In the past 6 years, significant breakthroughs have been achieved in the treatment of heart failure (HF), especially in drug therapy. The classification of chronic HF and the treatment methods for HF and its complications are also constantly being updated. In order to apply these results to the diagnosis and treatment of patients with HF in China and further improve the level of diagnosis and treatment of HF in China, the HF Group of Chinese Society of Cardiology, Chinese Medical Association, Chinese College of Cardiovascular Physician, Chinese HF Association of Chinese Medical Doctor Association, and Editorial Board of Chinese Journal of Cardiology have organized an expert group and update the consensus and evidence-based treatment methods in the field of HF based on the latest clinical research findings at home and abroad, combined with the national conditions and clinical practice in China, and referring to the latest foreign HF guidelines while maintaining the basic framework of the 2018 Chinese Guidelines for Diagnosis and Treatment of HF.

Fabry disease(FD)is an X-linked genetic disorder caused by mutations in the GLA gene.It leads to reduced or complete deficiency of the activity of α-galactosidase A(α-Gal A),resulting in an accumu-lation of the metabolic substrate globotriaosylceramide(Gb3)and its derivative,globotriaosylsphingosine(Lyso-Gb3),in a wide range of cells and tissues,which causes multiple organ pathologies.In the cardiovascu-lar system,FD predominantly leads to left ventricular hypertrophy and/or conduction abnormalities known as FD cardiomyopathy.Since FD cardiomyopathy is the leading cause of death in adult patients with FD,early diagnosis combining cardiac imaging,enzyme and substrate activity,genetic testing,and tissue biopsy,as well as early specific enzyme replacement therapy are important to improve patient prognosis.This consensus comprehen-sively summarizes the published evidence related to the diagnosis and treatment of FD cardiomyopa-thy at home and abroad,and provides a basis for the diagnosis and management of FD cardiomyopathy.

Background Atrial fibrillation (AF) is a common arrhythmia associated with increased cardiovascular morbidity and mortality. This study was undertaken to analyze the epidemiological factors and evaluate the current status of treatment in patients with AF in Mainland China. Methods Retrospective analysis of hospital records were taken from patients with primary diagnosis of AF, discharged from January 1999 to December 2001. A total of 9297 cases (mean age 65.5 years) with AF were enrolled from 40 hospitals in major parts of China. Results The percentage of hospital admissions with AF was gradually increased comparing to those of total cardiovascular admission during three years, with the average of 7.9%. The cases distribution progressively rose with age. The causes and associated conditions of AF: advanced age 58.1%, hypertension 40.3%, coronary heart disease 34.8%, heart failure 33.1%, rheumatic valvular disease 23.9%, idiopathic AF 7.4%, cardiomyopathy 5.4%, diabetes 4.1%. The most common coexistence among these variables was advanced age with hypertension. Permanent AF almost accounted for half of these cases (49.5%), paroxysmal and persistent AF were 33.7% and 16.7%, respectively. Paroxysmal AF was mainly treated with rhythm control (56.4%). However, 82.8% of patients with chronic AF had therapeutic strategy of rate control. In patients with persistent AF, the cardioversion had been attempted in cases more than 50%, with only 31.1% of these patients who could maintain stabilized sinus rhythm. The prevalence of stroke in this group was 17.5%. In nonvalvular AF patients the risk factors that significantly associated with stroke included advanced age, history of hypertension, coronary heart disease and type of AF. Sixty-four point five percent of these patients received antithrombotic therapy with dominated use of antiplatelet agents. The long-term prevention with anticoagulants only accounted for 6.6%. In this investigation patients with antiplatelets as well as patients with anticoagulants showed significant lower stroke rate in comparison with those managed neither. However, the difference between antiplatelets and anticoagulants in terms of stroke rate was not significant. Conclusions Most epidemiological factors of AF from this group showed highly in accordance with those from the reports from other countries, such as age distribution, causes and associated conditions, type of AF, dominantly with approach of rate control. Both antiplatelet and anticoagulant treatments significantly reduced stroke rate. But there was no significant difference between these two kinds of treatments in reducing stroke rate.

Objective To analyze the status and trend of the development of percutaneous coronary intervention (PCI) in Chinese military hospitals from 2003 to 2004. Methods In April 2005, a registry form was dispatched to all army hospitals, and items in regard of PCI during 2003 to 2004 were asked to be filled for analysis. Results From 2003 to 2004, a total of 16842 cases of PCI performed in 61 PLA hospitals (7052 in 2003, 9790 in 2004) were registered and reported. The intervention procedures were performed in a total of 23706 target lesions, of which only 1632 target lesions (6.9%) were dilated by balloon, and 22074 target lesions (93.1%) were implanted with coronary stents, and 8086 stents among all were drug eluted (36.6% of all stents), including 4270 eluted with rapamycin (Cypher and Firebird, 52.8%), 2072 Paclitaxel eluted (25.6%) and 1744 eluted with other kinds of drug (21.6%). Total success rate of PCI was 97.7% (16449/16842), and success rate was 99.8% in patients with stented procedure. The incidence of major complications and major adverse cardiovascular events was 4.2% (708/16842), including acute occlusion of coronary artery (0.3%), subacute occlusion (0.4%), pericardial tamponade (0.1%), falling of stent (0.1%), emergency coronary artery bypass grafting (0.1%), an inhospital mortality of 1.2% (including death resulted in acute myocardial infarction), and slow-flow or no-flow (1.6%). During follow-up period, target vessel revascularization was done in 5.1% of the patients. Emergency PCI for acute myocardial infarction was performed in 2467 cases, PCI for left main coronary artery and grafted vessel was performed in 576 cases and 137 cases, respectively. Trans-radial PCI was done in 3051 cases. 2124 PCI were done for chronic total occlusion lesions, and the number increased tremendously compared with the last registry. In 57.3% of the hospitals enrolled in the registry, the annual PCI number was less than 100 cases, while in 13.2% of the hospitals the annual number of PCI was over 200 cases, and in only 2 hospitals the annual PCI number was over 1000 cases. Conclusions The annual case numbers of PCI in PLA hospitals within the recent two years increased by around 40% every year. The success rates for complicated lesions, the use of new technique, and the complication rate of PCI were comparable with that reported in domestic and foreign literature published in recent years. It is noted that, the development has been quite different among different hospitals, so that technical training and cooperation should be emphasized in the future.