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The benefits of atherosclerotic cardiovascular disease prevention/treatment and lipid-lowering therapy come from the reduction of cholesterol itself. However, based on safety considerations, all guidelines note that high-intensity statin therapy is not suitable for the Asian/Chinese population. Therefore, moderate-intensity statin therapy is more beneficial for the Chinese population. However, for some very high-risk patients when moderate-intensity statin cannot satisfy the lipid-lowering needs, statin combination with ezetimibe is an ideal choice.

Background: Myocardial fibrosis is closely associated with cardiac dysfunction, arrhythmia, and sudden cardiac death. A model of myocardial fibrosis induced by isoprenaline was used to determine the influence of exogenous adiponectin on myocardial fibrosis. Materials and Methods: A total of 30 mice were equally and randomly divided into three groups as follows: isoproterenol (ISO, n = 10), adiponectin and isoproterenol (APN + ISO, n = 10), and sham (n = 10). ISO (7.5 mg/kg/day) was injected intraperitoneally (i. p.) in the ISO group and APN + ISO group for three consecutive days to establish a model of myocardial fibrosis; normal saline was injected in the sham group. From day 4, adiponectin was injected (10 μg/kg/day; i. p.) in the APN + ISO group for 32 days; normal saline was injected in ISO and sham groups for 32 days. Five weeks later, mice were sacrificed, and myocardial tissue was dyed by Sirius Red to observe the collagen morphology. The collagen volume fraction was calculated. Protein and messenger RNA (mRNA) expression of type-I and type-III collagen in the myocardium was detected by reverse transcription-polymerase chain reaction and western blotting, respectively. Results: Type-I collagen in myocardial interstitial tissue was significantly increased in the ISO group. Collagen in myocardial interstitial tissue in the ISO + APN group was decreased significantly compared with the ISO group. Expression of type-I collagen mRNA in ISO and ISO + APN groups was significantly higher than that in the sham group (3.01 ± 0.78, 2.32 ± 0.82 vs. 1, respectively; P < 0.01). Expression of type-I collagen mRNA in the ISO + APN group was significantly lower than that in the ISO group (2.32 ± 0.82 vs. 3.01 ± 0.78, respectively; P < 0.01). Expression of type-III collagen mRNA in the ISO group, and ISO + APN group was significantly higher than that in the sham group (2.39 ± 0.70, 1.62 ± 0.57 vs. 1, respectively; P < 0.01). Expression of type-III collagen mRNA in the ISO + APN group was significantly lower than that in the ISO group (1.62 ± 0.57 vs. 2.39 ± 0.70, respectively; P < 0.01). Expression of type-I collagen protein in the myocardium in the ISO + APN group was significantly higher than that in the sham group (0.73 ± 0.19 vs. 0.28 ± 0.15, respectively; P < 0.001), but it was significantly lower than the expression of type-I collagen protein in the ISO group (0.53 ± 0.17 vs. 0.73 ± 0.19, respectively; P < 0.001). Conclusions: Supplementation with exogenous adiponectin can inhibit myocardial fibrosis induced by ISO.

Homocysteine (Hcy) is a nonprotein α-amino acid. It is a homolog of the amino acid cysteine, differing by an additional methylene bridge (-CH₂-). It is biosynthesized from methionine by the removal of its terminal C^ε methyl group. Hcy can be recycled into methionine or converted into cysteine with the aid of B-Vitamins. Elevated Hcy levels (hyperhomocysteinemia [HHcy]) have been associated with increased cardiovascular disease and mortality rates. We present a case of acute myocardial infarction in a 25-year-old Chinese patient, associated with HHcy. His other risk factors for coronary artery disease were smoking and a moderately high low-density lipoprotein level. This case indicates that measuring plasma Hcy levels may be necessary in patients with acute coronary syndromes and premature atherosclerosis.

Background and Objectives: Sinus pause association of paroxysmal atrial fibrillation (PAP) is generally considered a sinus node dysfunction (SND) known as tachycardia-bradycardia syndrome (TBS). Cure of tachyarrhythmias in some patients with prolonged pauses on termination of tachyarrhythmia resulted in an improvement in sinus node function and/or a return to normal ranges thus avoiding the need for permanent pacing. The purpose of this study was to investigate the electrophysiological and clinical characteristics as well as their sinus node function in patients with prolonged pauses and PAP. Methods and Results: Of 1266 PAP patients undergoing radiofrequency catheter ablation (RFCA), 122 patients with pauses (>2 s) were studied. The mean maximum symptomatic prolonged pause on termination of tachycardias was 2.67 ± 1.4 s (2.0–12.6 s). SND developed in 32 patients. There was no difference between the patients with and without SND in terms of the age and sex. Patients were divided into two groups based on the intracardiac electrophysiology study after the RFCA procedure. Eleven patients (8 men, 3 women; age 30–72 years, mean 48.2 ± 9.3 years) were placed in a normal sinus node function (NSF) group, and 17 patients (12 men, 5 women; age 37–75 years, mean 62.2 ± 7.5 years) were in an SND group. There was no significant difference in gender, left atrial dimension, left ventricular ejection fraction, blood pressure, or the longest pause between the two groups. RFCA was successful in 28 patients. Electrophysiological data show that corrected sinus node recovery time (CSNRT) was 409 ± 152 ms in NSF group patients and 558 ± 178 ms in SND group before the ablation procedure (P < 0.001). After ablation, SNRT was 1312 ± 387 ms, with CSNRT <550 ms (392 ± 147 ms) in NSF group. While in the SND group, SNRT was 1492 ± 385 ms, CSNRT was 496 ± 165 ms, CSNRT longer than 550 ms in >2 cycle lengths in 12 patients. In the multivariate analysis, prolonged pauses on termination of tachyarrhythmia, frequency of pauses, and mean heart rate after ablation were independent predictors of SND. Conclusions: (1) Catheter ablation of atrial fibrillation (AF) is effective in treating paroxysmal AF-related TBS; (2) in some patients, there is progressive improvement of sinus node function after elimination of AF, an indication that these sinus pauses may be a manifestation of tachycardia-mediated remodeling of the sinus node, and that permanent pacemaker implantation is unnecessary; (3) among the extrinsic and intrinsic causes of SND, intrinsic causes are seldom reversible and some causes of extrinsic SND may be reversible; and (4) prolonged pauses on termination of PAF, frequency of pauses (>2.0 s), and mean heart rate after ablation were independent predictive factors of SND.

Objective: To investigate the incidence and pathogenic genes of familial III degree atrioventricular block (AVB). Data and Methods: The clinical features of all members of the family were collected, including physical examination, electrocardiogram, and echocardiography. Their genes by gene sequencing and mutation analysis were detected. Results: This family contains 22 members, including six patients. The symptom began to appear in the heart at 40 years old, performing for II degree AVB, eventually developed into the III degree AVB. These six cases have been performed permanent pacemaker implantation. The genetic family chart spectrum suggested that the autosomal may not be completely dominant. Compared with normal subjects, 24 different genes were detected in patients with familial AVB. Conclusion: This family is unambiguously affected by familial AVB, and it is caused by incomplete dominant inheritance of euchromosome, and another genetic mutations may contribute to it.

In recent years, the treatment of coronary atherosclerotic heart disease has achieved rapid development. Percutaneous coronary intervention (PCI) has become the first choice of treatment for patients with acute coronary syndrome and stable coronary artery disease. Over the last decade, drug-eluting stents (DESs) have remarkably reduced restenosis and the need for iterance after implantation of metallic stents. However, the implanted permanent metallic endovascular devices in the coronary artery to reestablish the patency of a stenotic artery have inherited pitfalls, including vascular inflammation, restenosis, and stent thrombosis. Bioresorbable scaffolds (BRSs) exhibit a new approach in coronary stent technology. In contrast to DESs, they offer transient scaffolding, thereby safeguarding acute gain and early vessel patency. The aim of this review is to describe the history and provide an update on the status of BRS, present the evidence from the clinical evaluation of BRS, and discuss this innovative technology and prospects for improved interventional cardiology.

Carotid atherosclerotic disease increases the risk for ischemic stroke and transient ischemic attack and challenges are presented when seeking the appropriate strategy of management. In this review, we will discuss the current diagnostic and treatment approaches of asymptomatic and symptomatic carotid stenosis (SCS). The definition of carotid plaques, staging of stenotic severity, and noninvasive tests including carotid duplex ultrasound, computed tomographic angiography, magnetic resonance angiography, and transcranial Doppler will be summarized. Optimal management for asymptomatic and SCS with medical therapy, carotid artery stenting, or carotid endarterectomy has been controversial and should be judged in specific clinical settings. More clinical data are needed to better understand the correlation of different diagnostic measures and the disease progress and to optimize the treatment approach to improve patient outcomes.

Online since 8^th January 2018