摘要：Background Low diastolic blood pressure (DBP) was reported to be associated with reduced coronary blood flow,subclinical myocardial damage,and cardiovascular events. The aim of this study was to explore the impact of low DBP on clinical outcomes in patients with ST-elevation myocardial infarction(STEMI)undergo-ing percutaneous coronary intervention(PCI). Methods A total of 1232 patients with STEMI were retrospec-tively enrolled and divided into two groups according to admission DBP level:≥70 mm Hg(n=817)and<70 mm Hg (n=415). The relationship between DBP and in-hospital and 1-year adverse events was evaluated. Results In-hospital death occurred in 2.4％of patients. The in-hospital mortality(5.3％vs. 1.0％,P<0.001)and major adverse clinical events(11.1％vs. 7.5％,P=0.033)were significantly higher in patients with a low DBP. DBP<70 mm Hg was associated with in-hospital death(adjusted odds rate=3.31,95％CI:1.36-8.07,P=0.009). Additional significant indicators included eGFR<60 mL/min/1.73 m2 and intra aorta balloon pump(IABP)treat-ment. Seventy-seven(6.3％)patients died in the one-year follow-up. DBP<70 mm Hg was associated with in-creased risk of 1-year death(8.9％vs. 4.8％,Log-rank=9.9 ,P=0.002). Conclusion Low DBP was associat-ed with increased risk of in-hospital and 1-year adverse prognosis in patients with STEMI undergoing PCI, which could be a tool for risk assessment.

摘要：Background Septal Surfing Technology (SST) is one of the most important techniques for collateral channels (CCs) crossing in retrograde chronic total occlusion (CTO) of percutaneous coronary intervention (PCI).We examined this technique's usefulness in retrograde CTO-PCI cases.Methods We retrospective analyzed 728 consecutive CTO-PCI cases from January 2014 to September 2016.One hundred and forty-two patients who had undergone retrograde PCIs using septal collateral channels (CCs) were collected.Univariate and multivariate analyses were conducted to identify independent predictors for SST CCs crossing success.Results The CCs crossing success rate was 89.4％ during retrograde PCI.Three factors were figured out as independent predictors,including CCs tortuosity (OR 0.164,95％CI:0.041-0.657;P=0.011),diameter of distal CTO lesion (2.035,95％CI:1.011-4.099;P=0.047) and LAD-CTO (OR 0.244,95％CI:0.067-0.894;P=0.033).There were complications of CCs injury in 23.2％ cases and 2.1％ cases had cardiac tamponade without any in-hospital death.Conclusion SST is an effective method in collateral crossing during retrograde CTO-PCI.It has high successful rate regard less of the Wemer Collateral Class of interventional collaterals,especially in invisible collaterals.This technology is feasible in daily practice of retrograde PCI.

摘要：Background In recent years, Percutaneous coronary intervention(PCI) as an effective treatment for coronary heart disease has been widely carried out in China. However, people is still confronted with the problem that the incidence of in-stent restenosis (ISR) after PCI. Some risk factors of coronary heart disease have been obviously known, but the in-dependent predictor factors for the ISR has not been clear. Clarifying risk factors for ISR to establish interfering meas-ures may be a new direction for PCI treatment in the future. At present, it has been reported that aldosterone (ALD) may be involved in ISR. In order to further investigate the relationship between the serum ALD levels and ISR, our re-search was to determine the ALD and other serum markers to explore the impact factors of ISR. Methods We meas-ured serum ALD, high sensitivity C-reactive protein (hs-CRP), adiponectin (ADP) and other indicators in 258 pa-tients with coronary stenting, and made routine follow-up for 6-9 months to perform coronary angiography. According to the results of coronary angiography, all patients were divided into restenosis group and non-restenosis group. We an-alyzed the relationship between ALD, other indicators and ISR to explore whether serum ALD was an independent risk factor ISR. Results Serum ALD levels were significantly higher in restenosis group than non-restenosis group. Logis-tic regression analysis showed that diabetes, ALD, hs-CRP and complex lesions were also independent risk factors for ISR (P < 0.05), while the ADP was as a protective factor for ISR (P < 0.05). Conclusions ALD is one of inde-pendent risk factors for ISR after undergoing coronary stent implantation in patients. It has the possibility of becoming one new method in this medical field.

摘要：Background Fish oil,rich in long-chain n-3 PUFAs,EPA and DHA,are known to reduce various risk factors for CAD1-3.However,conclusive regarding the benefits of n-3 PUFAs on arterial stiffness,a risk factor for CAD,has not yet been established.Methods In the placebo-controlled,single-blind,prospective study,60 subjects were randomly allocated to consume daily nutritional supplement of 3 gram capsules containing either placebo (soybean oil) or fish oil,EPA (540 mg) + DHA (360 mg) for 12 weeks.Anthropometry,pulse wave velocity (PWV) and polyunsaturated fatty acid were measured and compared before and after study therapy.Results After study therapy,PWV reduced significantly in the fish oil group compared with the placebo group (-8 + 18 cm/s vs 39 ± 19 cm/s,P＜ 0.05).Conclusions Fish oil shows beneficial effect on improving arterial stiffness in patients with coronary disease.[S Chin J Cardiol2012; 13(2):80-87]

摘要：Objectives To analyze the six-minute walk test (6MWT) and gas exchange of 5 heart transplantation patients and to approach the variation tendency of exercise tolerance,oxygen uptake (VO2) and heart rate chronotropic response.Methods 5 cases of heart transplantation patients (age 25～52 years) were undertaken 6MWT 6～30 months after operation,synchronizing gas exchanging parameters were measured by wireless portable remote sensing K4B2 gas analyzer,51 normal controls were compared.Results The six-minute walk distance (6MWD) of 5 patients were (592.61±26.7)m (558～625)m,the ascending tendency during exercise was slower,the maximum heart rates were 80%±6% of age-predicting maximal heart rate,lower than normal control (86%);the end point VO2/kg were (21.8±1.4)mL/min·kg(19.94～23.60)mL/min·kg.Conclusions The 6WMD and VO2 of 5 patients reached normal range,but the heart rate chronotropic response and VO2 ascending tendency were slower than those of normal controls.

摘要：Background The epidemiologic features and outcomes of chronic heart failure(CHF)patients with atrial fibrillation(AF)remain not clear in China.We aim to evaluate the epidemiologic features and outcomes of CHF patients with AF,compared by those CHF patients with sinus rhythm(SR),which is still not clear in China.Methods From January 2005 to December 2008,1161 patients were admitted to the PLA general hospitals and First Affiliated Hospital of Shantou University Medical College with a discharge diagnosis of CHF were enrolled in the study.The patients were divided into two groups according to the presence or absence of AF.The main outcomes were defined as death within one year and readmission to the hospital for heart failure.Results The rate of CHF patients with AF was 36%.During I year follow-up,the overall main outcomes was higher in AF patients than in those with SR(P = 0.02).After adjusting for other covariables,including age,gender,left ventricular ejection fraction(LVEF),NYHA classification,et al,AF was no longer related to increased the risk of main outcomes during 1 year follow-up(RR: 1.052,CI: 0.938 ±1.165,P = 0.629).A Cox model showed that risk of main outcomes were associated with NYHA Ⅳ(P < 0.001),age(P = 0.022),left atrial dimension(P = 0.020).Conclusion The generally observed higher adverse outcome during1-year follow-up in patients with AF thus seems to be related to other factors,such as NYHA Ⅳ,age,left atrial dimension,but not AF.

摘要：Backrround Hypothermia is common in surgical patients admitted to intensive care units and may contribute to adverse outcomes.This study evaluates the impact of postoperative hypothermia on outcomes in neonates after cardiopulmonary bypass surgery.Methods We conducted a retrospective cohort study enrolling neonate who underwent congenital heart surgery at a tertiary hospital from 2015 to 2017.Normothermia was defined as core temperature ≥36℃ and hypothermia as ＜36℃ on admission to intensive care unit after surgery.Neonates with hypothermia received warm resuscitation using a preheated radiant warmer.After 3-hour active warming,core temperatures ≥36℃ was defined as transient hypothermia,and core temperatures ＜36℃ was defined as persistent hypothermia.Outcome measures included chest drainage,in-hospital mortality,reoperation for bleeding,mechanical ventilation duration,and length of hospital stay after surgery.Results 255 neonates were included for final analysis.Sixty neonates (23.5％) were included in the normothermia group,130 neonates (51％) in the transient hypothermia group and 65 neonates (25.5％) in the persistent hypothermia group.The mortality in the persistent hypothermia group (16.9％) was significantly higher than in the transient hypothermia group (3.1％)and the normothermia hypothermia group (5％) (P=0.001).Multivariable linear regression analysis demonstrated that persistent hypothermia group had more chest drainage compared to normothermia (adjusted β=12.79 mL/kg,95％ CI: 1.88 mL/kg to 23.69 mL/kg,P=0.022).Conclusions Early postoperative hypothermiais common in neonates undergoing cardiopulmonary bypass surgery.Persistent hypothermia,but not transient hypothermia,is associated with increased chest drainage and higher in-hospital mortality compared to normothermia.

摘要：Background Muscle wasting is a common clinical phenomenon that affects at least 20 percent of patients with heart failure. The exercise capacity of heart failure patients is limited; if left unchecked, which can form cachexia, seriously affecting the quality of life of patients with heart failure. This paper summarizes the clinical manifestations, pathophysiological mechanisms and its latest research direction including microRNA - regulated networks, and potential therapeutic strategies of muscle wasting in heart failure. Our goal is to provide a basis for clinicians to further understand and treat the muscle wasting in heart failure patients.

摘要：Background Diabetic cardiomyopathy(DCM)represents a severe cardiovascular complication of diabetes mellitus,characterized by insidious onset,diagnostic challenges in early stages,and poor prognosis.Current diag-nosis of DCM primarily relies on imaging techniques,lacking convenient and effective early biomarkers.Method Using a case-control study design,we enrolled 50 DCM patients(DCM group)and 50 diabetes-only patients(con-trol group)diagnosed at our hospital between January 2023 and January 2025.Demographic data were collected from all participants.Serum levels of hemoglobinA1c(HbA1c),interleukin-1β(IL-1β),and superoxide dismutase(SOD)were measured and compared between groups.Logistic regression analysis was performed to identify DCM risk factors,while receiver operating characteristic(ROC)curve analysis evaluated the diagnostic value of individu-al and combined biomarkers for DCM screening.Results The levels of HbA1c and IL-1β in the DCM group were higher than those in the control group,and the level of SOD was lower than that in the control group(P<0.05).Mul-tivariate Logistic regression analysis showed that HbA1c,IL-1β and SOD were all independent risk factors for DCM.The results of the ROC curve showed that the areas under curve(AUC)of HbA1c,IL-1β,and SOD levels in diagnosing DCM patients were 0.673,0.783,and 0.728,respectively.The AUC predicted by the combination of the three was 0.836,which was higher than that detected by any above single index(P<0.05).Conclusions DCM pa-tients exhibited significantly higher HbA1c and IL-1β levels but lower SOD activity compared to the controls.Each biomarker demonstrated significant diagnostic value for DCM,and their combination yielded superior diagnostic performance compared to any single marker.[S Chin J Cardiol 2025;26(2):114-120]

摘要：Depression/anxiety is commonly present in paced patients and is associated with increased cardiovascular morbidity and mortality. The high prevalence of depression/anxiety in paced patients supports a strategy of increased awareness and treatment for depression/anxiety in paced patients. Health-related quality of life (HRQoL) is being increasingly considered as an expected out-come of therapeutic interventions and rehabilitation programs in clinical cardiology including patients before and after pacemaker(PM) implantation. This multispecialty consensus document reviews the evidence linking depression/anxiety with arrhythmia and cardiac pacing; HRQoL and cardiac pacing, at the same time, provides recommendations for healthcare providers for the treatment of depression/anxiety.

摘要：Background Despite the proven benefit of 600-mg loading dose of clopidogrel in patients with acute ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous cronary intervention (PCI),there is still concern about its benefit and safety on elderly population.Methods Data of 172 consecutive elderly patients (≥75 years) with STEMI who underwent primary PCI at Guangdong Provincial Cardiovascular Institute from January 2008 to December 2011 were retrospectively collected.Patients were divided into 600-mg loading clopidogrel group and 300-mg clopidogrel group aceoring to the loading dose of clopidogrel before primary percunaeous coronary intervention(PCI).Enzymatic myocardial infarction size estimated by peak creatine kinase-myocardial band (CK-MB) and patency of the infarct-related artery (IRA) were compared.Thirty-day major adverse cardiac events (MACEs),which consist of death,nonfatal myocardial infarction (MI),nonfatal stroke,target vessel revascularization (TVR) or stent thrombosis (ST) were compared to assess the efficacy of different loading dose.Bleeding information was compared as well to assess the safety of different pretreatment stragety before primary PCI.Results 96 patients were adminstered with 600-mg loading clopidogrel before primary PCI while 76 were administered with 300-mg.Pateney of the IRA was significantly higher in patients administered with 600-mg loading clopidogrel therapy as compared with those who received 300-mg loading clopidogrel (94.8％ vs.85.5％,P =0.038).600-mg loading dose of clopidogrel was associated with lower incidence of 30-day MACEs compared with 300-mg loading dose of clopidogrel (8.3％ vs.19.7％,P =0.029)while did not increase the risk of TIMI major (3.1％ vs.3.9％,P =0.770) and minor bleeding (10.4％ vs.6.6％,P =0.376).Conclusion 600-mg loading clopidogrel improves final patency of the IRA and clinical outcome as compared with 300-mag loading clopidogrel without increasing bleeding hazard. [S Chin J Cardiol 2012; 13(2):59-66]

摘要：The best time of stem cells transplantation for treating acute myocardial infarction (AMI) is still to be followed with interest and a focus issue for clinical cardiologist. A brief meta-analysis of clinical trials about timing-window and therapeutic effects of stem cell transplantation for treating AMI will be made out in this article.

摘要：Background The prevalence of heart failure (HF) appears to be 1％-2％ in adults and increases with age,ranging from approximately 1％ in those younger than 50 years to 10％ in those older than 70 years.Malnutri-tion is associated with increased mortality and readmission in patients with cardiovascular disease.Triglyceride total cholesterol body weight index (TCBI),which is a new nutritional index,can be used as a useful prognostic index for patients with coronary artery disease or heart failure.The incidence of readmission due to heart failure remains high in patients with heart failure.The purpose of this study was to investigate whether there is a corre-lation between the TCBI and readmission rate to facilitate the identification of patients with heart failure at high risk of readmission.Methods This study was a retrospective study that included patients with heart failure who were hospitalized at the Zigong Fourth People's Hospital from December 2016 to June 2019.TCBI =Serum level of triglyceride (TG,mg/dL) × total cholesterol (TC,mg/dL) × body weight (BW,kg)/1000.The 1685 pa-tients were enrolled and divided into three groups as follows according to the tertiles of TCBI:Low TCBI group(TCBI ＜460,n=562),medium TCBI group (460≤TCBI ＜806,n=561) and High TCBI group (TCBI ≥806,n=562).The endpoint event was the patient's readmission in 6 months.Multivariate Cox regression analysis was used to assess the independent association between TCBI levels and 6-month readmission rate.The Kaplan-Mei-er method was used to draw a time-to-event curve.The Log-rank test was used to determine the difference in event rate among the three TCBI groups.Results During 6-month follow-up,a total of 619 patients (36.7％)applied for readmission,and the low TCBI group had the highest 6-month readmission rate (40.9％ vs.35.1％vs.34.2％,P=0.039).Kaplan-Meier curves showed the highest readmission rate for patients with low TCBI dur-ing the 6-month follow-up (Log-rank test:P=0.044).In the extended multivariate Cox model,the 6-month read-mission hazard ratio (HR) for the low TCBI group was stable in all four models (HRs range:1.24-1.26,P＜0.05 for all).After adjusted for variables,a 25％ higher of 6-month readmission rate could be observed in patients with low TCBI (HR:1.25,95％ CI:1.00-1.56,P=0.046).Conclusions TCBI can be used as an objective indi-cator to assess the nutritional status of patients.In patients with heart failure,there is a correlation between TC-BI levels and the 6-month readmission rate.Lower TCBI level is associated with higher 6-month readmission rate.

摘要：To summarize a case of late pregnancy complicated with acute Stanford type A aortic dissection who underwent multidisciplinary treatment perioperative nursing experience in emergency surgery.The patient was 37 weeks of intrauterine pregnancy and suffered from sudden chest pain.The emergency admission was diagnosed with aortic dissection(Stanford A type),and the condition was dangerous and life-threatening.After preoperative multidisciplinary combined systematic comprehensive disease assessment and comprehensive surgical emergency plan was formulated,do a good job of effective psychological counseling and operation cooperation education,nursing cooperation during intraoperative anesthesia and nursing focus of multidisciplinary combined surgical treat-ment,postoperative prevention of massive bleeding,puerperium infection and a series of effective nursing mea-sures,no perioperative period occurred nursing complications.The newborn survived,the patient recovered and was discharged from the hospital,and returned to the hospital for re-examination with normal indicators and good physical condition.