Objective To investigate the independent risk factors of major adverse cardiovascular events(MACE) after incomplete revascularization in elderly patients with coronary heart disease combined with multi-vessel disease, establish a predictive model based on clinical indicators and verify its efficacy.Methods A total of 143 elderly patients with coronary heart disease and multi-vessel disease were selected from November 2022 to November 2023. The data set was divided into a training set(100 cases) and a verification set(43 cases) using the train＿test＿split function in the sklearn toolkit. The training set was divided into MACE group(n=28) and non-MACE group(n=72) according to whether MACE was present in the training set. By comparing the baseline data of the two groups, multivariate Logistic regression was used to analyze the adverse prognostic factors, and a neagram model and model efficacy were established. Results There was no statistical significance between the training set and the verification set(P>0.05). Compared with the non-MACE group, the age, diabetes and abnormal glucose tolerance ratio, Cr and UA levels in the MACE group were higher than those in the non-MACE group(P<0.05), the male ratio, UB level and TIMI blood flow grade in the MACE group were lower than those in the non-MACE group(P<0.05), and="" there="" were="" no="" statistically="" significant="" differences="" among="" other="" p="">0.05). Multivariate Logistic regression analysis showed abnormal glucose tolerance[OR=1.656, 95%CI:1.049-1.818], SCr[OR=1.071, 95%CI:1.013-1.598], UA[OR=1.079, 95%CI:1.012-1.663] and TIMI blood flow grade[OR=1.083, 95%CI:1.027-1.196]were risk factors for poor prognosis(P<0.05). The nomogram model shows that the consistency index of training set and verification set are 0.812 and 0.809, respectively. The AUC was 0.836(95%CI:0.709-0.875) and 0.901(95%CI:0.722-0.983), respectively. Conclusion Abnormal glucose tolerance, increased Cr and UA, and decreased TIMI blood flow grade are independent risk factors for MACE after incomplete re-vasculopathy in elderly patients with multi-vessel coronary heart disease. The constructed histogram model has good predictive efficacy. Clinical attention should be paid to glucose metabolism, renal function and hemodynamic management to improve prognosis.

Objective To investigate the prognostic impact of morphological differences in cardiac magnetic resonance(CMR)-derived late gadolinium enhancement(LGE) patterns and their associations with electrocardiographic(ECG) characteristics in patients with non-ischemic dilated cardiomyopathy(NIDCM). Methods A prospective cohort study was conducted involving 387 NIDCM patients who underwent CMR at the Department of Cardiology, Liuyang People's Hospital Affiliated to University of South China, between January 2022 and June 2024. Based on CMR LGE morphology, patients were divided into a linear enhancement pattern group(n=255) and a patchy enhancement pattern group(n=132). Kaplan-Meier analysis was used to compare 12-month survival. Multivariate Cox and Logistic regression analyses were performed to identify predictors of all-cause mortality and patchy LGE, respectively. Results The proportions of inverted T waves in inferior leads, inverted T waves in anterolateral leads, and first-degree atrioventricular block were significantly higher in the patchy pattern group compared to the linear pattern group( χ2/P=22.016/<0.001, 13.595/<0.001, 14.448/<0.001, respectively). At the 12-month follow-up, the survival rate was higher in the linear pattern group(Log-Rank χ2=17.381,P<0.001). Multivariate Cox regression showed that a patchy enhancement pattern was an independent risk factor for all-cause mortality [HR(95%CI)=4.011(1.952-8.243)].Multivariate logistic regression revealed that inverted T waves in inferior leads, inverted T waves in anterolateral leads, and first-degree atrioventricular block were independent risk factors for the presence of a patchy LGE pattern [OR(95%CI)=2.936(1.496-5.880),2.095(1.301-3.370),5.034(1.816-16.258),respectively].Conclusion Morphological characteristics of CMR LGE in NIDCM patients show significant prognostic differences. Patients with a patchy enhancement pattern have a higher risk of death. ECG characteristics, specifically inverted T waves in inferior and anterolateral leads and first-degree atrioventricular block, are significantly associated with a patchy LGE pattern, providing new insights for risk stratification.

Objective To explore the clinical efficacy of Shensong Yangxin Capsule combined with rivaroxaban in the treatment of middle and high risk atrial fibrillation with deficiency of both qi and yin. Methods From June 2022 to June 2024, 100 patients with moderate and high-risk atrial fibrillation of deficiency of both qi and yin were selected and divided into treatment group and control group according to random envelope and double-blind method, with 50 cases in each group. The control group was treated with rivaroxaban, while the treatment group was treated with Shensong Yangxin Capsule. The clinical efficacy and incidence of adverse reactions of the two groups were evaluated. The TCM syndrome score, inflammatory factors[Interleukin-6(IL-6), High-sensitivity C-reactive protein(hs-CRP)], Insulin-like growth factor(IGF-1), Thyroid stimulating hormone(TSH) and P-selectin(GPM-140) were compared between the two groups before and after treatment.Results The effective rate in the treatment group was significantly higher than that in the control group(χ2/P=6.859/<0.001). After treatment, the scores of TCM syndromes, IL-6, hs-CRP, IGF-1, TSH and GMP-140 in the treatment group were lower than those in the control group(t/P=5.378/<0.001, 9.444/<0.001, 7.155/<0.001, 5.602/<0.001, 7.344/<0.001, 9.029/<0.001). there="" was="" no="" significant="" difference="" in="" adverse="" reactions="" between="" the="" treatment="" group="" and="" control="" p="">0.05). Conclusion Shensong Yangxin Capsule combined with rivaroxaban can effectively control the symptoms of patients with atrial fibrillation of deficiency of both qi and yin, improve TCM syndromes, and reduce the risk of inflammatory factors and stroke.

Objective To investigate the therapeutic effect of the combination of vericiguat and Qili Qiangxin Capsules in treating chronic heart failure(CHF) and its impacts on serum N-terminal pro-B-type natriuretic peptide(NT-proBNP).Methods From January 2023 to November 2024, 106 CHF patients treated in our hospital were randomly divided into two groups: the vericiguat group(n=53, received vericiguat in addition to conventional therapy) and the combination group(n=53, received vericiguat plus Qili Qiangxin Capsules). The two groups were compared in terms of therapeutic efficacy, Yang deficiency edema syndrome score, Minnesota Living with Heart Failure Questionnaire(MLHFQ) score, cardiac function indicators [left ventricular ejection fraction(LVEF) and stroke volume(SV)], serum NT-proBNP level, vascular endothelial indicators [endothelin-1(ET-1) and nitric oxide(NO)], and adverse drug reactions.Results The total effective rate in the combination group was 94.00%, which was higher than that in the vericiguat group(78.43%)(χ2/P=5.125/0.024). After treatment, both groups showed decreased scores of Yang deficiency edema syndrome, MLHFQ score, and serum levels of NT-proBNP and ET-1, with the combination group exhibiting lower values than the vericiguat group(t/P=6.167/<0.001, 8.048/<0.001, 3.692/<0.001, 4.278/<0.001). after="" both="" groups="" showed="" increased="" and="" no="" with="" the="" combination="" group="" exhibiting="" higher="" values="" than="" vericiguat="" p="" .="" there="" was="" significant="" difference="" in="" incidence="" of="" adverse="" reactions="" between="" vs.="">0.05).Conclusion The combination of vericiguat and Qili Qiangxin Capsules demonstrates better therapeutic efficacy in CHF patients. It can effectively reduce serum NT-proBNP levels, significantly improve vascular endothelial function and related symptoms, enhance cardiac function and quality of life, and is safe.

Objective To evaluate serum orosomucoid(ORM) and milk fat globule-EGF-8(MFG-E8) in aSAH severity assessment. Methods According to 1 : 1, 50 patients with mild, moderate and severe aSAH( aSAH group) were selected from the Emergency Internal Medicine of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to August 2024, and 150 healthy volunteers were selected as healthy control group.Serum ORM and MFG-E8 levels were detected by enzyme-linked immunosorbent assay; Spearman rank correlation analysis was used to analyze the correlation between serum ORM, MFG-E8 levels and Hunt-Hess grade in patients with aSAH; The relationship between serum ORM, MFG-E8 levels and the severity of aSAH patients was analyzed by ordinal multivariate Logistic regression analysis; ROC curve was used to analyze the energy efficiency of serum ORM and MFG-E8 levels in evaluating the severity of aSAH patients.Results Compared with the healthy control group, the serum ORM level in the aSAH group increased and the MFG-E8 level decreased(t/P=40.777/<0.001,177.515/<0.001).The serum ORM levels in the mild subgroup, the moderate subgroup and the severe subgroup increased in turn, and the MFG-E8 levels decreased in turn(F/P=81.031/<0.001,96.356/<0.001); the Hunt-Hess grade of aSAH patients was positively correlated with serum ORM level and negatively correlated with MFG-E8 level(rs/P=0.647/<0.001,0.655/<0.001);high ORM was an independent risk factor for aggravation of aSAH, and high MFG-E8 was an independent protective factor [OR(95%CI)=1.007(1.002-1.012),0.291(0.110-0.773)];the area under the curve of serum ORM, MFG-E8 levels and the combination of the two in evaluating the severity of aSAH patients were 0.806,0.820 and 0.897, respectively. The AUC of the combination of the two was greater than that of serum ORM and MFG-E8 levels alone(Z/P=1.928/0.004,1.659/0.006).Conclusion ORM/MFG-E8 are promising biomarkers for aSAH triage and monitoring.