Objective:This study aims to investigate the effect of exercise prescription based on cardiopulmonary ex-ercise test(CPET)on symptom improvement and quality of life in patients with arrhythmia.Methods:This ran-domized controlled study enrolled 152 arrhythmic patients admitted in Second Affiliated Hospital of Chinese PLA Air Force Military Medical University between September 2020 and May 2022.They were divided into control group(n=76)and intervention group(n=76).Both groups were given amiodarone anti-arrhythmic therapy at admis-sion.After recovering to sinus rhythm,patients in control group received routine exercise training,compared to those in intervention group receiving CPET-based exercise prescription training,both groups were trained for 12 weeks.Oxygen metabolism,cardiopulmonary function,clinical symptoms,quality of life and total satisfaction were compared between two groups.Results:Compared with participants in control group,those in intervention group had significant higher maximal oxygen uptake(VO2max)[(1.56±0.42)ml·kg-1·min-1 vs.(1.29±0.42)ml·kg-1·min-1],proportion of VO2max in predicted VO2 ratio(VO2max/VO2pred％)[(72.35±12.68)％vs.(65.32±11.74)％],metabolic equivalent(MET)[(4.65±1.29)ml·kg-1·min-1 vs.(3.82±1.12)ml·kg-1·min-1],peak oxygen pulse(Peak VO2/HR)[(13.05±3.48)ml·kg-1·beat-1 vs.(10.24±2.65)ml·kg-1·beat-1],forced vital capacity(FVC)[(3.51±0.82)L vs.(3.02±0.56)L],maximal voluntary ventilation(MVV)[(95.35±6.49)L/min vs.(87.12±9.48)L/min],peak cardiac output(Peak CO)[(11.24±2.67)L/min vs.(9.24±1.52)L/min],score of short form 12 health survey(SF-12)[(77.93±15.41)points vs.(65.18±13.48)points]and total satisfaction(96.05％vs.85.53％),and significant lower score of visual analogue scale(VAS)[(7.28±2.31)points vs.(13.65±3.62)points](P＜0.05 or＜0.01).Conclusion:Exercise prescription based on CPET can improve oxygen metabolism,cardiopulmonary function,clinical symptoms,quality of life and total satisfaction in arrhythmic patients.

Objective:To investigate the association of levels of creatine kinase isoenzyme(CK-MB),myoglobin(MYO)with heart rate deceleration capacity(DC)and heart rate variability(HRV)in patients with acute myocar-dial infarction(AMI).Methods:A total of 117 AMI patients with complete clinical data admitted in People's Hospi-tal of Baise between July 2022 and June 2023 were included as the observation group,and 117 healthy subjects who received physical examination in our hospital simultaneously were selected as the control group.The CK-MB and MYO levels were compared between the two groups.Receiver operating characteristic curve(ROC)was used to an-alyze the diagnostic value of CK-MB,MYO and their combined detection for AMI.The DC and HRV were com-pared between the two groups.Pearson correlation analysis was used to analyze the association of CK-MB,MYO with DC and HRV indexes.Results:Compared with participants in control group,patients in observation group had significant higher CK-MB[(35.27±20.27)U/L vs.(18.06±3.65)U/L]and MYO[(233.88±13.83)μg/L vs.(30.87±5.08)μg/L](P＜0.001 all),and significant lower DC[(5.67±2.59)ms vs.(7.62±1.12)ms],heart rate deceleration run(DR)2[(8.07±0.69)％vs.(9.13±0.98)％],DR4[(0.41±0.10)％vs.(0.81±0.15)％],standard deviation of NN intervals(SDNN)[(80.24±27.82)ms vs.(142.45±16.79)ms],standard deviation of mean sinus R-R interval every 5 min(SDANN)[(67.25±24.47)ms vs.(115.12±12.18)ms],root mean square of successive differences(RMSSD)[(25.64±17.37)ms vs.(37.37±5.93)ms](P＜0.001 all).ROC analysis indicated that the area under the diagnostic curve(AUC)of combined detection(0.881)was signifi-cantly higher than those of single detection(Z=5.284,5.317,P＜0.001 all).Pearson correlation analysis showed that CK-MB was significantly negatively correlated with DC,DR2,DR4,SDNN,SDANN and RMSSD(r=-0.453～-0.639,P＜0.05 or＜0.01).There was a significant negative correlation between MYO and above-mentioned indexes(r=-0.438～-0.840,P＜0.05 or＜0.01).Conclusion:CK-MB and MYO have certain di-agnostic value for AMI,but the combined test has a higher diagnostic performance,and CK-MB and MYO are sig-nificantly negatively associated with both DC and HRV indicators.

Objective:To investigate the effect of family primary caregiver-centered enabling education on mental resilience and self-efficacy in patients with acute myocardial infarction(AMI)after percutaneous coronary inter-vention(PCI).Methods:This randomized controlled study enrolled 94 AMI patients undergoing PCI in First Affili-ated Hospital of Xinjiang Medical University between July 2022 and December 2022.They were divided into control group(n=47,traditional nursing)and intervention group(n=47,family primary caregiver-centered enabling ed-ucation).Both groups were intervened for 3 months.Cardiac function,mental resilience,self-efficacy,social support,sleep quality,quality of life and incidence of adverse events were compared between the two groups.Re-sults:After intervention,compared with patients in control group,those in intervention group had significant high-er left ventricular ejection fraction(L VEF)[(59.20±5.93)％vs.(52.57±4.67)％],scores of Connor-Davidson Resilience Scale(CD-RISC)[(91.96±1.61)points vs.(80.02±2.63)points],General Self-Efficacy Scale(GSES)[(32.53±3.21)points vs.(21.45±2.09)points],Social Support Rating Scale(SSRS)[(49.27±3.11)points vs.(39.45±2.72)points],and significant lower left ventricular end-diastolic diameter(LVEDd)[(50.54±3.57)mm vs.(59.03±3.62)mm],left ventricular end-systolic diameter(LVESd)[(39.60±2.31)mm vs.(45.52±2.68)mm],scores of Athens Insomnia Scale(AIS)[(9.63±1.68)points vs.(12.90±1.20)points],Myocardial Infarction Dimensional Assessment Scale(MIDAS)[(89.24±2.63)points vs.(117.63±4.89)points]and incidence of adverse events(4.26％vs.21.28％)(P＜0.05 or＜0.01).Conclusion:Family primary caregiver-centered enabling education could improve the cardiac function and mental resilience,enhance self-efficacy and social support,improve sleep quality and quality of life,and reduce the incidence of adverse events in AMI patients after PCI.

Objective:To investigate the effect of different administration routes of unfractionated heparin(UFH)during left atrial appendage closure(LAAC)on activated clotting time(ACT)values and thrombosis event.Meth-ods:We retrospectively analyzed 96 patients with atrial fibrillation undergoing LAAC in Affiliated Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine between August 2020 and December 2021.According to administration routine of UFH,patients were divided into peripheral administration group(n=45)and left atrium administration group(n=51).Each group was given one-off 100 IU/kg UFH.ACT values at 20,40 and 60 min after first-dose UFH administration,incidence of perioperative thrombosis and bleeding were compared between two groups.Results:① There were no significant differences in baseline data,including age,gender,albumin,platelet count,hemoglobin,estimated glomerular filtration rate,preopcrative anticoagulant usages etc.between two groups(P＞0.05 all);② There were no significant difference in ACT values at 20,40 and 60min after adminis-tration between peripheral and left atrium administration(P＞0.05 all),but first-dose ACT standard-reaching rate in left atrium administration group was significantly higher than that of peripheral administration group(52.9％vs.31.1％,P=0.031);③ Left atrium administration group had lower incidence of perioperative thrombosis(2.0％vs.8.9％,P=0.287)comparing to peripheral administration group without statistical difference;there was no significant difference in incidence of perioperative bleeding between two groups(P=1.000).Conclusion:Intra-left atrium administration of unfractionated heparin could increase first-dose ACT standard-reaching rate(＞250s)and might provide a trend of decreased thrombosis.

Objective:To investigate the cffect of Orem's self-care theory on mental health and cognitive function in patients with chronic heart failure(CHF).Methods:We retrospectively collected clinical data of 97 CHF patients treated in the First Affiliated Hospital of Xinjiang Medical University between February 2019 and August 2022.According to intervention way,they were divided into control group(n=45,routine intervention)and intervention group(n=52,Orem's self-care theory model intervention).Both groups were intervened for 6 months.Scores of Hamil-ton Anxiety scale(HAMA),Hamilton Depression scale(HAMD),Mini-Mental State Examination(MMSE),left ven-tricular ejection fraction(LVEF),resting heart rate(HR),scores of the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36)and Barthel index were compared between two groups.Kaplan-Meier survival curve was used to compare incidence of unfavorable outcome between two groups.Results:After 6-month intervention,compared with pa-tients in control group,those in intervention group had significant lower scores of HAMA[(12.50±4.89)points vs.(19.09±5.80)points],HAMD[(12.31±4.28)points vs.(19.56±5.79)points]and HR[(87.33±7.42)beats/min vs.(100.11±7.89)beats/min],and significant higher LVEF[(50.25±5.24)％vs.(42.11±4.51)％],scores of MMSE[(21.90±3.37)points vs.(18.27±3.50)points],SF-36[(63.65±10.43)points vs.(51.71±6.83)points]and Barthel index[(60.67±8.43)points vs.(45.00±9.56)points](P＜0.001 all).Kaplan-Meier survival analysis indicated that incidence of unfavorable outcome in intervention group was significantly lower than that of control group(5.77％vs.24.44％,P=0.035).Conclusion:Orem's self-care theory intervention could significantly improve negative emotions and cognitive ability,restore patients'cardiac function,improve the quality of life and self-care capacity,and re-duce risk of unfavorable outcome in CHF patients.

Objective:To investigate exercise fear condition and its influencing factors in patients with coronary heart dis-ease(CHD)involving in phase Ⅱ cardiac rehabilitation after percutaneous coronary intervention(PCI).Methods:Conven-ience sampling was performed among cardiac rehabilitation patients from a Shanxi grade-A tertiary hospital between Janu-ary 2023 and June 2023.General data questionnaire,Tampa Scale for Kinesiophobia-Short Version for Heart patients(TSK-SV H),the Multidimensional Scale of Perceived Social Support(MSPSS)and the Post Percutaneous Coronary In-tervention Health Literacy Scale(PPCIHLS)were used for assessment.Pearson and Spearman rank correlation analyses were applied to investigate the relationships between social support factors and health literacy factors with patients'fear of exercise;multivariate linear regression models and quantile regression models were used to analyze the influencing factors of fear of exercise.Results:Among the 118 patients,average TSK-SV H score was(33.78±3.79)points;10.2％patients showed significant fear.The correlation analysis showed that PPCIHLS score was negatively correlated with TSK-SV H score(r=-0.423,P＜0.001).Results from multivariate regression analysis indicated that health literacy,cardiac func-tion class and drinking status affected the average score of exercise fear(P＜0.05 all).The quantile regression model pro-vided additional insights,showing that the impact of factors such as living situation,drinking status,cardiac function class and health literacy on exercise fear varied across different quantiles.Notably,cardiac function class had a consistently posi-tive effect on TSK-SV H score at various quantiles.Conclusion:Improving health literacy and tailored rehabilitation plans are vital to reduce exercise fear and improve cardiac rehabilitation effect.

Objective:This study aims to explore the application effect of anticipatory risk intervention combined with health education under LEARNS mode in elderly patients with chronic heart failure(CHF).Methods:This randomized controlled enrolled 126 elderly CHF patients admitted in Panzhihua Central Hospital between January 2022 and February 2023.They were divided into control group(n=63)and intervention group(n=63).All patients received routine nursing care,patients in control group received additional health education under LEARNS mode,compared to those in intervention group receiving additional anticipatory risk intervention based on control group,both groups were intervened for 2 months.Physiological indexes,negative emotion,quality of life,sleep quality,disease perception&control and self-efficacy,as well as incidence of adverse events,were compared between two groups.Results:Compared with patients in control group after intervention,those in intervention group had signif-icant lower systolic blood pressure(SBP)[(119.84±8.60)mmHg vs.(129.49±9.24)mmHg],diastolic blood pressure(DBP)[(81.59±5.08)mmHg vs.(88.51±6.36)mmHg],N terminal pro brain natriuretic peptide(NT-proBNP)[(2604.46±204.80)ng/L vs.(3024.87±212.27)ng/L],scores of Self-Rating Anxiety Scale(SAS)[(55.90±2.43)points vs.(60.11±2.62)points],Self-Rating Depression Scale(SDS)[(57.03±2.56)points vs.(61.54±2.66)points],Minnesota Living with Heart Failure Questionnaire(MLHFQ)[(52.05±6.32)points vs.(60.46±7.10)points]and Pittsburgh Sleep Quality Index(PSQI)[(9.00±1.65)points vs.(11.05±1.96)points],and significant higher left ventricular ejection fraction(LVEF)[(51.83±7.28)％vs.(47.57±5.98)％],scores of Control Attitude Scale-Revised(CAS-R)[(35.59±2.97)points vs.(30.60±3.52)points]and Gen-eral Self-Efficacy Scale(GSES)[(36.98±4.21)points vs.(30.52±4.14)points](P＜0.001 all).Incidence of adverse events in intervention group was significantly lower than that of control group(3.17％vs.12.70％,P=0.048).Conclusion:Anticipatory risk intervention combined with health education under the LEARNS model could effectively improve the physiological indexes,quality of life and sleep,enhance disease perception and self-effica-cy,and reduce negative emotion and incidence of adverse events in elderly CHF patients.

Objective:This study aims to compare the efficacy on patients with severe coronary artery calcification(CAC)coronary heart disease(CHD)between common balloon predilation and spinous process balloon predilation and their effect on short-term incidence of major adverse cardiovascular events(MACE).Methods:This retro-spective study enrolled 110 severe CAC patients with CHD who underwent percutaneous coronary intervention(PCI)in Beijing Pinggu District Hospital between January 2017 and January 2022.According to therapeutic pro-gram,they were divided into spinous process balloon group(n=55)and common balloon group(n=55),each group received corresponding balloon predilation before PCI.Application effect,perioperative complications and incidence of MACE within 6 months were compared between two groups.Results:Immediate surgical success rate in spinous process balloon group was significantly higher than that of common ballon group(92.73％vs.78.18％,P=0.031).Compared with patients in common balloon group,those in spinous process balloon group had signifi-cant lower times of balloon predilation[(2.79±0.14)times vs.(7.29±2.24)times],operation time[(1.24±0.29)h vs.(1.59±0.34)h]and incidence of perioperative complications(3.64％vs.14.55％),and significant larger lumen diameter after PCI[(3.79±0.26)mm vs.(3.29±0.24)mm](P＜0.05 or＜0.01).There was no significant difference in incidence of MACE within 6 months between two groups(P=0.428).Conclusion:The ap-plication of spinous process balloon predilation could significantly reduce times of balloon predilation,operation time,improve surgical success rate and reduce risk of short-term MACE in severe CAC patients with CHD.

Objective:To investigate clinical application effect of 5E rehabilitation management combined with health education knowledge in elderly patients with acute myocardial infarction(AMI).Methods:This randomized con-trolled study enrolled 98 elderly AMI patients admitted in Department of Cardiology,Hefei Eighth People's Hospital between July 2020 and February 2023.They were divided into control group(n=49,routine health education knowl-edge mode nursing)and intervention group(n=49,additional 5E rehabilitation management).Both groups were intervened for 2 months.Cardiac function indexes,mental state,scores of disease cognition,Pittsburgh Sleep Qual-ity Index(PSQI),Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36)and incidence of com-plications were compared between two groups.Results:After 2-month intervention,compared with patients in control group,those in intervention group had significant higher left ventricular ejection fraction(LVEF)[(51.66±2.01)％vs.(45.88±1.51)％],scores of disease cognition[(89.43±2.38)points vs.(81.13±1.16)points]and SF-36[(645.58±26.00)points vs.(432.72±18.50)points],and significant lower left ventricular end-dias-tolic diameter(LVEDd)[(47.74±0.86)mm vs.(51.20±1.36)mm],creatine kinase(CK)[(140.89±5.15)U/L vs.(154.32±2.61)U/L],scores of Self-Rating Depression Scale(SDS)[(31.88±1.16)points vs.(41.06±1.22)points],Self-Rating Anxiety Scale(SAS)[(31.09±1.12)points vs.(40.47±0.87)points]and PSQI[(5.54±0.64)points vs.(7.70±0.85)points](P＜0.001 all).Incidence of complications in intervention group was significantly lower than that of control group(4.08％vs.18.36％,P=0.025).Conclusion:5E rehabilitation management combined with health education knowledge mode could significantly improve cardiac function,negative emotions and sleep quality,improve disease cognition and quality of life,and reduce incidence of complications in elderly AMI patients.

Objective:To explore the clinical application value of low intensity exercise control training in patients with acute myocardial infarction(AMI).Methods:This randomized controlled study enrolled 109 eligible elderly patients with AMI treated in Wuxi Peoples Hospital between May 2022 and May 2023.They were divided into routine group(n=55)and exer-cise group(n=54).The routine group received basic nursing care,health education and exercise guidance,while the exer-cise group received low intensity exercise control training based on routine group.After 1,2,and 3-month intervention,score of Generic Quality of Life Inventory 74(GQOLI-74),motor function[6-min walking distance(6MWD),peak oxygen uptake(VO2max)],cardiac function[wall motion score index(WMSI),left ventricular ejection fraction(LVEF)]and incidence of major adverse cardiovascular events(MACE)were compared between two groups.Results:Compared with patients in routine group,those in exercise group had significant higher GQOLI-74 total score[(61.04±2.18)points vs.(57.39±2.10)points],LVEF[(55.00±1.84)％vs.(50.33±2.37)％],6MWD[(441.58±26.55)m vs.(399.35±17.90)m]and VO2max[(18.86±1.32)ml·kg-1·min-1 vs.(15.26±0.90)ml·kg-1·min-1](P＜0.001 all),and significant lower WMSI[(2.04±0.41)points vs.(2.16±0.31)points]after 2-month intervention(P＜0.001);significant higher GQOLI-74 total score[(65.14±2.17)points vs.(59.12±2.10)points],LVEF[(57.96±1.84)％vs.(51.34±2.37)％],6MWD[(518.05±26.89)m vs.(429.97±17.69)m]and VO2max[(20.82±1.32)ml·kg-1·min-1vs.(16.09±0.90)ml·kg-1·min-1](P＜0.001 all),and significant lower WMSI[(1.34±0.31)points vs.(1.91±0.41)points]after 3-month intervention(P＜0.001).We detected significant lower incidence of MACE in exercise group compared with routine group(5.67％vs.22.64％,P=0.012).Conclusion:Low intensity exer-cise control training can improve the quality of life,motor function and cardiac function,and help to reduce the risk of car-diovascular events in AMI patients after PCI.