OBJECTIVE:This study aimed to identify risk factors associated with mitral annular calcification (MAC) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to evaluate its relationship with clinical outcomes. METHODS:A total of 310 patients with HOCM who underwent interventricular septal myectomy were retrospectively analyzed. Patients were divided into a MAC group (n = 24) and a non-MAC group (n = 286). Demographic characteristics, echocardiographic parameters, and clinical data were compared between groups. Major adverse cardiovascular and cerebrovascular event (MACCE) and circulating levels of brain natriuretic peptide, Apelin, and Galectin-3 were analyzed. RESULTS:Patients with MAC were older and showed higher prevalence of aortic annular calcification, mitral leaflet thickening, and moderate-to-severe tricuspid regurgitation (P < 0.05). Multivariate analysis identified gender, age, aortic annular calcification, moderate-to-severe tricuspid regurgitation, and mitral leaflet thickening as independent risk factors for MAC. Patients with MAC showed larger left ventricular end-diastolic volume, reduced left ventricular ejection fraction, and greater left atrium mass, and a higher incidence of MACCE than those without MAC (P < 0.05). CONCLUSION:In HOCM undergoing septal myectomy, MAC is associated with adverse cardiac remodeling and unfavorable clinical outcomes. Identification of related factors may aid risk stratification and perioperative management.

Objective This research aimed to ascertain the risk factors for the development of mitral annular calcification (MAC) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and the impact of MAC on prognosis. Methods HOCM patients underwent interventricular diaphragmatic myectomy were collected and examined by echocardiography and CT to test whether MAC occurred or not. General data and risk factors affecting MAC development in HOCM patients were observed. Differences in cardiac function indicators and perioperative clinical data were compared between patients with MAC and those without MAC. After surgery, patients were followed up until December 2022, with the primary endpoint being postoperative all-cause mortality and the secondary endpoint being major adverse cardiovascular and cerebrovascular events (MACCE). Prognosis and MACCE occurrence were analyzed, and differences in brain natriuretic peptide (BNP), Apelin, and Galectin-3 levels were assessed between patients with MAC and patients without MAC, and the correlation between factor levels and cardiac function indicators were explored. Results There were 24 patients with MAC (7.74%) and 286 patients without MAC (92.26%). Female and older patients were more common in the MAC group. The MAC group had a higher incidence of SAM sign, aortic annular calcification, aortic calcification, coronary artery calcification, mitral leaflet thickening, and moderate and severe tricuspid regurgitation. Gender, age, aortic calcification, aortic annular calcification, SAM sign, and mitral leaflet thickening were independent risk factors for MAC development. The MAC group had higher LVEDD, lower LVEF and heavier LVMM than the no-MAC group. Patients in the no-MAC group had a better prognosis and better MACCE incidence than patients in the MAC group. Conclusion Independent risk factors affecting MAC development in HOCM patients are gender, age, aortic calcification, aortic annular calcification, SAM sign, and mitral leaflet thickening. MAC development may lead to a poor prognosis in HOCM patients.

A total of 25 patients with right cardiac system tumors in the Department of Cardiac Surgery, Beijing Anzhen Hospital from January 2012 to October 2022 were retrospectively included in the study. The preoperative data, and information of surgical treatment and perioperative management on these patients were analyzed and summarized. One patient developed pulmonary embolism and died before surgery, and the other 24 patients (16 males and 8 females) received surgical treatment, with an average age of (44.7±10.2) years (24-74 years). Nine patients were diagnosed with malignant tumors. Among the 24 patients who received surgical treatment, two patients died during the perioperative period, in-situ tumor recurrence was seen in three patients within about 1 year after surgery (two patients died without surgery, and one patient died 3 months after surgery), two patients had distant metastasis, and 17 patients had a good prognosis. Right cardiac system tumors are rare, with a high malignant rate, and the clinical manifestations vary greatly. Active surgical intervention is found to be effective, and the prognosis is closely related to the pathological type and extent of tumor invasion.

目的:通过分析双房粘液瘤(BM)的临床特点,总结围术期治疗经验及中短期预后效果.方法:回顾性分析2004年12至2021年5月,北京安贞医院心外科6例双房粘液瘤患者的临床资料,结合国内外相关文献与本组患者术前资料,手术治疗及围术期处理进行分析总结.结果:6例患者均行粘液瘤切除术,术后6例患者心功能均有不同程度改善,无围术期死亡病例,中短期预后良好.结论:双房粘液瘤患者早期明确诊断,尽早行手术治疗可降低并发症发生,降低围术期风险,提高预后效果.

Hypertrophic obstructive cardiomyopathy (HOCM) is a well-recognized inherited cardiac disease. This study was conducted to explore the role of lncRNA ADAMTS9 antisense RNA 1 (ADAMTS9-AS1) in HOCM-induced cardiomyocyte hypertrophy. The serum of HOCM patients was collected. AC16 cells were treated with isoproterenol (ISO) and transfected with oe-ADAMTS9-AS1 vector, miR-185-5p mimic, and lysine acetyltransferase 7 (KAT7) specific small interfering RNA. lncRNA ADAMTS9-AS1, miR-185-5p, KAT7, brain natriuretic peptide (BNP), and atrial natriuretic peptide (ANP) in the serum or cells were determine by qRT-PCR or Western blot assay. Cell surface area was observed by Texas Red-Phalloidin staining. Subcellular localization of lncRNA ADAMTS9-AS1 was tested by nuclear/cytoplasmic fractionation assay, with RNA pull-down and dual-luciferase assay to validate gene interactions. lncRNA ADAMTS9-AS1 was downregulated in the serum of HOCM patients and ISO-treated AC16 cells. lncRNA ADAMTS9-AS1 overexpression inhibited ISO-induced cardiomyocyte hypertrophy and reduced levels of ANP and BNP. lncRNA ADAMTS9- AS1 was located in cytoplasm and inhibited miR-185-5p expression through targeted binding. miR-185-5p bound to KAT7 3’UTR and inhibited KAT7 expression. miR-185-5p overexpression and KAT7 knockdown both neutralized the inhibitory role of lncRNA ADAMTS9-AS1 in cardiomyocyte hypertrophy. Overall, lncRNA ADAMTS9-AS competitively bound to miR-185-5p to up-regulate KAT7 and thus inhibited cardiomyocyte hypertrophy.

Objective:To explore the feasibility of applying quantitative flow ratio(QFR) to assess the degree of coronary artery functional stenosis before surgery, and to guide coronary artery bypass grafting(CABG) revascularization strategy.Methods:The study prospectively included a total of 154 patients who were electively treated with CABG in the 11th ward of the Department of Cardiac Surgery of Beijing Anzhen Hospital from January 2019 to September 2020, and their coronary angiography visually showed stenosis of the coronary artery to perform QFR analysis to know the diseased blood vessels. For functional stenosis, the surgeon was blinded to the results of QFR analysis before surgery. Collect its baseline data, perioperative data and recent clinical outcomes for summary analysis.Results:One year later, the coronary artery CTA showed that the occlusion rate of functionally significant disease(QFR<0.8) was 5.5%, and that of non-functionally significant disease(QFR≥0.8) was 15.6%. There was no difference in angina class or repeat interventions between patients with or without occluded bypass grafts.Conclusion:According to QFR analysis, coronary arteries with functional non-significant disease have a higher risk of grafts failure than those with functionally significant disease. For coronary arteries with negative QFR lesions, the risk of occlusion of arterial grafts is higher than that of venous. However, this finding is not significantly related to clinical prognosis, because patients with patency or occlusion of the grafts in non-significant lesions have not found excessive angina pectoris or repeated coronary interventions. QFR-guided selection of coronary surgery strategies is safe and feasible.

Background Quantitative flow ratio (QFR) is a new functional index to assess the functional significance of coronary stenosis. While whether there is an association between QFR and transit-time flow measurement (TTFM) parameters of the target coronary artery has not been well addressed. Methods A total of 89 patients receiving the in situ left internal thoracic artery (LITA) grafts to the left anterior descending artery (LAD), and 19 patients undergoing the saphenous vein grafts (SVG) were enrolled in this retrospective study. The QFR value of the LAD was evaluated preoperatively. According to the QFR values, patients with the LITA to the LAD bypass grafts were divided into two groups (group A1: QFR < 0.75, group A2: QFR ≥ 0.75), and SVG patients were divided into two groups (V1 group: QFR < 0.75, V2 group: QFR ≥ 0.75). Results In groups A1 and A2, respectively, median graft flow (Qm) was 44 (34) mL/minute and 26.5 (30.0) ml/minute; median pulsatility index (PI) was 2.00 (1.00) and 2.65 (0.90). Significant differences were observed in Qm (P = 0.034) and PI (P = 0.030). And the correlation coefficients of the TTFM variables with QFR were Qm: r = r = −0.226, (P = 0.036), PI: r = 0.265 (P = 0.012) among the LITA to LAD population. Conclusion TTFM variables, especially the PI, of the LITA in situ graft to the LAD during Coronary artery bypass grafting (CABG) are strongly affected by preoperative QFR values. Moreover, in functionally mild coronary stenosis, the chance of competitive flow increases.

目的:本研究旨在探讨冠状动脉旁路移植术(CABG)后1年内患者经皮冠状动脉介入治疗(PCI)的临床特征和随访结果.方法:分析总结既往在北京安贞医院接受CABG且随后1年内接受PCI的121例患者的临床数据,并进行随访.结果:患者平均年龄为60.71岁,男性占71.9％,合并糖尿病、高血压、高脂血症和吸烟史等冠心病危险因素比例高.81.0％的患者有桥血管病变.在有桥血管病变的患者98例(82.7％)中,74.5％的患者桥血管闭塞.53.7％的患者原位血管为C型病变;45.5％的患者原位血管有慢性完全闭塞病变;9.9％的患者有弥漫性病变;36.4％的患者有分支累及病变.90.9％的患者接受了单纯的原位血管PCI,68.5％的支架为第一代药物洗脱支架.中位随访时间为5.61年,5.0％的患者死于心脏性死亡,13.2％的患者患有心力衰竭,其次是心肌梗死(12.4％)和中风(3.3％).24.0％的患者在PCI术后再次接受了以支架置入为主的血运重建.结论:CABG术后1年接受PCI治疗的患者,90.9％仅在原位血管接受PCI,长期结果显示,MACCE事件的发生率较高,包括心肌梗死、心力衰竭和血运重建.

目的 探讨冠状动脉旁路移植术（coronary artery bypass grafting,CABG）后症状复发患者的冠状动脉造影特征。方法 回顾性分析北京安贞医院2010—2020年997例CABG术后症状复发患者的临床资料，其中男762例、女235例，平均年龄（62.41±8.70）岁。结果 有高血压、糖尿病、吸烟史等危险因素患者的比例较高。动脉桥血管病变占27.44%，静脉桥血管病变占54.40%;240例（24.07%）患者桥血管全部通畅。病变桥血管以慢性完全闭塞病变为主（79.57%）。CABG术后大多数患者的原位血管病变程度较术前增加。674例（67.60%）患者与缺血区相关的原位血管病变以C型病变为主。CABG术后症状复发的患者多为桥血管和原位血管共同病变的结果（525例，52.66%）。结论 CABG术后症状复发患者的桥血管状况比我们预期的更糟。大多数患者CABG术后症状复发是由桥血管和原位血管共同病变引起。CABG术后原位血管病变继续发展。

Objective:To investigate the relationship between the expression of mammalian Ste20-like kinase 1 (MST1) and cardiac hypertrophy in hypertrophic cardiomyopathy (HCM) and to determine the associated signaling pathway.Methods:Hypertrophied inter-ventricular septal tissues from 20 patients with HCM and normal myocardial tissues from 4 healthy control group were collected. Firstly, clinical specimens including HCM patients and normal control group, animal models including MST1 gene knockout (KO) mouse model and transverse aortic constriction (TAC) mouse model, and in vitro cell culture models were used to confirm the correlation between MST1 gene expression and cardiac hypertrophy. Then, the role of MST1 signaling pathway including MST1, YAP2, Survivin and AKT in the pathogenesis and development of HCM was verified by cell (H9C2) level, animal model level and clinical specimen level.Results:(1) Compared with normal myocardium, the levels of protein expression and RNA transcription of MST1 gene were significantly decreased in patients with HCM. Moreover, the level of protein expression of MST1 gene was negatively correlated with inter-ventricular septal thickness detected by echocardiograpy in patients with HCM. (2) The ventricular wall thickness and heart weight ratio of MST1 gene KO mice were higher than those of control mice (MST1 gene wild-type). The ventricular wall thickness and heart weight ratio in TAC group were also higher than those in sham group. Furthermore, the ventricular wall thickness and heart weight ratio of mice with MST1 gene KO and TAC were significantly higher than those of control group. (3) In vitro cell culture results showed that lower expression of MST1 gene could promote cardiac hypertrophy. (4) In addition, down-regulation of MST1 gene expression can lead to up-regulation of downstream related genes (YAP2 and Survivin) and active expression of related specific gene (AKT) and subsequently to promote cardiac hypertrophy, which is verified by cell (H9C2) level, animal model and clinical specimen level.Conclusions:The abnormal expression of MST1 is related to the occurrence of HCM. Decrease in the expression of MST1 gene may regulate the up-regulation of downstream genes including YAP2 and Survivin, and then affect the activity of AKT gene, which promoting cardiac hypertrophy and leading to the occurrence of HCM.

Background and Aims: Patients with heart failure with reduced ejection fraction (HFrEF) are among the most challenging patients undergoing coronary artery bypass grafting surgery (CABG). Several surgical risk scores are commonly used to predict the risk in patients undergoing CABG. However, these risk scores do not specifically target HFrEF patients. We aim to develop and validate a new nomogram score to predict the risk of in-hospital mortality among HFrEF patients after CABG.Methods: The study retrospectively enrolled 489 patients who had HFrEF and underwent CABG. The outcome was postoperative in-hospital death. About 70% (n = 342) of the patients were randomly constituted a training cohort and the rest (n = 147) made a validation cohort. A multivariable logistic regression model was derived from the training cohort and presented as a nomogram to predict postoperative mortality in patients with HFrEF. The model performance was assessed in terms of discrimination and calibration. Besides, we compared the model with EuroSCORE-2 in terms of discrimination and calibration.Results: Postoperative death occurred in 26 (7.6%) out of 342 patients in the training cohort, and in 10 (6.8%) out of 147 patients in the validation cohort. Eight preoperative factors were associated with postoperative death, including age, critical state, recent myocardial infarction, stroke, left ventricular ejection fraction (LVEF) ≤35%, LV dilatation, increased serum creatinine, and combined surgery. The nomogram achieved good discrimination with C-indexes of 0.889 (95%CI, 0.839–0.938) and 0.899 (95%CI, 0.835–0.963) in predicting the risk of mortality after CABG in the training and validation cohorts, respectively, and showed well-fitted calibration curves in the patients whose predicted mortality probabilities were below 40%. Compared with EuroSCORE-2, the nomogram had significantly higher C-indexes in the training cohort (0.889 vs. 0.762, p = 0.005) as well as the validation cohort (0.899 vs. 0.816, p = 0.039). Besides, the nomogram had better calibration and reclassification than EuroSCORE-2 both in the training and validation cohort. The EuroSCORE-2 underestimated postoperative mortality risk, especially in high-risk patients.Conclusions: The nomogram provides an optimal preoperative estimation of mortality risk after CABG in patients with HFrEF and has the potential to facilitate identifying HFrEF patients at high risk of in-hospital mortality.

OBJECTIVE:Coronary heart disease (CHD) is a notable contributor to the burden of human health. Dysregulated long non-coding RNAs (lncRNAs) are implicated in the pathogenesis of CHD. This study investigated the expression pattern of lncRNA LOXL1-AS1 in CHD and its regulatory mechanism in oxidized low-density lipoprotein (ox-LDL)-induced human coronary artery endothelial cell (HCAEC) pyroptosis. METHODS:Serum was collected from 62 CHD patients and 62 healthy volunteers for the detection of LOXL1-AS1 expression. The value of LOXL1-AS1 in CHD diagnosis and major cardiovascular adverse event (MACE) prediction was analyzed using the ROC curve. LOXL1-AS1, miR-16-5p, and SNX16 expressions in ox-LDL-treated HCAECs were determined using RT-qPCR. NLPR3, cleaved-caspase-1, and GSDMD-N protein levels were measured using Western blot. IL-1β and IL-18 concentrations were measured using ELISA. The binding relationships between LOXL1-AS1 and miR-16-5p and miR-16-5p and SNX16 were verified. Functional rescue experiment was performed to verify the role of miR-16-5p in HCAEC pyroptosis. RESULTS:LOXL1-AS1 was highly expressed in CHD patients. LOXL1-AS1 had diagnostic value for CHD and predictive value for MACE occurrence. ox-LDL-treated HCAECs showed reduced viability, increased IL-1β and IL-18 concentrations, and elevated NLPR3, cleaved-caspase-1, and GSDMD-N levels. LOXL1-AS1 silencing promoted cell viability and reduced pyroptosis. LOXL1-AS1 bound to miR-16-5p and miR-16-5p targeted SNX16. Inhibition of miR-16-5p reversed the inhibitory effect of LOXL1-AS1 silencing on HCAEC pyroptosis. CONCLUSION:LOXL1-AS1 was elevated in CHD patients with a good diagnostic value for CHD and predictive value for MACE. LOXL1-AS1 downregulated miR-16-5p expression by binding to miR-16-5p to enhance ox-LDL-induced HCAEC pyroptosis, which may be associated with upregulation of SNX16 transcription.

Hypertrophic cardiomyopathy (HCM) is a heterogeneous myocardial disease characterized by myocardial hypertrophy, myocardial mechanical and electrical activity obstacles.This study aimed to explore the relationship between YAP2 (Yes-associated protein 2) and HCM and clarify a signaling path about the pathogenesis of HCM.Our study confirms that YAP2 can promote myocardial cell hypertrophy at the molecular level (myocardial lineage cell H9C2), organ level (clinical specimens of human HCM), and an animal model (a mouse model of HCM with cardiac-specific transgenic and knockout YAP2).The detailed molecular mechanisms linking YAP2 to cardiomyocyte hypertrophy and HCM were investigated.This study proved that YAP2, as the final reaction factor in Hippo pathways, influences Akt1 activity to affect the downstream genes, which participate in the formation of HCM by promoting myocardial cell proliferation and cardiac hypertrophy.

It has been established that obstructive sleep apnea (OSA) is an independent risk factor for atherosclerosis. Chronic intermittent hypoxia (CIH) activates sympathoadrenal system and upregulates β3 adrenergic receptor (β3 AR). However, the effect of selective β3 AR agonist mirabegron in CIH-induced atherosclerosis remains unknown. We generated a CIH-induced atherosclerosis model through exposing ApoE−/− mice to CIH (8 h per day, cyclic inspiratory oxygen fraction 5–21%, 60-s cycle) for 6 weeks after 4-week high-fat dieting and investigated the effects of mirabegron, a selective β3 AR agonist, on CIH-induced atherosclerosis. The coronary endarterectomy (CE) specimens from coronary artery disease patients with OSA and without OSA were collected. The expression of β3 AR was significantly elevated in CIH-induced atherosclerosis model. Furthermore, treatment with mirabegron (10mg/kg per day by oral administration for 6 weeks) ameliorated atherosclerosis in ApoE−/− mice in CIH but not in normoxia. Mechanistically, mirabegron activated β3 AR and ameliorated intraplaque oxidative stress by suppressing p22phox expression and reactive oxygen species (ROS) level. In addition, in human CE specimens, β3 AR was also upregulated associated with increased p22phox expression and ROS level both in the lumen and in the plaque of coronary artery in OSA subjects. This study first demonstrated that mirabegron impeded the progression of CIH-induced atherosclerosis, at least in part, via β3 AR–mediated oxidative stress, suggesting a promising therapeutic strategy for protecting against atherosclerosis induced by CIH.

Background It’s necessary to analyze the related risk factors and complications of low cardiac output syndrome (LCOS) after operation in children with congenital heart disease (CHD), to elucidate the management strategy of LCOS. Methods CHD children admitted to the department of cardiology in our hospital from January 15, 2019 to October 31, 2020 were included. The personal and clinical data of CHD children with LCOS and without LCOS were collected and compared. Logistic regression analyses were conducted to identify the risk factors of postoperative LCOS. Besides, the complication and mortality of LCOS and no LCOS patients were compared. Results A total of 283 CHD patients were included, the incidence of postoperative LCOS in CHD patients was 12.37%. There were significant differences in the age, preoperative oxygen saturation, two-way ventricular shunt, duration of CPB and postoperative residual shunt between two groups (all p < 0.05). Logistic regression analyses indicated that age ≤ 4y(OR2.426, 95%CI1.044 ~ 4.149), preoperative oxygen saturation ≤ 93%(OR2.175, 95%CI1.182 ~ 5.033), two-way ventricular shunt (OR3.994, 95%CI1.247 ~ 6.797), duration of CPB ≥ 60 min(OR2.172, 95%CI1.002 ~ 4.309), postoperative residual shunt (OR1.487, 95%CI1.093 ~ 2.383) were the independent risk factors of LCOS in patients with CHD (all p < 0.05). There were significant differences in the acute liver injury, acute kidney injury, pulmonary infection, tracheotomy, duration of mechanical ventilation, length of ICU stay and mortality (all p < 0.05), no significant difference in the 24 h drainage was found( p = 0.095). Conclusion LCOS after CHD is common, more attentions should be paid to those patients with age ≤ 4y, preoperative oxygen saturation ≤ 93%, two-way ventricular shunt, duration of CPB ≥ 60 min, postoperative residual shunt to improve the prognosis of CHD patients.

目的:通过观察射血分数降低型心力衰竭(HFrEF)患者行冠状动脉旁路移植术(CABG)的围术期风险及远期生存率,比较单纯药物治疗与CABG术对这类患者临床结果的差异,探讨HFrEF患者的最优治疗策略.方法:连续收集2014年1月至2018年12月入院,LVEF＜40％合并心力衰竭的症状和体征行CABG术的患者118例及单纯药物治疗的患者45例.住院期间行经胸超声心动图检查测定LVEF和左心室收缩末期容积指数(LVESVI),采用正电子发射断层显像技术(PET)行静息心肌灌注显像及心肌代谢断层显像测定存活心肌占左心室心肌比例.手术组患者除接受指南指导下的药物治疗外均由同一主刀医师行CABG术,单纯药物治疗组患者接受指南指导下的规范化药物治疗.术后平均随访时间(37±12)个月,观察手术组患者手术死亡率,围术期并发症,远期无主要不良心血管事件(MACE)生存率并对比单纯药物治疗组患者与CABG术治疗组患者的远期无MACE事件生存率.结果:全组118例患者围术期死亡8例,死亡率6.8％.死亡原因包括:术后心排4例,感染中毒性休克3例,IABP腿部并发症导致全身代谢紊乱1例.围术期应用主动脉内球囊反搏(IABP)或体外膜式氧合(ECMO)等机械辅助措施的患者分别达到56.8％和8.5％.术中71.2％的患者采用不停跳CABG,全静脉桥血管比例占39.8％.术后平均机械通气时间和ICU时间分别为60 h和84 h.术后对两组患者进行随访,CABG组参与随访103例,药物治疗组参与随访40例,平均随访时间为(37±12)个月.随访期间药物治疗组患者脑卒中,心肌梗死及再次血运重建发生率显著高于CABG组患者(12.5％ vs.6.8％,P=0.000, 27.5％ vs.12.6％,P=0.005,22.5％ vs.4.9％,P=0.000).CABG组患者24个月,36个月,48个月免MACE事件存活率明显高于药物治疗组组患者(96.9％ vs.75.6％,86.4％ vs.45.5％,44.4％vs7.2％,P＜0.01).结论:HFrEF患者行CABG术围术期风险较高,需根据患者左心室存活心肌比例及左心室重构情况制定个性化治疗策略.手术治疗与药物治疗相比,手术治疗中远期获益显著,能够有效改善患者预后.

Objective: To explore the impact of left ventricle remodeling on perioperative risk and short-term survival in patients with heart failure and reduced ejection fraction (HFrEF) undergoing coronary artery bypass grafting (CABG). Methods: A total of 78 coronary artery disease (CAD) patients (54 males, 24 females) with symptoms and signs of heart failure and a left ventricular ejection fraction (LVEF)<40% were consecutively enrolled from January 2014 to December 2018 in Beijing Anzhen Hospital. The average age was (59±8) years old. Transthoracic echocardiography was performed to measure LVEF and left ventricle end-systolic volume index (LVESVI) during hospitalization, and the average LVESVI was (92±18) ml/m(2). According to the mean value of LVESVI, the patients were divided into 2 groups: mild left ventricle remodeling group (group M, n=46, LVESVI<92 ml/m(2)) and severe left ventricle remodeling group (group S, n=32, LVESVI≥92 ml/m(2)). The follow-up period was (30±12) months. Operative mortality, perioperative complications and long-term survival were compared between the two groups. Results: Perioperative mortality was 5.1% (4/78), which was significantly higher in group S than that of group M (9.4% vs 2.2%, P=0.03). The proportion of patients with intra-aortic balloon pump (IABP) was higher in group S than that of group M during the perioperative period (62.5% vs 36.9%, P<0.01). Compared with patients in group M, those with severe left ventricle remodeling were more susceptible to atrial fibrillation after surgery (25.0% vs 6.5%, P=0.02). The mean follow-up time was (30±12) months. There was no difference in major adverse cardiac event (MACE)-free survival in 12 month, 24 month and 36 month between the two groups (100% vs 100%, 87.9% vs 92.1%, 80.3% vs 78.3%, P=0.68). Conclusion: Left ventricular remodeling increases the perioperative mortality and complications of patients with ischemic HFrEF undergoing CABG, but it has no impact on short-term survival.

Objective:To assess the clinical characteristics and grafts status by coronary angiography(CAG) in symptomatic patients with prior coronary artery bypass graft(CABG).Methods:A retrospective descriptive study of symptomatic patients with prior CABG who underwent CAG was performed, 1 136 patients were included and analyzed. The mean age was(62.5±8.7) years, 76.4% were male. There was a high prevalence of risk factors like hypertension(75.0%), dyslipidemia(48.2%), diabetes(46.1%) and smoking history(62.8%).Results:The mean duration after CABG was (4.65±3.39) years. 94.5% of patients had chest pain. 12.9% of patients had all diseased grafts and 28.7% had all patent grafts. The proportion of diseased SVG was higher than that of diseased arterial grafts. The proportion of diseased grafts anastomosed to RCA territory was higher than that of grafts anastomosed to LCX territory or LAD territory. 52.5% of patients received percutaneous coronary intervention(PCI) revascularization, and 88.3% of PCI was performed in native vessels.Conclusion:The most common symptom recurring to patients with prior CABG was chest pain. Graft status in symptomatic patients with prior CABG was worse than we expected. Patients received repeated revascularization mostly by PCI and PCI was mainly performed in native vessels.

Background: Hypertrophic cardiomyopathy (HCM) is the most common chromosomal abnormal heart disease. The pathophysiological mechanism of HCM is complex. Several studies have suggested that the level of Soluble ST2 (sST2) may be a biomarker of chronic systolic heart failure, however, the role of sST2 in HCM remains unclear. So we performed this study to analyze the role of Soluble ST2 (sST2), Galectin-3 (Gal-3) and its correlations with clinical prognosis of patients with hypertrophic cardiomyopathy (HCM) undergoing ventricular septal myectomy. Methods: HCM patients who underwent modified Morrow surgery in our hospital during June 2016-June 2018 were included. We divided the patients into different groups stratified by sST2 and Gal-3 level. Besides, we included volunteers without heart disease for medical examination as normal controls. Biochemical analyses were conducted to identify the biomarkers difference. The predictive value of sST2 and Gal-3 on all-cause mortality was evaluated with Cox regression analysis. Results: A total of 125 HCM patients were included in this present study. The sST2 and Gal-3 levels in HCM patients were significantly higher than that in control group (all P<0.001); there were significant differences in the incidence of all-cause mortality for HCM patients stratified by the sST2 and Gal-3 level; Cox univariate regression survival analysis showed that the hypertension (HR =1.19, 95% CI: 1.01-1.38), maximum wall thickness (HR =1.48, 95% CI: 1.04-1.98), Log sST2 (HR =1.02, 95% CI: 1.01-1.05), Log Gal-3 (HR =1.17, 95% CI: 1.09-1.32) were the predictors for all-cause mortality in patients with HCM, and Cox multivariate risk regression showed that maximum wall thickness was the independent predictors of all-cause mortality in patients with HCM (HR =1.63, 95% CI: 1.35-1.97). Conclusions: Even through sST2 and Gal-3 were not associated with clinical prognosis of patients with HCM undergoing ventricular septal myectomy, it may be involved in the progress of HCM, more studies are warranted to identify the potential mechanism and reverence value.

Objective:To explore the perioperative effect of coronary artery bypass grafting(CABG) or CABG+ mitral valve repair(MVP) in patients with coronary heart disease(CAD) and moderate ischemic mitral regurgitation(IMR).Methods:The clinical data and perioperative complications of 210 patients with CAD and moderate IMR, who underwent CABG from January 2018 to December 2019, were included into this study, with 155 males and mean age of(62.3±8.5) years old. According to the operation mode, patients were divided into CABG group(138 cases) and CABG+ MVP group(72 cases).Results:There were no significant differences in age, gender, comorbidities(diabetes, hypertension, hyperlipidemia, peripheral vascular disease, cerebrovascular events, previous history of myocardial infarction and PCI), LVEF and of coronary artery lesions between the two groups(all P>0.05). Sequential anastomosis was the main method, and most patients underwent internal mammary artery graft in both groups, there was no significant difference between the two groups( P>0.05). CABG group was higher than CABG+ MVP group in all-cause death, heart failure, cerebrovascular events, secondary thoracotomy, CRRT and IABP support events, but there were no significant differences between the two groups( P>0.05). Echocardiographic reexamination showed that the indexes of cardiac function in CABG+ MVP group were higher than those in CABG group, but there was no significant difference between the two groups( P>0.05). The mean area of mitral regurgitation in CABG + MVP group was 1.3 cm 2, significantly lower than that in CABG group(2.5 cm 2), P<0.05. Conclusion:CABG+ MVP has low perioperative risk in patients with CAD and moderate IMR, and the area of mitral regurgitation is lower.