摘要：Aortic regurgitation(AR)poses distinct challenges in interventional cardiology,necessitating novel approaches for treatment.This editorial examined the evolving landscape of transcatheter aortic valve replacement(TAVR)as an alternative therapeutic strategy for AR,particularly in patients deemed high risk for surgery.We explored the anatomical and patho-physiological disparities between AR and aortic stenosis(AS)and elucidates the technical nuances of TAVR procedures in AR pa-tients,emphasizing the need for precise prosthesis positioning and considerations for excessive stroke volume.Additionally,we discussed the safety and efficacy of TAVR compared to SAVR in AR management,drawing insights from recent case series and registry data.Notably,dedicated TAVR devices tailored for AR,such as the J-Valve and JenaValve,demonstrate promising out-comes in reducing residual AR and ensuring procedural success.Conversely,"off-label"TAVR devices,including balloon-ex-pandable and self-expandable platforms,offer feasible alternatives-particularly for large aortic annuli-with favorable device suc-cess rates and low residual AR rates.We highlighted the need for further research,including randomized trials,to delineate the definitive role of TAVR in AR treatment and to address remaining questions regarding device selection and long-term outcomes.In conclusion,TAVR emerges as a viable option for patients with AR,particularly those facing high surgical risks or frailty,with ongoing investigations poised to refine its position in the therapeutic armamentarium.

摘要：Falls remain a prevalent source of injury in daily life and underlying aetiology of falls are often complex and multi-factorial.[1,2]Older persons living with heart failure(OPLHF)are of a particular in-terest when discussing falls as multiple factors associ-ated with heart failure(HF)aetiology and treatment are assumedly implicated in falls occurrence.A retrospect-ive study reported a 14％increased risk of falls among OPLHF,and prospective data has shown that up to 40％of HF patients may experience a fall within a year from diagnosis.[1,2]However,the true prevalence of falls among OPLHF remains largely undocumented in Asia.The aim of our study was to identify the prevalence of falls among OPLHF within an Asian population,and determine risk factors associated with its development,in OPLHF.

摘要：Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk. Methods This study was based on the China Health and Retirement Longitudinal Study.12009 adults aged 45 years and older from five waves were included.CVD events were measured by self-reports of heart disease and stroke.We first used group-based trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020,and then employed logistic re-gression models to analyze their risk for CVD. Results We identified three sleep duration and PA trajectories.The risk of heart disease increased by 33％(OR=1.31,95％CI:1.12-1.53)for the short sleep duration trajectory(vs.moderate sleep duration trajectory),by 40％(OR=1.40,95％CI:1.06-1.84)for the high decreasing PA trajectory,and by 20％(OR=1.20,95％CI:1.01-1.42)for the low stable PA trajectory(vs.high stable PA trajectory),respectively.Similar results for stroke and CVD as the outcomes were also observed,but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant.The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep dura-tion and a low stable PA trajectory. Conclusions Short total sleep duration,high decreasing PA,and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults.Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.

摘要：Background Biomarkers-based prediction of long-term risk of acute coronary syndrome(ACS)is scarce.We aim to develop a risk score integrating clinical routine information(C)and plasma biomarkers(B)for predicting long-term risk of ACS patients. Methods We included 2729 ACS patients from the OCEA(Observation of cardiovascular events in ACS patients).The earlier admitted 1910 patients were enrolled as development cohort;and the subsequently admitted 819 subjects were treated as valida-tion cohort.We investigated 10-year risk of cardiovascular(CV)death,myocardial infarction(MI)and all cause death in these pa-tients.Potential variables contributing to risk of clinical events were assessed using Cox regression models and a score was de-rived using main part of these variables. Results During 16,110 person-years of follow-up,there were 238 CV death/MI in the development cohort.The 7 most import-ant predictors including in the final model were NT-proBNP,D-dimer,GDF-15,peripheral artery disease(PAD),Fibrinogen,ST-segment elevated MI(STEMI),left ventricular ejection fraction(LVEF),termed as CB-ACS score.C-index of the score for predica-tion of cardiovascular events was 0.79(95％CI:0.76-0.82)in development cohort and 0.77(95％CI:0.76-0.78)in the validation co-hort(5832 person-years of follow-up),which outperformed GRACE 2.0 and ABC-ACS risk score.The CB-ACS score was also well calibrated in development and validation cohort(Greenwood-Nam-D'Agostino:P=0.70 and P=0.07,respectively). Conclusions CB-ACS risk score provides a useful tool for long-term prediction of CV events in patients with ACS.This model outperforms GRACE 2.0 and ABC-ACS ischemic risk score.

摘要：1 Introduction Rapid socioeconomic progress has greatly affected the lifestyle in China.Consequently,owing to lifestyle changes,urbanization,and accelerated population aging,the risk of cardiovascular diseases (CVD) has increased.The incidence of CVD has been increasing continuously and this upward trend is projected to continue in the next decade.The growing burden of CVD has become a major public health issue.Accordingly,since 2005,the National Center for Cardiovascular Diseases of China has directed experts in cardiology,neurology,nephrology,diabetes,epidemiology,community healthcare,health economics,biostatistics,and other related fields to prepare the annual Report on Cardiovascular Diseases in China.This report aims to provide a timely review of the growing epidemic of CVD in the country as well as to assess the progress made in its prevention and control.We present herein an updated summary of the Report on Cardiovascular Diseases in China 2018 that includes trends in CVD,the morbidity and mortality of CVD,risk factor assessment,health resources for CVD,and a profile of medical expenditure.

摘要：Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Inflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction (AMI). Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes (such as death, recurrent myocardial in-farction, and heart failure) in patients with AMI.

摘要：Table of Contents Preamble 1 Prevalence of hypertension in Chinese population 1.1 Prevalence,incidence and epidemic trend of hypertension in Chinese population 1.2 Awareness,treatment and control of Hypertension in China 1.3 Important risk factors for hypertension in Chinese population 2 Hypertension and cardiovascular risk 2.1 Relationship between blood pressure and cardiovascular risk 2.2 Cardiovascular risk characteristics of hypertension population in China 3 Diagnostic evaluation 3.1 Medical history

摘要：A physiological sequence called autophagy qualitatively determines cellular viability by removing protein aggregates and damaged cyto-plasmic constituents, and contributes significantly to the degree of myocardial ischemia-reperfusion (I/R) injury. This tightly orchestrated cata-bolic cellular‘housekeeping’ process provides cells with a new source of energy to adapt to stressful conditions. This process was first described as a pro-survival mechanism, but increasing evidence suggests that it can also lead to the demise of the cell. Autophagy has been implicated in the pathogenesis of multiple cardiac conditions including myocardial I/R injury. However, a debate persists as to whether autophagy acts as a protec-tive mechanism or contributes to the injurious effects of I/R injury in the heart. This controversy may stem from several factors including the va-riability in the experimental models and species, and the methodology used to assess autophagy. This review provides updated knowledge on the modulation and role of autophagy in isolated cardiac cells subjected to I/R, and the growing interest towards manipulating autophagy to increase the survival of cardiac myocytes under conditions of stress-most notably being I/R injury. Perturbation of this evolutionarily conserved intracellular cleansing autophagy mechanism, by targeted modulation through, among others, mammalian target of rapamycin (mTOR) inhibitors, adenosine monophosphate-activated protein kinase (AMPK) modulators, calcium lowering agents, resveratrol, longevinex, sirtuin activators, the proapoptotic gene Bnip3, IP3 and lysosome inhibitors, may confer resistance to heart cells against I/R induced cell death. Thus, therapeutic ma-nipulation of autophagy in the challenged myocardium may benefit post-infarction cardiac healing and remodeling.

摘要：Coronary stent implantation has significantly improved percutaneous coronary intervention and enabled the management of early complications of plain balloon angioplasty.However,a new complication has accompanied these improvements:in-stent restenosis (ISR)arising from neointimal hyperplasia.ISR after coronary angioplasty is currently one of the main limitations of this method,leading to the recurrence of exertional angina pectoris or acute coronary syndromes.The clinical incidence of ISR after bare-metal stent (BMS)implantation is approximately 20％-35％.The use of drug-eluting stents (DES) has led to a further decrease in the occurrence of ISR to 5％-10％.Evidence resulting from controlled clinical studies suggests that DES and drug-eluting balloon catheters (DEB) provide the best clinical and angiographic results in the treatment of ISR.We undertook a systematic review of the pathophysiology,diagnostics and treatment options for BMS-and DES-ISR.We discuss recent randomised studies,comparing different DES or DEB used for BMS or DES-ISR treatment,as well as the use of new biovascular scafolds and the topic of scafold restenosis.

摘要：Background Serum cystatin C levels can be used to predict morbidity and mortality in patients with cardiovascular disease. However, the clinical relevance of serum cystatin C levels in patients with hypertensive left ventricular hypertrophy (LVH) has rarely been investigated. We designed the present study to investigate whether serum cystatin C levels are associated with cardiac structural and functional alterations in hypertensive patients. Methods We enrolled 823 hypertensive patients and classified them into two groups:those with LVH (n=287) and those without LVH (n=536). All patients underwent echocardiography and serum cystatin C testing. We analyzed the relationship be-tween serum cystatin C levels and LVH. Results Serum cystatin C levels were higher in hypertensive patients with LVH than in those without LVH (P<0.05). Using linear correlation analysis, we found a positive correlation between serum cystatin C levels and interven-tricular septal thickness (r=0.247, P<0.01), posterior wall thickness (r=0.216, P<0.01), and left ventricular weight index (r=0.347, P<0.01). When analyzed by multiple linear regression, the positive correlations remained between serum cystatin C and interventricular septal thickness (β=0.167, P<0.05), posterior wall thickness (β=0.187, P<0.05), and left ventricular weight index (β=0.245, P<0.01). Con-clusion Serum cystatin C concentration is an independent marker for hypertensive LVH.

摘要：Cardiovascular disease (CVD) is the leading cause of death and disability worldwide.The primary prevention of CVD is dependent upon the ability to identify high-risk individuals long before the development of overt events.This highlights the need for accurate risk stratification.An increasing number of novel biomarkers have been identified to predict cardiovascular events.Biomarkers play a critical role in the definition,prognostication,and decision-making regarding the management of cardiovascular events.This review focuses on a variety of promising biomarkers that provide diagnostic and prognostic information.The myocardial tissue-specific biomarker cardiac troponin,highsensitivity assays for cardiac troponin,and heart-type fatty acid binding proteinall help diagnose myocardial infarction (MI) in the early hours following symptoms.Inflammatory markers such as growth differentiation factor-15,high-sensitivity C-reactive protein,fibrinogen,and uric acid predict MI and death.Pregnancy-associated plasma protein A,myeloperoxidase,and matrix metalloproteinases predict the risk of acute coronary syndrome.Lipoprotein-associated phospholipase A2 and secretory phospholipase A2 predict incident and recurrent cardiovascular events.Finally,elevated natriuretic peptides,ST2,endothelin-1,mid-regioual-pro-adrenomedullin,copeptin,and galectin-3 have all been well validated to predict death and heart failure following a MI and provide risk stratification information for heart failure.Rapidly developing new areas,such as assessment of micro-RNA,are also explored.All the biomarkers reflect different aspects of the development of atherosclerosis.