Objective:To explore the effect of multiple modified process management intervention on cardiac func-tion,psychological state,stress level,sleep quality and adverse events in patients with severe coronary atherosclerot-ic heart disease(CHD).Methods:This randomized controlled study enrolled 130 severe CHD patients who were treated in Affiliated Beijing Shijitan Hospital of Capital Medical University between January 2020 and May 2023.Patients were randomly divided into control group(n=65)and intervention group(n=65).Patients in the control group were treated with routine management intervention,while those in the intervention group were given addi-tional multiple modified process management interventions.Both groups were intervened for 4 weeks.Cardiac func-tion,levels of norepinephrine(NE)and cortisol(COR),scores of Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),General Comfort Questionnaire(GCQ),Pittsburgh Sleep Quality Index(PSQI),and the incidence of adverse events during intervention were compared between the two groups.Results:Compared to those in control group after intervention,patients in intervention group had significant higher left ventricular ejection fraction(LVEF)[(57.81±2.15)％vs.(50.11±2.99)％]and GCQ score[(95.88±5.37)points vs.(75.81±6.67)points](P＜0.001 all),and significant lower left ventricular end-diastolic volume(LVEDV)[(109.81±5.37)ml vs.(129.26±5.17)ml],left ventricular end-systolic volume(LVESV)[(50.85±3.08)ml vs.(66.02±3.77)ml],levels of NE[(61.56±5.49)pg/ml vs.(69.86±5.03)pg/ml],COR[(85.63±5.19)ng/ml vs.(92.28±6.57)ng/ml],scores of SAS[(30.06±5.19)points vs.(49.51±5.85)points],SDS[(31.86±4.51)points vs.(40.00±5.10)points]and PSQI[(8.72±1.58)points vs.(13.89±2.40)points],and incidence of ad-verse events(4.69％vs.23.44％)(P＜0.01 all).Conclusion:The multiple modified process management interven-tion may improve the cardiac function,adverse psychological state,stress level,sleep quality and reduce the inci-dence of adverse events in patients with severe CHD.

Objective:This systematic review and meta-analysis aims to evaluate the effect of traditional Chinese medicine(TCM)combined with acupuncture on chronic heart failure(CHF).Methods:CNKI,CBM,VIP,Wanfang database,the Cochrane Library,PubMed and Embase databases were searched for randomized controlled trials that com-pare the clinical efficacy between TCM combined acupuncture therapy and routine western medical treatment on CHF from establishment to July 23rd,2024.Results:A total of 14 studies were included in the final analysis.Compared to patients in control group,those in trial group had significant higher total effective rate[OR=3.84,95％CI(2.58,5.72),P＜0.001]and left ventricular ejection fraction[MD=4.69,95％CI(3.74,5.63),P＜0.001],and significant lower left ventricular end-systolic diameter[MD=-3.35,95％CI(-5.24,-1.46),P＜0.001],left ventricular end-diastolic diameter[MD=-3.54,95％CI(-5.08,-2.00),P＜0.001],levels of N terminal pro brain natriuretic peptide[SMD=-1.72,95％CI(-2.28,-1.15),P＜0.001],high sensitive C reactive protein[MD=-6.73,95％CI(-10.16,-3.31),P＜0.001],tumor necrosis factor-α[SMD=-3.77,95％CI(-6.08,-1.45),P=0.001]and interleukin-6[SMD=-1.52,95％CI(-2.21,-0.82),P＜0.001].Conclusion:Traditional Chinese medicine combined with acupuncture may improve the cardiac structure and function,reduce the level of NT-proBNP,and has a certain effect of inhibiting micro-inflammation in patients with chronic heart failure.

Objective:To explore the relationship between the prognostic nutritional index(PNI)and the prevalence of coronary heart disease(CHD)in adults.Methods:A cross-sectional analysis was conducted based on the 2017-2020 National Health and Nutrition Examination Survey(NHANES)database.A total of 12,141 adult participants were initially included and divided into CHD group and control group according to the disease status questionnaire.PNI was calculated using serum albumin level and lymphocyte count.Multivariable logistic regression was applied to explore the association between PNI and the prevalence of CHD in adults.Subgroup analysis was conducted to assess whether this association remained consistent across different populations.A restricted cubic spline model was con-structed to clarify the dose-response relationship between PNI and CHD prevalence in adults.Results:Among the 3,894 adult participants,200(5.14％)had CHD.The PNI level in CHD patients was significantly lower than that of the control group[(49.20±8.59)vs.(51.57±4.80),P＜0.001].Multivariable logistic regression analysis showed that,after adjustment for sex,age,race,marital status,body mass index(BMI),hypertension,diabetes and family history of cardiovascular disease,an increase in PNI was still independently associated with a lower prev-alence of CHD(odds ratio[OR]=0.92,95％CI 0.89～0.94,P＜0.001).The dose-response relationship indica-ted a negative linear correlation between PNI and CHD prevalence(P＜0.001).Subgroup analysis showed that the association between PNI and CHD differed significantly across BMI,hypertension and diabetes subgroups(P for in-teraction＜0.05 or＜0.01).Conclusion:Increasing PNI was significantly associated with a lower prevalence of CHD in adults,and this association was more pronounced in specific high-risk populations,such as those with obe-sity,hypertension,and diabetes.Our findings suggest that maintaining good nutritional status is of great significance in reducing the risk of CHD.

Objective:To explore the effect of Taichi motor imagination therapy combined with resistance exercise on the recovery of heart function and quality of life in patients with chronic heart failure(CHF).Methods:A total of 118 elderly CHF patients admitted to Huangshan Shoukang Hospital between January 2020 and December 2023 were included in this randomized controlled trial.Participants were randomly divided into intervention group(n=59)and control group(n=59).Participants in the control group received conventional anti-heart failure treatment,while those in the intervention group received additional Taichi motor imagination therapy and resistance exercise.The in-tervention lasted for 3 months.Cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd)and interventricular septal thickness at diastole(IVSTd)],quality of life[Minnesota Living with Heart Failure Questionnaire(MLHFQ)],markers of heart failure and neurohormones[B-type natri-uretic peptide(BNP),norepinephrine(NE),aldosterone(ALD)and angiotensin Ⅱ(AngⅡ)]levels and the inci-dence of major adverse cardiovascular events(MACE)during intervention were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significant higher LVEF[(50.52±1.96)％vs.(45.84±2.21)％],and significant lower LVEDd[(57.12±1.72)mm vs.(60.45±2.14)mm],IVSTd[(8.84±0.82)mm vs.(10.00±1.19)mm],MLHFQ score[(28.86±5.34)points vs.(34.51±6.57)points],BNP[(9.23±1.35)pg/ml vs.(13.62±1.49)pg/ml],NE[(13.09±0.93)pmol/L vs.(16.63±0.86)pmol/L],ALD[(1.82±0.12)ng/L vs.(2.35±0.15)ng/L],AngⅡ[(0.75±0.07)ng/L vs.(0.90±0.06)ng/L]and incidence of MACE(6.90％vs.26.32％)(P＜0.01 all).Conclusion:Taichi motor imagination therapy combined with resistance exercise may improve the cardiac function and quality of life in CHF patients.

Echocardiography is commonly utilized in clinical practice to assess cardiac function in patients with ische-mic heart disease(IHD)due to its convenience,non-invasiveness and safety.With the development and advances in medical technique,innovative echocardiographic modalities can offer enhanced understanding of the morphologi-cal and functional changes of heart during the occurrence and progression of cardiovascular diseases.This article re-views some of the newest echocardiographic modalities and their application prospect in IHD.

Cardiovascular disease morbidity and mortality are increasing year by year,and cardiac rehabilitation,as an emerging branch of rehabilitation medicine,is gradually gaining attention.Through combing relevant literature,this paper summarizes and analyzes the theoretical basis and clinical research of acupuncture and moxibustion therapy applied to cardiac rehabilitation based on the systematic and comprehensive discussion of the development,current clinical application and clinical implementation status of cardiac rehabilitation,aiming to provide some reference for the clinical application of acupuncture and moxibustion therapy in cardiac rehabilitation.

Objective:To investigate the association of serum levels of myoglobin(Myo)and reticulocyte(Ret)with cardiac function class in patients with chronic heart failure(CHF).Methods:A total of 106 CHF patients treated in First Rongjun Special Care Hospital of Hebei Province between February 2020 and February 2024 were retrospec-tively selected as the observation group.According to New York Heart Association(NYHA)cardiac function class,patients were divided into class Ⅱ group(n=61)and class Ⅲ～Ⅳ group(n=45),and 107 healthy people with nor-mal physical examination results were selected from our hospital simultaneously as control group.The Myo and Ret levels were compared between control group and observation group,class Ⅱ group and class Ⅲ～Ⅳ group.Spearman correlation analysis was used to analyze the association of Myo and Ret levels with NYHA class in CHF patients.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of Myo,Ret and their combined detection for NYHA class Ⅲ～Ⅳ in CHF patients.Results:Compared to participants in the control group,those in the observation group had significant higher Myo level[(50.42±9.98)μg/ml vs.(35.22±5.36)μg/ml]and significant lower Ret level[(2.24±0.68)％vs.(2.91±0.61)％](P＜0.001 all).Compared to those in class Ⅱ group,those in class Ⅲ～Ⅳ group had significant higher Myo level[(60.77±5.94)μg/ml vs.(42.79±2.97)μg/ml]and significant lower Ret level[(1.73±0.31)％vs.(2.62±0.62)％](P＜0.001 all).Spearman correlation analysis showed that Myo(r=0.654)was positively correlated with NYHA cardiac function class in CHF patients,while Ret(r=-0.589)was inversely correlated with it(P＜0.001 all).ROC analysis showed that a combination of Myo and Ret had significant higher predictive efficacy(AUC=0.926,95％CI 0.858～0.968)for NYH A class Ⅲ～Ⅳ in CHF patients than Myo(AUC=0.804,95％CI 0.716～0.875)and Ret(AUC=0.701,95％CI 0.604～0.786)alone(Z=2.745,4.183,P＜0.01 both).Conclusion:Our study showed that Myo and Ret levels were significantly correlated with NYHA class in CHF patients.Moreover,a combination of Myo and Ret levels showed better diagnostic value for NYHA class Ⅲ～Ⅳ in this population.

Objective:To analyze the association of QRS duration on electrocardiogram,serum high density lipopro-tein cholesterol(HDL-C)level with cardiac function class in patients with chronic heart failure(CHF).Methods:A total of 128 CHF patients admitted in the Third People's Hospital of Hefei between March 2021 and March 2024 were retrospectively selected.According to New York Heart Association(NYHA)classification,class Ⅱ～Ⅲ pa-tients were included in the mild-moderate group(n=92),and those of class Ⅳ were included in the severe group(n=36).The characteristics of QRS duration on electrocardiogram,blood lipid indexes and other clinical data were compared between the two groups.Spearman correlation test was used to analyze the association of QRS duration on electrocardiogram,HDL-C with cardiac function class in CHF patients.Multivariate Logistic regression analysis was performed to screen the factors associated with NYHA cardiac function class Ⅳ in CHF patients.Results:Compared to those in mild-moderate group,patients in severe group had significant higher QRS duration[(138.32±4.76)ms vs.(112.5±6.50)ms],and significant lower amplitude of QRS wave[(10.43±2.08)mV vs.(11.94±2.73)mV]and HDL-C level[(0.73±0.23)mmol/L vs.(1.20±0.20)mmol/L](P＜0.01 all).Spearman correlation analysis showed that cardiac function class was positively correlated with QRS duration(r=0.341),and negatively correlated with QRS wave amplitude and HDL-C level(r=-0.318,-0.335,P＜0.001 all)in CHF patients.Multivariate Logistic regression analysis showed that QRS duration was an independent risk factor for car-diac function class Ⅳ in CHF patients(OR=1.902,95％CI 1.371～2.639,P＜0.001),and HDL-C was an inde-pendent protective factor(OR=0.466,95％CI 0.273～0.798,P=0.006).Conclusion:Cardiac function class was closely associated with QRS duration and HDL-C level in CHF patients.Detection of the two indexes during clini-cal diagnosis or treatment may be beneficial to guide improving the prognosis.

Objective:To investigate the association of cumulative resting heart rate(cumRHR)exposure with cardi-ovascular disease(CVD)risk and accumulation of cardiovascular risk factors in the elderly.Methods:This prospec-tive study enrolled 336 elderly physical examinees from Cangzhou People's Hospital between March and October 2016.Resting heart rate(RHR)measured by electrocardiogram was collected during three consecutive health check-ups at 2-year intervals to calculate cumRHR.Six common cardiovascular risk factors were recorded,including smoking,alcohol consumption,hypertension,diabetes,hyperuricemia,and dyslipidemia.A three-year follow-up commenced after the third health check-up,with incident CVD(including coronary heart disease and ischemic stroke)as the endpoint event.The association between cumRHR and CVD risk was assessed using a Logistic regres-sion model,with subgroup analysis stratified by gender.Spearman correlation analysis was performed to examine the association of cumRHR with the number of accumulated cardiovascular risk factors.Results:During follow-up,21 participants occurred incident CVD.Compared to participants in the no CVD group,those in CVD group had sig-nificant higher proportions of smoking(47.6％vs.20.3％,P=0.003),hypertension(61.9％vs.35.9％,P=0.017),diabetes(38.1％vs.19.1％,P=0.035),hyperuricemia(38.1％vs.13.0％,P=0.002),dyslipidemia(71.4％vs.41.9％,P=0.008)and cumRHR[(349.90±30.24)bpm*year vs.(290.77±32.43)bpm*year,P＜0.001].After adjusting for confounding factors,multivariate Logistic regression analysis showed that cumRHR was still an independent risk factor of incident CVD(OR 1.05,95％CI 1.03～1.07,P＜0.001).This association remained in subgroup analysis stratified by gender in both males and females(OR 1.05,95％CI 1.03～1.07 and OR 1.06,95％CI 1.03～1.09,respectively,P＜0.001 both).Spearman correlation analysis detected a positive correla-tion between cumRHR and number of accumulated cardiovascular risk factors≥3(r=0.459,P＜0.001).Conclu-sion:Higher cumRHR is associated with an increased risk of CVD,and there is a significant positive correlation be-tween the number of accumulated cardiovascular risk factors and the risk of elevated cumRHR.

Objective:To investigate the risk factors of new onset atrial fibrillation(AF)after off-pump coronary artery bypass grafting(OPCABG)and predictive efficacy of the nomogram model.Methods:A total of 116 patients who under-went OPCABG surgery in Jiangsu Provincial People's Hospital between January 2020 and December 2023 were included in this observational study.Multivariate Logistic regression was performed to analyze the risk factors of new onset AF after OPCABG and a nomogram model was constructed.Receiver operating characteristic(ROC)curve was used to assess the predictive efficacy of the model.Results:Among 111 patients in the final analysis,45 patients developed new AF after sur-gery.Multivariate Logistic regression showed that age＞65 years(OR 4.780,95％CI 2.503～9.126,P＜0.001),hyper-tension(OR 7.587,95％CI 3.925～14.666,P＜0.001),right coronary artery stenosis(OR 2.261,95％CI 1.159～4.408,P=0.017),renal insufficiency(OR 2.973,95％CI 1.631～5.420,P＜0.001),β-receptor blockers usage(OR 2.337,95％CI 1.238～4.410,P=0.009)and left ventricular end-diastolic diameter(LVEDd)＞50mm(OR 3.659,95％CI 1.923～6.960,P＜0.001)were independent risk factors for new onset AF after OPCABG surgery.Based on the above-mentioned risk factors,the nomogram prediction model of the risk of new onset AF after OPCABG surgery was es-tablished.ROC analysis showed that the corrected AUC of nomogram model was 0.903(95％CI:0.832～0.951).Conclu-sion:A nomogram constructed based on age＞65 years,hypertension,right coronary artery stenosis,renal insufficiency,β-receptor blockers usage and LVEDd＞50mm had good predictive performance for new onset AF after OPCABG.