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.

Heart failure(HF)has complex pathophysiological mechanisms and is associated with high mortality and readmission rates.As the terminal manifestation of cardiovascular disease and the main cause of death,HF remains a critical focus in the medical community.Despite advances in standardized treatment through western medicine,many patients remain at high risk for cardiovascular events.Shenfu Qiangxin pill,a traditional Chinese patent medicine,has shown promising results in recent years regarding its mechanisms and clinical applications for HF treatment.This article elaborates on the latest research trends of Shenfu Qiangxin pill in the treatment of HF,examining its composition,efficacy,and mechanisms from both traditional Chinese and western medical perspectives.It also explores its clinical applications and safety,highlighting its potential and prospects in HF treatment and providing a theoretical basis for clinical practice.

OBJECTIVETo evaluate the effectiveness and safety of endovascular stent insertion for non-small cell lung cancer patients with superior vena cava syndrome.

METHODSWe retrospectively studied 123 patients referred to our hospital for the treatment of non-small cell lung cancer presenting with superior vena cava syndrome. Patients were devided in two groups according to the use of endovascular stent insertion in superior vena cava syndrome or not. 64 patients underwent endovascular stent insertion was designed as the stenting group and 59 without stenting as control group. The differences between the two groups in complete response, complication and survival were analyzed.

RESULTSThe complete response rate of superior vena cava obstruction was 92.0% for the stenting group, and 42.0% for the control group, showing a significant difference between the two groups (P < 0.001). The median time to complete response was (3.76 ± 2.83) days in the stenting group, significantly shorter than that of the control group (28.08 ± 16.06) days (P < 0.001). The relapse rate after complete response was 12.0% in the stenting group and 16.0% in the control group, showing a non-significant difference between the two groups (P = 0.607). The median time to relapse was 2.7 months in the stenting group and 1.1 months in the control group (P = 0.533). In the stenting group, stent stenosis occurred in 1 case and thrombosis was observed in 3 cases. The incidence rate of complications was 6.3%. Thrombosis occurred in 1 case of the control group, with an incidence rate of complications of 1.7%, showing a non-significant difference between the two groups (P = 0.201). Seven among the 123 patients were still alive at the endpoint of following up. The median survival time was 8.0 months (stenting group) and 5.5 months (control group) (P = 0.382).

CONCLUSIONSEndovascular stent insertion is effective and safe for non-small lung cell cancer patients with superior vena cava syndrome, and it may be recommended as the first choice for palliative treatment of superior vena cava obstruction.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; complications ; surgery ; Female ; Humans ; Lung Neoplasms ; complications ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Palliative Care ; Remission Induction ; Retrospective Studies ; Stents ; Superior Vena Cava Syndrome ; complications ; surgery ; Thrombosis