Cardiology Plus

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As a serious and terminal stage of multiple cardiovascular diseases, heart failure (HF) is one of the most critical components of the current global strategies for the prevention and management of chronic diseases. With aging and the increased incidence of various cardiovascular diseases and related risk factors in the population, HF has also become a main reason for hospitalization and death of the elderly in China, which has resulted in a heavy burden on public health system and the economy. A 2003 report suggested that the prevalence of HF in China was 0.9%, higher in women than in men, and is increasing in proportion with aging. Although the mortality rate of HF seen in hospitals has declined, the long-term prognosis of HF in China is discouraging as demonstrated by a 3-year mortality rate of approximately 30%. HF diagnosis by brain natriuretic peptide, N-terminal pro-B-type natriuretic peptide, and echocardiography in China is unsatisfactory. Room for improvement is needed in drug and nondrug HF treatment in China. Intensive efforts are also needed to promote a real-world use of the current guidelines for recommended drugs that could improve HF patients' prognosis, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and β-blockers. Much work is also needed to embrace the concept of HF management and systems in China. In the future, more attention should also be given to domestic epidemiological and clinical study of HF, focusing on transformation of experimental results to a clinic setting, and ongoing recognition of and attention to HF preserved ejection fraction. An efficient HF management system in China should also highlight the importance of establishing the most cost-effective prevention and therapy strategies.

In this paper, the authors introduced a kind of hypertension called “C-type Hypertension (CtH)” which is related to “a new type of stress” caused by unhealthy lifestyles. Unlike H-type hypertension caused by an elevated serum level of Hcy, the clinical feature was found to cause a temporary remarkable increase or continually slow increase in the level of human cortisol, the standard biomarker of CtH. This kind of hypertension often appears among young- or middle-age people and may present as a new killer which may result in acute myocardial infarction, acute or chronic heart failure, stroke, or sudden cardiac death.

Objective: The main objective is to investigate the value of the treadmill exercise test (TET) for guiding the clinical therapy of myocardial bridging (MB) patients. Subjects and Methods: We retrospectively analyzed the TET results of 70 patients with MB and their electrocardiography (ECG) characteristics then evaluated the relationship between the TET results and the patients' clinical characteristics, including sex, age, bridge length, and the degree of bridge compression. Results: There were 27 patients (38.6%) with a positive TET, 31 (44.3%) negative, and 12 (17.1%) probably positive. For positive and probably positive patients, 31 patients had ECGs that shared similar ST segments depression in II, III, and avF leads with or without V4–V6 segments depression. Male patients had a higher TET positive rate than female patients. No relationships were found between the bridge length, bridge compression, and TET results. In addition, no relationships were identified between hypertension, diabetes, hyperlipemia, smoking, age, and TET results. Conclusions: The main ECG characteristics of patients with MB whose TET results were positive were II, III, and avF ST-T segment depression with or without V4–V6 segment depression. Male patients had higher TET positive rates than female patients. No relationships were identified between the bridge length, bridge compression, and the TET results.

The goal of the China chest pain center (CPC) is to optimize the diagnosis and treatment processes for patients with acute chest pain by establishing a regional cooperative rescue system. This article introduces the developing history, accreditation criteria, current status, efficiencies of accreditation, and prospects of the China CPC.

Severe pulmonary arterial hypertension (PAH) is rarely observed as initial manifestation of systemic lupus erythematosus (SLE). Lupus myocarditis may rarely be initial presentation as a fatal complication of SLE, which mainly involved with the left ventricle. Here, we present a case of an incident PAH woman who had a delivery history 4 months previously. During hospitalization, she suffered from extensive myocardial damage, refractory ventricular tachycardia, and cardiogenic shock. Ultimately, she was diagnosed with SLE, fulminant lupus myocarditis, and PAH associated with connective tissue disease. After a large dose of methylprednisolone and PAH target therapy treatment, she recovered successfully and got a good result. To the best of our knowledge, this is the first case report of PAH and fulminant lupus myocarditis as initial manifestation of SLE in a previously healthy postpartum woman.

Hypercholesterolemia is one of the major risk factors for the development of cardiovascular disease. There are still controversies surrounding cholesterol and blood lipid management. To explore an effective way to better optimize blood lipid management, over the past century, experts in the blood lipid field have been continuously debating, collaborating, and investigating. In this review, we will provide a brief overview of various cholesterol/lipid guidelines and discuss “cholesterol hypothesis,” low-density lipoprotein cholesterol target, intensive lipid-lowering therapy, and so on.

Online since 8^th January 2018