Abstract:Objective To investigate the relationship between serum CXC chemokine ligand 12(CXCL12),poly ADP-ribose polymerase 1(PARP1)and Kruppel-like factor 15(KLF15)along with cardiac function and major adverse cardiovascular events(MACE)in patients with chronic heart failure(CHF).Methods From September 2022 to December 2023,156 CHF patients accepted by Wuhan Third Hospital were as the CHF group,and they were divided into the MACE group(n=57)and non MACE group(n=99)according to the occurrence of MACE within 6 months.Another 124 healthy volunteers with in the same period were selected as the control group.ELISA method was used to detect serum CXCL12 and PARP1,and real-time fluorescence quantitative PCR was used to detect serum KLF15.The correlation between serum CXCL12,PARP1 and KLF15 and cardiac function indicators of patients with CHF,as well as the influencing factors of MACE in CHF patients were analyzed.ROC curve was used to analyze the predictive value of serum CXCL12,PARP1 and KLF15 for the occurrence of MACE in CHF patients.Results Compared with the control group,the levels of serum CXCL12[(19.81±3.57)μg/L vs.(10.08±2.45)μg/L]and PARP1[(8.71±1.97)μg/L vs.(4.95±0.74)μg/L]were higher in the CHF group(t=25.885,20.148,P<0.05),while the level of KLF15[(0.47±0.08)vs.(0.96±0.18)]was lower(t=30.438,P<0.05).Compared with the non MACE group,the levels of serum CXCL12[(24.63±4.25)μg/L vs.(17.04±3.18)μg/L]and PARP1[(11.59±2.42)μg/L vs.(7.05±1.71)μg/L]were higher in the MACE group(t=12.659,13.669,P<0.05),and the level of serum KLF15[(0.39±0.07)vs.(0.52±0.09)]was lower(t=9.388,P<0.05).Left ventricular ejection fraction(LVEF)(OR=0.951),N-terminal B-type natriuretic peptide precursor(NT-proBNP)(OR=1.437),CXCL12(OR=1.575),PARP1(OR=1.821)and KLF15(OR=0.942)were all the influencing factors of MACE in CHF patients(P<0.05).ROC results showed that the AUC of CXCL12,PARP1 and KLF15 alone in predicting MACE in CHF patients were 0.830,0.804 and 0.793,respectively,and the AUC of the combined prediction was 0.934.Conclusion The levels of serum CXCL12,PARP1 and KLF15 are closely related to cardiac function and the occurrence of MACE in CHF patients,and the combination of three indicators has better efficacy in predicting the occurrence of MACE in CHF patients.

Abstract:Objective To investigate the predictive value of the Age-Adjusted Charlson Comorbidity Index(ACCI)for long-term adverse prognosis in patients with heart failure with reduced ejection fraction(HFrEF).Methods The patients diagnosed with HFrEF[left ventricular ejection fraction(LVEF)≤40%]at the Third People's Hospital of Chengdu from January 2018 to June 2023 were enrolled.The baseline clinical data were collected and ACCI scores were calculated.The follow-up was conducted for 12 months via outpatient and inpatient electronic medical records and telephone interviews.The primary endpoint was cardiac death.The survival analysis was performed using the Kaplan-Meier method,and multivariate Cox regression was employed to assess the relationship between ACCI and cardiac death in HFrEF patients.The predictive performance of ACCI for cardiac death was evaluated using the area under the curve(AUC).Results A total of 1,662 patients were included and divided into the high-score group(888 cases,ACCI≥6)and the low-score group(774 cases,ACCI<6)based on the median ACCI value of 6.Kaplan-Meier analysis revealed significantly lower survival in the high-score group(Log-rank P<0.001).Multivariate Cox regression analysis indicated that ACCI(as a continuous variable:HR=1.273,95%CI 1.185-1.367,P<0.001)and ACCI≥6(as a categorical variable:HR=1.775,95%CI 1.378-2.285,P<0.001)were independently associated with prognosis in HFrEF patients even after adjusting for potential confounders.Furthermore,ACCI demonstrated a certain predictive value for cardiac death(AUC=0.647,95%CI 0.614-0.681).Conclusion ACCI can serve as an effective tool for assessing the risk of cardiac death in HFrEF patients,aiding in the identification of high-risk populations and providing a basis for clinical stratification management.

Abstract:Vericiguat is a novel soluble guanosine cyclase stimulator,which can decrease the rate of rehospitalization and cardiovascular events in patients with deteriorate heart failure and reduced ejection fraction.The latest clinical studies have shown that vericiguat could improve the clinical outcomes of patients with the use of foundational pharmacal therapy through non-neurohormonal inhibition mechanism.In this paper,we systematically reviewed the population,safety and efficacy evidence of vericiguat,and summarized the research progress on the synergic effect,aiming to provide evidence for the early initiation of"new quadruple"regimen and combination of vericiguat in HFrEF patients.

Abstract:Heart failure with preserved ejection fraction(HFpEF)is a highly heterogeneous cardiovascular condition closely associated with insulin resistance(IR)and metabolic dysregulation,with its prevalence rising due to global population aging and the increasing of related metabolic diseases.This review systematically examines the epidemiological evidence,pathophysiological mechanisms and therapeutic strategies linking IR and hyperinsulinemia to HFpEF.IR is not only a prevalent pathological feature in HFpEF but also drives disease progression through multiple mechanisms,including inflammation,endothelial dysfunction,energy metabolism disturbances and myocardial remodeling.In recent years,sodium-glucose cotransporter 2 inhibitors(SGLT2i)and glucagon-like peptide-1 receptor agonists(GLP-1 RA)have demonstrated significant efficacy in HFpEF treatment,verifyng the potential of metabolic-targeted therapies.Future efforts should focus on precision phenotyping,combination therapies and multidisciplinary comprehensive management to further optimize clinical outcomes and deliver personalized interventions for HFpEF patients.

Abstract:This article is an excerpt from the chapters on"Arrhythmia and Heart Failure"in the third section titled"Diagnosis and Treatment Status of Cardiovascular Diseases"of Report on cardiovascular health and diseases in China 2024.It provides a detailed account of the patient characteristics,treatment status,hospitalization status,and current progress in the diagnosis and treatment of arrhythmia and heart failure in China.

Abstract:Finerenone,a naphthoadenosine derivative based on the dihydropyridine(DHP-1)structure,has higher selectivity and stronger antagonistic efficacy against the mineralocorticoid receptor(MR)than steroidal mineralocorticoid receptor antagonists(MRA),enabling it to achieve potent MR blockade at lower doses.As a new breakthrough in the treatment of heart failure(HF),fenetyllone has unique advantages in blocking MR overactivation,reducing myocardial inflammation and fibrosis,and improving cardiac remodeling.Therefore,this article reviews the application and research progress of fenetyllone in HF treatment.

Abstract:Objective To assess the safety and efficacy of FARAPULSE system in atrial fibrillation(AF)catheter ablation under 3D mapping guidance.Methods Patients with non-valvular AF who were consecutively enrolled from September to November 2024 at the Department of Cardiology,Shanghai 1st Hospital and received ablation treatment for the first time using the three-dimensional mapping system combined with the FARAPULSE system,underwent left atrial electroanatomical mapping before and after the ablation to observe the success rate of ablation during the procedure and perioperative complications.Results 21 patients were included,with an average age of(59.63±12.11)years,and among whom 9 cases(42.86%)had persistent AF.All the patients underwent ablation treatment under the guidance of three-dimensional mapping using the FARAPLUSE system,including pulmonary vein antrum electrical isolation in 21 cases,posterior wall ablation in 11 cases,mitral isthmus line ablation in 5 cases and tricuspid isthmus line ablation in 1 case.The intraoperative pulmonary vein isolation rate was 100%.The average surgery time for all the patients was(144.81±20.58)minutes;the left atrial operation time for the ablation catheter was(41.33±14.49)minutes;the X-ray exposure time was(26.19±7.46)minutes and the number of ablation discharge groups was(57.52±11.25).Among them,5 cases(55.56%)of persistent AF were converted to sinus rhythm during the ablation procedure.Coronary spasm occurred during the tricuspid isthmus line ablation in 1 case;hemolysis and hematuria occurred in 1 case during the procedure.No other surgery-related complications such as vagal reflex,stroke,phrenic nerve injury,pericardial tamponade or esophageal injury were observed in any of the patients.Conclusions The success rate of FARAPULSE system treatment for AF under 3D mapping guidance is high with fewer perioperative complications,but these results still need to be verified by large samples and long-term follow-up data.

Abstract:Objective To evaluate the short-term and long-term efficacy of thrombus aspiration in ST-segment elevation myocardial infarction(STEMI)patients with high thrombus burden.Methods 318 STEMI patients who underwent emergency percutaneouscoronary intervention(PCI)from January 2015 to December 2018 were included.The patients were divided into the thrombus aspiration group(159 cases)and the non-thrombus aspiration group(159 cases)based on whether thrombus aspiration was performed.The general clinical data,thrombus burden classification and procedural details were collected,and the major adverse cardiovascular events(MACE)were followed up by outpatients and telephone.Kaplan-Meier survival analysis was used to assess the impact of thrombus aspiration on short-term and 5-years'long-term outcomes.Results The proportion of patients with high thrombus burden was significantly higher in the thrombus aspiration group compared to the non-thrombus aspiration group(23.27%vs.0%,P<0.001).The peak levels of creatine kinase-MB and troponin I(indicating infarct size)were significantly higher in the thrombus aspiration group(P=0.001 and P<0.001,respectively).No significant differences were observed between the two groups in most other clinical characteristics and treatment strategies.Kaplan-Meier survival analysis showed that the probability of not experiencing MACE during follow-up was not significantly different between the 2 groups(P=0.557).Further analysis based on thrombus burden revealed no statistically significant difference in long-term survival probability between the high thrombus burden and low thrombus burden groups(P=0.149).Conclusion Among STEMI patients,the thrombus aspiration group shows slightly worse in-hospital outcomes(indicating larger infarct size),but no significant difference in long-term prognosis.It is hypothesized that thrombus aspiration may have improved the poorer long-term outcomes in this population.For patients with high thrombus burden,the use of thrombus aspiration should be carefully considered based on individual circumstances.

Abstract:Objective To evaluate the value of plasma volume status indicator in predicting all-cause death in patients with ejection fraction preserved heart failure.Methods A total of 346 hospitalized patients with heart failure as the main diagnosis were selected from the First Affiliated Hospital of Shihezi University from January 2019 to July 2023,and the results of plasma volume status index(PVS)were calculated using Duarte formula based on hemoglobin and hematocrit.According to themedian,175 patients were divided into the low-value PVS group(PVS≤4.80 ml/g)and 171 patients were the high-value PVS group(PVS>4.80 ml/g),and the basic clinical characteristics of the two groups were compared.The diagnostic value of PVS in all-cause death was analyzed by ROC curve.Kaplan-Meier curve and Cox regression analysis were used to evaluate therelationship between PVS and all-cause death in patients with heart failure with ejection fraction preservation.Results The age,proportion of female,hospital days,aldosterone receptor antagonist use,creatinine value,N-terminal pro-brain natriuretic peptide(NT-proBNP),cystatin C in the high PVS group were higher than those in the low PVS group,and the body mass index(BMI),survival time,diastolic blood pressur,hyperlipidemia history,free triiodothyronine were lower than those in the low PVS group(P<0.05,P<0.01).The area under the curve for PVS predicting all-cause death in patients with ejection fraction preservation heart failure was 0.602(95%CI 0.546-0.659,P<0.001);and at a median follow-up of 29(28,31)months,Kaplan-Meier curve analysis showed that the cumulativesurvival rate of the high PVS group was lower than that of the low PVS group(P<0.01).Multifactor regression models showed that increased PVS was associated with an increased incidence of all-cause death from heart failure with ejection fraction preservation.Conclusion Increased PVS is associated with an increased incidence of all-cause death inpatients with ejection fraction preserved heart failure,and higher PVS is an independent risk predictor of all-cause death inpatients with ejection fraction preserved heart failure.

Abstract:Cardiovascular disease is one of the major causes of death and disability worldwide.Acute coronary syndrome,as one of the critical types,has an increasing incidence year by year in China.Its main pathophysiological basis is coronary atherosclerosis,and inflammatory processes play a crucial role in its progression.Recent studies have found that peripheral blood inflammation indicators have important predictive value in judging the adverse prognosis of acute coronary syndrome,which is helpful for clinicians to grasp the development of the disease and implement timely effective intervention.This paper reviews the research progress on peripheral blood inflammatory indicators such as neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,monocyte-to-lymphocyte ratio,systemic immune-inflammatory index,systemic inflammation response index,systemic immune inflammatory response index,soluble urokinase-type plasminogen activator receptor in the prognosis of acute coronary syndrome to provide valuable reference and basis for clinical treatment and diagnosis.

Abstract:Transcatheter pulmonary valve replacement(TPVR)is currently an effective treatment for pulmonary regurgitation(PR).However,the procedure still faces many perioperative challenges,including complex preoperative assessments and the risk of perioperative complications.In recent years,digital medicine has developed rapidly,and cutting-edge technologies such as 3D printing,finite element methods and virtual reality have gradually been applied to various aspects of TPVR.Not only has the level of surgical planning been improved,but more accurate and comprehensive support has also been provided in terms of complication prediction,which has greatly improved the safety and effectiveness of the surgery,and in turn,the patient's prognosis and quality of life.This review aims to evaluate the current status of the application of digital medical technology in TPVR,look ahead to future development prospects,and explore its profound impact on clinical practice.

Abstract:Previous medications for heart failure with reduced ejection fraction(HFrEF)have had limited success,with a high rate of hospitalization and mortality and a 5-year mortality rate similar to that of malignancy.In recent years,a series of landmark clinical trials have significantly improved the prognosis of patients with HFrEF.This article reviews recent advances in the treatment of HFrEF with angiotensin receptor-neprilysin inhibitors,sodium-glucose co-transporter 2 inhibitors,vericiguat,omecamtiv mecarbil and anti-inflammatory agents.

Abstract:Since the 1990s,China has experienced rapid economic and social development,and the prevalence of overweight and obesity among the Chinese population has risen rapidly.Obesity is closely related to various diseases such as cardiovascular diseases,diabetes,and cancer.Its prevalence has caused serious health and economic burdens.The occurrence and development of obesity are influenced by individual factors,such as diet,physical activity,and genetic susceptibility,as well as external environmental factors such as economy condition and society circumstance,the intervention of obesity need to be comprehensively considered.Currently,the primary treatment for obesity is lifestyle intervention;the approaches of drug or surgical treatment supported by high-quality evidence are also promising.However,the improvement of obesity management in population still requires the attention of the entire society,and continuous efforts with the help of new technologies and methods.

Abstract:Objective To explore the effect of targeted guiding catheter percutaneous coronary intervention(PCI)in treating abnormal right coronary artery opening combined with coronary stenosis.Methods Between January 2021 to October 2023,214 patients with abnormal right coronary artery opening combined with coronary stenosis accepted by Shijiazhuang People's Hospital were stochastically assigned into the group A(n=113,targeted guiding catheter PCI)and group B(n=101,conventional guiding catheter PCI)via the random number table.The operation time,left ventricular ejection fraction(LVEF),thrombolysis in myocardial infarction(TIMI)grade,complications and major adverse cardiovascular events(MACE)were compared.Results The group A had shorter D2B time[(62.53±8.82)min vs.(68.21±8.65)min]and P2B time[(19.81±6.07)min vs.(26.63±7.81)min]than group B(P<0.05).One year after the surgery,the LVEF of both groups was greater than 7 days after the surgery(P<0.05),and the LVEF of the group A was greater than that of the group B[(48.49±6.13)%vs.(46.64±6.97)%](P<0.05).The group A had a higher proportion of TIMI grade 3 than the group B(P<0.05).During hospitalization,the incidence of various complications was no statistically different between the two groups(P>0.05).After a one-year follow-up,the group A had a lower total incidence of MACE than the group B(P<0.05).Conclusion Targeted guided catheter PCI for abnormal coronary right artery opening combined with coronary stenosis can shorten the operation time,improve LVEF and TIMI grade,reduce MACE,and not increase complications.

Abstract:Objective To investigate the influence of metabolic disorders on the risk of premature coronary heart disease(PCHD).Methods The patients who received coronary angiography and/or coronary intervention treatment at Peking University Third Hospital from December 2020 to April 2021 and met the inclusion and exclusion criteria were retrospectively continuously enrolled.The patients were divided into the PCHD group and control group according to the results of coronary angiography,and the prevalence and control of metabolic disorders between the two groups were compared.Results A total of 725 patients were included in the PCHD group,and 252 in the control group.Patients with PCHD had higher proportions of males,smokers,family history of PCHD,hypertension,diabetes,dyslipidemia and obesity compared to the control group(P<0.05).Multivariate Logistic regression analysis showed that diabetes(OR=1.77,95%CI 1.28-2.46)and dyslipidemia(OR=2.00,95%CI 1.42-2.81)were independently associated with PCHD.The number of metabolic disorders with the patients were significantly positively correlated with the severity of coronary artery lesions.The proportions of patients with PCHD achieving target levels of blood glucose or lipids respectively were lower.Conclusion Metabolic disorders increase the risk of developing PCHD and the extent of coronary artery disease,and patients can benefit from the treatment of these metabolic disorders.

Abstract:Objective To investigate the predictive value and clinical significance of the triglyceride glucose(TyG)index for microvascular obstruction(MVO)in patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods 311 patients with first-time STEMI who underwent emergency PCI at Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School from July 2018 to June 2023 were included in the retrospective study.Based on cardiac magnetic resonance(CMR)results at 1 week post-PCI,patients were divided into the MVO(n=198)and the non-MVO(n=113)groups.The baseline characteristics,laboratoryparameters and echocardiographic indexes of the 2 groups were compared.Multicariate Logistic regression was used to identify the independent risk factors for MVO,and the receiver operating characteristic(ROC)curve analysis sed to evaluate the predictive performance of the TyG index.Results The MVO group exhibited significantly higher admission heart rate,white blood cell count,neutrophil count,fasting blood glucose,troponin T(cTnT),creatine kinase-MB(CK-MB)and TyG[8.90(8.41,9.35)vs.8.66(8.25,9.15)]index(all P<0.05),while the systolic blood pressure and left ventricular ejection fraction(LVEF)were lower,but the left ventricular end-diastolic diameter(LVDd)was larger(all P<0.05).Multivariate analysis revealed that the TyG index(OR=2.10,95%CI 1.16-2.93),CK-MB(OR=1.00,95%CI 1.00～1.01),and neutrophil count(OR=1.66,95%CI 1.03-2.73)were the independent risk factors for MVO.ROC analysis showed that the TyG index alone had an area under the curve(AUC)of 0.585(sensitivity 0.626,specificity 0.558)for predicting MVO.When combined with systolic blood pressure,heart rate,LVEF and other parameters,the AUC increased to 0.774(sensitivity 0.756,specificity 0.658).Conclusion Elevated TyG index is independently associated with MVO formation after emergency PCI in STEMI patients.Combining TyG index with traditional clinical parameters significantly improves MVO prediction,offering a novel noninvasive strategy for early risk stratification.

Abstract:Objective To investigate the protective effect and mechanism of action of Linderene in the pathological process of myocardial infarction.Methods Construction of the mouse myocardial infarction model was completed in the laboratory of the Second Affiliated Hospital of Zhejiang University between April and December 2024.Following modelling,different concentrations of linderene were injected intraperitoneally into the mice once a day for three consecutive days.Use various staining and detection techniques such as echocardiography to evaluate the effect of Linderene on the progression of myocardial infarction.To analyse its regulatory effect on neutrophil aggregation and neutrophil extracellular trap formation(NETosis)phenomenon after myocardial infarction using various techniques such as citrullinated histone H3(citH3)immunofluorescence staining.An in vitro model of myocardial cell hypoxia was established and Western blot was used to detect the effect of Linderene on the expression level of dihydroorotate dehydrogenase(DHODH)protein in mitochondria.At the same time,multiple staining techniques were used to investigate its intervention effect on the ferroptosis process of myocardial cells.Establish a co-culture system to further validate the inhibitory effect of Linderene on NETosis in vitro.Result Linderene significantly reduced the area of myocardial infarction and effectively improved cardiac function.In the development process of myocardial infarction,Linderene has a significant inhibitory effect on ferroptosis in cardiomyocytes,and can also significantly reduce Reactive Oxygen Species(ROS)levels and lipid peroxidation levels.The partial protective mechanism of Linderene is through the up-regulation of the mitochondrial DHODH pathway,thereby exerting antioxidant and anti-ferroptotic effects.In addition,Linderene can effectively reduce the aggregation of neutrophils in the infarcted area and inhibit the formation of NETosis after MI.Conclusion Linderene can reduce the occurrence of ferroptosis in myocardial cells by upregulating the mitochondrial DHODH pathway,and reduce the aggregation of neutrophils and the formation of NETosis after myocardial infarction,thereby significantly reducing the area of myocardial infarction and providing a new potential strategy for the treatment of myocardial infarction.

Abstract:Objective To explore the relationship between renal function indicators and metabolically healthy obesity(MHO),while also assessing the association between MHO and 10-year cardiovascular disease risk.Methods Data for this study were derived from the China Health and Retirement Longitudinal Study(CHARLS)database.Participants were classified into four obesity-metabolic phenotypes based on body mass index(BMI)and metabolic status:metabolically healthy non-obese(MHNO,n=2512),metabolically unhealthy non-obese(MUNO,n=2354),MHO(n=566),and metabolically unhealthy obese(MUO,n=1742).Univariate and multivariate Logistic regression analyses were used to investigate the association between renal function indicators and MHO,as well as the relationship between MHO and 10-year cardiovascular disease risk.Results Among the 7174 participants,the prevalence of MHO was 7.89%,while the prevalence of MHO among obese adults was 24.52%.Significant differences were observed among the four phenotypes in serum uric acid(SUA)and serum creatinine(Scr)levels.Multivariate Logistic regression analysis showed that after adjusting for confounding factors,SUA was positively associated with MHO(OR=1.20,95%CI 1.11-1.29,P<0.001).Furthermore,MHO was positively associated with a moderate to high 10-year cardiovascular disease risk as assessed by the Framingham score(OR=2.54,95%CI 1.46-4.35,P<0.001).Conclusion SUA was independently associated with MHO.MHO was independently associated with a moderate to high 10-year cardiovascular disease risk as assessed by the Framingham score.

Abstract:Objective To explore the diagnostic value of coronary CT fractional flow reserve(FFR)combined with serum Krüppel like factor 2(KLF2)and soluble tumor necrosis factor receptor 1(sTNFR1)for ischemic cardiomyopathy.Methods Two hundred patients with coronary heart disease admitted to Emergency General Hospital from January 2022 to May 2024 were regarded as the study subjects.They were separated into ischemic cardiomyopathy group(n=96)and non ischemic cardiomyopathy group(n=104)based on the presence or absence of myocardial ischemiamyocard(MI)myocardial ischemiamyocard symptoms.The serum levels of KLF2 and sTNFR1 were measured using an ELISA kit.Clinical data was collected,and patients underwent coronary angiography to measure FFR value.Four grid table method was applied to analyze the diagnostic efficacy of FFR and serum KLF2 and sTNFR1 for ischemic cardiomyopathy.The consistency Kappa test was applied to compare the consistency between FFR and serum alone and in combination for the diagnosis of ischemic cardiomyopathy and clinical examination results.ROC curve was applied to analyze the value of FFR and serum KLF2 and sTNFR1 in diagnosing ischemic cardiomyopathy.Results The serum KLF2 level in the ischemic cardiomyopathy group was lower than that in the non ischemic cardiomyopathy group[(5.16±0.72)pg/ml vs.(5.91±0.79)pg/ml,P<0.05],while the sTNFR1 level was higher[(255.89±35.57)ng/ml vs.(225.25±31.64)ng/ml,P<0.05].The AUC of serum KLF2 for diagnosing ischemic cardiomyopathy was 0.775,with a sensitivity of 89.58%and a specificity of 61.92%.The AUC of serum sTNFR1 for diagnosing ischemic cardiomyopathy was 0.763,with a sensitivity of 78.13%and a specificity of 83.65%.The FFR diagnostic results showed 14 false positives and 30 false negatives,which were consistent with the pathological examination results,the Kappa value was 0.556(P<0.05),the diagnostic AUC was 0.776(95%CI 0.712-0.832),the sensitivity was 68.75%,and the specificity was 86.54%.The diagnostic results of FFR combined with serum KLF2 and sTNFR1 showed 1 false positive and 19 false negative cases,with high consistency compared to pathological examination results,the Kappa value was 0.798(P<0.05),the AUC was 0.896(95%CI 0.845-0.935),with a specificity of 99.04%and a sensitivity of 80.21%.The combined diagnosis of FFR,serum KLF2,and sTNFR1 showed increased specificity and accuracy compared to single indicator diagnosis(P<0.05).Conclusion The expression level of serum KLF2 decreases and the expression level of sTNFR1 increases in patients with ischemic cardiomyopathy.The combined diagnosis of FFR and serum KLF2 and sTNFR1 increases the specificity and accuracy of ischemic cardiomyopathy.

Abstract:Diabetic cardiomyopathy(DCM)is a serious complication of diabetes mellitus that significantly increases the risk of heart failure and death in diabetic patients.Recent studies have shown that mitochondrial autophagy restores mitochondrial homeostasis,attenuates oxidative stress,and ameliorates DCM by removing damaged mitochondria from cardiomyocytes.This article provides an in-depth discussion of the molecular regulatory mechanisms,including mitochondrial autophagy pathways such as PINK1/Parkin,FUNDC1 and AMPK/mTOR,and further analyzes the role of sodium-glucose cotransporter protein 2 inhibitors,glucagon like peptide-1 receptor agonists and biguanides by regulating mitochondrial autophagy to improve the potential mechanism of DCM,in order to provide new ideas and theoretical basis for the prevention and treatment of DCM.