Cardiovascular nursing research focuses on solving practical nursing problems, and nursing practice is continuously improved based on nursing research. This article provides an overview of the development of cardiovascular nursing research, summarizes and generalizes the current research status and future research hotspots in cardiovascular nursing according to the Fuwai Subject Headings, aiming to provide references for nursing staff.

Cardiovascular nursing research focuses on solving practical nursing problems, and nursing practice is continuously improved based on nursing research. This article provides an overview of the development of cardiovascular nursing research, summarizes and generalizes the current research status and future research hotspots in cardiovascular nursing according to the Fuwai Subject Headings, aiming to provide references for nursing staff.

Background and purpose:BRCA1/2 plays an important role in maintaining the genome stability.Whether BRCA1/2 germline mutation could increase the tumor sensitivity to radiotherapy,thereby inducing secondary primary cancer after radiotherapy is unclear.This study aimed to investigate whether postoperative radiotherapy is a risk factor for the development of second primary cancer in triple-negative breast cancer(TNBC)patients with BRCA1/2 germline mutation.Methods:This research was based on a previously reported retrospective cohort,i.e.,the Fudan University Shanghai Cancer Center TNBC cohort.Between January 1,2007 and December 31,2014,a total of 292 female TNBC patients with BRCA1/2 mutation were enrolled.We performed logistic regression analysis in patients without BRCA1/2 germline mutation(n=261)and BRCA1/2 germline mutation patients(n=31),respectively,to assess the risk factors affecting the incidence of second primary cancer.We then performed interactive analysis on the above two analyses to evaluate the interactive effect between BRCA1/2 germline mutation and postoperative radiotherapy.P<0.05 indicates a statistically significant difference.The research was approved by Fudan University Shanghai Cancer Center TNBC Ethics Committee(050432-4-2108),and each patient provided written informed consent.Results:Logistic regression analysis in patients with BRCA1/2 germline mutations showed that postoperative radiotherapy significantly increased the risk of secondary primary disease compared to non-radiotherapy[odds ratio(OR)=2.475,95%confidence interval(CI):1.933-3.167,P<0.001].In patients without BRCA1/2 germline mutation,the effect of radiotherapy on the incidence of second primary tumor was not significant.There was a significant interaction between BRCA1/2 germline mutation and postoperative radiotherapy for the incidence of secondary primary cancer(OR=9.710,95%CI:0.320-295.250,P=0.193).Conclusion:Although statistical analysis results show that patients with BRCA1/2 germline mutations have an increased risk of developing a second primary tumor after postoperative radiotherapy compared to patients who have not received radiotherapy,there is no significant correlation between BRCA1/2 germline mutations and radiotherapy for the development of a second primary tumor.Therefore,patients with BRCA1/2 germline mutations who receive radiotherapy after surgery may not increase the risk of developing a second primary tumor.

Objective:To explore the influencing factors of immune checkpoint inhibitor-related pneumonitis (CIP) in lung cancer patients caused by programmed cell death 1 receptor (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors.Methods:A retrospective analysis was conducted on clinical data of lung cancer patients treated with PD-1/PD-L1 inhibitors in the First Affiliated Hospital of Guangzhou Medical University from January 2018 to June 2022. Patients with CIP were included in the CIP group, and those who did not experience any immune-related adverse events during the same period were screened in a 1∶1 ratio and included in the control group. The clinical characteristics in patients of the 2 groups were compared and influencing factors of CIP were analyzed using binary logistic regression method. The effect sizes were the odds ratio ( OR) and its 95% confidence interval ( CI). Results:A total of 246 patients (123 in the CIP group and 123 in the control group) were entered in the analysis, including 208 males and 38 females, aged (63±9) years with a range of 32 to 86 years. The diagnosis was non-small-cell lung cancer in 234 patients and small cell lung cancer in 12 patients. There were no statistically significant differences in age, gender, history of respiratory diseases, tumor histological types, TNM stages, and types of immune checkpoint inhibitors used in patients between the 2 groups (all P>0.05). Compared with the control group, patients in the CIP group had a lower body mass index [(21.5±3.2) kg/m 2vs. (22.6±3.0) kg/m 2, P=0.004], higher proportion of patients with Eastern Cooperative Oncology Group Performance Scale (ECOG-PS) ≥2 points[39.0% (48/123) vs. 22.0% (27/123), P=0.004], higher proportion of patients with a history of radiation therapy [25.2% (31/123) vs. 13.8% (17/123), P=0.024], and lower proportion of patients with combination therapy with chemotherapy/targeted drugs[82.9%(102/123) vs. 97.6%(120/123), P<0.001]. Before immunotherapy, the peripheral blood interleukin-1β and interferon-α were lower [1.97 (1.04, 2.74) ng/L vs. 2.40 (1.75, 4.03) ng/L, P=0.021; 2.08 (0.89, 3.00) ng/L vs. 2.76 (1.97, 3.94) ng/L, P=0.012], lymphocyte count was lower [1.4(1.0, 1.8)×10 9/L vs. 1.5(1.2, 2.1)×10 9/L, P=0.030], and the neutrophil-to-lymphocyte ratio was higher [3.85 (2.50, 6.40) vs. 3.11 (2.25, 4.61), P=0.006] in patients of the CIP group than those in the control group. The binary logistic regression analysis showed that baseline ECOG-PS ≥2 points ( OR=3.400, 95% CI: 1.180-9.798, P=0.023) and combination of PD-1/PD-L1 inhibitors and chemotherapy/targeted therapy ( OR=0.047, 95% CI: 0.005-0.454, P=0.008) were independent influencing factors for the occurrence of CIP. Conclusion:The ECOG-PS ≥ 2 points before immunotherapy is an influencing factor for CIP, and the combination with chemotherapy/targeted therapy may reduce the risk of developing CIP in patients treated with PD-1/PD-L1 inhibitors.

Objective:To explore the influencing factors of immune checkpoint inhibitor-related pneumonitis (CIP) in lung cancer patients caused by programmed cell death 1 receptor (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors.Methods:A retrospective analysis was conducted on clinical data of lung cancer patients treated with PD-1/PD-L1 inhibitors in the First Affiliated Hospital of Guangzhou Medical University from January 2018 to June 2022. Patients with CIP were included in the CIP group, and those who did not experience any immune-related adverse events during the same period were screened in a 1∶1 ratio and included in the control group. The clinical characteristics in patients of the 2 groups were compared and influencing factors of CIP were analyzed using binary logistic regression method. The effect sizes were the odds ratio ( OR) and its 95% confidence interval ( CI). Results:A total of 246 patients (123 in the CIP group and 123 in the control group) were entered in the analysis, including 208 males and 38 females, aged (63±9) years with a range of 32 to 86 years. The diagnosis was non-small-cell lung cancer in 234 patients and small cell lung cancer in 12 patients. There were no statistically significant differences in age, gender, history of respiratory diseases, tumor histological types, TNM stages, and types of immune checkpoint inhibitors used in patients between the 2 groups (all P>0.05). Compared with the control group, patients in the CIP group had a lower body mass index [(21.5±3.2) kg/m 2vs. (22.6±3.0) kg/m 2, P=0.004], higher proportion of patients with Eastern Cooperative Oncology Group Performance Scale (ECOG-PS) ≥2 points[39.0% (48/123) vs. 22.0% (27/123), P=0.004], higher proportion of patients with a history of radiation therapy [25.2% (31/123) vs. 13.8% (17/123), P=0.024], and lower proportion of patients with combination therapy with chemotherapy/targeted drugs[82.9%(102/123) vs. 97.6%(120/123), P<0.001]. Before immunotherapy, the peripheral blood interleukin-1β and interferon-α were lower [1.97 (1.04, 2.74) ng/L vs. 2.40 (1.75, 4.03) ng/L, P=0.021; 2.08 (0.89, 3.00) ng/L vs. 2.76 (1.97, 3.94) ng/L, P=0.012], lymphocyte count was lower [1.4(1.0, 1.8)×10 9/L vs. 1.5(1.2, 2.1)×10 9/L, P=0.030], and the neutrophil-to-lymphocyte ratio was higher [3.85 (2.50, 6.40) vs. 3.11 (2.25, 4.61), P=0.006] in patients of the CIP group than those in the control group. The binary logistic regression analysis showed that baseline ECOG-PS ≥2 points ( OR=3.400, 95% CI: 1.180-9.798, P=0.023) and combination of PD-1/PD-L1 inhibitors and chemotherapy/targeted therapy ( OR=0.047, 95% CI: 0.005-0.454, P=0.008) were independent influencing factors for the occurrence of CIP. Conclusion:The ECOG-PS ≥ 2 points before immunotherapy is an influencing factor for CIP, and the combination with chemotherapy/targeted therapy may reduce the risk of developing CIP in patients treated with PD-1/PD-L1 inhibitors.

Objective:To discuss the relationship between heart rate (HR) and heart rate differences (HRD) at different time points in head-up tilt test (HUTT) and the occurrence of postural tachycardia syndrome(POTS) in children and adolescents.Methods:A total of 217 children and adolescents diagnosed as POTS, who complained of syncope or presyncope, were chosen as POTS group (aged 6 to 16 years). During the same period, 73 healthy children and adolescents with matching gender and age were selected as control group.All subjects underwent HUTT from October 2000 to November 2019.Get HR (HR0, HR5, HR10) in baseline, HUTT 5 min and 10 min, HRD (HRD5, HRD10) of HR in HUTT 5 min and 10 min minus HR in baseline.Results:(1) HR5, HR10, HRD5, and HRD10 were higher in the POTS group than those in the control group( P<0.05). (2) Univariate Logistic regression: There was a correlation between HR5, HR10, HRD5, HRD10 and the risk of POTS( P<0.01). (3) Multivariable Logistic regression: For each additional unit of HRD5 and HRD10, the risk of POTS increased by 27% ( OR=1.27, 95% CI1.16 to 1.36) and 28% ( OR=1.28, 95% CI1.20 to 1.38). Conclusion:HR and HRD are related with the occurrence of POTS in children and adolescents, but HR and HRD at different time points of HUTT play the little role on the effect size of the occurrence of POTS.

Objective:To study the diagnostic efficacy and prognostic evaluation value of QT interval dispersion (QTd) in children and adolescents with cardioinhibitory vasovagal syncope (VVS-CI).Methods:From July 2010 to January 2020, 80 children and adolescents who received their first visit or admission to the Pediatric Syncope Clinic of The Second Xiangya Hospital of Central South University and definite diagnosed of VVS-CI due to syncope or presyncope were selected as the VVS-CI group, meanwhile, 80 children and adolescents who had physical examination in the hospital were selected as the control group.QT interval were measured by 12-lead electrocardiogram at the baseline.Results:(1) Comparison between the two groups: Compared with the control group, the VVS-CI group had a significantly lower heart rate ( P<0.05) and significantly longer QT interval, such as the maximum QT interval (QTmax), minimum QT interval (QTmin), QTd, corrected maximum QT interval (QTcmax) and corrected QT interval dispersion (QTcd) ( P<0.05). After follow-up 84 (45, 127) days, compared with the responsive group, the non-responsive group had a significantly longer QT interval, such as QTmax, QTd, QTcmax, corrected minimum QT interval (QTcmin)and QTcd ( P<0.05). (2) Diagnostic efficiency: QTmax, QTmin, QTd, QTcmax and QTcd had a certain diagnostic value in children and adolescents with VVS-CI ( P<0.001). QTd had the largest area under the curve (AUC) (0.914), and had a sensitivity of 86.30% and a specificity of 84.95% at the optimal cut-off value of 28.50 ms for VVS-CI diagnosis.(3) Prognostic evaluation value: QTmax, QTd, QTcmax, QTcmin, QTcd had an estimated value for the prognosis of VVS-CI in children and adolescents ( P<0.05 or 0.01). QTd had the largest AUC (0.906) and the best cut-off value was 34.50 ms, the sensitivity to predict response to VVS-CI intervention was 90.00%, and the specificity was 82.35%. Conclusion:QTd of electrocardiogram has a good estimation value in the diagnosis and prognosis of VVS-CI in children and adolescents.

Objective:To investigate the difference of heart rate variability in cardioinhibitory type vasovagal syncope(VVS-CI) children with different body mass index(BMI).Methods:Clinical data of thirty-four children with syncope or pre-syncope were retrospectively analyzed, who visited specialist clinic for syncope and diagnosed as VVS-CI at the Second Xiangya Hospital of Central South University from January 2012 to December 2019.BMI was calculated based on height and weight, and divided into lean group(BMI≤18.4 kg/m 2, n=19) and normal group(BMI 18.5-23.9 kg/m 2, n=15). Heart rate variability(HRV) of 24 h dynamic electrocardiogram was analyzed using linear analysis method.Time domain index included SDNN, SDANN, rMSSD and pNN50.Frequency domain index included total power(TP), ultra low frequency power(ULF), very low frequency power(VLF), low frequency power(LF), high frequency power(HF) and LF/HF. Results:There was no significant difference in SDNN, SDANN and rMSSD between lean and normal group( P>0.05), but pNN50 increased in lean group( P<0.05). No significant differences were found in TP, ULF, LF, HF and LF/HF between two groups( P>0.05), while VLF was lower in lean group than that in normal group( P<0.05). There was no statistical difference in time domain index and frequency domain index between different gender between lean and normal group( P>0.05). SDNN, SDANN and LF were higher in<12 years old than those in≥12 years old in lean group( P<0.05). There was no statistical difference in rMSSD, pNN50, TP, ULF, VLF, HF and LF/HF( P>0.05). ULF increased and LF decreased in<12 years old compared to ≥12 years old in normal group( P<0.05). No statistical differences were found in SDNN, SDANN, rMSSD, pNN50, TP, VLF, HF and LF/HF( P>0.05). Conclusion:The autonomic nervous regulation function of VVS-CI children with low BMI and normal BMI is different, resulting in HRV difference.There were also differences in HRV between<12 years old and ≥12 years old with the same BMI.

Objective:To investigate the relationship between body mass index (BMI) and response time of cardioinhibitory type vasovagal syncope (VVS-CI) in children.Methods:The clinical data of 56 children with syncope or pre-syncope were retrospectively analyzed and they visited specialist clinic for syncope and were diagnosed as VVS-CI in the Second Xiangya Hospital, Central South University from December 2012 to September 2019.Based on height and weight, BMI was calculated, and divided into low BMI group (35 cases) and normal BMI group (21 cases). Between the 2 groups, baseline heart rate, head-up tilt test (HUTT) positive response heart rate, baseline head-up tilt test (BHUT) positive response time, and sublingual nitroglycerin-provocated HUTT (SNHUT) positive response time were compared.The correlation between BMI and positive response time was analyzed.SPSS 22.0 software was applied for statistical analysis.Results:There were no significant differences in age, sex, duration of disease and number of syncope between the 2 groups (all P>0.05). No significant differences were found in baseline heart rate and positive response heart rate between the 2 groups [(78.5±15.3) times/min vs.(72.8±8.7) times/min, t=1.223, P=0.230; (44.0±13.9) times/min vs.(47.0±10.0) times/min, t=-0.664, P=0.511]. Compared with normal BMI group, BHUT positive patients/SNHUT positive patients were higher in low BMI group (27/8 cases vs.9/12 cases, χ2=4.839, P=0.027), and the positive response time of BHUT was shorter [(13.1±4.6) min vs.(23.7±9.5) min, t=-2.691, P=0.023]. There were no significant differences in SNHUT positive response time between the 2 groups ( P>0.05). Low BMI was correlated with BHUT positive response time ( r=0.750, P=0.005). Normal BMI was not associated with BHUT positive response time ( r=0.316, P=0.217). There was no correlation between low BMI and normal BMI and SNHUT positive response time ( r=0.177, P=0.431; r=0.021, P=0.940). Conclusions:Low BMI is positively correlated with BHUT positive response time of children with VVS-CI.The time it takes for syncope occurrence was shorter in children with low BMI than that in normal BMI.

Objective:To investigate the circadian rhythm of blood pressure and morning blood pressure surge (MBPS) in children with neurally mediated syncope (NMS).Methods:From July 2018 to June 2019, 135 cases [aged 3-16 years old (10.12±2.53) years old, with 74 males and 61 females] with unexplained syncope, presyncope, and symptoms such as headache, dizziness, chest pain, and chest tightness were collected in the Second Xiangya Hospital, Central South University for the first time.The 24 hour ambulatory blood pressure monitoring (24 h ABPM) was completed on the same day of the head-up tilt test (HUTT). Patients were divided into HUTT negative and positive groups, and dippers and non-dippers groups. MBPS (sleep-trough surge) was calculated and compared respectively.Results:(1) There were 51 patients in the HUTT positive group, including 27 patients with vasovagal syncope, 23 patients with postural orthostatic tachycardia syndrome, and 1 patient with orthostatic hypotension. In HUTT positive group, there were 22 cases (43.14%) of dippers and 29 cases of non-dippers.There were 84 patients in the HUTT negative group, there were 32 cases (38.10%) of dippers and 52 cases of non-dippers. There were no statistical significances in the dipper proportion between HUTT positive and negative group ( χ2=1.305, P>0.05). (2) Sleep-trough systolic blood pressure (SBP) surge was 1-45 mmHg [(15.97±8.03) mmHg](1 mmHg=0.133 kPa), and sleep-trough diastolic blood pressure (DBP) surge was -6-43 mmHg[(14.05±7.97) mmHg]. There were no statistical significances in sleep-trough surge between the HUTT negative and positive group (all P>0.05). (3) The age in the dipper group was higher than that in the non-dipper group [(10.72±2.20) years old vs. (9.72±2.66) years old, t=2.288, P<0.05]. The daytime average SBP [(110.20±8.33) mmHg vs.(105.54±7.51) mmHg, t=3.381, P<0.01], and morning peak SBP [(109.99±10.19) mmHg vs.(106.63±8.71) mmHg, t=2.045, P<0.05] of the dipper group were higher than those of the non-dipper group.The nighttime average SBP[(95.41±7.50) mmHg vs.(98.59±6.88) mmHg, t=2.540, P<0.01], nighttime average DBP[(48.61±4.52) mmHg vs.(52.28±4.65) mmHg, t=4.547, P<0.01], nocturnal minimum SBP[(89.62±8.18) mmHg vs.(93.60±7.38) mmHg, t=2.940, P<0.01], and nocturnal minimum DBP[(44.99±5.32) mmHg vs.(49.01±5.54) mmHg, t=4.205, P<0.01] of the dipper group were lower than that of the non-dipper group.Nocturnal SBP reduction rate [(13.42±2.68)% vs.(6.48±2.49)%, t=15.384, P<0.01], nocturnal DBP reduction rate[(19.98±4.92)% vs.(12.46±5.05)%, t=8.561, P<0.01], sleep-trough SBP surge[(20.37±8.30) mmHg vs.(13.03±6.36) mmHg, t=5.800, P<0.01], and sleep-trough DBP surge[(16.91±8.06) mmHg vs.(12.13±7.36) mmHg, t=3.554, P<0.01] of the dipper group were higher than those of the non-dipper group. Conclusions:Nocturnal blood pressure reduction and sleep-trough surge decreased in NMS children, and there is a circadian rhythm disorder of blood pressure.