Objectives:To establish the Chinese Healthy Lifestyle Index(CHLI),which can be applied to comprehensively assess healthy level of lifestyle among Chinese population.Methods:Potential indicators were screened through literature review.Enrolled indicators were determined by the Delphi expert consultation method and the weight of the indicator was assessed by the analytic hierarchy process(AHP).Finally,the CHLI was obtained though weighted sum.Results:In both rounds of correspondence,the positive coefficients were 92.9% and 93.8%,and the expert authority coefficients were 0.846±0.027 and 0.861±0.030,respectively.The coordination coefficients Kendall's W of the importance scores on primary/secondary indicators were 0.482/0.451 and 0.535/0.557 for the first and second round of consultation,respectively(all P<0.001),indicating a good coordination between expert opinions.The final index system of CHLI includes 5 primary indicators and 28 secondary indicators.Regarding the weights of primary indicators,the highest weight was assigned to diet(0.239),followed by psychological health(0.220),physical activity(0.198),nicotine exposure(0.175)and sleep health(0.167).The combined weights of the secondary indicators ranged from 0.009 to 0.198.The consistency ratios of the AHP judgment matrices were all less than 0.1,indicating the results were credible.Conclusions:The CHLI can be used to comprehensively evaluate the healthy level of lifestyle among Chinese population.

Objectives:There is a lack of long-term follow-up study results on severe microvascular complications in a larger Chinese population with diabetes.This study aims to explore long-term impact of newly diagnosed diabetes(NDD)on the incidence and risk of severe microvascular complications.Methods:A total of 598 NDD and 493 normal glucose tolerance(NGT)subjects were included in this study in 1986.By questionnaire and systematic case review,the occurrence of severe microvascular complications,including severe diabetic retinopathy,severe diabetic nephropathy,and severe diabetic neuropathy,was followed up and collected over a period of 34 years.Results:The cumulative incidence of severe microvascular complications in the NDD population was 65.03%(95%CI:58.90%-70.48%)over 34 years,significantly higher than that in the NGT population(16.8%,95%CI:12.64%-20.11%).After adjusting for related risk factors,the risk of severe microvascular complications in the NDD population was 7.08 times than that of the NGT population(HR=7.08,95%CI:5.09-9.84,P<0.0001).Stratified analysis by sex showed that the cumulative incidence and risk of severe microvascular complications were slightly higher in male NDD population(68.02%,95%CI:57.27%-76.61%;HR=9.45,95%CI:5.78-15.47,P<0.0001)than in female NDD population(63.37%,95%CI:55.69%-70.09%;HR=5.86,95%CI:3.75-9.16,P<0.0001);however,the cumulative incidence increased more rapidly in women during the follow-up period of 10-25 years.Conclusions:The incidence and risk of severe microvascular complications in diabetes were significantly higher than those in the NGT population;and the incidence of severe vascular complications increased rapidly after the duration of diabetes exceeded 10 years,indicating that strict control of blood glucose in the early stage of diabetes is of vital importance.

Objectives:To evaluate the performance of AVEIR VR single chamber leadless pacemaker(AVEIR VR)in the real world in China and the predictive factors of pacing threshold to assess the feasibility of AVEIRTM VR implantation in the domestic population.Methods:All patients who underwent AVEIR VR implantation by experienced operators from Peking University People's Hospital in multiple domestic hospitals from June 2024 to October 2024 were consecutively included,and their baseline characteristics,procedural data(including pacemaker electrical measurements at various stages),and follow-up results were observed,recorded,and statistically analyzed.Results:This study included 20 patients who met the indication for pacemaker implantation and underwent AVEIR VR implantation.Their mean age was(71.40±13.37)years,body mass index(BMI)was(23.05±3.71)kg/m2,body surface area(BSA)was(1.70±0.16)m2,all 20 patients were successfully implanted with pacemakers,there were no major complications(newly occurred pericardial effusion during the perioperative period,cardiac tamponade,poor pacemaker function,pacemaker dislocation/perforation,tricuspid valve injury,myocardial infarction,stroke,pulmonary embolism,and clinical death).One patient developed new frequent ventricular premature contractions after pacemaker release.The pacing threshold(PCT)at one week after implantation was correlated with PCT in tether mode(r=0.650,P=0.009)and PCT in release phase(r=0.596,P=0.019),but not with the sensing and impedance in each phase.Conclusions:This preliminary exploration study show that AVEIRTM VR implantation demonstrates satisfactory performance among real world patients in China,especially in elderly and low weight populations,confirming its safety.

Objectives:To analyze the cardiac involvement of patients with Fabry disease(FD)in Anhui region.Methods:This retrospective analysis included 48 previously and currently diagnosed FD patients(25 males)in Anhui region,overall patient and gender specific cardiac involvement was analyzed.Results:The median age of FD patients is 28.0(19.0,46.0)years.The cardiac manifestations of patients with FD were most commonly characterized by palpitations/arrhythmias(13/42 cases)and exertional dyspnea(11/42 cases),electrocardiographic changes were most commonly characterized by T-wave inversion(22/42 cases),ST-segment depression(16/42 cases),and left ventricular hypervoltage(18/42 cases),cardiac structural and functional changes were most common in papillary muscle hypertrophy(29/36 cases),bilateral sign(22/37 cases)and left ventricular hypertrophy(21/46 cases),as well as reduced left ventricular global longitudinal strain(26/39 cases).Neuropathic pain(28/43 cases)was the most common extracardiac manifestation of FD patients.FD patients of different gender differed in age at diagnosis(P=0.018),alpha galactosidase A activity(P<0.001),globotriaosylsphingosine(lyso-GL3)levels(P<0.001),enzyme replacement therapy rate(P=0.043),dyshidrosis(P<0.01),and the incidence of angiokeratoma(P=0.004).Correlation analysis showed that genotype was not correlated with enzyme activity or Lyso-GL-3 levels,whereas the Sokolow-Lyon index was positively correlated with Lyso-GL-3 levels(ρ=0.423,P=0.008),and the Sokolow-Lyon indices(septal thickness:ρ=0.562,P<0.001;left ventricle posterior wall thickness:ρ=0.569,P<0.001)and QRS duration(septal thickness:ρ=0.543,P<0.001;left ventricle posterior wall thickness:ρ=0.557,P<0.001)were positively correlated with left ventricular wall thickness.Conclusions:Cardiac involvement in patients with FD in the Anhui region is characterised by palpitations or arrhythmias,accompanied by nonspecific electrocardiographic changes.Echocardiography frequently reveals papillary muscle hypertrophy.The manifestation of cardiac involvement in patients of different genders is similar.

The morbidity and mortality rate of cardiogenic stroke caused by atrial fibrillation is high,and anticoagulant therapy is the first therapeutic choice in the management of atrial fibrillation.International normalized ratio of warfarin should be strictly controlled at 2.0-3.0.The efficacy of direct oral anticoagulants for preventing embolism events is non-inferior to warfarin,but the risk of bleeding is significantly lower.Severe renal function decline has a great impact on the efficacy and safety of oral anticoagulants.The use of oral anticoagulants in patients with end-stage renal disease is now still controversial.This article reviews the research progress of oral anticoagulant therapy in patients with non-valvular atrial fibrillation complicated with end-stage renal disease.

The"Report on Cardiovascular Health and Diseases in China"is compiled by the National Center for Cardiovascular Diseases under the guidance of the National Health Commission.Since its inception in 2005,the report has spanned two decades.It has consistently adhered to the principles of professionalism,cutting-edge insights,representativeness,and authority.By continuously collecting,analyzing,and disseminating data on changes in cardiovascular health-related factors and disease trends,the report serves as a critical reference for policymakers in formulating public health strategies,identifying priority intervention areas,evaluating the effectiveness of prevention and control measures,and optimizing resource allocation.Cardiovascular diseases(CVD)remain the leading cause of death among urban and rural residents in China,accounting for 48.98%of rural deaths and 47.35%of urban deaths in 2021,and 2 out of every 5 deaths were CVD-related.The Healthy China 2030 initiative includes a dedicated"Cardiovascular and Cerebrovascular Disease Prevention and Control Action"among its 15 key campaigns,setting a clear target:reducing CVD mortality to 190.7 per 100 000 or lower by 2030.To achieve this goal,more refined action plans and high-quality multidimensional data are needed to track the CVD prevention progress.This includes not only monitoring and reporting CVD incidence,prevalence,mortality,disease burden,and healthcare quality but also actively promoting and tracking improvements in cardiovascular health indicators,such as tobacco consumption,diet,physical activity,sleep,body mass index(BMI),blood pressure,cholesterol,blood glucose,and environmental factors.

Objectives:To explore the progress in the application of cardiovascular related innovative patent technologies between China and the United States from 2014 to 2023,and to further analyze the differences in driving forces and policy orientations in the transformation of scientific and technological achievements between the two countries,providing reference data for improving the efficiency of the transformation of cardiovascular scientific and technological achievements in China.Methods:Based on the Himmpat patent database,we searched invention patent application data in the cardiovascular fields by using the Fuwai Subject Headings and adopting the method of the international patent classification(IPC)-title-claims-abstract,from January 1,2014 to December 31,2023(excluding utility model and design patents).Fourteen indicators regarding patent value evaluation were selected as independent variables and the transfer and transformation rate of invention patent family as the dependent variable.Then we construct univariate and multivariate prediction models by utilizing logistic regression to compare and analyze the differences in various predictors for the transformation rate of patent family in the cardiovascular field between the two countries,and calculate the respective population attributable fraction(PAF)for each predictor.Results:Over the past 10 years,there have been 45 413 invention patent family in the cardiovascular field in China,which exceeded the 35 582 invention patent family in the United States.The transformation rate of cardiovascular invention patent family in the United States was 49.77%,while in China it was only 9.18%.In the United States,the transformation rate of invention patent family's applicants involving medical institutions is significantly higher than that of universities,research institutions,and enterprises,with transformation rates of 63.75%,56.74%,50.00%,and 49.76%,respectively.In contrast,in China,the transformation rate of invention patent family in the cardiovascular field is 6.87%in medical institutions and 7.90%in universities,slightly higher in research institutions(10.99%),while the highest rate is in enterprises(15.83%).Moreover,the transformation rates of biomedical invention patent family is higher than that of medical devices in China(9.45%vs.7.81%),while the opposite is true in the United States(42.39%vs.59.03%).The results of PAF based on full multivariate logistic regression,the top three predictors for the transfer and transformation of invention patent family in China are applicants including enterprises(PAF=71.17%),overseas distribution country number more than one(PAF=30.76%),and invention authorized(PAF=29.95%).In the United States,citation frequency exceeding 10 times(PAF=46.92%),overseas distribution country number more than one(PAF=32.56%),and applicants including enterprises(PAF=20.54%)are the top three predictors for the transfer and transformation of invention patent family.Conclusions:Since the implementation of the 13th Five-Year Plan,the number of patent family applications for cardiovascular related inventions in China has surpassed that of the United States.However,the transfer and transformation efficiency of cardiovascular invention patents in China is significantly lower than that of the United States.In depth analysis of the reasons,this study finds it mainly lies in China's insufficient research and development potential for high-value patents,weak awareness of overseas market layout,insufficient motivation for universities and medical institutions to transfer and transform invention patents,and the underutilization of the transformation potential of medical device invention patents as well.

Objectives:This study aims to explore the value of the baseline extracellular volume(ECV)measured by cardiac magnetic resonance(CMR)in predicting cardiac response in patients with light chain cardiac amyloidosis(AL-CA)after treatment.Methods:This single-center retrospective cohort study included AL-CA patients diagnosed between May 2020 and March 2023.Baseline ECV measurement and other relevant parameters were derived from CMR.Therapeutic cardiac response was assessed through serial measurements of N-terminal pro-B-type natriuretic peptide(NT-proBNP).Complete recovery was defined as achieving NT-proBNP≤350 pg/ml post-treatment.Patients demonstrating>60%reduction from baseline NT-proBNP without attaining complete response criteria were classified as very good partial recovery.Those showing 31%-60%decreases from baseline NT-proBNP without meeting the threshold for very good partial recovery were qualified as partial recovery,while≤30%reductions from baseline were considered as non-recovery.The study evaluated two endpoints:the initial emergence of any cardiac recovery(encompassing partial recovery,very good partial recovery,or complete recovery)and the subsequent attainment of optimal cardiac recovery(encompassing partial recovery,very good partial recovery,or complete recovery).The patients were divided into two groups based on whether they experienced cardiac recovery at the end of follow-up:the recovery group(n=24,comprising 7 with partial recovery,14 with very good partial recovery,and 3 with complete recovery)and the non-recovery group(n=16).Cox Proportional hazards regression models were used to analyse the impact of baseline ECV on the cardiac recovery.The Kaplan-Meier method and log-rank test were used to assess and compare the probability and timing of cardiac recovery between different baseline ECV groups.Results:Among the 40 patients,28(70%)were male,with a mean age of(58?±?8)years.32 patients(80%)had the λ subtype of AL-CA.During a median follow-up of 568(155,1 049)days,15 patients showed partial cardiac recovery at 60 days post-treatment,and 3 patients achieved very good partial cardiac recovery;by 720 days of treatment and until the end of follow-up,3 patients achieved complete cardiac recovery.Multivariate Cox regression analysis revealed that baseline ECV(HR=0.937,95%CI:0.879-0.999,P=0.045)and daratumumab-based regimens(HR=3.279,95%CI:1.098-9.796,P=0.033)were significant predictors of the initial cardiac recovery.Similarly,baseline ECV(HR=0.931,95%CI:0.867-1.000,P=0.048)and daratumumab-based regimens(HR=3.132,95%CI:1.052-9.319,P=0.040)were also independent predictors for the best cardiac recovery.Kaplan-Meier analysis demonstrated that patients with baseline ECV<54%achieved an earlier first cardiac recovery than those with baseline ECV≥54%(log-rank P=0.014)and the group with baseline ECV<55%were more likely to achieve the best cardiac recovery compared to those with baseline ECV≥55%(log-rank P=0.006).Conclusions:Baseline ECV measured by CMR can serve as an independent predictor of cardiac recovery in AL-CA patients after treatment.Lower baseline ECV levels are associated with a faster and more favorable cardiac recovery.The daratumumab-based regimens demonstrated superior cardiac recovery outcomes.

Objectives:To explore the correlation between preoperative frailty and postoperative pulmonary complications in elderly patients undergoing cardiac surgery,and to provide a scientific basis for the comprehensive perioperative management of these patients.Methods:In this prospective cohort study,elderly patients(≥60 years old)who were scheduled to undergo coronary artery bypass grafting(CABG)and/or heart valve surgery at Fuwai Hospital,Chinese Academy of Medical Sciences from December 2022 to December 2023 were consecutively enrolled.Patients were divided into the postoperative pulmonary complication group and the non-postoperative pulmonary complication group based on whether they developed postoperative pulmonary complications.Demographic data,preoperative frailty status,physical function indicators(6-meter walking speed,pulmonary function),laboratory test indicators,and surgical data of the two groups were collected and compared.Multivariate logistic regression analysis was used to evaluate the correlation between preoperative frailty and postoperative pulmonary complications in these patients.Results:A total of 522 patients were included in the study,66(12.6%)had preoperative frailty.There were 159 cases(30.5%)in the postoperative pulmonary complication group and 363 cases(69.5%)in the non-postoperative pulmonary complication group.Compared with the non-postoperative pulmonary complication group,the postoperative pulmonary complication group had a higher prevalence of preoperative frailty,cerebral infarction,and pulmonary hypertension,lower maximal inspiratory pressure,slower 6-meter walking speed,a higher proportion of patients undergoing heart valve surgery and CABG+heart valve surgery,and significantly longer mechanical ventilation time,intensive care unit stay,and postoperative hospital stay(all P<0.05).Multivariate logistic regression analysis showed that preoperative frailty(OR=1.998,95%CI:1.005-3.973,P=0.048),maximal inspiratory pressure(OR=0.987,95%CI:0.977-0.997,P=0.011),6-meter walking speed(OR=0.003,95%CI:0.001-0.017,P<0.001),mechanical ventilation time(OR=2.295,95%CI:1.601-3.290,P<0.001),and CABG+heart valve surgery(OR=1.772,95%CI:1.294-2.428,P<0.001)were independent risk factors of postoperative pulmonary complications in elderly patients undergoing cardiac surgery.Conclusions:Preoperative frailty increases the risk of postoperative pulmonary complications in elderly patients undergoing cardiac surgery.

Objectives:This study aims to investigate the relationship between neutrophil to high-density lipoprotein cholesterol ratio(NHR)and incidence of cardiovascular disease(CVD)among individuals with metabolic associated fatty liver disease(MAFLD).Methods:We conducted a prospective cohort study utilizing health check-up data from 2006 to 2007 at Kailuan General Hospital and its 10 affiliated hospitals.The study population consisted of employees and retirees diagnosed with MAFLD,excluding those with incomplete neutrophil and high-density lipoprotein cholesterol data or a history of heart failure,myocardial infarction,cerebral hemorrhage,or cerebral infarction.CVD was defined as the presence of heart failure,myocardial infarction,cerebral hemorrhage,or cerebral infarction.Annual follow-ups were conducted from 2006,new-onset CVD cases identified through discharge records from the 11 Kailuan Group hospitals and records from municipal social insurance agencies,the final follow up date was December 31,2022.NHR was calculated as the ratio of neutrophil to high-density lipoprotein cholesterol,and the MAFLD cohort(n=28 952)was stratified into four groups by NHR quartiles:Q1 group(NHR<1.97,n=7 241),Q2 group(1.97≤NHR<2.57,n=7 235),Q3 group(2.57≤NHR<3.36,n=7 240),and Q4 group(NHR≥3.36,n=7 236).The Kaplan-Meier method was employed to plot survival curves for new-onset CVD,and the cumulative incidences of CVD across different NHR quartiles groups were determined.Intergroup comparisons were made using the log-rank test,and a multifactorial Cox proportional hazards regression model was used to assess the association between NHR quartiles and the risk of new-onset CVD in the MAFLD population.Results:The average follow-up duration was(14.03±3.99)years,during which 4 666 new CVD cases were recorded among the study population.The number of CVD cases across Q1 group to Q4 group were 1 061,1 167,1 186 and 1 252,respectively,with an overall incidence density of 11.5 cases per 1 000 person-years.The incidence densities for Q1 group to Q4 group were 10.4,11.4,11.7 and 12.5 cases per 1 000 person-years,respectively.The multifactorial Cox proportional hazards regression analysis revealed that higher NHR quartiles were associated with an increased relative risk of new-onset CVD(Q2 group:HR=1.13,95%CI:1.04-1.23;Q3 group:HR=1.15,95%CI:1.05-1.25;Q4 group:HR=1.22,95%CI:1.12-1.33).Conclusions:The risk of new-onset cardiovascular disease in individuals with MAFLD escalates with increasing NHR.