Abstract:Coronary microvascular disease(CMVD)is highly prevalent and carries significant potential for triggering serious cardiovascular complications,necessitating heightened clinical attention.Early detection and diagnosis of CMVD are critical for preventing these adverse outcomes.Magnetocardiography(MCG),a safe and non-invasive imaging modality,demonstrates considerable potential for diagnosing CMVD and evaluating treatment efficacy,owing to its unique advantages.While an increasing number of global clinical studies are exploring MCG's role in CMVD diagnosis,classification,and prognostic assessment,existing clinical guidelines lack standardized evidence levels and recommendation grades for its application.This underscores an urgent need for a unified,evidence-based framework for MCG-based CMVD diagnosis.A further challenge is the inconsistency in CMVD diagnostic criteria across institutions,stemming from variations in MCG equipment,methodologies,and analytical techniques.To address these critical issues,Chinese experts have formulated a clinical consensus statement on the use of MCG for CMVD diagnosis.Synthesizing the latest research evidence and considering the specific context of China's healthcare system,this consensus aims to standardize MCG protocols,bridge implementation gaps,and accelerate the adoption of MCG across diverse clinical settings.Its publication is anticipated to significantly advance China's progress in CMVD research and diagnostics.

Abstract:Pulmonary venous stenosis(PVS)in children is a clinically rare but challenging disease with non-specific clinical symptoms.Chest X-rays and echocardiograms often fail to diagnose or misdiagnose PVS.Timely diagnosis through imaging studies such as CT angiography is key to treatment.The optimal treatment for PVS in children is still controversial.Surgery and transcatheter intervention are the two main clinical treatments,but restenosis is frequently seen post the procedures.With the increasing study of pathological findings and mechanisms of this disease,adjunctive drug therapies have demonstrated certain effectiveness and application prospects.This review aims to summarize the diagnostic methods and clinical treatments of PVS in children.

Abstract:Objective To analyze the correlation between left atrial functional parameters measured by cardiac computed tomography(CT)and left atrial appendage(LAA)thrombus in patients with paroxysmal atrial fibrillation(PAF).Methods A total of 457 consecutive PAF patients scheduled for catheter ablation at Chinese PLA General Hospital from March 2016 to June 2020 were enrolled.According to the results of transesophageal echocardiography(TEE),the patients were divided into the LAA thrombus group(32 cases)and the non-thrombus group(425 cases).The clinical characteristics and the left cardiac functional parameters obtained by cardiac CT were statistically compared between the two groups.Logistic regression analysis was used to screen the influencing factors of LAA thrombus formation,and the receiver operating characteristic(ROC)curve was applied to evaluate their predictive efficacy.Results In terms of the clinical characteristics,compared with the non-thrombus group,the patients in the thrombus group were older and had a higher prevalence of chronic heart failure,with statistically significant differences.Regarding left cardiac functional parameters,the thrombus group had significantly larger values in left ventricular diameter(LVD)[(45.76±4.48)mm vs.(47.59±4.49)mm,P=0.026],left atrial diameter(LAD)[(36.72±4.22)mm vs.(41.66±3.97)mm,P<0.001],maximum left atrial volume(LAVmax)[(111.27±32.93)ml vs.(193.72±60.67)ml,P<0.001],minimum left atrial volume(LAVmin)[(95.86±30.63)ml vs.(183.01±53.76)ml,P<0.001],maximum left atrial appendage volume(LAAVmax)[(9.47±4.50)ml vs.(14.94±7.02)ml,P<0.001]and minimum left atrial appendage volume(LAAVmin)[(8.05±3.88)ml vs.(13.38±6.19)ml,P<0.001].In contrast,the thrombus group had significantly smaller values in left ventricular ejection fraction(LVEF)[(60.02±5.17)%vs.(58.19±4.00)%,P=0.050],left atrial ejection volume(LAEV)[(15.41±7.79)ml vs.(10.70±8.88)ml,P=0.001],left atrial ejection fraction(LAEF)[(0.14±0.07)vs.(0.05±0.03),P<0.001]and left atrial appendage ejection fraction(LAAEF)[(0.15±0.08)vs.(0.10±0.05),P=0.003];all these differences were statistically significant.Logistic regression analysis showed that age[odds ratio(OR)=1.096,95%confidence interval(CI)1.008-1.192,P=0.032],LAD(OR=1.504,95%CI 1.205-1.876,P<0.001)and LAEF(OR=0.886,95%CI 0.803-0.966,P=0.003)were the independent risk factors for LAA thrombus formation in PAF patients.ROC curve analysis revealed the following:when age was used with a cutoff value of 73.5 years[area under the curve(AUC)=0.739],the sensitivity and specificity for predicting thrombus formation were 62.5%and 92.5%respectively;when LAD was used with a cutoff value of 41.5 mm(AUC=0.800),the sensitivity and specificity were 68.8%and 85.6%respectively;when LAEF was used with a cutoff value of 0.109(AUC=0.896),the sensitivity and specificity were 100%and 68.2%respectively.Conclusion The age,LAD and LAEF are all associated with left atrial appendage thrombosis in patients with PAF,among which LAD and LAEF are important influencing factors of left atrial appendage thrombosis in PAF patients.

Abstract:Objective To establish and validate a diagnostic model of atherosclerosis(AS)based on autophagy related genes.Methods The GSE100927 and GSE28829 datasets were downloaded from Gene Expression Omnibus(GEO)database( large amount of autophagy related gene expression data were obtained from the Human Autophagy Database(HADb)( the genes related to AS were screened.By analyzing the intersection of autophagy related genes and differentially expressed genes in the GSE100927 dataset,a total of 19 autophagy related genes were screened for differential expression.Subsequently,the machine learning methods were employed and validated using the GSE28829 dataset,ultimately six key genes identified.A new diagnostic model for AS was constructed based on these six genes and the corresponding nomogram was generated.Results The new diagnostic model based on NCKAP1,ATG16L2,CCR2,HSPB8,CTSD and RGS19 showed good accuracy and sensitivity in the diagnosis of AS.In addition,the roles of these 6 genes in 28 types of immune cells were explored through immune infiltration analysis.Further in vivo experimental verification showed that compared with the control group,the relative mRNA expression levels of ATG16L2,CCR2,CTSD and RGS19 in the AS group were significantly increased(all P<0.05),while the relative expression levels of NCKAP1 and HSPB8 were significantly decreased(all P<0.05).Conclusion The AS diagnostic model based on autophagy related genes is successfully established,providing new ideas and methods for early diagnosis and treatment of AS.

Abstract:Objective To evaluate the relationship between anemia and restenosis after coronary artery stenting.Methods A nested case-control study was conducted in which patients who underwent coronary artery stenting from January 1 to December 31,2021 were enrolled at a single center and followed up until June 30,2024.According to whether the presence of anemia,the patients were divided into the anemia group(76 cases)and non-anemia group(248 cases),and the occurrence of coronary artery restenosis was compared between the two groups.Outpatient and telephone follow-up of 294 patients included 53 patients in the stenosis group and 241 patients in the non-restenosis group.The clinical baseline data and interventional therapy data of the two groups were compared,and Logistic regression was used to analyze the influencing factors of restenosis in elderly patients after coronary artery stenting.The correlations between hemoglobin levels and Framingham scores were performed in elderly patients after coronary stenting.ROC curves were used to analyze the predictive value of anemia for restenosis.Results Kaplan-Meier survival curves showed that there were 25 patients with restenosis in the anemia group and 28 patients in the non-anemia group,RR(relative risk)was 2.914.The cumulative restenosis rate in the anemia group was higher than that in the non-anemia group(Log-ranktestχ2=22.986,P<0.01).The age,low-density lipoprotein cholesterol(LDL-C)and smoking history rate in the restenosis group were higher than those in the non-restenosis group,and hemoglobin(Hb)and glomerular filtration rate(GFR)were lower than those in the non-restenosis group.The hemoglobin concentration was negatively correlated with Framingham score(r=0.868,P<0.001).ROC curve analysis showed that the AUC of Hb for predicting restenosis after coronary artery stenting in elderly patients was 0.892,the sensitivity was 83.3%,the specificity was 90.0%and the cutoff value was 118 g/L.Conclusion Anemia is significantly associated with the risk of restenosis in elderly patients after coronary artery stenting,and low hemoglobin has a good predictive value for restenosis.

Abstract:Objective Myocardial ischemia-reperfusion injury(MIRI)is a significant complication of reperfusion therapy and remains a major clinical challenge worldwide.Shexiang Baoxin Pill(SXBX),a traditional Chinese medicine,has shown promising potential in the treatment of cardiovascular diseases.However,its precise mechanisms in alleviating MIRI remain unclear.The aim of this study was to investigate the pharmacological effects of SXBX on MIRI.Methods Seventy-two clean-grade healthy male C57BL/6J mice,aged 6-8 weeks and weighing 20-25 g,were selected.They were randomly divided into three groups(n=24)using a random number table:the sham operation group(Sham group),the myocardial ischemia-reperfusion group(MIRI group),and the myocardial ischemia-reperfusion+Shexiang Baoxin Pill group(MIRI+SXBX group).The MIRI model was established by ligation and reperfusion of the left anterior descending coronary artery.Mice were administered SXBX(20 mg/kg)for 10 consecutive days before and after surgery.Pathological changes,cardiac function,and autophagy markers were evaluated through histopathology,echocardiography,and Western blotting.Network pharmacology was utilized to identify potential molecular targets and signaling pathways of SXBX,and the findings were validated through pathway enrichment analyses and protein expression studies.Results SXBX treatment alleviated myocardial fiber damage,reduced serum levels of myocardial injury markers,and improved cardiac function,as evidenced by increased LVEF and LVFS.Moreover,SXBX inhibited myocardial autophagy by upregulating P62 expression while downregulating Beclin-1 and LC3Ⅱ/Ⅰ expression.Network pharmacology analysis identified the PI3K/AKT signaling pathway as a key therapeutic mechanism of SXBX.Western blotting confirmed increased phosphorylation of PI3K and AKT,validating the involvement of this pathway.Conclusion In this study,we demonstrated that SXBX exerts protective effects against MIRI,primarily through the regulation of the PI3K/AKT signaling pathway and the modulation of autophagy.

Abstract:LMNA gene mutations are a significant genetic cause of dilated cardiomyopathy(DCM),disrupting the function of lamin A/C proteins and leading to cardiomyocyte dysfunction and structural remodeling.Clinically,LMNA-associated DCM is characterized by early-onset,rapidly progressive left ventricular dilation and systolic dysfunction with a high incidence of malignant arrhythmias associated with sudden cardiac death.Treatment requires a combination of anti-heart failure medications,device-based interventions,and targeted therapies.Moreover,research on potential pathways such as PDGF and the E2F/DDR/TP53 axis points to future directions.Genetic counseling and testing are crucial for familial disease management.This review systematically summarizes the mechanisms,clinical management,and therapeutic advancements of LMNA-related DCM.

Abstract:Objective To explore the correlation between atrial fibrillation(AF)and the prognosis of patients with acute coronary syndrome(ACS).Methods A retrospective cohort study was conducted.A total of 1680 patients diagnosed with ACS at Xuanwu Hospital of Capital Medical University from January 2018 to December 2020 were included.The patients were divided into the group with AF before discharge and the group without AF before discharge based on whether they had AF before discharge.The baseline data and the occurrence results of major adverse cardiovascular and cerebrovascular events(MACCE)within 1 year after discharge were recorded.The survival curve was plotted using the Kaplan-Meier method in survival analysis to analyze the differences in the occurrence of MACCE within 1 year after discharge between the two groups.Cox regression analysis was used to investigate the impact of AF on the occurrence of MACCE after discharge in ACS patients.Results The one-year incidence of MACCE after discharge was 17.39%in the group with pre-discharge AF,with a mortality rate of 6.52%;in the group without pre-discharge AF,the corresponding rates were 7.57%for MACCE and 1.53%for mortality.A statistically significant difference was observed between the two groups(P<0.05),which remained significant in the Log-rank test(P<0.05).However,after adjustment for potential confounders,the association between pre-discharge AF and the risk of MACCE no longer reached statistical significance.Cox regression analysis did not find that AF had an independent impact on the prognosis of ACS patients.Hypersensitive C reactive protein(hs-CRP)(HR=1.024,95%CI 1.009-1.039)and gastrointestinal bleeding during hospitalization(HR=129.976,95%CI 8.023-2105.663)were verified by the Bootstrap method and the regression coefficient B was 4.928(95%Bootstrap CI 0.000-4.928,P=0.002),which was an independent risk factor for MACCE within one year after discharge and the result was statistically significant(P<0.05).Conclusions AF has no statistically significant impact on the clinical prognosis of ACS patients.Elevated hs-CRP levels and gastrointestinal bleeding during hospitalization are the independent risk factors for MACCE in ACS patients within one year after discharge.

Abstract:Cardiovascular-kidney-metabolic syndrome(CKM)is a systemic disease caused by the interaction of common pathophysiological mechanisms of obesity,diabetes,chronic kidney disease and coronary atherosclerotic heart disease.In addition to the traditional risk factors,the gut microbiota and its metabolites have been found to be associated with cardiovascular diseases,chronic kidney disease and metabolic syndrome,and may serve as new potential therapeutic targets.This review aims to summarize the changes in the gut microbiota and their metabolites,and the potential mechanisms involved in the development and progression of cardiovascular diseases,chronic kidney disease and metabolic syndrome.

Abstract:Objective To investigate the relationship between thyroid-stimulating hormone(TSH),thyroglobulin antibody(TGAb)and thyroid peroxidase antibody(TPOAb)levels and cardiovascular disease(CVD)risk stratification and cardiovascular events in type 2 diabetes mellitus(T2DM)patients combined with hypertension with normal thyroid function.Methods A total of 204 patients with T2DM and hypertension with normal thyroid function admitted to Xi'an No.1 Hospital from June 2022 to October 2023 were selected and divided into the low-risk group(52 cases),the intermediate-risk group(34 cases)and the high-risk group(118 cases)according to The Chinese Guidelines for Cardiovascular Disease Risk Assessment and Management.The serum TSH,TGAb and TPOAb levels were compared among the three groups,and a Spearman correlation was performed to analyse the relationship between the serum TSH,TGAb and TPOAb levels and CVD risk stratification.They were categorised into the occurrence group(51 cases)and the non-occurrence group(153 cases)based on the occurrence of cardiovascular events.Comparisons of the general information and the levels of the serum TSH,TGAb and TPOAb between the occurrence and non-occurrence groups were conducted;multifactorial Logistic regression was used to analyse the risk factors for the occurrence of cardiovascular events;and the subject work characteristics(ROC)and their area under the curve(AUC)was used to analyse the predictive value of the serum TSH,TGAb and TPOAb levels for the occurrence of cardiovascular events in patients with T2DM and hypertension who had normal thyroid function.Results Compared with the low-risk group,the serum TSH,TGAb and TPOAb levels were higher in the intermediate-risk and high-risk groups;and they were higher in the high-risk group than in the intermediate-risk group(P<0.05).The results of Spearman's analysis suggested that the serum TSH,TGAb and TPOAb levels were positively associated with CVD risk stratification(P<0.05).The Glycosylated hemoglobin,type A1C(HbA1c),low-density lipoprotein cholesterol(LDL-C),TSH,TGAb and TPOAb were higher in the occurrence group than in the non-occurrence group(P<0.05).Analysed by multifactorial Logistic regression model showed that the high levels of HbA1c,LDL-C,TSH,TGAb and TPOAb were all the independent risk factors for cardiovascular events(P<0.05).The ROC results showed that the AUC of the serum TSH,TGAb and TPOAb levels alone and in combination to predict the occurrence of cardiovascular events in patients with T2DM and hypertension with normal thyroid function were 0.796(0.734-0.849),0.725(0.658-0.785),0.738(0.672-0.797),and 0.920(0.874-0.954);and the combined predictive efficacy of the three was higher(P<0.05).Conclusion The TSH,TGAb and TPOab levels are closely associated with CVD risk stratification and cardiovascular events in patients with T2DM and hypertension with normal thyroid function;and the combined serum TSH,TGAb and TPOab test has a higher predictive value for cardiovascular events.

Abstract:Objective To evaluate the predictive efficacy of jointly measuring the residual cholesterol/high-density lipoprotein cholesterol ratio(RC/HDL-C)and serum uric acid(UA)for the risk of recent acute adverse cardiovascular events in patients with borderline coronary heart disease.Methods A total of 203 patients with borderline coronary artery disease admitted to Yuncheng Central Hospital from September 2022 to October 2024 were selected as the training set.The patients were divided into the concurrent group and the non-concurrent group based on the recent occurrence of acute adverse cardiovascular events.Propensity score matching(PSM)was used to match the two groups in a 1∶1 ratio.The other 30 patients were selected as the external validation set.The levels of the serum RC/HDL-C and UA were compared between the two groups.Logistic regression analysis was conducted to identify the risk factors for the recent occurrence of acute adverse cardiovascular events in patients with borderline coronary artery disease.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of the serum RC/HDL-C,UA,and their combined use for predicting the risk of acute adverse cardiovascular events.In the external validation set,the consistency between the combined prediction results and clinical reality was analyzed using the Kappa value.An economic analysis was also conducted on the RC/HDL-C,UA and their combined prediction.Results The concurrent group had significantly higher serum RC/HDL-C and UA levels than the non-concurrent group,the differences were statistically significant(P<0.05).Logistic regression analysis indicated that the levels of the serum RC/HDL-C and UA were associated factors for the recent occurrence of acute adverse cardiovascular events in the patients with borderline coronary artery disease(P<0.05).The ROC curve analysis revealed that the AUC values of the serum RC/HDL-C,UA and their combined prediction for the risk of acute adverse cardiovascular events were 0.733,0.741 and 0.909,respectively(P<0.05);the combined AUC value was significantly higher than that of the serum RC/HDL-C and UA alone(Z=2.720,2.589;P=0.007,0.009).The Kappa value consistency analysis showed that the combined prediction results had a concordance rate of 90.00%with clinical reality,with a Kappa value of 0.706(P<0.05).Economic analysis indicated that,using the AUC value as the final outcome measure,the costs per unit AUC for the serum RC/HDL-C,UA and their combined detection were 13.64 yuan,26.99 yuan and 33.00 yuan,respectively.The cost per unit AUC for the combined detection was 19.36 yuan and 6.01 yuan higher than that for the UA and RC/HDL-C alone respectively,which was within an acceptable range.Furthermore,combining the two tests improved the predictive performance by 17.60%(AUC increased from 0.733 to 0.909)and 16.80%(AUC increased from 0.741 to 0.909).Conclusions The combined detection of the serum RC/HDL-C and UA can enhance the predictive value of the risk of recent acute adverse cardiovascular events in the patients with borderline coronary artery disease,providing a reference for precise stratification and intervention timing selection for these patients.

Abstract:With population aging,the incidence of atrial fibrillation continues to rise.As an important measure of stroke prevention for patients with non-valvular atrial fibrillation,left atrial appendage closure(LAAC)has been increasingly used,and its safety and efficacy have been widely recognized.However,device migration or embolization(DME)as a rare yet serious complication following LAAC,may lead to systemic embolism,arrhythmia even death.This article reviews the incidence,prognostic impact,mechanisms,diagnostic approaches and prevention and management strategies of device migration or embolization after left atrial appendage closure,with the aim to provide reference for clinical practice.

Abstract:Inherited cardiac diseases,caused by single or multiple gene mutations,represent a category of cardiovascular disorders characterized by sudden cardiac death and heart failure as primary clinical manifestations.Existing treatments struggle to reverse their pathophysiological progression.Gene therapy offers a groundbreaking strategy for eradicating these diseases through targeted correction of pathogenic mutations or regulation of aberrant gene expression.This article reviews recent advances in gene therapy for inherited cardiac disorders,discusses the advantages,limitations,and optimization approaches of different delivery vectors and molecular strategies,and summarizes their potential applications in inherited arrhythmias and cardiomyopathies.Additionally,it outlines the latest translational pathways addressing challenges such as balancing delivery efficiency-specificity and overcoming limitations of animal models.

Abstract:Objective To explore the predictive value of transesophageal echocardiography(TEE)combined with serum triglyceride glucose(TyG)product index for left atrial appendage thrombosis(LAAT)in patients with non valvular atrial fibrillation(NVAF).Methods The clinical data from 260 patients with NVAF at Linfen People's Hospital from October 2023 to January 2025 were retrospective selected and the patients were categorized into LAAT group(n=62)and non LAAT group(n=198)based on the presence or absence of LAAT formation.The general information,TEE parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),left atrial diameter(LAD),left atrial appendage emptying velocity(LAAeV),left atrial appendage filling velocity(LAAfV)and three-dimensional volumetric ejection fraction(3D-EF)]and serum TyG index were compared between the two groups.The influencing factors of LAAT formation in NVAF patients were analyzed;the dose-response relationship between TEE parameters and serum TyG index and LAAT formation was analyzed and the value of predicting LAAT formation was analyzed.Results The incidence of LAAT formation in NVAF patients was 23.85%.The proportion of cauliflower-shaped LAA,CHA2DS2-VASc score,plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)level and serum TyG index in LAAT group were higher than those in non-LAAT group[29.03%vs.12.12%、(3.94±1.12)scores vs.(2.40±0.56)scores、(1220.39±262.87)pg/ml vs.(986.54±231.54)pg/ml、(8.65±1.42)vs.(7.01±1.19),all P<0.05];LVEF,LAAeV,LAAfV and 3D-EF were lower than in the non-LAAT group[(55.37±6.48)%vs.(58.81±6.12)%、(51.62±6.13)cm/s vs.(59.16±6.52)cm/s、(48.74±5.86)cm/s vs.(57.32±6.17)cm/s、(40.35±3.57)%vs.(47.08±4.23)%,all P<0.05].Cauliflower-shaped LAA,CHA2DS2-VASc score and serum TyG index were the independent risk factors for LAAT formation in NVAF patients;LAAeV,LAAfV and 3D-EF were the independent protective factors(P<0.05).There was a negative linear dose-response relationship between LAAeV,LAAfV and 3D-EF and LAAT formation in NVAF patients,and a positive linear dose-response relationship between serum TyG index and LAAT formation in NVAF patients(P<0.05).The area under the curve(AUC)of LAAeV,LAAfV,3D-EF and serum TyG index for predicting LAAT formation in NVAF patients were 0.736,0.752,0.726 and 0.748,respectively.The AUC predicted by LAAeV,LAAfV,3D-EF combined with serum TyG index was 0.877,which was greater than the AUC predicted by each index alone and CHA2DS2-VASc score(AUC was 0.809)(P<0.05).Compared with CHA2DS2-VASc score,the net reclassification index(NRI)and comprehensive discriminant improvement index(IDI)of LAAeV,LAAfV and 3D-EF combined with serum TyG index were both>0(P<0.05).The prediction of LAAeV,LAAfV and 3D-EF combined with serum TyG index had a significant positive net benefit and had a good clinical effect in predicting LAAT formation in NVAF patients.Conclusion The LAAeV,LAAfV and 3D-EF of TEE parameters and serum TyG index have the certain value in the formation of LAAT in NVAF patients and their combined application can provide reliable evidence for clinically identifying the patients at high risk of LAAT formation.

Abstract:This article is an excerpt from the second section"Epidemiological Status of Cardiovascular Diseases and Their Risk Factors"of"Report on cardiovascular health and diseases in China 2024".It provides a detailed account of the incidence and mortality of cardiovascular and cerebrovascular diseases in China,as well as the epidemiological status and trends of risk factors such as smoking,overweight and obesity,hypertension,dyslipidemia,diabetes,and chronic kidney disease.Compiled by the National Center for Cardiovascular Diseases,the report covers cardiovascular impact factors,risk factors,diagnosis,treatment and epidemiological trends of cardiovascular diseases,rehabilitation,basic research and development,and economic burden and evaluation.It is currently the most comprehensive and representative comprehensive compilation of practices and research achievements in cardiovascular disease prevention and treatment in the industry.

Abstract:Heart failure is one of the common and severe complications following myocardial infarction(MI).The continuous increase in the aging of the population and the burden of comorbidities have led to a rising incidence of post-MI heart failure.Ventricular remodeling is a crucial pathophysiological process that occurs after MI.It significantly elevates the morbidity of post-MI heart failure and is also a vital factor contributing to adverse cardiac events and influencing the long-term prognosis.In recent years,substantial advancements have been achieved in the treatment of post-MI heart failure.This review integrates the current guidelines'recommendations and collates the latest research findings in all aspects,aiming to provide certain references for the management of post-MI heart failure.

Abstract:Objective To mine big medical test data through machine learning algorithms and construct a prediction model and risk stratification for heart failure(HF)complications in acute myocardial infarction(AMI)patients.Methods Clinical data of 1,500 AMI patients admitted to Shanxi Cardiovascular Hospital from October 2020 to October 2024 were collected through the electronic medical record system.The patients were divided into the training set(n=1050)and the validation set(n=450)at a ratio of 7∶3.According to whether the patients had HF complications,the patients in the training group were further divided into the heart failure group(n=425)and the non-heart failure group(n=625).Logistic regression,support vector machine and random forest training models were used to screen the risk variables for HF complications in AMI.The best subset of each algorithm was selected through cross-validation,and the intersection was taken as the final input variable.The results of the model intersection were included to construct a model for predicting HF complications in AMI patients.The intersection results of the models were included to construct a model for predicting HF in AMI patients,and the predictive efficacy of the model was tested.Results There were statistically significant differences between the heart failure group and the non-heart failure group in terms of age,hypertension,Killip cardiac function classification,soluble growth stimulated gene 2 protein(sST-2),high-sensitivity cardiac troponin I(hs-cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP),blood urea nitrogen(BUN),serum creatinine(Crea),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)levels(P<0.05).Logistic regression,support vector machine and random forest machine learning algorithms were used to analyze the 10 statistically significant risk variables mentioned above.The intersection variables screened by the three machine algorithms were Killip cardiac function classification≥gradeⅡ,sST-2,hs-cTnI,NT-proBNP,HDL-C and LDL-C.Based on these results,a nomogram model for predicting HF complications in AMI patients was constructed.The areas under the ROC curves(AUC)of the model in the training set and the validation set were 0.837 and 0.804 respectively(95%CI 0.751-0.960 and 0.729-0.883).The Hosmer-Lemeshow test curves showed that the calibration curves of the model in the training set and the validation set fitted well with the ideal curve(χ2=1.443 and 1.234,P=0.276 and 0.203).Conclusion The prediction model for HF complications in AMI patients constructed based on big medical test data has good predictive efficiency and can provide a reference for clinical practice.

Abstract:Objective To investigate the abnormal expression of serum matrix metalloproteinases(MMPs),N-terminal pro-B-type natriuretic peptide(NT-proBNP)and interleukin-6(IL-6)in inducing cardiac impairment and its impact on prognosis in patients with heart failure complicated by pulmonary infection.Methods A total of 154 patients with chronic heart failure(CHF)admitted to Xingtai Central Hospital were selected and divided into the infection group(n=108)and non-infection group(n=46)based on the presence or absence of pulmonary infection.Serum levels of MMPs,NT-proBNP,IL-6 and cardiac function were measured in both groups.The infection group was further divided into the good prognosis group and the poor prognosis group based on the occurrence of adverse events during hospitalization and within 6 months of telephone follow-up.The impact of MMPs,NT-proBNP and IL-6 on the prognosis of CHF patients with pulmonary infection was analyzed,and the receiver operating characteristic(ROC)curve was used to evaluate their predictive value.Results The levels of MMP-2,MMP-9,NT-proBNP and IL-6 in the infection group were significantly higher than those in the non-infection group[(250.32±30.32)ng/ml vs.(196.86±20.34)ng/ml,(422.23±38.67)ng/ml vs.(326.78±31.43)ng/ml,(10.32±2.01)pg/ml vs.(7.32±1.82)pg/ml,(18.02±3.12)ng/L vs.(11.32±2.13)ng/L,P<0.05].The heart rate(HR),left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)in the infection group were significantly higher than those in the non-infection group[(86.23±7.32)times/min vs.(78.23±6.98)times/min,(64.32±6.72)mm vs.(58.32±6.02)mm,(52.56±5.21)mm vs.(46.01±4.89)mm,P<0.05],while left ventricular ejection fraction(LVEF)was significantly lower than that in the non-infection group(42.67±3.21 vs.52.63±4.02,P<0.05).In the infection group,66 patients had a good prognosis,while 42 had a poor prognosis.Univariate analysis showed that the levels of MMP-2,MMP-9,NT-proBNP and IL-6 in the good prognosis group were significantly lower than those in the poor prognosis group[(236.42±27.86)ng/ml vs.(258.32±31.02)ng/ml,(402.32±34.67)ng/ml vs.(429.67±37.89)ng/ml,(8.94±1.96)pg/ml vs.(10.96±2.21)pg/ml,(16.24±2.86)ng/Lvs.(18.89±3.54)ng/L,P<0.05].Multivariate Logistic regression analysis indicated that MMP-2,MMP-9,NT-proBNP and IL-6 were the risk factors affecting the prognosis of CHF patients with pulmonary infection.ROC curve analysis further validated that the areas under the curve(AUC)for MMP-2,MMP-9,NT-proBNP,IL-6 and their combination in predicting the prognosis of CHF patients with pulmonary infection were 0.617,0.736,0.834,0.728 and 0.930,respectively,with the combined prediction outperforming individual indicators.Conclusion Abnormally elevated serum levels of MMPs,NT-proBNP and IL-6 are valuable for assessing cardiac impairment and prognosis in CHF patients with pulmonary infection,and they may serve as potential biomarkers for clinical treatment and prognosis management.

Abstract:Panvascular diseases(PVD)are a class of chronic inflammatory disorders affecting multiple vascular beds throughout the body,characterized by lipid deposition,fibrosis and calcification in the arterial intima.Inflammation plays a central role throughout the onset,progression,and complications of PVD,influencing specific conditions such as coronary artery disease,diabetes and its complications.Moreover,the impact of PVD extends beyond the cardiovascular system to include cerebrovascular,renal,ocular,and other non-cardiovascular systems.Recent advancements have been made in the discovery of biomarkers,improvement of diagnostic tools,development of anti-inflammatory therapies and application of personalized medicine.This review summarizes the mechanisms of inflammation in PVD and highlights recent research progress,emphasizing the importance of interdisciplinary collaboration to guide future research directions.

Abstract:Objective To explore the risk factors of increased mortality in patients with hypertensive heart failure(HHF)and to develop and verify the clinical significance of the prediction models.Methods A total of 4270 patients with HHF were included from The Medical Information Mart For Intensive Care-Ⅳ(MIMIC-Ⅳ)database.The patients were analyzed for mortality at the following time points:during hospitalization,at 7,14 and 30 days after discharge.The dataset was randomly divided into two parts,with 70%of the data used for model training and 30%for validation.Machine learning algorithms were used to identify the independent risk factors,and multiple Logistic regression analysis was used to establish a predictive model in the training set.The models were then validated in the test set and evaluated for its discrimination,calibration and clinical utility.The best performing models were selected to construct a column chart.The EICU Collaborative Research Database was used for the external validation.Results Among 4270 patients,the mortality rates were as follows:14.6%in-hospital,17.1%at 7 days,18.6%at 14 days,and 21.1%at 30 days.After screening,the final included risk factors were as follows:the white blood cell count,the platelet count,the phosphate,the bicarbonate and the anion gap,the acute physiology score Ⅲ(APSⅢ),the Oxford acute severity of illness score(OASIS),the simplified acute physiology score Ⅱ(SAPSⅡ),the charlson comorbidity index(CCI)and body weight.The ROC values of the four models were 0.817,0.810,0.785 and 0.796 in the training set,while were 0.828,0.819,0.793 and 0.801 in the testing set.The C-index values were 0.817,0.810,0.785 and 0.796 in the training set,while were 0.828,0.819,0.793 and 0.801 in the testing set.The models demonstrated strong and consistent performance in the training and testing datasets.Furthermore,the decision curve analysis showed that applying the model provided a net benefit over the strategies of treating all patients or treating no patients.In the external validation cohort(EICU database),the model for in-hospital mortality achieved a C-index of 0.754,demonstrating good discriminative ability.Moreover,decision curve analysis confirmed the model's clinical utility by showing a net benefit for the model-based strategy across a range of threshold probabilities when compared to the all-treated and treat-none strategies.Conclusions The prediction models can effectively predict the in-hospital,7-day,14-day,and 30-day mortality of hypertensive heart failure patients.They are helpful for clinical decision-making.Compared with established risk scores such as the Get with the Guidelines-Heart Failure(GWTG-HF)and the Charlson Comorbidity Index(CCI),our model demonstrates superior performance in predicting in-hospital mortality.It also shows comparative advantages over general severity-of-illness scores like OASIS,APSⅢ,and SAPSⅢ.