Objective To analyze the clinical value of quantitative indicators related to wide QＲS wave ( pre / syn-rhythmic interval，quasi compensatory interval / pre interval，quasi compensatory interval / synrhythmic interval) in the differen-tiation of atrial fibrillation ( AF) with wide QＲS wave ( AF with ventricular premature beats and ventricular differential trans-
mission) ． Methods From January 2020 to June 2022，113 patients with paroxysmal atrial fibrillation in the Department of Cardiology，People＇s Hospital of Wuhan University were selected for dynamic electrocardiogram，including 80 patients with at-rial fibrillation and ventricular premature beats ( atrial premature group) and 33 patients with atrial fibrillation and ventricular
differential transmission ( atrial differential group ) ． The distribution characteristics and quantitative indicators of the two groups of traditional identification indicators were compared，and the ＲOC curve was drawn to evaluate the clinical value of quantitative indicators in the identification of atrial fibrillation and wide QＲS wave． Ｒesults There was no significant differ-
ence between the two groups in terms of gender，age，smoking history，drinking history，hypertension，coronary heart disease and diabetes ( P ＞ 0． 05) ． The prevalence of heart failure in the atrial premature beats group was higher than that in the atrial arrhythmias group ( χ2 / P = 3． 935 /0． 047) ． In the traditional identification indicators，the association phenomenon of the atrial premature group，the QＲS wave duration ≤ 140 ms，the proportion of the phase 3 wave of the V1 lead QＲS form is lower than Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3that of the atrial poor group，the Ｒ wave or qＲ or Ｒ of the V1 lead is greater than r，or the deepest rS is greater than 60 ms，the QＲS wave of the aVＲ lead has a sudden setback or a slow decline or a large Ｒ，the aVＲ lead Vi / Vt ≥ 1，and the propor-tion of the electric axis in the unmanned area is higher than that of the atrial poor group( χ2 / P = 15． 061 / ＜ 0． 001，48． 035 / ＜0． 001，29． 697 / ＜ 0． 001，31． 926 / ＜ 0． 001，61． 464 / ＜ 0． 001，45． 286 / ＜ 0． 001，4． 034 /0． 045) ． Among the quantitative indi-cators，the ratio of quasi-compensation interval / synrhythmic interval and quasi-compensation interval / pre-interval in the atrialpremature group was higher than that in the atrial differential group ( t / P = 9． 165 / ＜ 0． 001，29． 015 / ＜ 0． 001) ，while the ra-tio of pre-interval / synrhythmic interval was lower than that in the atrial differential group ( t / P = 18． 907 / ＜ 0． 001) ． The ＲOCcurve showed that the AUC for distinguishing atrial fibrillation with wide QＲS wave was 0． 865，0． 688，0． 934 and 0． 944 re-spectively in the pre-interval / synrhythmic period，quasi-compensational interval / synrhythmic period，quasi-compensational in-terval / synrhythmic period and the combination of the three，and the combined predictive value of the three was higher than thesingle quantitative index ( Z / P = 7． 796 / ＜ 0． 001，12． 633 / ＜ 0． 001，3． 061 /0． 002) ． Conclusion The combination of the three quantitative indicators and the quasi-compensation interval / pre-interval have good diagnostic value，which can provide an important reference for the differentiation of atrial fibrillation with ventricular premature and ventricular differential transmis-sion．

Objective To investigate the relationship between the expression of serum histone deacetylase 2( HDAC2) ，secretory curl associated protein 2 ( SFＲP2) and ventricular remodeling in elderly patients with chronicheart fail-ure ( CHF) ． Methods One hundred and seventeen elderly patients with CHF diagnosedand treated by the First Departmentof Cardiology of Baoji People＇s Hospital from January 2021 to June 2022 were selected as the CHF group． According to the classification of cardiac function，they were divided into 47 cases of grade II，38 cases of grade III，and 32 cases of grade IV; 120 healthy people were selected as the healthy control group． The levels of serum HDAC2 and SFＲP2 were detected by ELISA，and the indexes related to cardiac function ( left atrial diameter ( LAD ) ，left ventricular end-diastolic diameter( LVEDD) ，left ventricular mass index ( LVMI) ，left ventricular ejection fraction ( LVEF) ，and left ventricular remodeling
index ( LVＲI) ) were examined by echocardiography The diagnostic value of SFＲP2 for CHF． Ｒesults The serum levels of HDAC2 and N-terminal pro-brain natriuretic peptide ( NT-proBNP) in CHF group were significantly higher than those in healthy control group，and the level of SFＲP2 was significantly lower than that in healthy control group ( t( Z) / P = 14． 476 / ＜Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 30． 001，17． 465 / ＜ 0． 001，23． 903 / ＜ 0． 001) ; The serum HDAC2 level was compared with Grade II ＜ Grade III ＜ Grade IV ( F / P = 54． 632 / ＜ 0． 001) ，and the serum SFＲP2 level was compared with Grade II ＞ Grade III ＞ Grade IV ( F / P = 78． 503 / ＜ 0． 001) ． LAD，LVEDD and LVMI in CHF group were significantly higher than those in healthy control group，and
LVEF and LVＲI were significantly lower than those in healthy control group ( t / P = 15． 221 / ＜ 0． 001，14． 824 / ＜ 0． 001，9． 728 / ＜ 0． 001，20． 848 / ＜ 0． 001，8． 335 / ＜ 0． 001) ;Compared with LAD，LVEDD and LVMI，Level II ＜ Level III ＜ Lev-el IV ( F / P = 71． 571 / ＜ 0． 001，45． 980 / ＜ 0． 001，16． 697 / ＜ 0． 001) ，LVEF and LVＲI，Level II ＞ Level III ＞ Level
IV ( F / P = 101． 017 / ＜ 0． 001，16． 544 / ＜ 0． 001) ． Pearson analysis showed that serum HDAC2 was positively correlated with LAD，LVEDD，LVMI and NT-proBNP ( P ＜ 0． 01) ，and negatively correlated with LVEF and LVＲI ( P ＜ 0． 01) ; Serum SFＲP2 was negatively correlated with LAD，LVEDD，LVMI and NT-proBNP ( P ＜ 0． 01 ) ，and positively correlated with LVEF and LVＲI ( P ＜ 0． 01) ． The ＲOC curve results showed that the area under the curve ( AUC) of serum HDAC2，SFＲP2 and their combined prediction of CHF were 0． 827，0． 865 and 0． 931，respectively． The combined prediction efficiency of the two was higher than that of independent detection ( Z / P = 3． 258 /0． 001，2． 286 /0． 022) ． Conclusion The increase of serum HDAC2 level and the decrease of SFＲP2 level in patients with CHF are related to ventricular remodeling，which can be used as a clinical auxiliary index to evaluate the condition of patients with CHF．

Objective To observe the expression level of serum agglutinin 1 ( ITLN-1) and angiopoietin-like protein
4 ( ANGPTL4) in patients with acute myocardial infarction ( AMI) ，and explore the correlation between them and the degree of coronary artery disease． Methods From June 2019 to July 2021，128 patients with AMI admitted by the Department of Cardiovascular Medicine of Lu＇an Hospital affiliated to Anhui Medical University were selected as the study group，and 120 pa-
tients with physical examination in the same period were selected as the health control group． According to the Gensini score of coronary artery disease，the patients in the study group were divided into 35 mild subgroups ( Gensini score ＜ 18) ，43 moder- ate subgroups ( Gensini score 18-40) ，and 50 severe subgroups ( Gensini score ＞ 40) ． The clinical data of the subjects were collected and the serum levels of ITLN-1 and ANGPTL4 were detected by enzyme-linked immunosorbent assay． Pearson meth-
od was used to analyze the correlation between serum ITLN-1，ANGPTL4 and Gensini score． Logistic regression analysis was used to analyze the factors affecting the degree of coronary artery disease． Ｒesults The left ventricular ejection fraction( LVEF) of the study group was lower than that of the healthy control group，and the high sensitivity C-reactive protein ( hs-CＲP) ，B-type brain natriuretic peptide ( BNP) ，left ventricular end-diastolic diameter ( LVEDD) were higher than those of Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3 the healthy control group ( t / P = 9． 368 / ＜ 0． 001，2． 810 /0． 005，8． 229 / ＜ 0． 001，7． 006 / ＜ 0． 001) ; The levels of serum
ITLN-1 and ANGPTL4 in the study group were lower than those in the healthy control group ( t / P = 8． 170 / ＜ 0． 001，7． 986 / ＜ 0． 001) ，and the levels of serum ITLN-1 and ANGPTL4 in patients with AMI in the mild subgroup，the moderate subgroupand the severe subgroup decreased in turn ( F = 38． 240，16． 527，P ＜ 0． 001) ; Pearson analysis showed that serum ITLN-1
and ANGPTL4 were negatively correlated with Gensini score ( r = － 0． 397，－ 0． 429，P ＜ 0． 001) ; Logistic regression analysisshowed that low ITLN-1，low ANGPTL4，high BNP，high LVEDD and low LVEF were risk factors for the severity of coronaryartery disease in AMI patients ［OＲ ( 95% CI) = 2． 103 ( 1． 136 － 3． 892) ，2． 114 ( 1． 170 － 3． 821) ，1． 514 ( 1． 068 － 2．
146) ，2． 514 ( 1． 340 － 4． 716) ，2． 624 ( 1． 134 － 6． 071) ］． Conclusion The expression of ITLN-1 and ANGPTL4 in serumof patients with AMI was low，which was closely related to the degree of coronary artery disease．

Objective To analyze the relationship between multi-ligand proteoglycan-4 ( Syndecan-4) ，matrix metal-
loproteinase-1 ( TIMP-1) and the number of coronary artery lesions and echocardiographic parameters in patients with ST-seg-ment elevation myocardial infarction ( STEMI) ． Methods Sixty-seven patients with STEMI diagnosed and treated by the De-partment of Cardiology of the First Affiliated Hospital of the Naval Military Medical University from January 2021 to December
2021 were selected as the STEMI group，72 patients with chronic angina pectoris diagnosed at the same time were selected as Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3the chronic angina pectoris group，and 50 patients with normal coronary angiography results at the same time were selected as the control group． According to the Gensini score of coronary angiography，STEMI patients were divided into 25 patients in subgroup A ( 0-20 points，1 vessel lesion) ，23 patients in subgroup B ( 21-40 points，2 vessel lesions) and 19 patients in subgroup C ( more than 40 points，3 vessel lesions and more) ． Compare the levels of serum Syndecan-4 and TIMP-1，the pa-
rameters of echocardiography ( left ventricular ejection fraction ( LVEF) ，left ventricular end-diastolic diameter ( LVEDD) ， left ventricular end-systolic diameter ( LVESD) ，left ventricular end-diastolic volume ( LVEDV) ，left ventricular end-systolic volume ( LVESV) ，early diastolic mitral flow velocity / late diastolic mitral flow velocity ( E / A) ) Myocardial ischemia index［cardiac troponin I ( cTnI) ，creatine kinase isoenzyme MB ( CK-MB) ］，heart failure index ［N-terminal B-type natriuretic
peptide ( NT-proBNP) ］，Pearson method was used to analyze the relationship between serum Syndecan-4 and TIMP-1 levels and Gensini score and echocardiographic parameters in patients with STEMI，and the value of serum Syndecan-4 and TIMP-1 in predicting STEMI was analyzed by subject working characteristic curve ( ＲOC) ． Ｒesults Compared with the serum levels
of Syndecan-4，TIMP-1 and LVESD，STEMI group ＞ chronic angina pectoris group ＞ control group ( F = 253． 293，
67 612． 917，20． 563，P ＜ 0． 001) ． LVEF level: STEMI group ＜ chronic angina pectoris group ＜ control group ( F = 28． 194，P＜ 0． 001) ，there was no significant difference in LVEDD，LVEDV，LVESV and E / A among the three groups ( P ＞ 0． 05) ．The levels of cTnI，CK-MB and NT-proBNP in STEMI group were higher than those in chronic angina pectoris group and con-
trol group ( F = 1809． 343，1352． 872，2289． 851，P ＜ 0． 001) ． The levels of cTnI and NT-proBNP in chronic angina pectorisgroup were higher than those in control group ( P ＜ 0． 05) ． Gensini score comparison: subgroup C ＞ subgroup B ＞ subgroup A
( F = 951． 801，P ＜ 0． 001) ． The serum levels of Syndecan-4，TIMP-1 and LVESD in subgroups A，B and C increased in turn( F / P = 4． 405 /0． 016，2965． 986 / ＜ 0． 001，3． 520 /0． 035 ) ，while the LVEF level decreased in turn ( F / P = 5． 385 /0．
007) ． There was no statistically significant difference between LVEDD，LVEDV，LVESV and E / A in subgroups 3 ( P ＞ 0．05) ． The serum levels of Syndecan-4 and TIMP-1 in STEMI patients were positively correlated with Gensini score and LVESD ( Gensini score: r / P = 0． 418 / ＜ 0． 001，0． 375 / ＜ 0． 001; LVESD: r / P = 0． 391 / ＜ 0． 001，0． 278 /0． 004 ) ，and
negatively correlated with LVEF ( r / P = － 0． 492 / ＜ 0． 001， － 0． 436 / ＜ 0． 001) ，but not with LVEDD，LVEDV，LVESV and E / A ( P ＞ 0． 05) ． The area under the curve ( AUC) of serum Syndecan-4，TIMP-1 and their combination to predict STEMI were 0． 849，0． 917 and 0． 927，respectively． The combined predictive value of the two indexes was higher than that
of the single index ( Z = 18． 623，11． 736，P ＜ 0． 001 ) ． Conclusion The serum levels of Syndecan-4 and TIMP-1 are highly correlated with the number of coronary artery lesions and echocardiographic parameters，and can be used as important biomarkers for the detection of coronary artery lesion degree and myocardial injury in STEMI patients．

Objective To analyze the relationship between the expression of microＲNA-208a ( miＲ-208a) and miＲ-
17-5p in serum and left ventricular remodeling ( LVＲ) and prognosis in patients with acute myocardial infarction ( AMI) ．
Methods 133 patients with AMI were selected from the Coronary Heart Disease Center of the Department of Cardiology，Bei-jing Anzhen Hospital affiliated to Capital Medical University from January to August 2021． According to the left ventricularend-systolic volume ( LVESV) at the follow-up of 6 months，they were divided into LVＲ group ( 51 cases) and non-LVＲgroup ( 82 cases) ，and were divided into poor prognosis group ( 44 cases) and good prognosis group ( 89 cases) according towhether major adverse cardiovascular events occurred at the time of 6 months． The expression levels of serum miＲ-208a andmiＲ-17-5p were detected by qPCＲ． The left ventricular end-diastolic diameter ( LVEDD) ，end-diastolic ventricular septalthickness ( IVST) ，left ventricular posterior wall thickness ( LVPWT) ，left ventricular mass index ( LVMI) and LVESV wereexamined by echocardiography． Spearman correlation analysis was used to analyze the correlation between the expression ofmiＲ-208a and miＲ-17-5p in serum of patients with LVＲ and LVESV at the time of diagnosis，multivariate logistic regressio Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3 analysis was used to analyze the factors affecting the poor prognosis of patients with AMI，and the working characteristic curve( ＲOC) of subjects was used to analyze the predictive value of the expression of miＲ-208a and miＲ-17-5p in serum on the poorprognosis of patients with AMI． Ｒesults The expression levels of serum miＲ-208a and miＲ-17-5p in LVＲ group were higherthan those in non-LVＲ group ( t / Z = 7． 432，10． 964，P ＜ 0． 001) ． LVEDD，IVST，LVPWT，LVMI and LVESV in LVＲgroup were higher than those in non-LVＲ group ( t / Z = 11． 774，8． 611，6． 416，9． 676，5． 336，P ＜ 0． 001) ． The expressionof miＲ-208a and miＲ-17-5p in the poor prognosis group was higher than that in the good prognosis group ( t / Z = 5． 270，5．376，P ＜ 0． 001) ． Spearman correlation analysis showed that the expression of miＲ-208a and miＲ-17-5p in serum of LVＲgroup was positively correlated with LVESV at the time of diagnosis ( r s = 0． 868，0． 735，P ＜ 0． 001) ． Multivariate logistic re-gression analysis showed that older age，Killip grade ≥ III，and miＲ-208a，miＲ-17-5p elevation were independent risk factorsfor poor prognosis of AMI patients ［OＲ ( 95% CI) = 1． 058 ( 1． 005 － 1． 114) ，4． 984 ( 1． 564 － 15． 880) ，1． 051 ( 1． 007 －1． 097) ，1． 098 ( 1． 027 － 1． 175) ］，and LVEF elevation was its independent protective factor ［OＲ ( 95% CI) = 0． 932 ( 0． 892 － 0． 975) ］． The ＲOC curve analysis showed that the area under the curve of serum miＲ-208a，miＲ-17-5p and their com- bination to predict the poor prognosis of patients with AMI were 0． 781，0． 795 and 0． 866，respectively． The value of their combination prediction was higher than the single index ( Z / P = 2． 102 /0． 025，2． 511 /0． 014) ． Conclusion The increased expression of miＲ-208a and miＲ-17-5p in serum of patients with AMI is related to LVＲ and poor prognosis，and can be used as an auxiliary predictor of poor prognosis in patients with AMI．