Objective To investigate whether there exist differences in the improvement of left ventricular diastolic function between angiotensin receptor-neprilysin inhibitor(ARNI)and angiotensin-converting enzyme inhibitor(ACEI)/angiotensin receptor blocker(ARB)in patients with hypertensive heart disease(HHD).Methods A retrospective cohort study was conducted on the HHD patients admitted in Department of Cardiovascular Diseases of our hospital from January 2021 to December 2024.The general information,echocardiographic parameters before and after treatment,and results of routine tests were collected.Finally,517 HHD patients were subjected,including 117 receiving ARNI treatment(ARNI group)and 400 getting ACEI/ARB treatment(ACEI/ARB group).A 1∶1 propensity score matching(PSM)was performed with a caliper value of 0.02,resulting in 89 matched cases for each group.Electrocardiography was performed to assess left ventricular diastolic dysfunction(LVDD),with various parameters,including left atrial volume index,early diastolic peak velocity at the interventricular septal portion of mitral annulus(septal e'),early diastolic peak velocity at the lateral wall portion of mitral annulus(lateral e'),tricuspid regurgitation velocity,and E/e'.These parameters were followed up and reassessed during the treatment period.Kaplan-Meier survival curve was plotted to compare the incidence of LVDD between the 2 groups.Multivariable logistic regression model was employed to identify the risk factors contributing to LVDD.Results The median follow-up time was 412(309,736)d in the whole cohort,and was 409(300,729)d for the patients after PSM.Kaplan-Meier survival analysis demonstrated that the incidence of LVDD was lower in the ARNI group than the ACEI/ARB group both before and after PSM(P<0.05).After treatment,the ARNI group obtained lower lateral e'[8.00(7.00,9.40)vs 9.00(7.10,10.30)cm/s,P<0.001],thinner left ventricular posterior wall thickness[12.20(10.80,12.80)vs 12.30(11.20,12.90)mm,P<0.048]when compared with the ACEI/ARB group.After adjusting for confounding factors,multivariable logistic regression analysis revealed that advanced age(OR=1.082,P<0.001),increased systolic blood pressure(OR=1.009,P=0.005),thicker left ventricular posterior wall thickness(OR=1.462,P<0.001),left atrial enlargement(OR=1.081,P<0.001),and use of calcium channel blocker(OR=1.548,P=0.006)were independent risk factors for LVDD,and positively correlated with the risk of LVDD.While,male(OR=0.709,P=0.043)and BMI(OR=0.933,P=0.006)were protective factors,which were negatively correlated with LVDD risk.Conclusion In HHD patients,ARNI is superior to ACEI/ARB in reducing the incidence of LVDD.

Objective : To investigate the mortality of cardiovascular and cerebrovascular diseases and to examine the effects on life expectancy among residents in Yuhang District of Hangzhou City from 2010 to 2020, so as to provide insights into the management of cardiovascular and cerebrovascular diseases. Methods: The mortality surveillance data of cardiovascular and cerebrovascular diseases of registered residents in Yuhang District from 2010 to 2020 were collected from Zhejiang All-cause Death Surveillance System. The crude mortality, standardized mortality, annual percent change ( APC ), Fulfillment index, life expectancy, cause-eliminated life expectancy and years of life lost, and the mortality of cardiovascular and cerebrovascular diseases and the impact on life expectancy were analyzed. Results: A total of 21 761 deaths occurred due to cardiovascular and cerebrovascular diseases in Yuhang District from 2010 to 2020, and the annual average crude and standardized mortality rates of cardiovascular and cerebrovascular diseases were 206.14/105 and 129.62/105, respectively. The annual crude and standardized mortality of cardiovascular and cerebrovascular diseases both appeared a tendency towards a decline from 2010 to 2020, with APC of -3.63% and -5.45%, respectively ( P<0.05 ), and the Fulfillment index showed a tendency towards a reduction in residents at ages of 50 to 79 years ( P<0.05 ). The mean life expectancy and cause-eliminated life expectancy were 82.71 and 88.39 years in Yuhang District from 2010 to 2020, which both appeared a tendency towards a rise, both with APC of 0.50% ( P<0.05 ). The years of life lost were 5.02 to 6.47 years due to cardiovascular and cerebrovascular diseases, and the life loss rates were 6.00% to 7.73%. Conclusions The mortality of cardiovascular and cerebrovascular diseases appeared a tendency towards a decline decreased and the cause-eliminated life expectancy appeared a tendency towards a rise in Yuhang District from 2010 to 2020. Intensifying the management of cardiovascular and cerebrovascular diseases death may increase the life expectancy.

Objective To discuss the complications of percutaneous kyphoplasty (PKP) in treatment of osteoporotic compression fractures (OVCFs) of the thoracic and lumbar vertebrae,and to investigate their causes and prevention.Methods From Jan.2004 to Dec.2012,PKP or PKP combined with percutaneous vertebroplasty(PVP) was performed on 126 vertebrae in 112 thoracolumbar OVCFs patients.There were 21 males and 91 females.The average age was 69 years (ranging from 36 to 85).100 cases had single vertebra,10 cases had double vertebrae,and 2 cases had 3 vertebrae.The injured segments were identified by MRI before surgery,and the fractures of the vertebrae were observed clearly by X ray and CT scan.The causes of the complications were retrospective analyzed.Results Perioperative complication happened in 68 cases (54％).The leakage of the bone cement happened in 66 cases (52.4％):one of them had high fever after the leakage happened behind the post-wall of the vertebra body,and it disappeared after one week with the relevant treatment.There was no injury of the nerve.Most of the leakage happened in front of the vertebra body,few happened in the terminal plate,and few happened behind the vertebral plate.There was no pulmonary embolism.Toxic reaction of the bone cement wasn't found in this team.There was no artery or nerve injury.One temporary spinal cord injury happened,one case was punctured in a wrong vertebra,and balloon rupture happened in one case.One case didn't achieve pain release.No infection happened.Conclusion The bone cement leakage was the most common complication associated with PKP in treatment of OVCFs.The complication rate can be reduced if the operation indications are strict,the volume of the filling cementis is well controlled,and the operation is performed in experienced hands.