentner D, Sanders P, Kistler PM, Kalman JM (2016) Progression of atrial remodeling in patients with high-burden atrial fibrillation: Implications for early ablative intervention. Heart Rhythm 13:331\u2013339","journal-title":"Heart Rhythm"},{"key":"664_CR21","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1016\/j.jacc.2017.07.758","volume":"70","author":"JB King","year":"2017","unstructured":"King JB, Azadani PN, Suksaranjit P, Bress AP, Witt DM, Han FT, Chelu MG, Silver MA, Biskupiak J, Wilson BD, Morris AK, Kholmovski EG, Marrouche N (2017) Left atrial fibrosis and risk of cerebrovascular and cardiovascular events in patients with atrial fibrillation. J Am Coll Cardiol 70:1311\u20131321","journal-title":"J Am Coll Cardiol"},{"key":"664_CR22","doi-asserted-by":"publisher","first-page":"323","DOI":"10.2217\/fca.15.22","volume":"11","author":"H Kamel","year":"2015","unstructured":"Kamel H, Okin PM, Longstreth WT Jr, Elkind MS, Soliman EZ (2015) Atrial cardiopathy: a broadened concept of left atrial thromboembolism beyond atrial fibrillation. Future Cardiol 11:323\u2013331","journal-title":"Future Cardiol"},{"key":"664_CR23","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1093\/eurheartj\/ehv514","volume":"38","author":"P Gal","year":"2017","unstructured":"Gal P, Marrouche NF (2017) Magnetic resonance imaging of atrial fibrosis: redefining atrial fibrillation to a syndrome. Eur Heart J 38:14\u201319","journal-title":"Eur Heart J"},{"key":"664_CR24","doi-asserted-by":"publisher","first-page":"1812","DOI":"10.1093\/europace\/euaa179","volume":"22","author":"B Kirstein","year":"2020","unstructured":"Kirstein B, Neudeck S, Gaspar T, Piorkowski J, Wechselberger S, Kronborg MB, Zedda A, Hankel A, El-Armouche A, Tomala J, Schmidt T, Mayer J, Wagner M, Ulbrich S, Pu L, Richter U, Huo Y, Piorkowski C (2020) Left atrial fibrosis predicts left ventricular ejection fraction response after atrial fibrillation ablation in heart failure patients: the Fibrosis-HF Study. Europace 22:1812\u20131821","journal-title":"Europace"},{"key":"664_CR25","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.ijcard.2017.07.007","volume":"248","author":"PN Azadani","year":"2017","unstructured":"Azadani PN, King JB, Kheirkhahan M, Chang L, Marrouche NF, Wilson BD (2017) Left atrial fibrosis is associated with new-onset heart failure in patients with atrial fibrillation. Int J Cardiol 248:161\u2013165","journal-title":"Int J Cardiol"},{"key":"664_CR26","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1161\/CIRCEP.113.000689","volume":"7","author":"C McGann","year":"2014","unstructured":"McGann C, Akoum N, Patel A, Kholmovski E, Revelo P, Damal K, Wilson B, Cates J, Harrison A, Ranjan R, Burgon NS, Greene T, Kim D, Dibella EV, Parker D, Macleod RS, Marrouche NF (2014) Atrial fibrillation ablation outcome is predicted by left atrial remodeling on MRI. Circ Arrhythm Electrophysiol 7:23\u201330","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"664_CR27","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1002\/joa3.12174","volume":"35","author":"F Ahmed-Jushuf","year":"2019","unstructured":"Ahmed-Jushuf F, Murgatroyd F, Dhillon P, Scott PA (2019) The impact of the presence of left atrial low voltage areas on outcomes from pulmonary vein isolation. J Arrhythm 35:205\u2013214","journal-title":"J Arrhythm"},{"key":"664_CR28","doi-asserted-by":"crossref","unstructured":"Andrade JG, Yao RRJ, Deyell MW, Hawkins NM, Rizkallah J, Jolly U, Khoo C, Raymond JM, McKinney J, Cheung C, Steinberg C, Ha A, Ramanathan K, Luong C, Glover B, Verma A, Macle L, Khairy P; CIRCA-DOSE Study Investigators (2020) Clinical assessment of AF pattern is poorly correlated with AF burden and post ablation outcomes: a CIRCA-DOSE sub-study. J Electrocardiol 60:159-164","DOI":"10.1016\/j.jelectrocard.2020.03.008"},{"key":"664_CR29","doi-asserted-by":"publisher","first-page":"e208748","DOI":"10.1001\/jamanetworkopen.2020.8748","volume":"3","author":"JG Andrade","year":"2020","unstructured":"Andrade JG, Deyell MW, Verma A, Macle L, Champagne J, Leong-Sit P, Novak P, Badra-Verdu M, Sapp J, Khairy P, Nattel S (2020) Association of atrial fibrillation episode duration with arrhythmia recurrence following ablation: a secondary analysis of a randomized clinical trial. JAMA Netw Open 3:e208748","journal-title":"JAMA Netw Open"},{"key":"664_CR30","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1002\/clc.23378","volume":"43","author":"T Seewoster","year":"2020","unstructured":"Seewoster T, Buttner P, Zeynalova S, Hindricks G, Kornej J (2020) Are the atrial natriuretic peptides a missing link predicting low-voltage areas in atrial fibrillation? Introducing the novel biomarker-based atrial fibrillation substrate prediction (ANP) score. Clin Cardiol 43:762\u2013768","journal-title":"Clin Cardiol"},{"key":"664_CR31","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1093\/europace\/euy120","volume":"21","author":"J Kornej","year":"2019","unstructured":"Kornej J, B\u00fcttner P, Sommer P, Dagres N, Dinov B, Schumacher K, Bollmann A, Hindricks G (2019) Prediction of electro-anatomical substrate using APPLE score and biomarkers. Europace 21:54\u201359","journal-title":"Europace"},{"key":"664_CR32","doi-asserted-by":"publisher","first-page":"12686","DOI":"10.1038\/s41598-018-31133-x","volume":"8","author":"J Kornej","year":"2018","unstructured":"Kornej J, Schumacher K, Dinov B, Kosich F, Sommer P, Arya A, Husser D, Bollmann A, Lip GYH, Hindricks G (2018) Prediction of electro-anatomical substrate and arrhythmia recurrences using APPLE, DR-FLASH and MB-LATER scores in patients with atrial fibrillation undergoing catheter ablation. Sci Rep 8:12686","journal-title":"Sci Rep"}],"container-title":["The Egyptian Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-025-00664-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43044-025-00664-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-025-00664-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T09:27:41Z","timestamp":1757323661000},"score":1,"resource":{"primary":{"URL":"https:\/\/tehj.springeropen.com\/articles\/10.1186\/s43044-025-00664-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["664"],"URL":"https:\/\/doi.org\/10.1186\/s43044-025-00664-w","relation":{},"ISSN":["2090-911X"],"issn-type":[{"type":"electronic","value":"2090-911X"}],"subject":[],"published":{"date-parts":[[2025,7,31]]},"assertion":[{"value":"14 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was carried out in accordance with the principles of the Declaration of Helsinki and was approved by Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (2023-SR-171). This is a retrospective study, so, the written informed consent was not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"77"}}