Objective:This study aims to investigate the association of blood pressure,electrocardiogram(ECG)pa-rameters with body mass index(BMI)changes among adolescents of different genders.Methods:A cohort of 1,352 ad-olescents,aged 15 to 25,who underwent physical examinations at the Shanxi international travel health care center between January and December 2021,were enrolled.According to BMI,they were divided into underweight group(n=186),nor-mal weight group(n=742),overweight group(n=268)and obese group(n=156).Each group was further stratificd by sex.ECG parameters,including PR interval,QRS duration,Tp-e/QT and Tp-e/QTc,along with blood pressure and other relevant data,were collected to facilitate comparisons across different BMI categories and between male and female participants within each group.Results:Compared to participants in normal weight group,those in overweight group and obese group had significantly higher diastolic blood pressure(DBP),systolic blood pressure(SBP),QRS duration,Tp-e/QT and Tp-e/QTc,and those in obese group had significantly higher PR interval(P＜0.05 or＜0.01).Within the nor-mal weight group,compared to male participants,the females had significantly lower SBP,DBP,Tp-e/QTc,PR interval and QRS duration,and significantly higher heart rate(HR)and Tp-e/QT(P＜0.01 all).In the overweight group,fe-male participants had significantly lower SBP,DBP,Tp-e/QTc,Tp-e/QT,PR interval and QRS duration compared to males(P＜0.05 or＜0.01);in the obese group,females had significantly lower SBP,PR interval and QRS duration com-pared to males(P＜0.01 all).In male adolescents,compared to those in normal weight group,participants in overweight group and obese group had significantly higher SBP,DBP,Tp-e/QT and Tp-e/QTc(P＜0.01 all).In female adoles-cents,those in overweight group and obese group had significantly higher SBP,Tp-e/QT and Tp-e/QTc compared to those in normal weight group(P＜0.05 or＜0.01).Conclusion:With the increase in BMI,the risk of cardiovascular disea-ses in adolescents elevates.Meanwhile,the impact of BMI changes on blood pressure and ECG parameters varies across ad-olescents of different genders.

Objective:To explore the predictive value of serum levels of annexin A1(AnxA1),clusterin(CLU)and γ-glutamyltransferase/albumin ratio(GAR)for atherosclerotic cardiovascular disease(ASCVD).Methods:A total of 300 patients treated in Xi'an No.9 Hospital between October 2020 and March 2024 were selected.According to ASCVD diagnosis,patients were divided into ASCVD group(n=149)and no ASCVD group(n=151).The base-line data,serum levels of AnxA1,CLU and GAR were compared between two groups.The factors associated with ASCVD were analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum AnxA1,CLU,GAR and combined detection for ASCVD.Results:Com-pared to patients in the no ASCVD group,those in the ASCVD group had significantly higher proportions of family history of early onset coronary heart disease(CHD)(37.76％vs.5.48％),smoking(44.76％vs.23.97％),AnxA1[(1.98±0.39)μg/L vs.(1.05±0.27)μg/L],CLU[(71.61±9.88)mg/L vs.(30.53±6.52)mg/L]and GAR[(1.42±0.32)vs.(0.70±0.19)](P＜0.001 all).Multivariate Logistic regression analysis showed that family history of early onset CHD(OR=3.665,95％CI 1.456～6.072),smoking(OR=2.023,95％CI 1.016～4.073),AnxA1(OR=3.378,95％CI 1.293～5.846),CLU(OR=4.382,95％CI 1.179～7.534)and GAR(OR=3.153,95％CI 2.032～4.787)were independent risk factors for ASCVD(P＜0.001 all).ROC curve analysis in-dicated that the AUC of AnxA1,CLU,GAR alone and combined detection diagnosing ASCVD was 0.821(95％CI 0.766～0.871),0.859(95％CI 0.813～0.902),0.802(95％CI 0.751～0.862)and 0.945(95％CI 0.900～0.970)respectively,and the AUC of combined detection was significantly higher than those of single detection(Z=3.678,2.035,4.139,P＜0.05 or＜0.01).Conclusion:Serum levels of AnxA1,CLU and GAR significantly increase in ASCVD patients,and combined detection of above-mentioned indexes has good predictive efficacy for the occur-rence of ASCVD.

Objective:To analyze the effect of health education model based on the transtheoretical model and stages of change(TTM)on fatigue and daily quality of life in patients with chronic heart failure(CHF).Methods:This randomized controlled study enrolled 84 CHF patients admitted in Jiangsu Province Hospital between November 2022 and December 2023.Patients were randomly divided into control group(n=42,routine health education program)and intervention group(n=42,health education program based on TTM).Scores of Flinders fatigue scale(FFS)and Minnesota living with heart failure questionnaire(MLHFQ)were compared between two groups on 1,3 and 6 months after intervention.Results:Compared to those in the control group,patients in the intervention group had significantly lower scores of FFS[1 month:(16.13±2.70)points vs.(17.88±3.23)points,3 months:(14.20±2.29)points vs.(16.80±2.48)points,6 months:(10.90±2.11)points vs.(15.56±2.65)points]and MLHFQ[3 months:(33.73±9.64)points vs.(43.12±9.60)points,6 months:(27.35±8.81)points vs.(39.54±9.41)points](P＜0.05 or＜0.01).Conclusion:The health education model based on TTM may alleviate fatigue symp-toms and improve quality of life in patients with chronic heart failure.

Objective:To investigate the effect of risk forewarning hierarchical management on mental state,major adverse cardiovascular events(MACE)and quality of life in patients with acute coronary syndrome after percutane-ous coronary intervention(PCI).Methods:This randomized controlled study enrolled 152 patients with acute coro-nary syndrome who underwent PCI in the First Hospital of Qinhuangdao between July 2021 and June 2023.Patients were randomly divided into control group(n=76,conventional intervention program)and intervention group(n=76,additional risk forewarning hierarchical management).After 3-month intervention,mental state[Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)scores],health literacy[perceived knowledge scale for coronary heart diseases(PKS-CHD)score],quality of life[Seattle angina questionnaire(SAQ)score]and in-cidence of MACE were compared between the two groups.Results:Compared to those in the control group,patients in the intervention group had significantly higher total score of PKS-CHD[(35.08±3.59)points vs.(30.53±3.85)points],SAQ dimensional scores of physical limitation[(15.24±1.73)points vs.(13.26±1.45)points],an-ginal stability[(16.84±1.39)points vs.(15.18±1.48)points],disease perception[(17.00±1.46)points vs.(14.34±1.93)points],anginal frequency[(18.55±1.18)points vs.(16.11±1.39)points]and treatment satis-faction[(17.12±1.45)points vs.(14.04±1.93)points](P＜0.001 all),and significantly lower HAMA score[(11.89±1.64)points vs.(13.55±1.56)points],HAMD score[(12.61±1.76)points vs.(16.42±1.92)points]and the incidence of MACE(8.00％vs.28.38％)(P＜0.001 all).Conclusion:Risk forewarning hierarchical man-agement may effectively relieve patients'negative emotions,improve their health literacy and quality of life,and significantly reduce the risk of MACE in patients with acute coronary syndrome after PCI.

Cardiovascular disease is one of the most common causes of death in the world,and related western drugs usually have obvious side effects.Traditional Chinese medicine,characterized by its multi-component and multi-target,has unique advantage in the prevention and treatment of cardiovascular diseases.Cornus Officinal is a histor-ically used plants with medicinal and edible properties.Ancient books and modern literatures have shown that Cor-nus Officinal has the potential to prevent and treat cardiovascular diseases.With the in-depth study of the chemical composition and pharmacological effect of Cornus Officinal,its pharmacodynamic substances and mechanism in the prevention and treatment of cardiovascular diseases are gradually clear.This article reviews the pathways and targets of Cornus Officinal in the prevention and treatment of cardiovascular diseases in recent years,and summarizes its potential effective components,in order to provide theoretical support for the clinical application and traditional Chinese medicine development.

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 construct a risk prediction model of postoperative severe bradyarrhythmia for patients with valvular heart disease and verify the predictive efficacy of the model.Methods:A total of 636 patients undergoing heart valve surgery in Nanjing First Hospital between June 2023 and March 2024 were retrospectively selected.Ac-cording to the need for permanent pacemaker implantation after the surgery,the patients were divided into severe bradyarrhythmia group(n=80)and non-severe bradyarrhythmia group(n=556),then univariate and multivariate Logistic regression analysis were conducted to analyze the influencing factors of postoperative severe bradyarrhyth-mia in patients with valvular heart disease.R software was used to draw a nomogram prediction model for postoper-ative severe bradyarrhythmia in patients with valvular heart disease,and to verify the predictive effect of the model.Results:The incidence of postoperative severe bradyarrhythmia in patients with valvular heart disease was 12.6％in this study.Multivariate Logistic regression analysis showed that BMI＞28kg/m2(OR=2.094,95％CI 1.047～4.189,P=0.037),preoperative conduction block(OR=6.507,95％CI 2.909～14.552,P＜0.001),tricuspid valve surgery(OR=1.831,95％CI 1.094～3.063,P=0.021)and low cardiac output after surgery(OR=3.186,95％CI 1.310～7.751,P=0.011)were independent risk factors of postoperative severe bradyarrhythmia in these patients,while NYHA class Ⅲ～Ⅳ was its independent protective factor(OR=0.328,95％CI 0.194～0.555,P＜0.001).The nomogram model was constructed based on the influencing factors.H-L test in model group showed that x2=3.667,P=0.886,AUC under ROC curve was 0.744(95％CI 0.685～0.803),H-L test in validation group showed that x2=9.314,P=0.316,AUC under ROC was 0.718(95％CI 0.618～0.818),and the accuracy was 72.0％.Conclusion:The independent predictors for postoperative severe bradyarrhythmia in patients with val-vular heart disease include BMI,preoperative conduction block,NYHA class,tricuspid valve surgery and low cardi-ac output after surgery.A prediction model based on the above-mentioned risk factors may have good performance in predicting postoperative severe bradyarrhythmia in this population.

Objective:To explore the diagnostic efficacy of monocyte chemotactic protein-1(MCP-1)and creatine kinase isoenzyme(CK-MB)for chronic heart failure(CHF)and their association with New York Heart Associa-tion(NYHA)class.Methods:A total of 300 patients suspected of CHF who underwent physical examination in the Second People's Hospital of Hefei between January 2020 and August 2021 were analyzed.After 3-month follow-up,a total of 150 patients were diagnosed with CHF.According to NYHA cardiac function classification,CHF pa-tients were divided into class Ⅱ group(n=45),class Ⅲ group(n=45)and class Ⅳ group(n=60).MCP-1 and CK-MB levels were compared among above groups.Receiver operating characteristic(ROC)curve was used to an-alyze the diagnostic efficacy of each index and their combination for CHF and their association with NYHA class were analyzed using Spearman correlation analysis.Results:Compared to those without CHF,patients with CHF had significant higher levels of MCP-1[96.01(86.21,124.28)ng/ml vs.25.38(22.79,28.72)ng/ml,P＜0.001]and CK-MB[46.26(32.74,59.72)U/L vs.19.09(18.61,19.87)U/L,P＜0.001].ROC curve showed that a combination of MCP-1 and CK-MB had a significant higher area under the ROC curve(AUC)(0.947,95％CI 0.915～0.969)than MCP-1(0.797,95％CI 0.747～0.841)or CK-MB(0.855,95％CI 0.810～0.893)alone(Z=4.543,3.170,P＜0.001 all).Compared to those in the class Ⅱ group,those in the class Ⅲgroup and class Ⅳ group had significant higher MCP-1[94.57(91.18,96.92)ng/ml vs.125.27(123.20,128.24)ng/ml vs.68.38(27.55,86.38)ng/ml]and CK-MB[48.04(45.66,51.47)U/L vs.61.01(58.81,62.96)U/L vs.31.75(25.08,33.57)U/L],and those of class Ⅳ group were significantly higher than those of class Ⅲ group(P＜0.001 all).Spearman correlation analysis indicated that the levels of MCP-1 and CK-MB were significant positively correlated with NYHA class in CHF patients(r=0.712,0.878,P＜0.001 both).Con-clusion:MCP-1 and CK-MB were abnormally elevated in CHF patients.Serum levels of MCP-1 and CK-MB are significantly correlated with NYHA class.The combination had high diagnostic efficacy for CHF.