Abstract:Aim To analyze the incidence and influencing factors of coronary artery calcification (CAC) by low dose chest CT in asymptomatic middle-aged male patients, and to explore the value of low dose chest CT in early screening of cardiovascular diseases. Methods 2 571 asymptomatic male participants aged 40~65 were selected who underwent health examination at General Hospital of Eastern Theater Command from January to December 2022. General data, blood indicators, chest CT and other data were collected, and participants were divided into CAC group (n＝422) and non-CAC group (n＝2 149) according to whether chest CT indicated CAC. The differences between the two groups and the risk factors of CAC were analyzed. Results Among 2 571 asymptomatic middle-aged male patients, the positive rate of CAC was 16.41%. The age, body mass index (BMI), systolic blood pressure, diastolic blood pressure, pulse, waist circumference, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), triglycerides (TG), fasting blood glucose (FBG), and glycated hemoglobin (HbA1c) were higher in CAC group than in non-CAC group, and the red blood cell count (RBC) was lower in CAC group than that in non-CAC group (all P＜0.05). Univariate Logistic regression analysis showed that the effects of age, BMI, systolic blood pressure, diastolic blood pressure, pulse, waist circumference, RBC, ALT, AST, BUN, TG, FBG, and HbA1c on CAC were statistically significant (all P＜0.05). Multivariate Logistic regression analysis showed that age, BMI, diastolic blood pressure, RBC, and AST were independent risk factors for CAC (all P＜0.05). Conclusion Age, BMI, diastolic blood pressure, RBC, and AST are independent risk factors for CAC in low dose chest CT, and physical examination chest CT is valuable in cardiovascular disease screening.

Abstract:Aim To study the efficacy and safety of ibutilide for immediate cardioversion of recent-onset persistent atrial fibrillation (PAF) in elderly patients (＞65 years) with left ventricular dysfunction (LVD). Methods 100 elderly patients of recent-onset PAF with LVD were hospitalized in our department of Cardiology from January 2014 to August 2017, and divided into two groups by random number table method:ibutilide group (50 cases) were treated with ibutilide intravenous injection on conversion, initial dose was 1 mg, slow injection after dilution； amiodarone group (50 cases) were treated with amiodarone intravenous injection on conversion, initial dose was 150 mg, slow injection after dilution. The cardioversion rates were compared between the two groups within 30 min, 60 min, 4 hours and 24 hours, the left ventricular function indexes (LVEDD, LVESD, LVEF and NT-proBNP) were measured before treatment and 48 hours after treatment, and adverse events were recorded in the two groups during the conversion (within 24 hours). Results The cardioversion rates of PAF in the ibutilide group were higher than those in the amiodarone group within 30 min, 60 min, 4 hours and 24 hours (P＜0.01 or P＜0.05), the average cardioversion time of PAF in the ibutilide group were shorter than that in the amiodarone group (t＝－3.232, P＝0.002). QTc average recovery time in the ibutilide group were shorter than that in the amiodarone group (t＝－17.743, P＝0.000). LVEDD, LVESD, LVEF and NT-proBNP were significantly improved in the two groups compared with before treatment and 48 hours after treatment (P＜0.01 or P＜0.05), the ibutilide group improved more significantly (P＜0.01 or P＜0.05). The incidence of short-term adverse reactions in the ibutilide group was lower than that in the amiodarone group (χ2＝4.762, P＝0.029), the duration of adverse events in the ibutilide group were shorter than that in the amiodarone group (P＝－11.622, P＝0.000). Conclusion Compared with amiodarone, ibutilide was used in the treatment of recent-onset PAF in elderly patients with LVD, with rapid onset, high conversion rate, significant improvement in LVD and good safety.

Abstract:Aim To investigate the relationship between serum albumin level and long-term prognosis in elderly patients with heart failure and analyze the risk factors of hypoalbuminemia in patients with heart failure. Methods 1048 consecutive elderly patients with heart failure were enrolled, and divided into two groups according to serum albumin concentration:hypoalbuminemia group (serum albumin ＜35 g/L) and normoalbuminemia group (serum albumin ≥35 g/L). Risk factors associated with hypoalbuminemia were analyzed by binary Logistic regression analysis. The primary end point was all cause long-term mortality. COX proportional-hazards regression modeling was used to evaluate the prognostic value of serum albumin for long-term mortality in elderly patients with heart failure. Results Hypoalbuminemia group had higher age, rate of male, NYHA status, direct bilirubin, creatinine, brain natriuretic peptite and C-reactive protein, lower hemoglobin, total cholesterol and serum sodium on admission. Binary Logistic regression analysis revealed that higher NYHA class, higher age, higher brain natriuretic peptite, lower serum sodium, lower total cholesterol and lower hemoglobin were independent risk factors for hypoalbuminemia. The mean follow-up was 20±18 months in 1048 patients. During the follow-up period, 306 patients died, and the mortality was 29.2%. 116 patients died in hypoalbuminemia group, the mortality was 37.7%. 190 patients died in normoalbuminemia group, the mortality was 25.7%. The multivariate COX regression analysis indicated that when albumin decreased by every 1g/L, the risk of long-term death in elderly patients with heart failure increased 3.8% (HR was 1.8,5%CI was 1.007~1.070, P＝0.015), hypoalbuminemia group was associated with a 0.296-fold greater risk of long-term death than normoalbuminemia group (HR was 1.6,5%CI was 1.019~1.648, P＝0.035). Conclusions Serum albumin was an independent risk factor for long-term mortality in elderly patients with heart failure. Multifactors were significantly associated with hypoalbuminemia.

Abstract:Aim First, to investigate the influence of the injectable vinpocetine to QT dispersion in elderly patients with coronary heart disease, then, to assess the association between QT dispersion and coronary heart disease risk factors before treatment in elderly patients. Methods 150 cases elderly patients with coronary heart disease were randomly divided into 3 groups, including control group （fifty cases）, 30 mg group （fifty cases） and 50 mg group （fifty cases）. The control group was given conventional western medicine treatment,the treatment group was given the injectable vinpocetine （divided into 30 mg, 50 mg） on the basis of the conventional western medicine treatment, 1 time/day, 9 days as one period. The changes of QT dispersion were observed in three groups before and after the treatment,and the correlation was analysed between QT dispersion and age, gender, heart rate, body mass index, systolic blood pressure, diastolic blood pressure, pulse pressure, pulse pressure index, fasting blood sugar, total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol before treatment. Results ①QT dispersion in comparison of the three groups before treatment had no significant difference （P>0.05） After treatment, the comparisons between 50 mg group and control group, 30 mg group respectively were significantly different（P﹤0.01 and 0.05）The comparisons between before and after treatment of 30 mg group and 50 mg group were significantly different（P﹤0.05 and 0.01）. ②Single factor correlation analysis showed, a positive significant correlation was found between QT dispersion and systolic blood pressure （r0.758, P<0.01）, pulse pressure （r0.737, P<0.01）, pulse pressure index （r0.630, P<0.01）, triglyceride（r0.251, P<0.01）, fasting blood sugar（r0.172, P<0.05） A negative significant correlation was observed between QT dispersion and diastolic blood pressure（r－0.192, P<0.05）. Multiple linear regression analysis showed an independent association between QT dispersion and pulse pressure, pulse pressure index, triglyceride.Conclusions Vinpocetine can shorten QT dispersion in elderly patients with coronary heart disease, and which was more significant in 50 mg group than 30 mg group. QT dispersion were associated with coronary heart disease risk factors in elderly patients. By testing pulse pressure, pulse pressure index, triglyceride levels in elderly patients with coronary heart disease can provide certain help to evaluate QT dispersion.

Abstract:Aim To observed the efficacy of Escitalopram joint Tandospirone in treating older women patients with coronary heart disease complicating anxiety disorder combined depression disorder.Methods The 100 older women patients with coronary heart disease complicating anxiety disorder combined depressio.disorder selected as the research object,were randomly divided into treatment group (50 cases) and the control group (50 cases). Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate severity entrants of anxiety and depression of the patients. The changes of anxiety depression rating scale,angina pectoris,arrhythmia and acute myocardial infarction occurred situation before and after treatment in patients,drug safety,etc were observed.Results After Escitalopram joint Tandospirone treating in older women patients with coronary heart disease complicating anxiety disorder combined depression disorder based on routine treatment,the HAMA scores reducion was significantly higher in treatment group (14.07±5.39) than that in control group (7.19±4.81 P<0.05) The HAMD scores reducion were significantly higher in treatment group (14.59±6.76)than that in control group (7.28±6.27 P<0.05). The recurrence rate of coronary heart disease angina adverse events including angina pectoris,acute myocardial infarction,severe arrhythmia were 4.54%,0%,6.82% respectively in treatment group,they were 16.28%,2.33%,18.60% in control group,the coronary heart disease events of the treatment group were significantly lower than those in control group (P<0.05),and the drug safety was better.Conclusions Additional treatment of Escitalopram joint Tandospirone in older women patients with coronary heart disease complicating anxiety disorder combined depression disorder,may obtain a better benefit,improve the recovery.

Abstract:AimTo observe the impact of Shuxuening on the clinical effects and quality of life in old patients with ischemic stoke.Methods212 old patients with ischemic stroke were randomly divided into study group and control group.The control group was treated with conventional therapy; the study group was treated with Shuxuening additionally.All were treated for 2 weeks.The nerve function deficit score was evaluated, SS-QOL table was used to evaluate the quality of life in patients, the level of endothelin-1 (ET-1) and calcitonin gene related peptide(CGRP) were recorded.ResultsAfter treatment, the clinical efficiency were 86.8% in study group and 76.5% in control one(p<0.05); for the study group, the score of SS-QOL and CGRP increased greatly,ET-1 decreased greatly, and there were significant difference between the two groups (p<0.05 or p<0.01).ConclusionCombined with conventional therap, Shuxuening could improve the nerve function deficit score and quality of life in old patients with ischemic stoke.

Abstract:Aim To investigate the effects of renin angiotensin system (RAS) in atherosclerosis by observing the change of angiotensinⅡ type 1 (AT1) receptor expression and the effects of statin on it. Methods Sixty patients with hypercholesterolemia and forty healthy persons were investigated as hyperlipidemia group (Hyperlipidemias) and control group (Controls) respectively. Blood samples of ulnar vein were extracted from Controls and Hyperlipidemias. Blood serum, plasma and platelet were extracted and stored at a refrigerator of -80℃. The level of plasma angiotensinⅡ was detected by the method of radioimmunity. While the expression of AT1 mRNA and protein on platelet were assessed by reverse transcription polymerse chain reaction (RT-PCR) and Western blot respectively. Results The plasma angiotensinⅡ of Hyperlipidemias was higher than that of Controls (92.13±25.27 vs 50.85±21.12, p<0.01). The expression of AT1 mRNA and protein on platelets were higher in Hyperlipidemia than those of Controls(0.93±0.22 vs 0.25±0.06, p<0.01 and 1.35±0.32 vs 0.42±0.10, p<0.01). The expression of AT1 protein was directly correlated with the plasma angiotensinⅡ (r=0.369, p<0.01). Conclusions The increase of AT1 mRNA and protein on platelets is related with plasma angiotensin Ⅱ in patients with hypercholesterolemia.

Abstract:Aim To explore frequency of angiotensin converting enzyme (ACE) gene insertion/deletion( I/D ) polymorphism and effect of ACE gene polymorphism on level of serum ACE and blood lipid in patient with essential hypertension and healthy subjects. Methods 216 subjects (98 heathy subjects and 118 hypertensives) were collected for the determination of the I/D genotype in intron 16 of ACE gene by polymerase chain reaction(PCR) and the level of serum ACE, total cholesterol (TC), triglycerides(TG), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC), lipoprotein (a) [ Lp( a) ] , apolipoprotein AI (ApoAI), apolipoprotein B (ApoB). Results The frequency of I/D genotypes and D and I alleles of the ACE gene had no significant difference between hypertensives and healthy subjects (X2 = 0.468, P = 0.791; X2 = 0. 379, P = 0.538, respectively) . The level of serum ACE activity in deletion homozygotes (genotype DD) was the highest among three genotypes, and the lowest in insertion homozygotes (genotype II ), and intermediate in heterozygotes( genotype ID) (F= 17. 107, P = 0.000). Hypertensives had significantly higher TC, LDLC, Lp(a) than those of control group (p<0.0l). The level of blood lipid was significantly different among genotype DD, genotype ID, and genotype II in hypertensives group ( P< 0. 01). The level of TC, LDLC, HDLC, ApoB was significantly different among three genotypes in control group ( P< 0.05).Conclusions ACE gene polymorphism is associated with level of serum ACE and blood lipid. The level of serum ACE and blood lipid is higher in genotype DD than in genotype ID and genotype II .

Abstract:Aim To investigate the clinical implications of the expression of CD40 ligand (CD40L) on peripheral blood monocytes and sera soluble CD40L (sCD40L) changes in patients with unstable angina. Methods 16 normal controls and 40 patients including 20 with SA(8 patients by PTCA), 20 with UA entered in this study. The expression of CD40L on monocytes was analyzed by indirect-immonofluorescence flow cytometry and sera sCD40L levels were measured by ELISA. Results (1) The expression of CD40L on monocytes in UA were higher compared with SA and controls (P<0.01), while no significant difference was found between SA and controls(P>0.05). (2) Patients with UA had significantly raised sCD40L sera levels when compared with patients with SA and controls(P<0.01). Values also differed significantly between patients with SA and controls. (3) PTCA induced a marked rise in sCD40L levels in all patients, while the expression of CD40L on monocytes showed no significantly difference between patients with PTCA before and after. (4) A significant correlation was observed between sCD40L sera concentrations and the number of complex lesions(r=0.54,P<0.01). sCD40L, however, was not significantly associated with disease extent and range. Conclusions The enhanced level of serum soluble CD40L may play an important role in coronary plaque instability and disruption, and may represent a marker of coronary disease activity.

Abstract:Aim To investigate the relation between the expression of lipoprotein lipase mRNA and the different clinical class or severity of coronary atherosclerosis. Methods A total of 34 patients with coronary atherosclerosis and 10 healthy subjects underwent coronary angiography. There were 12 patients with a light coronary atherosclerosis (diameter stenosis <40%)(Group 1),11 patients with moderate coronary atherosclerosis (diameter stenosis 40%-80% in only one coronary artery) (Group 2), 11 patients with severe coronary atherosclerosis (diameter stenosis >80% in one or more coronary artery) (Group 3), 10 healthy subjects with normal coronary angiography (Group 5). Group 4 included 11 patients were on heparin. Circulating human lipoprotein lipase mRNA wAs detected by RT-PCR in all patients and healthy subjects. Results There was no statistic difference in any groups. There was no statistic difference between 21 patients with high serum triglyceride level and 13 patients with normal serum triglyceride level, between Group 3 and Group 4 (P>0.05). But the serum triglyceride level in Group 3 was higher than in Group 4 (P<0.05). Conclusion The similar expression of circulating human lipoprotein lipase mRNA is in healthy and patients with coronary atherosclerotic disease, who have different serum lipid level and severity of coronary stenosis. The expression of lipoprotein lipase mRNA is not stimulated by heparin.