摘要：Background Although the age,creatinine,and ejection fraction(ACEF)score effectively predicts risk in gen-eral populations with ST segment elevation myocardial infarction(STEMI),its performance specifically in elderly patients—who are often underrepresented in validation studies and present with unique pathophysiology—is not well established.This study was designed to directly evaluate and compare the predictive value of the ACEF score for short-term mortality in elderly versus non-elderly STEMI patients,addressing a critical gap in its clinical appli-cation.Methods We enrolled 934 consecutive STEMI patients undergoing percutaneous coronary intervention,categorized into a non elderly group(<65 years,n=534)and an elderly group(≥65 years,n=400).The ACEF score was calculated as age/left ventricular ejection fraction+1(if serum creatinine>2 mg/dL).Its predictive ability for in hospital and one year mortality was assessed.Results Overall,in hospital and one year mortality rates were 4.4%and 8.2%,respectively.Elderly patients had significantly worse in hospital outcomes,including higher all cause mortality(6.5%vs.2.8%,P=0.006)and major adverse cardiovascular events(16.0%vs.9.2%,P=0.002).The pre-dictive performance of the ACEF score for in hospital mortality was lower in the elderly group than in the non elder-ly group(area under the curve:0.753 vs.0.828,P=0.047).The optimal cut off value for ACEF was 1.65 in both groups.In multivariate analysis,an ACEF score>1.65 independently predicted in hospital mortality[adjusted odds ratio(OR):11.58,P=0.001]and one year mortality[adjusted hazard ratio(HR):7.12,P<0.001]in non elderly pa-tients.Similar associations were observed in elderly patients(in hospital mortality:adjusted OR:3.26,P=0.027;one year mortality:adjusted HR:2.79,P=0.003).Conclusions Despite a relatively lower discriminatory ability for short-term mortality in elderly STEMI patients,the ACEF score still demonstrated significant predictive value and might serve as a practical,initial tool for identifying high-risk individuals in clinical settings.[S Chin J Cardi-ol 2025;26(4):284-291]

摘要：Background Acute kidney injury(AKI)is a common and serious complication following coronary artery by-pass grafting(CABG),with an incidence rate ranging from 4%to 28%.The estimated plasma volume status(ePVS)—a novel marker calculated from routine hematocrit and hemoglobin levels—reflects both volume overload and hemodilution,which are potential contributors to renal impairment.Nevertheless,the relationship between ePVS and AKI in patients undergoing CABG remains poorly understood.Therefore,this study aimed to investigate the as-sociation of ePVS with the risk of AKI in adult patients who underwent CABG.Methods This retrospective co-hort study utilized data from the Medical Information Mart for Intensive Care(MIMIC)-IV database,covering the period from 2008 to 2019.The primary outcome was the occurrence of AKI following admission to the intensive care unit(ICU).Hematocrit and hemoglobin levels were measured within 24 hours after ICU admission.The ePVS was calculated using the Strauss-derived Duarte formula:ePVS=[100-hematocrit(%)]/hemoglobin(g/dL).AKI was defined in accordance with the Kidney Disease Improving Global Outcomes(KDIGO)criteria.Multivariable logistic regression models were used to adjust for demographics,comorbidities,and critical laboratory markers.Pa-tients were stratified into three groups based on the ePVS tertiles(low:≤6.30;middle:6.30-8.08;high:>8.08).Mul-tivariate logistic regression and subgroup analyses were applied to explore the association of the ePVS with the risk of AKI.Furthermore,we also examined the association of ePVS with AKI by employing generalized additive mod-els.Results A total of 3,388 patients were included in the final analysis,of whom 2,573(75.94%)developed AKI.Following multivariable adjustment,each unit increase in ePVS was associated with a 9%increase in the odds of AKI(OR:1.09,95%CI:1.05-1.14;P<0.001).When analyzed by ePVS tertiles,the highest tertile demonstrated a significantly elevated AKI risk compared with the lowest tertile(OR:1.48,95%CI:1.18-1.86,P=0.0007),with a significant dose-response relationship observed across tertiles(P for trend<0.001).Subgroup analyses further indi-cated that the association between ePVS and AKI was more pronounced among patients with pre-existing renal or peripheral vascular disease and was statistically significant only in White patients.Conclusions ePVS was inde-pendently associated with an increased risk of AKI in adults undergoing CABG.These findings supported the po-tential utility of ePVS as a simple,economical clinical tool for early identification of patients at high risk for AKI following cardiac surgery.[S Chin J Cardiol 2025;26(4):249-258]

摘要：Background Acute coronary syndrome(ACS)is a cardiovascular emergency with which patients continue to face a considerable long-term risk of major adverse cardiovascular events(MACE)even after receiving standard treatment.Intensive lipid-lowering therapy is central to the secondary prevention of ACS;However,some patients fail to achieve lipid targets or are intolerant to statin monotherapy.A dual lipid-lowering strategy combining ezeti-mibe with statins has demonstrated advantages in the management of various dyslipidemias,yet its clinical efficacy and impact on long-term cardiovascular outcomes in ACS patients require further substantiation.Methods A total of 60 ACS patients treated at our hospital from June 2023 to November 2024 were enrolled in this study.They were randomly assigned using a random number table method into two groups:the observation group(n=30,receiving ezetimibe plus atorvastatin)and the control group(n=30,receiving atorvastatin monotherapy).Lipid profiles[in-cluding low density lipoprotein cholesterol(LDL C),total cholesterol(TC),and triglycerides(TG)]and serum in-flammatory markers[high sensitivity C reactive protein(hs CRP)and interleukin 6(IL 6)]were assessed before and after treatment in both groups.Additionally,the occurrence of MACE during the treatment period was recorded and analyzed.Results After treatment,there was no significant difference in TG levels and the occurrence of adverse reactions mainly between the two groups(P>0.05).The observation group showed significantly lower levels of TC,LDL C,hs CRP,and IL 6 compared to the control group(P<0.05).There was no significant difference in the inci-dence of adverse reactions between the two groups after treatment(P>0.05).Kaplan-Meier survival analysis dem-onstrated that the incidence of MACE was significantly lower in the observation group compared to the control group(Log rank χ²=4.667,P=0.031).Conclusions The combination of ezetimibe and atorvastatin was more ef-fective in lowering lipid and inflammatory levels,demonstrated a trend toward reducing the risk of MACE,and did not significantly increase adverse reactions.[S Chin J Cardiol 2025;26(4):267-275]

摘要：Background Kawasaki disease(KD)is a common acute systemic vasculitis in children,with coronary artery injury being its most serious complication.Currently,intravenous immunoglobulin(IVIG)serves as the standard first line treatment.However,approximately 10%-20%of patients do not respond to initial IVIG therapy,leading to difficulties in inflammation control,increased risk of coronary artery lesions,and a lack of reliable early predictive indicators.Existing scoring systems(such as the Kobayashi and Egami scores)for predicting IVIG nonresponse are predominantly based on clinical features and conventional inflammatory markers,and thus have limited ability to specifically reflect the extent of myocardial involvement and cardiac functional impairment.Therefore,identifying biomarkers capable of predicting IVIG responsiveness is of significant importance for clinical decision making and improving patients'outcomes.Brain natriuretic peptide(BNP)and cardiac troponin I(cTnI),which reflect cardiac function and myocardial injury respectively,may serve as potential indicators for evaluating IVIG treatment re-sponse.Combining these two cardiac specific biomarkers with traditional scoring systems could provide a more comprehensive and accurate tool for early identification of IVIG nonresponsive patients.Methods A retrospec-tive analysis was conducted on the clinical data of 80 children with KD who were admitted to Longyan First Hospi-tal from January 2024 to October 2025.All patients received IVIG therapy.Based on treatment response,they were divided into an IVIG-responsive group and an IVIG-nonresponsive group.General information and laboratory pa-rameters were collected from both groups.Univariate and multivariate logistic regression analyses were employed to screen for independent risk factors affecting the efficacy of IVIG in KD patients.Additionally,receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of BNP and cTnI for IVIG treatment response.Results After standard IVIG treatment,all KD children were categorized based on treatment response into an IVIG-responsive group(n=68,85.00%)and an IVIG-nonresponsive group(n=12,15.00%).The Kobayashi score,ESR,BNP,and cTnI levels were significantly higher in the IVIG-nonresponsive group compared to the IVIG-responsive group(P<0.05).Multivariate logistic regression analysis identified Kobayashi score,BNP,and cTnI as independent risk factors affecting IVIG treatment efficacy.Furthermore,ROC curve analysis demonstrated that both BNP and cTnI exhibited predictive value for IVIG treatment outcomes.Conclusions The Kobayashi score,serum BNP level,and serum cTnⅠlevel were all independent risk factors influencing the efficacy of IVIG therapy in children with KD.Both serum BNP and cTnⅠlevels demonstrated certain predictive value for IVIG treatment outcomes.[S Chin J Cardiol 2025;26(4):259-266]

摘要：Background Coronary microvascular dysfunction(CMD)is a critical pathological mechanism underlying left ventricular ejection fraction(LVEF)decline after primary percutaneous coronary intervention(PPCI)in ST-seg-ment elevation myocardial infarction(STEMI)patients.Angiography-derived microcirculatory resistance(AMR),a novel wire-free index,offers noninvasive assessment of CMD.This study aimed to validate AMR's predictive val-ue for post-PPCI LVEF impairment.Methods A total of 190 STEMI patients who underwent PPCI at four centers between March 2017 and May 2022 were retrospectively enrolled.Patients were categorized into two groups based on whether their LVEF was below 50%when measured after 72 hours post-PPCI:the normal LVEF group(n=114)and the reduced LVEF group(n=76).The clinical characteristics of the two groups were compared.AMR was com-puted using quantitative flow ratio(QFR)analysis.Multivariable logistic regression,linear regression,and receiver operating characteristic(ROC)curves were applied to assess predictive performance.Results The reduced LVEF group exhibited significantly higher post-PPCI AMR(268 mmHg·s/m vs.229 mmHg·s/m,P<0.001)compared to the normal LVEF group.Multivariable logistic and linear regression confirmed that elevated AMR(OR:1.01;95%CI:1.00-1.02,P=0.001)was an independent predictor of LVEF decline to<50%after PPCI.ROC analysis revealed a moderate predictive capacity of AMR,with an area under the curve(AUC)of 0.684(95%CI:0.608-0.760).The optimal AMR cutoff of 262.5 mmHg·s/m demonstrated 55.26%sensitivity and 72.81%specificity for identifying LVEF decline in reperfused STEMI patients.Conclusions Post-PPCI AMR was an independent predictor of LVEF decline to<50%in STEMI patients.The data demonstrated that an AMR threshold of≥262.5 mmHg·s/m af-ter PPCI was associated with a statistically significant increase in the likelihood of LVEF reduction compared to in-dividuals with AMR values within the normal range.[S Chin J Cardiol 2025;26(4):207-218]

摘要：Background Continuous renal replacement therapy(CRRT)is frequently applied in critically ill patients with acute kidney injury who are vulnerable to cardiovascular complications.Differences in calcium management dur-ing CRRT may affect cardiac electrophysiology and hemodynamic stability,potentially influencing cardiovascular outcomes.Methods A total of 96 patients receiving CRRT were enrolled in this single-center study between Sep-tember 2020 and September 2023.Patients were divided into two groups:those receiving calcium-containing re-placement fluids(n=46)and those receiving calcium-free fluids(n=50).Clinical outcomes,including major adverse cardiovascular events(MACE),arrhythmias,hypotension,myocardial infarction,sudden cardiac arrest,intensive care units(ICU)stays,and hospital mortality,were compared between the two groups.Results The calcium-con-taining group had a significantly lower incidence of MACE(20%vs.32%,P<0.001)and arrhythmias(8%vs.17.3%,P=0.010)compared to the calcium-free group.ICU stays were also shorter in the calcium-containing group(11.6±8.8 days vs.16.6±7.6 days,P=0.004).Hospital mortality showed a trend toward being lower in the calcium-containing group,though this was not statistically significant(0.6%vs.10.1%,P=0.063).No significant differences were observed in the incidence of hypotension,myocardial infarction,or sudden cardiac arrest.Conclusions Calci-um-containing replacement fluids during CRRT were associated with improved clinical outcomes,including lower rates of MACE and arrhythmias,as well as shorter ICU stays.This simplified approach may be safer and more effi-cient,but larger studies are needed to confirm these findings and assess long-term outcomes.[S Chin J Cardiol 2025;26(4):219-227]

摘要：Background Acute kidney injury(AKI)is a common and serious complication following coronary artery by-pass grafting(CABG),with reported incidence rates ranging from 4%to 28%.Red cell distribution width(RDW),calculated as the standard deviation of erythrocyte size divided by mean corpuscular volume,reflects the heteroge-neity in red blood cell volume.Easily obtained from routine blood tests,RDW is increasingly recognized as a prog-nostic marker for various adverse clinical outcomes.Previous studies have also indicated a correlation between ele-vated RDW levels and declining renal function,as measured by estimated glomerular filtration rate.However,the specific relationship between RDW and the risk of AKI in patients undergoing CABG remains inadequately charac-terized.This study aimed to investigate the association between RDW and AKI incidence in this surgical popula-tion.Methods I n this secondary retrospective cohort study,data of patients who underwent CABG were extract-ed from the Medical Information Mart for Intensive Care(MIMIC)-IV database(2008-2019).The primary outcome was the occurrence of AKI as a postoperative complication following CABG,which was identified after intensive care unit(ICU)admission.RDW was measured within 24 hours on admission to ICU.AKI was defined according to Kidney Disease Improving Global Outcomes(KDIGO)criteria.Multivariable logistic regression models were used to adjust for demographics,comorbidities,and critical laboratory markers.Patients were stratified into RDW tertiles(T1:≤13.1%;T2:13.1%-13.8%;T3:≥13.8%).Multivariate logistic regression and subgroup analyses were applied to explore the association of the RDW with the risk of AKI.Furthermore,we also examined the association of RDW with AKI by employing restricted cubic splines(RCS).Results A total of 3,388 patients who underwent CABG were included in this study,of whom 2563(75.65%)had AKI.According to the multivariate regression mod-els,the RDW demonstrated a significant positive correlation with the risk of AKI after comprehensive covariate ad-justment.When each unit of RDW was increased,the risk of AKI in patients with CABG increased 10%(OR:1.10,95%CI:1.03-1.18,P=0.0063).In addition,When the RDW was analyzed by tertiles,patients in the high tertile(OR:1.33,95%CI:1.08-1.64,P=0.0072)presented a progressively higher risk of AKI than those in the low tertile,with a significant dose-response trend(P for trend<0.01).The subgroup analysis demonstrated that the positive as-sociation between elevated RDW and increased risk of AKI following CABG was robust and consistent across most major patient subgroups defined by demographics and comorbidities.The strength of this association was notably amplified in patients with pre-existing renal disease and in older patients(>65 years)and White race(P<0.05),sug-gesting a particularly prominent relationship between RDW and AKI risk in these specific populations.The lack of statistical significance in peripheral vascular disease subgroups required further investigation(P>0.05).Conclu-sions In ICU patients who received coronary revascularization by CABG,an elevated RDW demonstrated an pos-itive correlation with the risk of AKI.[S Chin J Cardiol 2025;26(4):228-238]

摘要：Background Patients with acute ischemic stroke(AIS)frequently present with subclinical cardiac injury.Cur-rent clinical assessments predominantly focus on neurological deficits,while the systematic identification and risk stratification of early cardiac complications remain inadequate.Myocardial injury markers and electrocardiograph-ic abnormalities reflect biochemical myocardial damage and electrophysiological disturbances,respectively.Their combined use may provide a more comprehensive evaluation of cardiac involvement following AIS,thereby com-pensating for the limitations of neurological assessment alone.However,their synergistic value in predicting the prognosis of AIS patients requires further clarification.Methods A retrospective analysis was conducted on the medical records of 204 AIS patients admitted to our hospital from July 2023 to July 2025.Based on cardiac troponin I(cTnI)and creatine kinase-MB(CK-MB)levels,as well as electrocardiographic findings within 72 hours of onset,patients were categorized into a myocardial injury group(n=87)and a non-myocardial injury group(n=117).Both groups received standardized treatment.The modified Rankin Scale(mRS)scores at 90 days post-onset and the in-cidence of in-hospital major adverse cardiovascular events(MACE)were compared between the groups.Indepen-dent prognostic factors were analyzed,and the predictive performance of these factors was evaluated.Results Among the 204 patients,myocardial injury markers were elevated in 42.65%(87/204)of them.The incidence of electrocardiographic abnormalities,such as ST T changes(38.24%,78/204)and arrhythmias(24.02%,49/204),was significantly higher in the injury group than in the non injury group(all P<0.05).Elevated cTnI level(OR=1.052),prolonged QTc interval(OR=1.049),and a high National Institutes of Health Stroke Scale(NIHSS)score(OR=1.458)were identified as independent risk factors for poor prognosis at 90 days(all P<0.05),whereas CK-MB level was not an independent risk factor(P>0.05).The combination of NIHSS score,cTnI,and QTc interval demonstrat-ed an area under the curve(AUC)of 0.920,with a specificity of 96.80%and a sensitivity of 70.89%,in predicting poor prognosis.Conclusions Patients with AIS frequently exhibit concomitant myocardial injury and electrocar-diographic abnormalities.Elevated cTnI levels and prolonged QTc intervals are independently associated with poor 90-day prognosis,serving as significant predictive biomarkers.Early monitoring of these indicators contributes to risk stratification and personalized management.[S Chin J Cardiol 2025;26(4):239-248]

摘要：Background Coronary heart disease with myocardial ischemia is closely associated with vascular endothelial dysfunction,dyslipidemia,and chronic inflammatory response.Atorvastatin,a classic lipid-lowering agent,exhib-its pleiotropic effects including plaque stabilization,endothelial function improvement,and anti-inflammatory ac-tions.Nicorandil,as a potassium channel opener with additional nitrate-like effects,directly dilates coronary arter-ies and improves myocardial microcirculation.Theoretically,the two drugs may synergistically enhance myocardi-al perfusion and endothelial function through distinct mechanisms.However,clinical evidence regarding the com-prehensive impact of their combination on vascular endothelial function,blood lipid profiles,and systemic inflam-matory status in patients with coronary heart disease and myocardial ischemia remains insufficient.Further studies are warranted to clarify their synergistic effects and clinical value.Methods A total of 60 patients with coronary heart disease and myocardial ischemia admitted to our hospital from January 2023 to October 2024 were enrolled and randomly divided into combination group and control group using a random number table,with 30 patients in each group.The control group received atorvastatin treatment,while the combination group received nicorandil combined with atorvastatin.After 12 weeks of continuous treatment,the clinical efficacy,vascular endothelial func-tion,blood lipid profiles,inflammatory factors,and adverse reactions were compared between the two groups.Re-sults The total effective rate in the combination group(93.33%)was significantly higher than that in the control group(70.00%)(P<0.05).After treatment,serum endothelin(ET)level was lower in the combination group than in the control group(P<0.05),while nitric oxide(NO)level was higher(P<0.05).In the combination group,the levels of total cholesterol(TC),triglyceride(TG),and low-density lipoprotein cholesterol(LDL-C)were all lower than those in the control group(P<0.05),while high-density lipoprotein cholesterol(HDL-C)level was higher(P<0.05).Levels of C-reactive protein(CRP),interleukin(IL)-8,and IL-6 in the combination group were also lower com-pared with the control group(P<0.05).No significant difference was observed in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The combination of nicorandil and atorvastatin demonstrated cer-tain short-term therapeutic effects in patients with coronary heart disease and myocardial ischemia.It not only effec-tively improves vascular endothelial function and regulates lipid metabolism but also suppresses the levels of in-flammatory factors,with a favorable safety profile.[S Chin J Cardiol 2025;26(4):292-299]

摘要：Background The co-existence of Type 2 diabetes mellitus(T2DM)and hypertension presents a significant clinical challenge due to their synergistic detrimental effects on cardiovascular outcomes.Conventional combina-tion therapies often fall short in comprehensively addressing the intertwined pathophysiologies,particularly vascu-lar endothelial dysfunction.This study aimed to evaluate the efficacy of a novel regimen combining sitagliptin-met-formin with nifedipine in managing blood pressure,blood glucose,and vascular function in this high-risk popula-tion.Methods 150 patients with T2DM and hypertension were randomly assigned to either the control group(n=75)treated with metformin and nifedipine,or the experimental group(n=75)treated with sitagliptin-metformin compound preparation combined with nifedipine.Changes in blood pressure,blood glucose levels,flow-mediated dilation(FMD)and nitroglycerin-mediated dilation(NMD)of the brachial artery,and serum levels of biomarkers[nitric oxide(NO),endothelin-1(ET-1)]were compared before and after treatment.The incidence of adverse reac-tions during treatment was also monitored.Results After treatment,both groups showed significant reductions in blood pressure,blood glucose parameters,and ET-1 levels compared to baseline.The experimental group demon-strated significantly lower values in these assessments at the same time points than control group(P<0.05).Con-versely,FMD,NMD,and NO levels increased significantly in both groups after treatment,with experimental group showing significantly higher values than control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The combination of sitagliptin-metformin compound preparation and nifedipine significantly enhanced blood pressure control and blood glucose control and exerted a positive regulatory effect on vascular endothelial function in patients with T2DM and hyper-tension,demonstrating high clinical value for widespread application.[S Chin J Cardiol 2025;26(4):276-283]

摘要：INTRODUCTION Cardiovascular system involvement is an im-portant determinant of long-term prognosis in patients with systemic lupus erythematosus(SLE).Aneurysmal dilatation of the aortic root combined with Stanford type A aortic dissec-tion(TAAD)is a highly catastrophic complica-tion in these patients.

摘要：Background Elderly patients(age≥60 years)with ST-segment elevation myocardial infarction(STEMI)are at an elevated risk of mortality.This study aimed to investigate the association of the creatinine to ejection fraction ra-tio(CER)with in-hospital and 1-year death in elderly patients with STEMI.Methods A total of 753 consecutive elderly patients(age≥60 years)with STEMI undergoing percutaneous coronary intervention(PCI)were enrolled and divided into three groups according to the tertiles of CER at admission:<1.5(n=250),1.5-2.2(n=249)and>2.2(n=254).Multivariate analyses were performed to evaluate the prognostic value of CRE for short-term death in this population.Results The in-hospital and 1-year mortality reached 6.0%and 13.3%,respectively.Patients with higher CER exhibited a higher in-hospital mortality(0.8%vs.2.8%vs.14.2%,P<0.001).An optimal cut-off value of 2.5 for CER was identified for predicting in-hospital death by receiver operating characteristic curve analysis,yielding a sensitivity of 77.8%and a specificity of 76.1%[area under curve(AUC):0.791,95%confidence interval(CI):0.734-0.847,P<0.001].Multivariate regression analyses revealed that CER>2.5 was an independent risk fac-tor for both in-hospital[adjusted odds ratio(OR):9.006,95%CI:2.707-29.967,P<0.001]and 1-year mortality[ad-justed hazard ratio(HR):5.082,95%CI:2.462-10.490,P<0.001].Conclusions Elevated CER is associated with adverse short-term mortality in elderly STEMI patients undergone PCI,offering valuable insights for the early iden-tification and management of high-risk individuals in clinical practice.[S Chin J Cardiol 2025;26(3):155-163]

摘要：INTRODUCTION Takotsubo syndrome(TTS),also known as stress cardiomyopathy,is characterized by tran-sient left ventricular dysfunction that resembles acute myocardial infarction(AMI)on electro-cardiogram(ECG)and biomarkers,despite the absence of coronary obstruction.

摘要：INTRODUCTION Pulmonary hypertension(PH)is a complex syndrome arising from diverse underlying con-ditions and characterized by elevated pulmo-nary arterial pressure.Current clinical guide-lines classify PH into five categories based on pathophysiology,clinical presentation,and he-modynamic characteristics.While left heart dis-ease and pulmonary disorders represent the most prevalent causes globally,hematologic ma-lignancies constitute a rare etiological group 1,2.In particular,PH secondary to pulmonary infil-tration by diffuse large B-cell lymphoma(DLB-CL)remains extraordinarily uncommon in clini-cal practice.We presented a case documenting this unusual clinical and pathological associa-tion.

摘要：Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress re-sponses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on both μ-and κ-receptors,may provide stable analgesia with less hemodynamic fluctuation compared with the pure μ-agonist sufentanil.This study aimed to compare the efficacy and cardiovascular safety of oxycodone-based versus sufent anil-based intravenous patient-controlled analgesia(IV-PCA)after laparoscopic abdominal surgery.Methods This single-center retrospective comparative study included patients who underwent laparoscopic abdominal sur-gery between March 2024 and March 2025.According to their postoperative PCA regimen,patients were divided into an oxycodone group and a sufentanil group.The primary endpoint was the incidence of cardiovascular adverse events(CVAE)within 48 h after surgery,including hypotension,bradycardia,and arrhythmia.Logistic regression was used to identify independent predictors of CVAE,and receiver operating characteristic(ROC)analysis as-sessed discriminative performance.Results A total of 356 patients were analyzed(oxycodone n=197;sufentanil n=159).The incidence of CVAE was significantly lower in the oxycodone group than in the sufentanil group(5.2%vs.12.1%,P=0.021).Oxycodone provided comparable analgesic intensity with fewer PCA bolus attempts(36±15 vs.52±17,P<0.001)and higher patient satisfaction scores(4.3±0.5 vs.4.1±0.5,P=0.002).Multivariate logistic re-gression identified sufentanil use(OR:2.53,95%CI:1.16-5.84,P=0.018)as independent predictors of CVAE.Conclusions Oxycodone-based IV-PCA provided effective postoperative analgesia with a lower incidence of car-diovascular adverse events compared with sufentanil-based PCA.The results suggested that oxycodone offered a fa-vorable balance between analgesic efficacy and hemodynamic stability,making it a safer alternative for postopera-tive pain management in patients at cardiovascular risk.[S Chin J Cardiol 2025;26(3):145-154]

摘要：Background Renal and liver dysfunction,which are common complications in infectious diseases,are associ-ated with poor clinical outcomes.This study aimed to evaluate the prognostic value of the Model for End-Stage Liv-er Disease Excluding International Normalized Ratio(MELD-XI)score for predicting short-term mortality in pa-tients with infective endocarditis(IE)complicated by sepsis.Methods A total of 496 consecutive IE patients com-plicated with sepsis at Guangdong Provincial People's Hospital were enrolled and divided into three groups accord-ing to the tertiles of MELD-XI score:<7.9(n=164),7.9-14.6(n=168),and>14.6(n=164).Major adverse clinical events(MACE)were composite endpoints that included acute heart failure,renal dialysis,stroke,and death during hospitalization.Multivariate analysis was used to explore the prognostic value of MELD-XI score.Results In-hospital and 6-month mortality were 14.3%and 21.5%,respectively.In-hospital mortality and the incidence of MACE rose significantly with higher MELD-XI scores(mortality:8.5%vs.12.5%vs.14.3%,P=0.002;Incidence of MACE:24.4%vs.31%vs.51.2%,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the optimal cutoff value of MELD-XI score was 15.7[area under the curve(AUC):0.648,95%CI:0.578-0.718,P<0.001].Multivariate regression analysis revealed that MELD-XI score>15.7 was a significantly indepen-dent risk factor for both in-hospital[adjusted odds ratio(OR):2.27,95%CI:1.28-4.05,P=0.005]and 6-month mor-tality[adjusted hazard ratio(HR):1.69,95%CI:1.13-2.53,P=0.011].Conclusions MELD-XI score>15.7 was independently associated with short-term mortality in IE patients complicated with sepsis,suggesting its potential value as a prognostic biomarker for risk stratification in this population.[S Chin J Cardiol 2025;26(3):164-172]

摘要：Background Abdominal aortic aneurysm(AAA)is a life-threatening vascular disease associated with endothe-lial cell senescence.Resveratrol(RSV),a natural polyphenol,exerts potent anti-senescent and anti-inflammatory ef-fects.However,its molecular mechanism in treating AAA remains unclear.Methods An AAA model was estab-lished in mice via angiotensin II(AngII)infusion[1000 ng/(kg·min)],with a subset receiving RSV treatment[100 mg/(kg·day)by gavage].Aortic diameter was measured,and histopathological changes were assessed by Hematox-ylin-Eosin(HE)and Elastica Van Gieson(EVG)staining.Vascular aging was evaluated by senescence-associated β-galactosidase(SA-β-gal)activity and pulse wave velocity(PWV).In vitro,human umbilical vein endothelial cells(HUVECs)were treated with Ang II(10-6 M)with or without RSV(40 μM)and/or the sirtuin 1(SIRT1)inhibi-tor EX527(10 μM).Senescence markers,senescence-associated secretory phenotype(SASP)factor expression[in-terleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)],and SIRT1/p21 pathway pro-teins were analyzed.Results In vivo,RSV significantly attenuated Ang II-induced AAA formation,reducing aor-tic diameter,preserving elastic fiber integrity,and suppressing vascular senescence and stiffness.In HUVECs,Ang II-induced senescence and SASP expression were markedly inhibited by RSV.However,these protective effects were abolished by EX527.Mechanistically,RSV reversed the Ang II-induced downregulation of SIRT1 and upregu-lation of p21,which was also blocked by SIRT1 inhibition.Conclusions RSV effectively prevented experimental AAA formation by alleviating vascular aging and endothelial cell senescence.This protective effect was abrogated by the SIRT1 inhibitor EX527,confirming that RSV mitigated AAA development and vascular senescence through the SIRT1/p21 signaling pathway.These findings highlighted RSV as a promising therapeutic candidate for AAA treatment.[S Chin J Cardiol 2025;26(3):173-182]

摘要：Background In recent years,the incidence of coronary heart disease(CHD)has continued to rise,and its co-morbidity with hyperlipidemia significantly increases the mortality risk in patients.Statin monotherapy faces limi-tations in efficacy for some patients and raises potential safety concerns.Ezetimibe,as a novel lipid-modulating agent,exhibits potential advantages in the treatment of hyperlipidemia.Based on this,the present study investigated the therapeutic efficacy of ezetimibe in CHD patients with hyperlipidemia,as well as its effects on lipid metabolism and the amelioration of atherosclerosis.Methods In this study,150 clinical cases with CHD and hyperlipidemia admitted in our hospital from July 2022 to July 2024 were collected for retrospective analysis.According to differ-ent treatment methods,they were randomly divided into the Atorvastatin group(control group,n=75)and the Ator-vastatin+Ezetimibe group(experimental group,n=75).Control group received atorvastatin monotherapy,while ex-perimental group were administered additional ezetimibe as an adjunct to the atorvastatin-based treatment regimen.The clinical efficacy of the two treatment groups was analyzed,including cardiac function-related parameters such as the cardiac index(CI),cardiac output(CO),left ventricular ejection fraction(LVEF)and left ventricular end-dia-stolic diameter(LVEDD)before and after treatment.The observed indicators encompassed coronary angiography findings,the Gensini score for assessing coronary stenosis severity,the inflammatory marker high-sensitivity C-re-active protein(hs-CRP),and lipid profile parameters including total cholesterol(TC),triglycerides(TG),high-den-sity lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C).Additionally,the occur-rence of adverse reactions during treatment was monitored.Results After treatment,the total effective rate in ex-perimental group was significantly higher than that in control group,with a statistically significant difference(P<0.05).In the comparison of the baseline data,both groups showed marked improvements in CI,CO,LVEF,and HDL-C.However,at the same time points,the experimental group demonstrated significantly better results in these parameters than control group(P<0.05).Additionally,LVEDD,LDL-C,hs-CRP and Gensini scores were signifi-cantly reduced after treatment in both groups compared to pretreatment levels.Moreover,at identical time points,the aforementioned parameters in the experimental group demonstrated significantly greater reductions compared to control group(P<0.05).Regarding safety assessment,comparative analysis of adverse drug reaction(ADR)inci-dence rates between the two treatment groups revealed no statistically significant difference(P>0.05).Conclusions In patients with CHD complicated by hyperlipidemia,ezetimibe demonstrates significant therapeutic advantages.It effectively enhances treatment efficacy,regulates lipid profiles,improves cardiac function,and mitigates the pro-gression of atherosclerosis.This regimen exhibits a favorable safety profile and holds substantial clinical value for both therapeutic processes and rehabilitation outcomes in this patient population.[S Chin J Cardiol 2025;26(3):137-144]

摘要：Background The relationship between estimated glomerular filtration rate(eGFR)and depression in patients with coronary artery disease(CAD)remained unclear.Methods A total of 561 patients with CAD were selected from Department of Cardiology between October 2017 and February 2018 while their depression status was evalu-ated by Patient Health Questionnaire-9(PHQ-9).The eGFR levels were compared between patients with and with-out depression and the link between eGFR and depression in CAD patients was explored.Results Among 561 CAD patients,63 patients(11.23％)were diagnosed with comorbid depression(PHQ-9≥10).The depression group presented significantly lower eGFR level than the non-depression group.In fully-adjusted multivariate analysis,higher eGFR level was proved to be a protective factor for depression in CAD patients,reducing a 22％risk of de-pression for every 10 mL/(min·1.73 m2)increase of eGFR level(OR:0.78,95％CI:0.66-0.93).Similar results were found in the stratified analyses of both eGFR quartiles and chronic kidney disease(CKD)stages(P for trend＜0.05),while no significant differences were found among subgroups(P for interaction＞0.05).A negative linear as-sociation was estimated between eGFR level and depression in CAD patients.Conclusions Our results suggested lower eGFR level in CAD patients with comorbid depression,displaying a negative linear correlation between eG-FR and risk of depression in CAD patients.The findings implied that screening depression in CAD patients with de-creased eGFR level or concomitant CKD should be highlighted in clinical practice.[S Chin J Cardiol 2024;25(1):1-10]

摘要：To observe the effects of perindopril on left ventricular remodeling and myocardial osteopontin expression in rats with myocardial infarction. Methods In this study male adult SD rats were randomly divided into 3groups: sham-operation group, MI-saline group and MI-perindopril group. Left anterior descending artery was ligated to generate myocardial infarction. Perindopril (2 mg/kg body weight/day) was administered from the next day of MI.Four weeks later, left ventricular diameter (LVEDD and LVESD) and left ventricular ejection fraction was estimated with echocardiography, LVSP, LVEDP and ± dp/dtmax was detected with hemodynamic measurement, cardiomyocyte diameter and interstitial fibrosis infiltration were evaluated with histological methods, and myocardium osteopontin protein expression level was detected with western blot. Results ①Compared with the sham-operation group, all rats with MI developed significant systolic and diastolic dysfunction, as was indicated by decreased LVEF, LVSP and ± dp/dtmax, as well as increased LVEDP. ②Rats with MI showed significantly dilated left ventricles and higher ventricular weight / body weight ratio, significantly increased cardiomyocyte diameter and marked interstitial fibrosis in the non-infarction area. ③Perindopril treatment partly prevented cardiac dysfunction and left ventricular remodeling as indicated by the parameters mentioned above. ④No osteopontin protein was detected in myocardium of sham-operation rats. In rats with MI, high level osteopontin protein expression was significantly inhibited by perindopril treatment. Conclusions In rats with MI, perindopril treatment significantly prevented left ventricular remodeling and myocardium osteopontin protein expression.