Objective:To investigate the effect of Omaha system interventional management on therapeutic effect and incidence of major adverse cardiovascular events(MACE)during follow-up in patients with heart failure(HF).Methods:This randomized controlled study enrolled 110 HF patients treated in Second Affiliated Hospital of Chi-nese PLA Air Force Military Medical University between January 2021 and January 2023.They were divided into control group(n=55,routine nursing)and intervention group(n=55,interventional management based on Omaha system).Both groups received intervention for 1 month and were followed up for 6 months.The heart function,negative emotion,self-care capacity,quality of life,and cumulative incidence of MACE during the 6-month fol-low-up were compared between two groups.Results:Compared with patients in the control group,those in the in-tervention group had significant higher left ventricular ejection fraction(LVEF)[(60.32±4.79)％vs.(50.11±4.58)％],scores of exercise of self-care agency(ESCA)[(142.33±6.58)points vs.(89.26±7.19)points]and General Quality of Life Inventory 74(GQOLI-74)[(88.61±4.15)points vs.(70.59±7.85)points](P＜0.001 all),and significant lower left atrial diameter(LAD)[(36.18±2.98)mm vs.(40.25±3.05)mm],left ventricu-lar end-systolic diameter(LVESd)[(42.11±3.46)mm vs.(48.49±3.78)mm],scores of hospital anxiety and depression scale[HADS(A)][(10.05±2.11)points vs.(14.33±2.05)points]and HADS(D)[(9.15±1.31)points vs.(13.37±2.18)points](P＜0.001 all).The incidence rate of MACE in intervention group(9.09％vs.29.09％)was significantly lower than that of control group(P=0.004).Conclusion:Omaha system interventional management could significantly improve cardiac function and negative emotions,improve self-care capacity and quality of life,and reduce the incidence of MACE during follow-up in patients with heart failure.

Objective:To investigate the association of lipid accumulation product(LAP),triglyceride glucose index(TyG)with the risk of coronary heart disease(CHD).Methods:A total of 433 patients admitted to Department of Cardiology,Cangzhou People's Hospital for chest pain between February 2021 and December 2021 were included and divided into case group(n=236)and control group(n=197)according to the results of coronary angiography.Gen-eral data,LAP,TyG and other biochemical indexes were compared between two groups.The subjects were grouped according to LAP and TyG quartiles(L1,L2,L3,L4;T1,T2,T3,T4),and different Logistic regression models were constructed to analyze the association of different LAP,TyG levels with the risk of CHD using the L1 group and the T1 group as references,respectively,and receiver operating characteristic(ROC)curve of LAP and TyG predicting risk of CHD were drawn.Results:Compared with participants in control group,those in case group had significant higher proportions of smoking(27.60％ vs.19.80％),diabetes(21.61％ vs.14.21％),hypertension(38.14％ vs.28.43％),dyslipidemia(36.86％ vs.24.87％)and body mass index(BMI)[(25.97±3.90)kg/m2 vs.(25.11±3.56)kg/m2],waist circumference[(85.44±5.39)cm vs.(83.59±5.39)cm],uric acid[325.50(270.25,378.25)μmol/L vs.300.00(245.00,365.00)μmol/L],homocysteine[13.34(10.90,16.46)μmol/L vs.12.27(10.26,15.00)μmol/L],leucocytes[(6.07±1.52)× 109/Lvs.(5.75±1.43)×109/L],LAP[39.84(30.06,59.02)vs.30.06(21.85,44.78)],and TyG[(8.86±0.57)vs.(8.56±0.60)](P＜0.05 or＜0.01).Multifactorial Logistic regression analysis showed that after adjusting for each risk factor,risk of CHD in L3 and L4 groups were significantly higher than that of L1 group,and risk of CHD in T3 and T4 groups were significantly higher than that of T1 group(P＜0.05 or＜0.01).ROC curve analysis showed that the area under curve(AUC)of LAP and TyG predicting the risk of CHD was 0.656(95％CI 0.609～0.701),0.665(95％CI 0.618～0.709)re-spectively,and the critical value was 30.21 and 8.73 respectively.Conclusion:LAP and TyG are risk factors for CHD,and with the elevation of their levels,the risk of CHD gradually increases.

Objective:To investigate levels of endothelin-1(ET-1)and Apclin in patients with hypertrophic car-diomyopathy(HCM)and diagnostic value of their combination with ECG for HCM,and their association with prognosis.Methods:A total of 150 HCM patients admitted in the Second Affiliated Hospital of Xi'an Medical Uni-versity between June 2020 and June 2022 were selected as observation group.According to death during follow-up,the observation group was divided into survival group(n=64)and death group(n=86),and another 100 healthy volunteers who underwent physical examination in our hospital simultaneously were selected as control group.ET-1,Apelin and ECG indexes were compared between above-mentioned groups.Diagnostic value of ET-1,Apelin and ECG combined detection for HCM was analyzed by receiver operating characteristic(ROC)curve.Multivariate Logistic regression was used to analyze influencing factors of death within 6-month follow-up in HCM patients,and nomogram model was established.Results:Compared with participants in control group,those in the observa-tion group had significant higher ET-1[(0.64±0.15)pmol/L vs.(0.39±0.07)pmol/L],QRS wave group(∑QRS)[(23.60±3.96)mm vs.(14.02±1.78)mm],Cornell voltage index(SV3+RaVL)[(2.12±0.40)mV vs.(1.05±0.20)mV]and S-wave on V1 lead+R-wave on V5 lead(SV1+RV5)[(3.88±0.73)mV vs.(2.24±0.34)mV],and significant lower Apelin[(1.10±0.25)pg/ml vs.(1.58±0.17)pg/ml]level(P＜0.001 all).ROC curve indicated that the area under the curve(AUC)of combined detection of above five indexes diagno-sing HCM was 0.933(95％CI 0.895～0.961),significantly higher than any single detection(Z=3.681～6.428,P＜0.001 all),the H-L goodness of fit test showed P=0.056,suggesting that the model was well accepted,and DCA showed that ET-1 and Apelin combined ECG detection model had good clinical application value in HCM.Multivariate Logistic regression indicated that ET-1,∑QRS,SV3+RaV and SV1+RV5 were independent risk factors for death within 6-month in HCM patients(OR=2.617～3.600,P＜0.001 all),and Apelin was its inde-pendent protective factor(OR=0.271,P＜0.001).The nomogram model of HCM patients dying within 6 months was 4.627+0.452 × ET-1+0.536 × Apelin+0.575 × ∑QRS+0.541 × SV3+RaVL+0.352 × SV1+RV5.Conclusion:Serum ET-1 and Apelin levels significantly change in HCM patients,and the combination of ECG detection and both indexes have good performance diagnosing HCM and are independent influential factors for the death of HCM patients within 6 months.

Objective:To review systematically the curative effect and safety of levocarnitine combined with Shenmai injection in the treatment of heart failure caused by ischemic cardiomyopathy.Methods:We searched the databases of PubMcd,Cochrane Library,EMbase,CBM,CNKI,WanFang and VIP for randomized controlled trials(RCTs)comparing the effect upon heart failure caused by ischemic cardiomyopathy between levocarnitine combined with Shenmai injection versus standard treatment from the establishment to June 12th,2023.The pooled odds ratio(OR)or mean difference(MD)with 95％confidence interval(CI)were calculated with a Meta-analysis using the Rev-Man 5.4 software.Results:21 eligible literatures were included,involving 2055 patients[mean age(63.86±9.90)years,males 61.27％].Pooled analysis showed that levocarnitine combined with Shenmai injection significantly im-proved the total effective rate(OR=5.04,95％CI 3.78～6.71,P＜0.001),left ventricular ejection fraction(MD=6.10,95％CI 5.18～7.02,P＜0.001),stroke volume(MD=10.64,95％CI 7.42～13.85,P＜0.001),cardiac output(MD=0.85,95％CI 0.74～0.97,P＜0.001),left ventricular fractional shortening(MD=5.27,95％CI 4.16～6.39,P＜0.001),and significantly reduced left ventricular end-diastolic diameter(MD=-5.64,95％CI-7.31～-3.98,P＜0.001)and left ventricular end-systolic diameter(MD=-5.08,95％CI-6.08～-4.09,P＜0.001)than standard treatment.There were no significant differences in the adverse reaction rate be-tween groups(P=0.220).Conclusion:Current research evidence suggests that levocarnitine combined with Shen-mai injection had better efficacy on the heart failure caused by ischemic cardiomyopathy,with good safety.

Objective:To study the rehabilitation effect of mindfulness meditation training on gastrointestinal symp-toms and emotions in patients with chronic heart failure(CHF).Methods:We enrolled 100 CHF patients admitted in Fenyang Hospital of Shanxi Province between June 2022 and May 2023.They were divided into control group(n=50,routine nursing)and intervention group(n=50,additional mindfulness meditation training intervention)ac-cording to hospitalization time order.Both groups were intervened for 8 weeks.Scores of gastrointestinal symptom rating scale(GSRS),profile of mood states-short form(POMS-SF)and clinical conditions were compared be-tween the two groups.Results:Compared with patients in control group after 8-week intervention,those in inter-vention group had significant lower GSRS total score[9.00(3.00)points vs.14.0(2.00)points,P＜0.001],di-mensional scores of tension-anxiety(TA)[(4.14±0.90)points vs.(5.14±0.81)points],anger-hostility(AH)[(4.34±0.96)points vs.(5.16±0.51)points],depression-dejection(DD)[(4.42±0.88)points vs.(5.14±0.86)points],fatigue-inertia(FI)[(4.62±0.60)points vs.(5.32±0.77)points],confusion-bewil-derment(CB)[(4.24±0.74)points vs.(5.24±0.62)points],and significant higher dimensional score of vigor-activity(VA)[(16.82±3.21)points vs.(12.84±2.32)points]in POMS-SF scale(P＜0.001 all).Serum N-terminal pro brain natriuretic peptide(NT-proBNP)level[(2.03±0.42)μg/L vs.(2.35±0.50)μg/L,P＜0.001]in intervention group was significantly lower than that of control group.Conclusion:Mindfulness meditation training has a good effect on the rehabilitation of gastrointestinal symptoms and emotions in CHF patients.It could improve the positive mood state and reduce the negative mood state,and improve gastrointestinal symptoms.

Objective:This study aimed to investigate the value of myocardial contrast echocardiography(MCE)in the prognostic assessment of patients undergoing revascularization for acute anterior ST-segment elevation myocar-dial infarction(STEMI).Methods:A total of 234 patients with acute anterior STEMI who underwent percutaneous coronary intervention(PCI)and completed MCE admitted in Dongguan People's Hospital between July 1st 2019 and October 1st 2021 were included.According to presence of major adverse cardiovascular events(MACE)during 6 months,patients were divided into no MACE group(n=188)and MACE group(n=46).General data and MCE indexes were compared between the two groups.Multivariate Logistic regression analysis was employed to analyze influencing factors for MACE in patients with acute anterior STEMI after PCI.Receiver operating characteristic(ROC)curve was applied to analyze predictive value of MCE indexes for MACE in patients with acute anterior STE-MI after PCI.Results:Compared with patients in no MACE group,those in MACE group had significant higher proportion of previous myocardial infarction,D-dimer,C reactive protein,B-type natriuretic peptide,creatine kinase isoenzyme MB(CK-MB),incidence of T-wave inversion and ST-segment resolution amplitude(P＜0.05 or＜0.01).MCE showed that compared with those in no MACE group,those in MACE group had significant lower left ventricular ejection fraction(LVEF)[(52.54±7.66)％ vs.(55.98±10.04)％],and significant higher wall motion score index(WMSI)[(1.22±0.13)vs.(1.17±0.15)]and contrast score index(CSI)[(1.54±0.32)％vs.(1.16±0.21)％](P＜0.05 or＜0.01).Multivariate Logistic regression analysis revealed that previous myocar-dial infarction,C-reactive protein,CSI and T-wave inversion were independent risk factors for MACE in patients with acute anterior STEMI after PCI(OR=13.790～6601.747,P＜0.05 or＜0.01).ROC curve indicated that CSI had good predictive value for MACE in patients with acute anterior STEMI after PCI,the area under curve(AUC)was 0.874(95％CI 0.825～0.914)and optimal cutoff point was 1.33％.Conclusion:Myocardial contrast echocardiography plays an important role in prognostic assessment of patients undergoing revascularization for acute anterior STEMI.

Objective:To investigate the mediating role of perceived stress between frailty and major adverse cardio-vascular events(MACE)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart dis-ease(CHD).Methods:A convenience sampling method was employed to select 270 elderly patients who were first diagnosed as CHD and underwent PCI in Department of Cardiology,Cangzhou People's Hospital between October 2021 and February 2022.A comprehensive investigation was carried out using general demographic questionnaires,the Fried frailty phenotype scale,the Chinese version of perceived stress scale(CPSS),and follow-up question-naires.The association among frailty,CPSS score and MACE was analyzed using Logistic regression model.Bidi-rectional Spearman correlation analysis was used to explore the association of CPSS score with frailty and MACE.The R 4.2.2 software was employed to examine the mediating effects of perceived stress on frailty.Results:Within one year after PCI,the incidence rate of MACE was 13.70％.Multivariate Logistic regression analysis indicated that frailty(OR=3.554,95％CI 1.332～9.485,P=0.011)and CPSS score(OR=1.095,95％CI 1.038～1.154,P＜0.001)were independent risk factors for MACE in elderly CHD patients after PCI.Spearman correlation analy-sis indicated that CPSS score was positively correlated with frailty and MACE(r=0.506,0.346,P＜0.001 all).Perceived stress partially mediated the relationship between frailty and MACE after PCI,accounting for 38.03％of the total effect.Conclusion:Frailty may directly affect MACE in elderly CHD patients after PCI,and indirectly af-fect MACE through perceived stress.Clinically,the significant roles of both frailty and perceived stress in MACE should be fully considered,and early identification should be conducted for predictive interventions.

Objective:To investigate the predictive value of heart rate variability(HRV)and heart rate turbulence(HRT)related parameters for major adverse cardiovascular events(MACE)in patients with coronary heart disease(CHD).Methods:A total of 330 CHD patients admitted to Zaozhuang Hospital of Traditional Chinese Medicine between May 2020 and October 2022 were enrolled.According to the occurrence of MACE,they were divided into MACE group(n=30)and no MACE group(n=300).HRV and HRT parameters were compared between two groups.Receiver operating characteristic(ROC)curve was employed to analyze the predictive value of HRV and HRT parameters for MACE in CHD patients.Results:Compared with patients in no MACE group,those in MACE group had significant higher turbulence onset(TO)[(1.80±0.29)％ vs.(1.31±0.26)％],and significant lower turbulence slope(TS)[(2.46±0.72)ms/RRI vs.(3.08±0.56)ms/RRI],standard deviation of normal to normal RR intervals(SDNN)[(68.61±4.96)ms vs.(80.87±7.83)ms],root mean square of successive differences(rMSSD)[(16.85±4.96)ms vs.(19.85±4.76)ms]and percentage of NN intervals differing by more than 50 ms(PNN50)[(3.32±0.92)％ vs(4.36±1.12)％](P＜0.01 all).ROC curve indicated that TO(AUC=0.854,95％CI 0.811～0.890),TS(AUC=0.649,95％CI 0.595～0.700),SDNN(AUC=0.850,95％CI 0.807～0.887),rMSSD(AUC=0.656,95％CI 0.602～0.707)and PNN50(AUC=0.708,95％CI 0.656～0.757)had cer-tain predictive value for MACE in CHD patients,among which TO and SDNN had the highest predive performance.Conclusion:HRV and HRT parameters have certain predictive value for MACE in CHD patients,and the predictive performance of TO and SDNN are the highest,which could be used as sensitive indicators for MACE in CHD pa-tients.

Objective:The predictive value of oxidized low density lipoprotein(ox-LDL)and electrocardiogram(ECG)ischaemia grade for major adverse cardiovascular events(MACE)in patients with ST elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI)was assessed by a retrospective cohort study de-sign.Methods:A total of 336 STEMI patients admitted to Cangzhou People's Hospital between October 2019 and May 2022 were selected,and the medical record information was obtained through the hospital medical record sys-tem,and all patients received PCI and physician-recommended basic treatment.With occurrence of MACE with in 12-month follow-up as the evaluation index,they were divided into MACE group(n=65)and no MACE group(n=271).Multifactorial Logistic regression model was used to study the influencing factors of MACE after PCI in STEMI patients,and Spearman test for association of ox-LDL level,ECG ischaemia grade with MACE after PCI.ROC curve was used to evaluate the predictive efficacy of ox-LDL,ECG ischaemia grade and their combination for MACE after PCI.Results:The overall MACE incidence was 19.35％.Compared with patients in no MACE group,those in MACE group had significant higher ox-LDL level[46.34(29.46,66.29)U/L vs.33.00(23.02,50.03)U/L]and proportion of ECG grade Ⅲ ischaemia(64.62％vs.42.80％)(P＜0.01 all).Multifactorial Logistic re-gression analysis showed that ox-LDL(OR=1.022,95％CI 1.011～1.033,P=0.001)and ECG grade Ⅲ ischae-mia(OR=1.878,95％CI 1.007～3.504,P=0.048)were the independent risk factors of post-PCI MACE in STEMI patients.Spearman test showed that ox-LDL and ECG grade Ⅲ ischaemia were positively correlated with post-PCI MACE(r=0.209,0.173,P＜0.001 all).ROC curve analysis showed that the AUCs of ox-LDL,ECG grade Ⅲ ischaemia and their combination in predicting post-PCI MACE were respectively 0.653(95％CI 0.599～0.704),0.609(95％CI 0.555～0.662)and 0.758(95％CI 0.709～0.803),in which the predictive value of the combination of the two was significantly higher than any single detection(Z=2.030,3.097,P=0.042,0.002).Conclusion:ox-LDL combined with ECG ischaemia grading has a high predictive value for the occurrence of MACE with in 12 months after PCI in STEMI patients.

Objective:To analyze the association of peripheral blood systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)with disease severity and progno-sis in elderly patients with chronic pulmonary heart disease(CPHD).Methods:A total of 180 elderly CPHD pa-tients admitted in Xuancheng Central Hospital between September 2021 and January 2023 were enrolled as case group.Healthy volunteers who simultaneously underwent physical examinations in our hospital were selected as con-trol group(n=50).According to the 28d prognosis,the case group was divided into death group(n=45)and sur-vival group(n=135).Levels of peripheral blood SII,NLR and PLR were compared among above-mentioned groups;Spearman correlation analysis was used to analyze the association of above indexes with cardiac function class and prognosis in these patients.Multivariate Logistic regression analysis was used to analyze risk factors for death in these patients.The predictive value of SII,NLR,and PLR for death in elderly CPHD patients was ana-lyzed using receiver operating characteristic(ROC)curve.Results:Compared with those in control group,those in the case group had significant higher levels of peripheral blood SII,NLR and PLR(P＜0.001 all).Compared with NYHA class Ⅱ group and class Ⅲ group,those in class Ⅳ group had significant higher levels of peripheral blood SII[(1759.87±179.43)vs.(1148.33±121.57)vs.(1392.44±146.36)],NLR[(8.65±0.89)vs.(7.14±0.75)vs.(7.76±0.81)],PLR[(152.45±16.79)vs.(125.29±13.46)vs.(138.77±13.58)];and levels of peripheral blood SII,NLR,PLR in class Ⅲ group were significantly higher than those of class Ⅱ group(P＜0.001 all).Com-pared with patients in survival group,those in death group had significant higher levels of peripheral blood SII[(1723.86±189.65)vs.(1296.81±142.33)],NLR[(8.24±0.89)vs.(7.63±0.78)],PLR[(148.75±15.26)vs.(134.41±14.58)](P＜0.001 all).Spearman correlation analysis indicated that the levels of peripheral blood SII,NLR and PLR were significant positively correlated with the severity and poor prognosis(r=0.336～0.432,P＜0.05 or＜0.01;r=0.319～0.504,P＜0.05 or＜0.01)in elderly CPHD patients.Multivariate Logistic regression analy-sis indicated that peripheral blood SII,NLR,PLR and smoking were independent risk factors for death(OR=1.024～9.514,P＜0.05 or＜0.01)in elderly CPHD patients.ROC curve indicated that area under curve(AUC)of combination of SII,NLR and PLR predicting death in elderly CPHD patients was 0.979(95％CI 0.946～0.995),significantly higher than those of each single detection[SII:0.847(95％CI 0.786～0.896),NLR:0.832(95％CI 0.769～0.883),PLR:0.881(95％CI 0.825～0.925),Z=3.988,4.386,4.217,P＜0.01 all].The nomogram calibration curve and decision curve showed good consistency and net benefit of the model.Conclusion:Peripheral blood SII,NLR and PLR are associat-ed with the severity and prognosis of elderly CPHD patients,and have certain predictive value for patient's prognosis.