摘要：BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissect-ion(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for surgical strategies,however,its prognostic impact on postoperative mortality rates remains understudied in large-scale cohorts. METHODS We reviewed 600 ATAAD patients who underwent surgery and coronary computed tomography angiography from 2016 to 2020 at Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Un-ion Medical College,Beijing,China.Patients were classified based on the Neri classification system:no coronary artery involveme-nt,type A(ostial involvement),type B(dissection in coronary body),and type C(circumferential detachment or complete avulsion).The primary endpoint was 30-day mortality. RESULTS Overall,28.3%of the patients had coronary artery involvement,with Neri type A,Neri type B,and Neri type C accoun-ting for 13.3%,11.2%,and 3.8%,respectively.The right coronary artery was more frequently involved(25.3%)than the left coronary artery(8.0%).In the unadjusted analysis,patients with coronary artery involvement exhibited a numerically higher 30-day mortal-ity compared to those without(5.3%vs.2.3%)(OR=2.35,95%CI:0.94-5.88,P=0.07),though this difference did not reach statistic-al significance.However,multivariable adjustment revealed significant association(adjusted OR=3.71,95%CI:1.05-13.13,P=0.04).Interestingly,after additional adjustment for coronary artery bypass grafting,the impact of coronary artery involvement on 30-day mo-rtality no longer remained statistically significant(adjusted OR=3.13,95%CI:0.85-11.58,P=0.09).The 1-year mortality was high-er in those with coronary artery involvement,but this significant association disappeared after adjusting for potential confounding variables.Furthermore,no significant difference in 30-day and 1-year mortality were observed among patients with different Neri classifications. CONCLUSIONS In patients with ATAAD who undergo surgery,the presence of coronary artery involvement is significantly ass-ociated with an increased risk of 30-day mortality.Proactive coronary artery bypass grafting may potentially mitigate the adverse im-pact of coronary artery involvement on 30-day mortality.

摘要：Intravenous leiomyomatosis (IVL) is a rare,histolo-gically benign uterine smooth muscle tumor with malignant biological behavior due to its propensity for intravascular extension.[1]While gynecological in ori-gin,its most severe manifestations are cardiovascular,ari-sing from tumor propagation through the venous system into the inferior vena cava (IVC),right heart,and pulmon-ary arteries,mimicking thromboembolic disease.[2,3]This can lead to pulmonary embolism (PE),right heart obst-ruction,and even sudden cardiac death.[4]Diagnosis is ch-allenging,often delayed by misdiagnosis as conventional PE. We present two cases of IVL initially presenting with PE,highlighting the critical cardiovascular implications and diagnostic pitfalls.

摘要：BACKGROUND As the global population ages,the number of elderly patients with acute coronary syndrome(ACS)rises.However,pr-ognostic assessment tools for elderly patients with ACS remain lacking,particularly in the Chinese population.This study aimed to devel-op and validate a nomogram to predict 2-year major adverse cardiovascular and cerebrovascular events(MACCE)in elderly Chinese pati-ents with ACS. METHODS A retrospective analysis was conducted using two independent cohorts of ACS patients aged≥65 years who underwent pe-rcutaneous coronary intervention:the derivation cohort(n=1674)and the validation cohort(n=2333).Candidate predictors were selected using multivariable Cox proportional hazards regression and the Akaike information criterion.A final nomogram incorporating ten varia-bles was constructed.Model performance was evaluated in terms of discrimination[concordance index(C-index)and area under the rece-iver operating characteristic curve(AUC)]and calibration(calibration plots). RESULTS The 2-year incidence of MACCE was 12.5%(n=210)in the derivation cohort and 15.6%(n=364)in the validation cohort.The nomogram demonstrated good discrimination,with C-index values of 0.727 and 0.661 and AUCs of 0.723 and 0.699 in the derivation cohort and the validation cohort,respectively;significantly outperforming the GRACE risk score(P<0.001).Calibration plots showed good agree-ment between the predicted and observed outcomes.Patients classified as the high-risk group by the nomogram had a significantly high-er MACCE incidence compared to that of the low-risk group(log-rank P<0.001). CONCLUSIONS This newly developed nomogram provides a reliable tool for individualized prediction of the 2-year MACCE risk in elderly Chinese patients with ACS who underwent percutaneous coronary intervention.It outperformed the GRACE score in both discrim-mination and calibration and may help improve clinical decision-making and personalized risk stratification in this vulnerable population.

摘要：Cardiac amyloidosis (CA) is characterized by the deposition of the misfolded amyloid precursor proteins in the myocardium of the heart. The systemic form of CA is mainly caused by either the mis-folded monoclonal immunoglobulin light chains (kappa and lambda) or transthyretin.[1]The clinical manifestations are mainly overlap with symptoms of other cardiovascul-ar diseases mostly hypertrophic cardiomyopathy and he-art failure. Some cases often overlooked and remains un-diagnosed because of the atypical clinical manifestations,especially in the elderly. The incidence of CA has incre-ased across the world recently.[2]This paper reports the di-agnosis and treatment of an elderly male patient with wi-ld-type transthyretin CA (ATTRwt-CA). Combined with the standardized diagnosis procedure of CA,it can impr-ove the understanding and diagnosis of CA among cardi-ovascular physicians.

摘要：Arterial stiffness is considered an important indicator reflecting age-related changes in the vascular wall[1]and the risk of develop-ing comorbidities,[2]primarily cardiovascular diseases.[3]Cardiovascular diseases remain the leading cause of death worldwide. Many factors influence the rate of ar-terial aging. Research results have confirmed that arteri-al wall stiffness increases with an increasing number of risk factors,[4]as each of them acts independently through various mechanisms,adversely affecting the structure and function of the cardiovascular system.[5]In recent decades,most countries in the world have seen a pro-gressive increase in the number of older adult and senile individuals,which is exponential in nature,leading to an increase in the prevalence of frailty and other geriatric syndromes (GS). Frailty syndrome is one of the key GS.Frailty is characterized by an age-related decrease in the physiological reserve and functions of many body sys-tems,which increases the vulnerability of the older adult's organism to the action of endo-and exogenous factors,and is also accompanied by a high risk of adverse out-comes,loss of autonomy and death.

摘要：BACKGROUND Heart failure with preserved ejection fraction(HFpEF)following acute myocardial infarction(AMI)carries substa-ntial morbidity and mortality,yet reliable prognostic markers beyond conventional cardiovascular factors remain limited.Frailty,refle-cting diminished physiological reserve,has emerged as a potential determinant of adverse outcomes in this high-risk population.Theref-ore,the aim of this study was to address a critical knowledge gap and to provide evidence that may guide frailty-adapted management st-rategies to improve prognosis and quality of life in this high-risk population. METHODS We conducted a multicenter retrospective cohort study including 4507 patients with HFpEF discharged after AMI across 82 hospitals in China(from January 2010 to March 2024).Frailty was assessed using the Hospital Frailty Risk Score(HFRS),with HFRS<5 defined as non-frail and HFRS≥5 as frail.Multivariable Cox proportional hazards models,adjusted for demographics,comorbidities,le-ft ventricular ejection fraction,and therapies,were applied to evaluate associations between frailty and clinical outcomes.The primary end-points were all-cause death and major adverse cardiovascular events(MACE),which defined as the composite of cardiovascular death and heart failure rehospitalization.Secondary endpoints included net adverse clinical events(NACE),which defined as the composite of all-cause death,stroke,recurrent myocardial infarction,revascularization,and major bleeding,as well as the individual components of MACE. RESULTS Frailty was independently associated with a higher risk of all-cause death[adjusted hazard ratio(aHR)=1.52,95%CI:1.31-2.03,P=0.005]and NACE(aHR=1.20,95%CI:1.02-1.41,P=0.026).At one year,frail patients had higher unadjusted rates of all-cause dea-th(9.0%vs.2.9%)and NACE(19.8%vs.13.7%)compared with non-frail patients.For cardiovascular death,the association did not reach sta-tistical significance(aHR=1.42,95%CI:0.99-2.03,P=0.053).No significant associations were found for MACE(aHR=1.05,95%CI:0.86-1.28,P=0.636)or heart failure rehospitalization(aHR=0.94,95%CI:0.75-1.19,P=0.616). CONCLUSIONS Frailty,as measured by the HFRS,is an independent predictor of one-year mortality and composite adverse events in post-AMI HFpEF patients.These findings support the use of HFRS at discharge to identify high-risk population who may benefit from clo-ser follow-up,optimization of medical therapy,and targeted frailty-focused interventions.

摘要：Severe injuries due to electricity are rare,but when they occur,they may cause life-threatening cond-itions. In order to define the severity of electrical in-juries,the most widely used classification is voltage pow-er.

摘要：Background Cardiovascular disease(CVD)remains a major health challenge globally,particularly in aging populations.Using data from the China Health and Retirement Longitudinal Study(CHARLS),this study examines the Triglyceride-glucose(TyG)index dynamics,a marker for insulin resistance,and its relationship with CVD in Chinese adults aged 45 and older. Methods This reanalysis utilized five waves of CHARLS data with multistage sampling.From 17,705 participants,5,625 with TyG index and subsequent CVD data were included,excluding those lacking 2011 and 2015 TyG data.TyG derived from glucose and triglyceride levels,CVD outcomes via self-reports and records.Participants divided into four groups based on TyG changes(2011-2015):low-low,low-high,high-low,high-high TyG groups. Results Adjusting for covariates,stable high group showed a significantly higher risk of incident CVD compared to stable low group,with an HR of 1.18(95%CI:1.03-1.36).Similarly,for stroke risk,stable high group had a HR of 1.45(95%CI:1.11-1.89).Survival curves indicated that individuals with stable high TyG levels had a significantly increased CVD risk compared to con-trols.The dynamic TyG change showed a greater risk for CVD than abnormal glucose metabolism,notably for stroke.However,there was no statistical difference in single incidence risk of heart disease between stable low and stable high group.Subgroup analyses underscored demographic disparities,with stable high group consistently showing elevated risks,particularly among<65 years individuals,females,and those with higher education,lower BMI,or higher depression scores.Machine learning mod-els,including random forest,XGBoost,CoxBoost,Deepsurv and GBM,underscored the predictive superiority of dynamic TyG over abnormal glucose metabolism for CVD. Conclusions Dynamic TyG change correlate with CVD risks.Monitoring these changes could predict and manage cardiovascular health in middle-aged and older adults.Targeted interventions based on TyG index trends are crucial for reducing CVD risks in this population.

摘要：Clinical guidelines typically classify heart fail-ure (HF) into three categories based on left ventricular ejection fraction (LVEF):reduced(HFrEF),mildly reduced (HFmrEF),and preserved(HFpEF).[1]Sodium-glucose co-transporter 2 (SGLT2) in-hibitors have been demonstrated to lower cardiovascu-lar mortality and HF events. The EMPEROR trials indic-ated similar efficacy and safety for SGLT2 inhibitors compared to placebo in outpatients with HFrEF as well as HFmrEF and HFpEF.[2]A meta-analysis showed that dapagliflozin decreased the risk of cardiovascular death and hospital admissions for HF across the LVEF spec-trum.[3]However,a comprehensive evaluation of dapag-liflozin's efficacy and safety across the baseline LVEF spectrum in Chinese patients with HF is still lacking.[4]Therefore,this study aims to investigate the efficacy and safety of dapagliflozin across the full range of LVEF in Chinese patients.

摘要：Background Quantitative flow ratio(QFR)based lesion selection for percutaneous coronary intervention(PCI)treatment has shown clinical benefits in terms of reduced risk for myocardial infarction and repeat revascularization.Whether this benefit is consistent across different age groups still needs further investigation. Methods In this prespecified subgroup study of FAVOR III China trial,we compared long-term clinical outcomes between QFR-guided and angiography-guided PCI among different age groups among 3825 enrolled subjects.The primary endpoint was major adverse cardiac events(MACEs),a composite of all-cause death,myocardial infarction,and ischemia-driven revasculariza-tion. Results Of the 3825 patients,1717(44.9%)were aged≥65 years.At baseline,patients≥65 had higher rates of hypertension,hy-perlipidaemia,stroke history(P<0.0001),and peripheral vascular disease(P=0.024)and had higher SYNTAX scores(P=0.0095).Compared with standard angiography guidance,the QFR-guided strategy consistently reduced the 1-year(≥65 years,6.04%vs.9.19%,HR=0.65,95%CI:0.46-0.92;<65 years,5.53%vs.8.43%,HR=0.65,95%CI:0.47-0.91)and 3-year MACE rates in both age groups(≥65 years,11.8%vs.15.2%,HR:0.75,95%CI:0.58-0.98;<65 years,9.5%vs.14.6%,HR=0.63;95%CI:0.49-0.81),without a significant interaction(Pinteraction=0.99).Within the QFR-guided group,the 3-year MACE rate in patients with deferred vessels was numerically greater in patients aged≥65 years than in those aged<65 years(8.3%vs.3.0%,P=0.10). Conclusions Although with higher rate of comorbidities and more complex coronary anatomy,the long-term benefit of the QFR-guided PCI strategy remained consistent in patients≥65 years,compared with those<65 years.

摘要：Atrial fibrillation(AF)is the most common arrh-ythmia in clinical setting and has been increas-ingly prevalent due to the aging population.AF is associated with a three to fivefold increased risk of stro-ke.Treatment options include pharmacological and electri-cal cardioversion,each carrying specific risks.AF may reso-lve spontaneously,but often recurs,making a"watch-and-wait"strategy a reasonable approach to avoid unnecessa-ry antiarrhythmic therapy.Additionally,research has sho-wn that hypomagnesemia and hypokalemia contribute to AF development.Thus,potassium and magnesium supple-mentation may be a rational strategy to enhance spontane-ous sinus rhythm conversion rates.

摘要：BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in pre-vious studies.However,it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disea-se(CHD).Therefore,the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people. METHODS 19,194 participants aged ≥ 60 years who had three AIP measurements between 2018 and 2020 were included in this study.AIP was defined as log10(triglyceride/high-density lipoprotein cholesterol).The group-based trajectory model was used to identify diffe-rent trajectory patterns of AIP from 2018 to 2020.Cox proportional hazards models were used to estimate the hazard ratio(HR)with 95％CI of CHD events between different trajectory groups from 2020 to 2023. RESULTS Three different trajectory patterns were identified through group-based trajectory model:the low-level group(n=7410,mean AIP:-0.25 to-0.17),the medium-level group(n=9981,mean AIP:0.02-0.08),and the high-level group(n=1803,mean AIP:0.38-0.42).Duri-ng a mean follow-up of 2.65 years,a total of 1391 participants developed CHD.After adjusting for potential confounders,compared with the participants in the low-level group,the HR with 95％CI of the medium-level group and the high-level group were estimated to be 1.24(1.10-1.40)and 1.43(1.19-1.73),respectively.These findings remained consistent in subgroup analyses and sensitivity analyses. CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly.This sug-gests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.

摘要：The BRASH syndrome,an acronym for bradyca-rdia,renal failure,atrioventricular(AV)nodal bl-ockade shock,and hyperkalemia,was first de-scribed as a distinct clinical entity in 2016 by Josh Farkas.[1]He proposed a vicious pathophysiological cycle driven by the synergy between AV nodal blockade and hyperkale-mia,leading to refractory bradycardia and hypoperfusion-induced prerenal acute kidney injury(AKI).[1,2]Notably,th-ese cascading events may be triggered by relatively mild ins-ults,such as dehydration,infection,and up-titration or ove-ruse of medications or nephrotoxic agents that promote hy-perkalemia or renal dysfunction.[3,4]Common culprits inc-lude potassium-sparing diuretics,angiotensin-converting enzyme(ACE)inhibitors,angiotensin Ⅱ receptor blockers,calcium channel blockers and non-specific beta-blockers.

摘要：Coronary thrombosis remains a critical event in the pathophysiology of acute coronary syndr-omes,including myocardial infarction.The pr-ompt and effective removal of coronary thrombi is essen-tial to restore blood flow,minimize myocardial damage,and improve clinical outcomes.The reperfusion treatment of acute myocardial infarction(AMI)patients with large thrombus burden has been keeping challenging.Over the past decade,significant advancements have been made in the techniques and technologies available for thrombus removal.

摘要：Takotsubo syndrome(TTS),also known as stress cardiomyopathy,occurs in approximately 2％of all patients presenting with suspected acute co-ronary syndrome.[1]The in-hospital mortality rate of pati-ents with TTS is reported to be approximately 4％-5％.[2]Th-is condition is commonly associated with various rhythm and conduction disturbances,such as atrial fibrillation(5％-15％),ventricular arrhythmias(4％-9％),and rarely sinus node dysfunction(1.3％).[3]However,atrioventricular no-dal reentrant tachycardia(AVNRT)in the context of TTS is rare and poorly documented in current medical literature.

摘要：BACKGROUND The beneficial effects of sodium-glucose co-transporter-2 inhibitors(SGLT2i)on adverse cardiac outcomes in diab-etic patients are well-established.However,the effects of SGLT2i against cancer therapy-related cardiotoxicity remain understudied.We investigated the association between SGLT2i and cardiac outcomes in cancer patients. METHODS PubMed,Embase,and the Cochrane Library were searched from their inception until September 30,2024 for studies evaluating the effects of SGLT2i in patients with cancer.The primary outcomes included incident heart failure(HF),HF exacerbation,HF hospitalization,atrial fibrillation/atrial flutter(AF/AFL),myocardial infarction,and all-cause mortality.The secondary outcom-es included acute kidney injury and sepsis.Odds ratio(OR)with 95％CI was pooled. RESULTS Thirteen studies with 85,596 patients were included.Compared to non-SGLT2i use,SGLT2i treatment was associated with lower risks of incident HF(OR=0.51,95％CI:0.32-0.79,P=0.003),HF exacerbation(OR=0.74,95％CI:0.63-0.87,P＜0.001),AF/AFL(OR=0.67,95％CI:0.55-0.82,P＜0.001),myocardial infarction(OR=0.61,95％CI:0.41-0.90,P=0.01),and all-cause mortali-ty(OR=0.44,95％CI:0.28-0.69,P＜0.001),but not for HF hospitalization(OR=0.58,95％CI:0.22-1.55,P=0.28).As for safety outcom-es,SGLT2i use was associated with lower risks of acute kidney injury(OR=0.68,95％CI:0.57-0.81,P＜0.001)and sepsis(OR=0.32,95％CI:0.23-0.44,P＜0.001). CONCLUSIONS SGLT2i were associated with lower risks of incident HF,HF exacerbation,AF/AFL,myocardial infarction,all-cause mortality,acute kidney injury,and sepsis in cancer patients.

摘要：Iread with great interest the recent article by Shin,et al.[1]the authors present an important exploration in-to the use of drug-coated balloon(DCB)in patients ag-ed ≥ 75 years,a demographic increasingly encountered in modern cardiovascular practice.The authors conducted a re-trospective analysis involving2050 elderly patients(aged ≥ 75 years)undergoing successful percutaneous coronary inter-vention(PCI).Of these patients,232 patients received DCB-based PCI[either DCB alone or in combination with drug-el-uting stent(DES),depending on lesion preparation]and we-re compared to 1818 patients treated with second-generati-on DES(DES-only PCI).Impressively,the DCB-based gro-up showed significantly reduced stent burden and exhibit-ed a lower incidence of major adverse cardiovascular even-ts at 2-year follow-up(5.5％vs.13.1％,P=0.003),including lower rates of target vessel revascularization(1.1％vs.5.6％)and major bleeding(0.7％vs.5.1％).These findings highli-ght the clinical value of DCB in elderly cohorts,a group oft-en at higher bleeding risk and with greater frailty.

摘要：BACKGROUND Mild cognitive impairment(MCI)is common in atrial fibrillation(AF)patients and may develop earlier in those with multiple cardiovascular comorbidities,potentially impairing self-management and treatment adherence.This study aimed to characteri-ze the prevalence and profile of MCI in AF patients,examine its associations with cardiovascular comorbidities,and assess how these com-orbidities influence specific cognitive domains. METHODS This cross-sectional study analyzed data from AF patients who underwent cognitive assessment between 2017 and 2021.Cognitive status was categorized as MCI or non-MCI based on the Montreal Cognitive Assessment.Associations between comorbiditi-es and MCI were assessed by logistic regression,and cognitive domains were compared using the Mann-Whitney U test. RESULTS Of 4136 AF patients(mean age:64.7±9.4 years,64.7％male),33.5％of patients had MCI.Among the AF patients,31.2％of pat-ients had coronary artery disease,20.1％of patients had heart failure,and 18.1％of patients had hypertension.88.7％of patients had left atrial enlargement,and 11.0％of patients had reduced left ventricular ejection fraction.Independent factors associated with higher MCI prevalence included older age(OR=1.04,95％CI:1.03-1.05,P＜0.001),lower education level(OR=1.51,95％CI:1.31-1.73,P＜0.001),hyp-ertension(OR=1.28,95％CI:1.07-1.52,P=0.001),heart failure(OR=1.24,95％CI:1.04-1.48,P=0.020),and lower left ventricular ejecti-on fraction(OR=1.43,95％CI:1.04-1.98,P=0.028).A higher CHA2DS2-VASc score(OR=1.27,95％CI:1.22-1.33,P＜0.001;≥ 2 points vs.＜2 points),and greater atherosclerotic cardiovascular disease burden(OR=1.45,95％CI:1.02-2.08,P=0.040;2 types vs.0 type)were link-ed to increased MCI risk.These above factors influenced various cognitive domains. CONCLUSIONS MCI is common in AF and closely associated with cardiovascular multimorbidity.Patients with multiple comorbid-ities are at higher risk,highlighting the importance of routine cognitive assessment to support self-management and integrated care.

摘要：BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances survival,the role of implantable cardioverter-defibrillators(ICDs)alongside CRT in patients with non-ischemic cardiomyopathy(NICM)remains controversial.To evaluate and compare the outcomes of CRT with ICD(CRT-D)versus CRT with pacemaker-only(CRT-P)in in-dividuals diagnosed with NICM,with a specific focus on the elderly. METHODS A comprehensive search of PubMed,Embase,and the Cochrane Central Register of Controlled Trials was conduc-ted in January 2024.Studies comparing CRT-D and CRT-P in patients with NICM were included,with subgroup analyses focus-ing on patients aged 75 years and older. RESULTS Twelve studies,including two randomized clinical trials,with a total of 62,145 patients and 16,754 pooled death events(9,171 in CRT-D and 7,583 in CRT-P),were analyzed.CRT-D was associated with a significantly lower risk of all-cause mortality compared to CRT-P(pooled OR=0.72;95％CI:0.61-0.85;P＜0.01),with significant heterogeneity(I2=83％).RCT sub-group analysis,was not statistically significant(pooled OR=0.82;95％CI:0.64-1.06;P=0.41;I2=0％).In patients older than 75 years,no significant difference in mortality risk was observed(pooled OR 0.96;95％CI:0.81-1.15;I2=39％). CONCLUSION Our meta-analysis suggests that the addition of ICD therapy to CRT in patients with NICM significantly re-duces all-cause mortality.However,this benefit does not extend to cardiovascular mortality,likely due to the primary role of ICDs in preventing sudden cardiac death rather than other causes such as progressive heart failure.The survival advantage of CRT-D is most pronounced in younger patients,with those over 75 years of age deriving less benefit.This highlights the import-ance of careful patient selection,considering age and comorbidities,when deciding on ICD implantation in NICM patients.

摘要：Objectives To compare respiratory parameters of peripheral blood mononuclear cell mitochondria and iron metabolism indic-ators in patients with different NYHA functional classes of ischemic heart failure(HF). Methods This single center,prospective,non-blinded study enrolled 20 patients with diagnosed chronic HF of ischemic genes-is with reduced and mildly reduced left ventricle ejection fraction.The maximum oxygen consumption at the peak of the exercise test(VO2 peak),iron metabolism parameters and respiratory activity of peripheral blood mononuclear cell mitochondria were as-sessed. Results Among the patients,a half of individuals were diagnosed with iron deficiency.Subgroups of patients with different HF severity did not significant differ in VO2 peak(P=0.209),serum iron(P=0.468)and ferritin(P=0.235)levels.But there was a trend in increasing in these parameters with increasing NYHA HF functional class.Respiratory control coefficient(RC)in NAD-dependent and FAD-dependent mitochondrial oxidation were lower in patients with NYHA HF Ⅲ functional class compared to individuals with NYHA HF I functional class(P=0.028 and P=0.040,respectively).Serum iron(P=0.026),ferritin(P=0.045)levels,transferrin saturation(P=0.006)were negatively correlated with RC in NAD-dependent mitochondrial oxidation. Conclusions In aggravation of ischemic HF NYHA FC,there is a decrease in RC of PBMC mitochondria during the oxidation of NAD-dependent and FAD-dependent substrates.In the whole sample,patients with laboratory-confirmed iron deficiency ac-counted a half of the total number.Iron metabolism parameters had a paradoxical inverse relationship with the level of RC in PB-MC mitochondria of patients with HF.