Objective To explore the plasma levels and clinical significance of osteoprotegerin(OPG)and receptor activator of nuclear factor kappa B ligand(RANKL)in patients with chronic heart failure(CHF).Methods In 110 patients with CHF and 80 normal controls,the plasma levels of OPG and RANKL were measured by enzyme-linked immunosorbentassay method.Results The plasma level of OPG in patients with CHF[(135.91±41.83)ng/L]was significantly higher than that in normal controls[(90.13±29.09)ng/L](P＜0.05).The plasma level of RANKL in patients with CHF[(90.82±32.14)ng/L]was significantly higher than that in normal controls[(59.78±20.11)ng/L](P＜0.05).The plasma levels of OPG and RANKL increased with the augment of NYHA functional ranking(P＜0.05).The plasma levels of OPG and RANKL had negative relationship with left ventricular ejection fraction(r=-0.33 and-0.36,P＜0.05).Conclusions The plasma levels of OPG and RANKL in patients with CHF are elevated and related with heart function.OPG and RANKL may participate in the occurrence and development of CHF.

This article presents a case of acute ST-segment elevation myocardial infarction (STEMI) in a pregnant woman caused by coronary artery dissection. The 41-year-old patient had undergone cardiac valve surgery at the age of 1 and had no risk factors such as hypertension, diabetes, smoking, alcohol use, or a family history of coronary artery disease. At 31 +1 weeks of gestation, she experienced sudden chest pain for 4 hours and was emergently referred to Peking University First Hospital on June 1, 2021. Electrocardiogram revealed ST-segment elevation in leads I, aVL, and V 2 to V 6. Biochemical assays showed elevated levels of high-sensitivity cardiac troponin I and creatine kinase-MB. Echocardiography indicated segmental ventricular wall motion abnormalities (apical) and reduced left ventricular function, confirming the diagnosis of acute anterior wall STEMI. The patient promptly underwent emergency coronary angiography and percutaneous coronary intervention and confirmed coronary artery dissection. Postoperative care included antiplatelet, anticoagulation, and supportive treatment. At 34 +3 weeks of gestation, with the condition of acute anterior wall STEMI being relatively stable, a cesarean section was successfully performed. Regular cardiology follow-ups were scheduled postpartum, and cardiac function was normal in two years after discharge.