OBJECTIVE:To compare the efficacy and safety of metoprolol and bisoprolol in the treatment of diastolic heart fail-ure. METHODS:150 patients with diastolic heart failure were randomly divided into group A(75 cases) and group B(75 cases). All patients received aspirin,angiotensin-converting enzyme inhibitors,angiotensin receptor antagonists,calcium antagonists,di-uretic and cardiac drugs and other conventional treatment;based on it,group A received Metoprolol tartrate tablet with initial dose of 6.25 mg,orally,twice a day,then increased to 100-200 mg based on improvement and tolerability;group B received 1.25 mg Metoprolol tartrate tablet,orally,once a day,then increased to 10 mg based on improvement and tolerability. The treatment course for 2 groups was 12 weeks. Clinical efficacy,and left ventricular end systolic diameter(LVESD),left ventricular ejection fraction (LVEF)and left ventricular end-diastolic diameter(LVEDD),myocardial performance index(LVTei index),brain natriuretic pep-tide(BNP),interleukin(IL)-1,IL-6,tumor necrosis factor(TNF)-α before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:The efficacy in group B was significantly higher than group A,incidence of adverse reac-tions were significantly lower than group A,the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in the LVESD,LVEF,LVEDD,LVTei index,BNP,IL-1,IL-6 and TNF-α in 2 groups(P>0.05). Af-ter treatment,LVESD,LVEDD,LVTei index,BNP,IL-1,IL-6 and TNF-α in 2 groups were significantly lower than before,and group B was lower than group A,LVEF was significantly higher than before,and group B was higher than group A,the differenc-es were statistically significant(P<0.05). CONCLUSIONS:Based on the conventional treatment,bisoprolol is significantly superi-or to metoprolol in terms of efficacy,relieving clinical symptoms and improving cardiac functions in the treatment of diastolic heart failure,with better safety.

Objective:To investigate the clinical value of serum miR-208a in early differential diagnosis of acute coronary syndrome(ACS).Methods:One hundred ACS patients admitted to our department from January 2016 to January 2018 were randomly divided into the non-ST elevation myocardial infarction(NSTEMI)group(n=50)and the unstable angina(UA)group(n=50). Fifty healthy people during the same period were included as the control group(control). Serum levels of miR-208a, cardiac troponin-T(cTnT)and creatine kinase MB isoenzyme(CK-MB)were detected immediately, 4 h, 12 h and 24 h after admission and compared among the three groups of NSTEMI, UA and control.Receiver operating characteristic(ROC)curve was used to analyze the early diagnostic value of above serum indexes in NSTEMI and UA group, and the correlations of miR-208a level with cTnT and CK-MB were analyzed.Results:Serum miR-208a and cTnT levels had significant differences( P<0.05), while serum CK-MB level had no significant difference( P>0.05)among the NSTEMI and UA groups immediately after admission and the control group in the fasting state.There were significant differences in serum miR-208a, cTnT and CK-MB levels between NSTEMI group and UA group at different time points( P<0.05). After further multiple comparisons, the results showed that serum miR-208a and cTnT levels had statistical differences( P<0.05)and serum CK-MB level had no difference( P>0.05)between the NSTEMI group and the UA group immediately after admission.The above three biochemical indexes showed statistically significant differences between the NSTEMI group and the UA group at 4 h, 12 h and 24 h after admission( P<0.05). ROC curve analysis showed that miR-208a had a high diagnostic value in ACS(AUC>0.9, P=0.004), and the best diagnostic cut-off point was 9.278.The cTnT had a medium diagnostic value in ACS(0.70.05). Conclusions:Serum miR-208a has a higher value in early diagnosis of ACS than cTnT and CK-MB, and it has a better differentiation ability of NSTEMI than UA.

Objective To investigate the correlation between myeloperoxidase(MPO)levels and adverse cardiac events in patients undergoing coronary stent implantation.Methods A total of 76 patients undergoing coronary stent implantation from January 2015 to June 2016 in the cardiac surgery department of our hospital were enrolled in this study.Serum levels of MPO,high sensitivity C-reactive protein(hs-CRP),and interleukin 6 (IL-6)were detected by enzyme-linked immunosorbent assays(ELISA).After a one-year follow-up,the receiver operating characteristic(ROC)curve was used to determine the predictive value of the difference in MPO before and after the operation(△MPO)on the long-term prognosis of patients after coronary stent implantation.The correlations of △MPO with the traditional risk factors for coronary heart disease and adverse cardiac events were analyzed using multi factor Logistic regression analysis.Results Serum levels of MPO,hs-CRP and IL 6 increased in patients after coronary stent implantation,compared with those before treatment (P ＜ 0.05).The results of ROC curve analysis showed that the area under the curve(AUC)value of serum △MPO was 0.786,the 95 ％ confidence interval was 0.471～ 1.000 and the predictive value of serum △MPO for adverse cardiac events was significant(P ＜0.05).There was a significant correlation between △MPO and age,and the incidence of adverse cardiac events increased with increased △MPO levels.Logistic regression analysis showed that serum △MPO levels could preliminarily diagnose the cardiovascular risk after coronary stent implantation and independently predict the occurrence of adverse cardiac events.Conclusions MPO levels in peripheral blood are notably elevated in patients after coronary stent implantation when compared with pre-treatment levels.Serum △MPO levels can preliminarily diagnose adverse cardiac events after coronary stent implantation and can be used as a marker to predict adverse cardiac events.