Introduction Aortic stenosis (AS) involves aortic obstruction, pressure overload, reduced cardiac output, and impaired organ arterial hemodynamics. Many patients remain at risk of rehospitalization or death after transcatheter aortic valve replacement (TAVR) due to unclear mechanisms. Our previous studies linked bile acids (BAs) metabolism to heart-other organ crosstalk, but the BAs-hemodynamics interplay in AS remains unclear. Objectives To investigate metabolic abnormalities in AS, focusing on the role of BA metabolism in AS pathogenesis and the underlying mechanisms. Methods An acute canine model of AS was established via intra-aortic balloon catheter-induced transverse aortic obstruction (ITAO). Computational fluid dynamics (CFD) simulation was performed to assess the arterial hemodynamics of the aorta and other organs. Untargeted/targeted metabolomics and transcriptomics were performed in ITAO and deleting ITAO (deITAO) canines. The findings were validated in 33 controls and 30 AS patients. Metabolic predictive performance was assessed by the area under the receiver operating characteristic (AUROC) curve. Transcriptomic and western blot analyses were used to assess the effects of glycoursodeoxycholic acid (GUDCA) and glycoursodeoxycholic acid 3 sulfate sodium (GUDCA-3S) on isoproterenol (ISO)-induced myocardial remodeling. Results ITAO replicated AS hemodynamics (reduced cardiac output, increased aortic velocity), reversed post-deITAO. CFD revealed that ITAO increased organ (e.g., liver) artery pressure, improved after deITAO. Untargeted metabolomics identified 1583 differentially abundant metabolites; transcriptomics revealed 291 DEGs enriched in BA biosynthesis. Targeted BA analysis revealed that GUDCA-3S was elevated in ITAO canines, correlated with aortic velocity (R = -0.4822, P = 0.0002) and BNP (R = 0.3836, P = 0.0019) in AS patients, and exhibited superior AS diagnostic performance (AUROC = 0.844, P < 0.001). Reduced aortic flow upregulated hepatic SULT2A1, driving GUDCA sulfonation to GUDCA-3S and weakening GUDCA’s cardioprotection by impairing IL-17/NF-κB signaling inhibition in ISO-induced cardiomyocytes. Conclusions BA metabolism dysfunction responds to cardiac hemodynamic changes, with GUDCA-3S linking cardiac hemodynamics and BA metabolism in AS.

IntroductionThe primary objective of this study was to evaluate the association between maternal echocardiographic changes and the occurrence of preeclampsia (PE) in twin pregnancies. Additionally, we established and validated a prediction model for PE in twin pregnancies. Material and methodsThe first part of this study was retrospective and included data from 854 twin pregnancies that received antenatal care at Peking University Third Hospital from April 2017 to April 2021 (training cohort). Overall, 159 women who underwent transthoracic echocardiography were included in the analysis. To build a predictive model, cardiac findings were compared between normotensive women and those with PE. The model was then validated in a prospective longitudinal cohort (test cohort) that included 109 women with twin pregnancies who underwent two consecutive transthoracic echocardiography examinations during the second and third trimesters. ResultsFifty-four normotensive women and 105 women with PE were analyzed in the retrospective cohort that was used to build the model in which later preeclampsia was associated with higher left ventricular mass index (>61 g/m(2)), interventricular septal thickness (>7.87 mm), left atrial anteroposterior diameter (>33.5 mm), mitral inflow late diastolic velocity (A) (>0.685 m/s), ratio of early diastolic velocity (E) and peak early diastolic myocardial velocity of the lateral mitral annulus (>6.5), and lower peak early diastolic myocardial velocity (<13.1 cm/s). The optimized PE prediction model based on the interventricular septal thickness, left atrial anteroposterior diameter, A, peak early diastolic myocardial velocity and pre-pregnancy bodyweight index was then established (area under the curve [AUC] = 0.840, 95% CI 0.778-0.903, P < 0.001). The model was tested in the prospective cohort including 87 normotensive women and 22 women with PE; the validation test showed that the prediction model in the second (AUC = 0.801) and third (AUC = 0.811) trimesters had high discriminative ability and calibration. ConclusionsMaternal echocardiographic changes in twin pregnancies are associated with the development of preeclampsia. The model constructed, based on the echocardiographic parameters and body mass index, provides novel ideas for the prediction of PE.

随着全球人口老龄化,钙化性主动脉瓣疾病(calcifying aortic valve disease,CAVD)已经成为严重威胁人类健康的疾病.CAVD患者的影像学评估方法包括超声心动图、多层螺旋计算机断层扫描(multi-slice computed tomography,MSCT)、心脏磁共振成像和核素等.超声心动图是CAVD患者主动脉瓣狭窄程度、瓣叶结构、钙化程度、心功能状态评价的重要影像学方法,也在经导管主动脉瓣置换围手术期评估中发挥重要作用.本文就超声心动图在CAVD中应用的研究进展作一综述.

Background The prevalence of childhood obesity is rapidly increasing worldwide. Exercise has been suggested as the primary approach to manage body weight, but an effective exercise program tailored for school-age children is still lacking.Objective This trial aims to evaluate the efficacy of a novel multilevel (children, families, and schools)-coordinated exercise programmes with different intensities on adiposity and development among overweight and obese school-age children. It also aims to elucidate the complex interplays between the exercise interventions, multi-omic biomarkers, development, and metabolic homeostasis.Methods This is a multilevel –coordinated two-stage randomized double-blind controlled trial, comprising 366 overweight and obese children aged between 8 and 12 years from two elementary schools in Beijing, China. The novel multilevel exercise programs involve families and schools monitoring children’s exercise and diet via a specially designed smartphone application. The children will be randomly assigned to receive three school-based exercise programmes (exercise intervention stage), namely low-intensity exercise, moderate-intensity exercise, and intermittent vigorous exercise, for 12 weeks, followed by a 9-month post-intervention follow-up (follow-up stage). The primary outcomes of this trial are the changes in adiposity, development, and metabolic homeostasis during the two stages. The secondary outcomes include but are not restricted to genomics and changes in blood metabolomics, gut microbiota, and exercise performance.Discussion This trial has been approved by the ethics committee of Peking University Third Hospital (ethnic approval number 2021-283-08). The findings of this trial will help establish specialized multilevel coordinated school-based exercise programmes for overweight and obese school-age children in China and quantitatively and qualitatively evaluate the efficacy of the novel interventions.Trial registration This trial was prospectively registered at ClinicalTrials.gov with the identifier of [NCT04984005][1] on July 21, 2021.### Competing Interest StatementThe authors have declared no competing interest.### Clinical TrialNCT04984005### Funding StatementNational Key Research and Development Program (grant numbers: 2020YFA0803803 and 2020YFA0803800) and CAMS Innovation Fund for Medical Sciences (grant number: 2021-I2M-5-003).### Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Ethics committee/IRB of Peking University Third Hospital gave ethical approval for this workI confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.YesAll data produced in the present study are available upon reasonable request to the authors. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04984005&atom=%2Fmedrxiv%2Fearly%2F2023%2F06%2F13%2F2023.06.09.23291210.atom

The primary objective of this study was to evaluate the association between maternal echocardiographic changes and the occurrence of preeclampsia (PE) in twin pregnancies. Additionally, we established and validated a prediction model for PE in twin pregnancies. The first part of this study was retrospective and included data from 854 twin pregnancies that received antenatal care at Peking University Third Hospital from April 2017 to April 2021 (training cohort). Overall, 159 women who underwent transthoracic echocardiography were included in the analysis. To build a predictive model, cardiac findings were compared between normotensive women and those with PE. The model was then validated in a prospective longitudinal cohort (test cohort) that included 109 women with twin pregnancies who underwent two consecutive transthoracic echocardiography examinations during the second and third trimesters. Fifty-four normotensive women and 105 women with PE were analyzed in the retrospective cohort that was used to build the model in which later preeclampsia was associated with higher left ventricular mass index (>61 g/m 2 ), interventricular septal thickness (>7.87 mm), left atrial anteroposterior diameter (>33.5 mm), mitral inflow late diastolic velocity (A) (>0.685 m/s), ratio of early diastolic velocity (E) and peak early diastolic myocardial velocity of the lateral mitral annulus (>6.5), and lower peak early diastolic myocardial velocity (<13.1 cm/s). The optimized PE prediction model based on the interventricular septal thickness, left atrial anteroposterior diameter, A, peak early diastolic myocardial velocity and pre-pregnancy bodyweight index was then established (area under the curve [AUC] = 0.840, 95% CI 0.778–0.903, P  < 0.001). The model was tested in the prospective cohort including 87 normotensive women and 22 women with PE; the validation test showed that the prediction model in the second (AUC = 0.801) and third (AUC = 0.811) trimesters had high discriminative ability and calibration. Maternal echocardiographic changes in twin pregnancies are associated with the development of preeclampsia. The model constructed, based on the echocardiographic parameters and body mass index, provides novel ideas for the prediction of PE.

目的:强直性肌营养不良是一类罕见的由核苷酸序列不稳定扩增导致的常染色体显性遗传性疾病.本文旨在就强直性肌营养不良患者的心脏受累情况进行分析,以提高对该类疾病临床表现的认知和标准化的诊断思路.方法:本研究收集了北京大学第三医院2012年1月至2019年1月诊断的6例强直性肌营养不良患者.通过临床相关检查包括心电图及24小时动态心电图、超声心动图、肌酸激酶的检测、肌电图检查、肌肉活检病理检查(常规染色、免疫组化染色、电镜检查等)了解患者心脏受累情况.结果:临床表现及心脏基础疾病:6例患者中4例首发症状表现为进行性四肢无力;1例既往有高血压、陈旧性心肌梗死、阵发性心房颤动病史;2例存在间断心悸伴头晕.电生理检查提示,4例患者合并心律失常或传导阻滞.心脏结构方面:除1例患者外余均未见心脏结构明显异常;心脏功能方面:5例患者左心室收缩功能均正常,但3例患者存在舒张功能减退.6例患者均予改善代谢、营养肌肉等对症支持治疗后离院.结论:强直性肌营养不良患者易合并心脏受累,主要表现为心律失常及传导系统阻滞.应加强对此类患者的健康宣教,定期进行全面的心脏筛查,及早发现心脏异常,预防猝死的发生.

BackgroundRepeated remote ischemic conditioning (RIC) after myocardial infarction (MI) has been shown to improve left ventricular (LV) remodeling in the experimental studies, but its cardioprotective effect in patients with ST-segment elevation myocardial infarction (STEMI) is still unknown.ObjectiveTo investigate whether repeated RIC started early after primary percutaneous coronary intervention (PCI) can improve LV function in patients with STEMI.MethodsPatients with STEMI treated by primary PCI were included and randomized to the repeated RIC group (n = 30) or the control group (n = 30). RIC was started within 24 h after PCI and repeated daily for 1 week, using an Auto RIC device. 3D speckle-tracking echocardiography (STE) was used to assessed LV function. The primary study endpoint was the change in LV global longitudinal strain (GLS) from baseline to 1 month after PCI.ResultsThe repeated RIC group and the control group were well-matched at baseline including mean GLS (−9.8 ± 2.6% vs. −10.1 ± 2.5%, P = 0.62). Despite there was no significant difference in mean GLS at 1 month between the two groups (−11.9 ± 2.1% vs. −10.9 ± 2.7%, P = 0.13), the mean change in GLS from baseline to 1 month was significantly higher in the treatment group than in the control group (−2.1 ± 2.5% vs. −0.8 ± 2.3%, P = 0.04). There were no significant differences in the changes in global circumferential strain (GCS), global area strain (GAS), global radial strain (GRS), LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV) between the two groups. Peak creatine kinase isoenzyme-MB, peak high-sensitivity troponin T, and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at 24 h after PCI did not differ significantly between the two groups, but NT-proBNP levels at 1 week were significantly lower in the treatment group than in the control group [357.5 (184.8–762.8) vs. 465.0 (305.8–1525.8) pg/ml, P = 0.04].ConclusionDaily repeated RIC started within 24 h after PCI can improve GLS and reduce plasma NT proBNP levels in patients with STEMI.

Background Nicorandil is recommended as a second-line treatment for stable angina; however, randomized-controlled trials to evaluate the benefit of nicorandil for patients with chronic total occlusion (CTO) are lacking. Objective To determine whether nicorandil can improve left ventricular (LV) myocardial strain in patients with CTO. Methods Patients with CTO were included and randomized to the nicorandil group (n = 31) and the control group (n = 30). Nicorandil was given orally at 15 mg/day for 3 months in the nicorandil group. Three-dimensional speckle-tracking echocardiography and the Seattle Angina Questionnaire (SAQ) survey were performed at baseline and at 3 months. The primary study endpoint was the LV global area strain (GAS) at 3 months. Results The nicorandil and the control groups were well-matched at baseline, including the mean GAS and SAQ scores. At 3 months, GAS in the nicorandil group was significantly higher than that in the control group (−23.7 ± 6.3% vs. −20.3 ± 5.6%, respectively; p = 0.033). There were no significant differences in LV global longitudinal strain, global circumferential strain, global radial strain, LV ejection fraction, LV end-diastolic volume, and LV end-systolic volume at 3 months between the two groups. At 3 months, the SAQ scores for angina stability, angina frequency, and treatment satisfaction in the nicorandil group were significantly higher than those in the control group. Conclusion Nicorandil treatment can improve GAS and angina symptoms in patients with CTO. Clinical Trial Registration www.ClinicalTrials.gov, identifier: NCT05087797.

心脏瓣膜病是母体和胎儿不良结局的重要原因之一.妊娠期女性对瓣膜狭窄的耐受性差,容易发生心力衰竭,而对瓣膜反流的耐受相对较好.人工机械瓣膜置换术后女性在妊娠期间既有瓣膜血栓风险,又有抗凝治疗带来的出血风险.患有心脏瓣膜病的女性在计划妊娠前应接受充分的妊娠心血管风险评估.中重度二尖瓣狭窄患者、有症状的重度主动脉瓣狭窄患者、有症状的重度二尖瓣、主动脉瓣反流或重度二尖瓣、主动脉瓣反流合并左心室功能障碍患者应在计划妊娠前对瓣膜进行修复或置换.对于患有心脏瓣膜病的女性,在妊娠期间、分娩过程中、分娩后均要密切观察血流动力学的变化,并根据瓣膜病变的类型和严重程度,制定个体化的治疗方案.

目的:采用超声心动图评价中国优秀女子足球运动员心脏结构和功能.方法:纳入28名专业女子足球运动员为研究组,年龄25.2±3.4岁,技术等级专业二级以上,运动年限14.2±3.4年;选取28名年龄、体表面积(BSA)相匹配的长期静坐健康女性志愿者为对照组.所有受试者进行超声心动图检查,测量心脏结构和功能的各项指标.结果:与对照组相比,经BSA矫正后女子足球运动员主动脉根部径、主肺动脉内径、左房前后径、左房面积、右房面积、右室舒张末期前后径、右室舒张末期中段横径、右室舒张末期基底段横径、左室舒张末期前后径、左室收缩末期前后径、左室心肌重量指数均增大(P<0.01);右室舒张末期上下径增大(P<0.05);舒张末期前室间隔厚度、舒张末期后室间隔厚度、舒张末期后壁厚度、左室壁厚度,左室相对室壁厚度均增加(P<0.01);三尖瓣环收缩期位移增大(P<0.01),二尖瓣瓣口舒张早期血流速度/二尖瓣瓣口舒张晚期血流速度增大(P<0.05);而左室射血分数、左室短轴缩短分数、左室舒张末期前后径/右室舒张末期前后径减小(P<0.01).结论:运动员左室壁厚度和心肌质量增加,左右心室增大,为运动的良性适应性反应,运动对右心室的重塑较左心室更为显著.超声心动图在运动员心脏监测中有优势,可用于指导科学训练和医学监督.

目的 了解心力衰竭高危人群对心力衰竭的认知情况以及心力衰竭知识讲座提高认知水平的作用.方法 2019年6月至12月北京大学第三医院心力衰竭防治小组针对心力衰竭高危人群举办心力衰竭知识讲座6次,参加人员为心力衰竭A期和B期患者,共420例.在知识讲座前和讲座后,分别进行心力衰竭认知的问卷调查.心力衰竭的认知包括心力衰竭的病因、严重程度、临床表现、就诊和自我管理等5个方面的内容.结果 回收问卷363份,最终合格的问卷为345份,有效回收率为82.14％.心力衰竭高危患者对心力衰竭的认知存在很大不足,能够将问卷列出的8种导致心力衰竭的疾病均选择正确者为54例(15.7％);能够将问卷列出的5个心力衰竭临床表现均选择正确者为66例(19.1％);仅有205例(59.4％)患者表示出现了心力衰竭的症状,会尽早就诊;自我管理方面,只有128例(37.1％)患者认为应该限制饮水量,98例(28.4％)患者认为应该避免感染.在知识讲座后,课后得分高于课前,差异有统计学意义(P<0.05).结论 对心力衰竭高危患者进行心力衰竭知识的健康教育非常有必要.

目的 探讨心腔内超声(CartoSound)三维标测指导下射频消融室间隔治疗肥厚型梗阻性心肌病(HOCM)的安全性及疗效.方法 在CartoSound三维标测技术指导下,对5例HOCM患者行经皮室间隔射频消融治疗,以收缩期二尖瓣瓣叶前向运动(SAM)对应的左室室间隔部位作为消融靶点,应用Smartouch盐水灌注消融电极,消融能量35～40 W,冷盐水灌注流速20 m L/m in,温度43℃,贴靠压力5～10 g,每次放电时间60 s.以左室流出道(LVOT)压力阶差下降50％ 或SAM区域心肌活动显著减弱作为消融有效终点.比较术前、术后LVOT压力阶差变化,记录围术期并发症发生情况,评价疗效和安全性.结果 术中累计消融放电15～42次,消融范围占SAM区域比值22.9％ ～76.6％.术后即刻LVOT压力阶差由术前(105±93.6)mmHg下降至(40.6±37.2)mmHg(P<0.001).随访至术后6个月,患者临床症状消失,心功能改善;术后6个月室间隔厚度由术前(16.1±2.9)mm下降至(13.3±2.4)mm(P=0.115);LVOT压力阶差由术前(105±93.6)mmHg逐步下降至(94.7±71.9)mmHg(术后7日,P=0.146)、(30.72±12.9)mmHg(术后1个月,P<0.01)、(19.4±17.8)mmHg(术后6个月,P<0.01).5例患者均未出现手术并发症.结论 经心腔内超声CartoSound指导下室间隔射频消融术治疗HOCM安全、有效.

1 病例资料 患者,女,69岁,主因“间断活动时胸痛1年,加重2个月,发现左心室附壁血栓6d”入院.1年前患者从事农务劳动时间断出现胸痛,休息20 min左右可缓解.近2周一般家务劳动时胸痛症状反复发作,自觉活动耐力较前下降.6d前行超声心动图检查提示:左室心尖部运动减弱、局部变薄,可探及10.2 mm×10.5 mm的团块影,拟诊左心室附壁血栓,给予阿司匹林、氯吡格雷抗血小板,达肝素钠抗凝治疗.患者否认高血压、糖尿病病史.发现前庭功器官退行性改变2个月,同期行头颅CT提示多发性腔隙性脑梗死.

目的:探讨在新冠肺炎突发公共卫生事件情况下,如何保证超声心动图的教学质量.方法:选取2020年2月至4月学习超声心动图学生31名为实验组,均按照PBL与CBL联合教学;使用传统模式教学的2019年同期37名学生为对照组.根据出科考试成绩以及满意度来考核效果.结果:实验组的总分比对照组高,病例诊断中实验组在心肌梗死、心肌病、心包疾病方面显著优于对照组.结论:PBL与CBL联合教学方法在突发公共卫生事件时期对于超声心动图教学是行之有效的方法.

Objective:To observe the safety and efficacy of solo transcatheter closure of Patent Foramen Ovale (PFO) guided solely by transthoracic echocardiography (TTE).Methods:A total of 25 cases were retrospectively included who underwent the solo transcatheter closure of PFO guided by TTE in Peking University Third Hospital from December 2018 to December 2019. They were 20 females and 5 males with average age of (42.3±7.8) years. TTE was performed immediately after percutaneous closure. The follow-up interviews were conducted at 1 month, 3 months, and 6 months after the procedure, respectively. There were 6 patients with cryptogenic stroke (RoPE score＞6) and 19 patients with obstinate migraine. The presence of PFO was confirmed by preoperative transesophageal echocardiography (TEE). The diameter of PFO was 2-3 mm and the diameter of tunnel was 4-8 mm. The contrast-enhanced transcranial doppler (cTCD) was 2-3 grade.Results:All patients were successfully treated with the solo transcatheter closure of PFO guided by TTE. The mean procedural time (from puncture to sheath removal) was (32.1±7.5) mins. During the operation, 3 cases presented vagal reflex and 2 cases developed transient ventricular arrhythmia, which disappeared after conservative treatment. All patients were discharged the next day after operation without complications, e.g. pericardial effusion, peripheral vascular injury, or cardiac perforation. During the follow-ups, no patients suffered from pericardial effusion, occluder malposition, residual shunt, recurrence of headache and stroke. The cTCD is normal.Conclusion:The solo transcatheter closure of PFO guided by TTE is an effective procedure with high successful rate and low rate of complications.

Background: Pressure overload-induced myocardial hypertrophy is a key step leading to heart failure. Previous cellular and animal studies demonstrated that deteriorated excitation–contraction coupling occurs as early as the compensated stage of hypertrophy before the global decrease in left ventricular ejection fraction (LVEF). This study was to evaluate the cardiac electromechanical coupling time in evaluating cardiac systolic function in the early stage of heart failure. Methods: Twenty-six patients with Stage B heart failure (SBHF) and 31 healthy controls (CONs) were enrolled in this study. M-mode echocardiography was performed to measure LVEF. Tissue Doppler imaging (TDI) combined with electrocardiography (ECG) was used to measure cardiac electromechanical coupling time. Results: There was no significant difference in LVEF between SBHF patients and CONs (64.23 ± 8.91% vs. 64.52 ± 5.90%; P = 0.886). However, all four electromechanical coupling time courses (Qsb: onset of Q wave on ECG to beginning of S wave on TDI, Qst: onset of Q wave on ECG to top of S wave on TDI, Rsb: top of R wave on ECG to beginning of S wave on TDI, and Rst: top of R wave on ECG to top of S wave on TDI) of SBHF patients were significantly longer than those of CONs (Qsb: 119.19 ± 35.68 ms vs. 80.30 ± 14.81 ms, P < 0.001; Qst: 165.42 ± 60.93 ms vs. 129.04 ± 16.97 ms, P = 0.006; Rsb: 82.43 ± 33.66 ms vs. 48.30 ± 15.18 ms, P < 0.001; and Rst: 122.37 ± 36.66 ms vs. 93.25 ± 16.72 ms, P = 0.001), and the Qsb, Rsb, and Rst time showed a significantly higher sensitivity than LVEF (Rst: P =0.032; Rsb: P = 0.003; and Qsb: P = 0.004). Conclusions: The cardiac electromechanical coupling time is more sensitive than LVEF in evaluating cardiac systolic function.

Objective To carry out a cross-section study in community resident by application the 10-year atherosclerotic cardiovascular disease(ASCVD)risk assessment method and then to explore the situation of 4 statin benefit groups.Methods Application of the risk assessment mothod was recommended by ACC/AHA in 2013.A total of 3 516 individuals with integrated data were studied.1 891 individuals were calculated for the 10-year ASCVD risk.Then the distribution of 4 statin benefit groups and the situation of an estimated 10-year ASCVD risk of 7.5％ or higher were respectively found.Results Seven hundred and fifty-one patients were benefited from four statin treatments in the community.There were 418 cases with 10 years the risk of ASCVD more than 7.5％.These people accounted for 21.36％ and 11.89％ of the total number of candidates.In these 10 years the risk of ASCVD≥ 7.5％,60-69 years of age accounted for the highest proportion of 49.1％.The score of ASCVD in males was statistically higher than that in females(P＜0.05).Conclusion The prevalence of statin benefit community individuals and 10-year atherosclerotic ASCVD risk of 7.5％ or higher in adult were very high.The score of risk estimation in male was more serious than in female.

Objective To investigate clinical significance and the correlation between oxygen uptake efficiency slope(OUES) measured by the cardiopulmonary exercise test(CPET) and echocardiographic left ventricular function in elderly patients with coronary heart diseases after the percutaneous coronary intervention.Methods Patients aged 65 years and over after PCI and CPET were enrolled to collect relevant parameters including the peak oxygen consumption(VO2peak),oxygen pulse(VO2/HR),OUES and cardiorespiratory fitness(CRF) index,also mitral annulus systolic peak speed(Sm),early diastolic mitral flow velocity Em and mitral annular early diastolic peak velocity Em ratio(E/Em) using the echocardiography.Patients with systolic velocity of mitral annulus(Sm)≥8 cm/s were assigned to the normal Sm group,while the rest were selected into the lower Sm group.The correlation between the cardiopulmonary fitness and cardiac function was analyzed.Results Four hundred and two patients were enrolled,with an average age of 71 ± 5 years,283 males(70.40％),and 119 females(29.60％).Among them,111 (27.61％) were 75 years of age or older,202(50.25％) ranging from 65 to 69 and 89 (22.14％) between 70 and 74.Totally 227 patients were diagnosed as angina pectoris(56.47％),62 as acute myocardial infarction (15.42％),and 113 patients with old myocardial infarction (28.11％).It was found that the heart systolic function was associated with CRF:Sm and OUES were positively correlated independently(r=29.220,P=0.001);Em was positively related to VO2peak(r=0.176,P＜0.001) andOUES (r=0.151,P=0.003).However,E/Em was negatively correlated with VO2peak (r=-0.199,P＜0.001),VO2/HR (r=-0.118,P=0.018) and OUES (r=-0.201,P＜0.001).The left atrial pressure was negatively correlated with VO2peak (r=-0.187,P＜0.001),VO2/HR (r=-0.108,P=0.030) and OUES (r=-0.185,P＜ 0.001).Left ventricular ejection fraction and left ventricular end diastolic diameter were not found to be related to cardiorespiratory fitness parameters (P＞0.05).Conclusion The cardiopulmonary exercise test can be used as a practical method to evaluate and guide the rehabilitation exercises.The CRF parameters can evaluate the heart function exercise and is significantly correlated to the resting cardiac systolic and diastolic function parameters.

Objective To investigate the clinical significance of echogenic intracardiac foci (EIF) in fetuses using fetal echocardiography.Methods Echocardiography was performed in the mid-tri-mester of pregnancy.When the EIF that was found in fetuses,the position,size,number and the complication of cardiac abnormalities were recorded simultaneously.All the fetuses were followed up.Results 323 cases of fetuses with EIF were found,265 cases of them were found in the left ventricle.47 cases of them were found in the right ventricle.11 cases of them were found in both ventricles.All of the cases had no fetal congenital heart diseases,fetal arrhythmia or other fetal malformation.Fetal EIF disappeared or weakened in resonance in the following-up study.Conclusion Echocardiography reveal that most of the EIT is temporary.The presence of EIF in fetuses cannot be used as an indication for abortion