INTRODUCTION:Catheter ablation for atrial tachycardia (AT) in Budd-Chiari syndrome (BCS) presents unique challenges due to altered venous anatomy. This case demonstrates an innovative approach to overcome complete inferior vena cava (IVC) occlusion. METHODS:A 24-year-old female with BCS underwent catheter ablation via an innovative femoral vein-IVC-azygos-SVC approach, guided by preprocedural CT angiography and 3D electroanatomical mapping. RESULTS:Successful ablation was achieved at the anterior interatrial septum with no arrhythmia recurrence during the 3-month follow-up. CONCLUSION:This case demonstrates the successful use of an IVC-azygos-SVC approach guided by CT angiography and 3D mapping for atrial tachycardia ablation in Budd-Chiari syndrome, offering a viable solution for patients with complex venous obstruction.

Left atrial appendage occlusion (LAAO) is an established alternative stroke-prevention strategy for patients with atrial fibrillation (AF) who have contraindications to long-term oral anticoagulation. However, LAAO addresses only left-sided thromboembolism and does not eliminate the risk of thrombus formation in other cardiac chambers. We present the case of a 72-year-old man with dilated cardiomyopathy and persistent AF who developed right atrial appendage (RAA) thrombosis one year after percutaneous LAAO with an Amplatzer Cardiac Plug (ACP). The patient had initially undergone LAAO due to intracerebral hemorrhage during oral anticoagulant therapy. He presented to the emergency department with decompensated heart failure. Transthoracic echocardiography revealed a mobile mass (30 mm × 19 mm) in the right atrium, and contrast-enhanced cardiac computed tomography confirmed a filling defect within the RAA, consistent with RAA thrombus. Anticoagulation with rivaroxaban 15 mg once daily was initiated, and follow-up imaging at two weeks demonstrated complete resolution of the mobile thrombus. This case highlights the potential for RAA thrombosis in patients with AF following LAAO, particularly in the presence of heart failure and enlarged cardiac chambers. Clinicians should remain vigilant for right-sided intracardiac thrombi in this population, even after successful LAAO, and the decision to discontinue anticoagulation after LAAO should be carefully individualized.

Introduction: A 30-year-old woman with a history of prior ablation for a concealed left posteroseptal accessory pathway (AP) presented with incessant narrow QRS tachycardia, highlighting a rare complication of incomplete AP ablation. Methods and Results: Adenosine transiently terminated the tachycardia, which recurred immediately. Electrophysiology study confirmed orthodromic atrioventricular reentry tachycardia (AVRT) due to a slow-conducting AP at the previously ablated site. Three-dimensional mapping localized the AP to the left posteroseptal region, and radiofrequency ablation at the shortest VA interval successfully eliminated the arrhythmia. Conclusion: This case illustrates incessant AVRT caused by an iatrogenic slow-conducting posteroseptal accessory pathway following incomplete ablation. Recognition of this mechanism is important to guide appropriate repeat ablation and prevent tachycardia-induced cardiomyopathy.

Isolated right ventricular infarction (RVI) is an underrecognized clinical entity that often mimics anteroseptal myocardial infarction due to its characteristic ST-segment elevation (STE) in precordial leads. We report the case of a 55-year-old man who presented with acute chest pain and STE in leads V1 and V2. Despite typical anteroseptal infarction patterns, the electrocardiogram (ECG) revealed decremental STE (V1 > V2), concomitant STE in lead III, and reciprocal ST depression in lateral leads. Coronary angiography confirmed proximal occlusion of the non-dominant right coronary artery. This case highlights the diagnostic challenges of isolated RVI and underscores key ECG features that distinguish it from anteroseptal infarction. Early recognition is imperative to avoid detrimental therapies (e.g., vasodilators) and to prioritize reperfusion and preload optimization.

Cardiogenic shock secondary to acute myocardial infarction (AMI-CS) prohibitively impacts survival. This prospective study aimed to discover and internally verify candidate serum protein biomarkers and evaluate their potential prognostic value for 30-day mortality in AMI-CS patients. AMI-CS patients were consecutively enrolled into discovery (n = 30) and verification (n = 60) cohorts. Candidate biomarkers were screened using Data-Independent Acquisition (DIA) mass spectrometry, analyzed via differential abundance and weighted gene co-expression network analysis (WGCNA), and verified via targeted Parallel Reaction Monitoring (PRM). Boruta feature selection for five machine learning algorithms were embedded within a rigorous nested cross-validation scheme. Incremental prognostic value over clinical predictors was evaluated using Cox regression and metrics including the integrated discrimination improvement (IDI). DIA proteomics identified 216 proteins differentially abundant between 30-day survivors and non-survivors, and WGCNA defined an outcome-associated module linked to shock severity and enriched for oxidative stress and energy metabolism. During PRM verification, leakage-free nested cross-validation random forest model selected a seven-protein panel (YWHAZ, QDPR, MDH2, FAH, PSMA1, FABP5, and AHCY), which achieved a mean area under the ROC curve of 0.82 (95

We report a 69-year-old woman with persistent palpitation, a history of myocardial infarction. ECG showed irregular wide QRS tachycardia with positive precordial concordance and flutter waves, initially misdiagnosed as atrial flutter with accessory pathway. Direct current cardioversion restored sinus rhythm but failed to terminate tachycardia, revealing ventricular tachycardia (VT). Amiodarone resolved VT. This case highlights the challenge of differentiating wide QRS tachycardias, emphasizing QRS morphology and atrioventricular (AV) relationship analysis for accurate diagnosis.

We report a case of a 21-year-old female manifesting narrow QRS complex tachycardia and alternating R-R intervals. The fixed RP interval suggested ventriculoatrial conduction via an accessory pathway (AP). The alternating PR intervals indicated anterograde conduction through the fast and slow nodal pathways, respectively. The coexistence of AP and dual atrioventricular nodal pathways is not rare, with most of them exhibiting as atrioventricular reentry tachycardia (AVRT) using the fast or slow nodal pathway exclusively as the anterograde limb. We propose that alternating dual nodal pathway AVRT may occur when the fast pathway's effective refractory period is between the cycle lengths of fast-nodal-pathway AVRT and slow-nodal-pathway AVRT.

Background: Atrial fibrosis may act as a substrate for atrial fibrillation (AF) and atrial functional mitral regurgitation (MR); thus, recognition is required to select the optimal therapeutic intervention. Methods: We examined clinical data from 1045 consecutive patients in three centers who underwent catheter ablation for persistent AF between 2020 and 2022. 75 patients met the moderate and severe MR criteria and completed a 1-year follow-up. Voltage mapping during the ablation procedure was reviewed to classify the extent of atrial fibrosis. Results: Significant atrial fibrosis was found in 34 patients (45.3%), and these patients had a higher prevalence of congestive heart failure (New York Heart Association (NYHA) II–III: 76.5% vs. 36.6%, p < 0.001) and an increased incidence of biatrial enlargement at baseline than the mild fibrosis group. At the 1-year post-ablation period, the entire cohort exhibited a decrease in left atrial size (41.6 ± 6.5 mm vs. 45.5 ± 5.3 mm, p < 0.001), and a significant reduction in MR was achieved in 70.7% of patients. The significant fibrosis group had a higher recurrence rate of atrial arrhythmias (55.9% vs. 22.0%, log-rank p = 0.002) and no significant change in atria size compared with baseline diameters (left atrium, 44.4 ± 6.4 mm vs. 47.2 ± 5.6 mm, p = 0.068; right atrium, 44.7 ± 11.2 mm vs. 46.7 ± 6.2 mm, p = 0.427). Conclusions: This study revealed a considerable proportion of significant fibrosis in patients with atrial functional MR and AF, leading to limited effectiveness in reducing atrial size following catheter ablation. Optimal intervention to reduce atrial size and recurrent arrhythmias in this population requires further investigation.

A 66-year-old man with 5-year intermittent palpitation underwent an electrophysiologic (EP) study. Electrocardiograms (ECGs) on admission showed sinus rhythm with right bundle branch block (RBBB). During palpitation, regular tachycardia with RBBB occurred. Through detailed analysis, the diagnosis of Wolff-Parkinson-White (WPW) syndrome with orthodromic atrio-ventricular reentry tachycardia (AVRT) was established. The case emphasizes the significance of comparing sinus rhythm and tachycardia ECGs for accurate diagnosis.

INTRODUCTION:The optimized ablation index (AI) value for catheter ablation of atrial fibrillation (AF) remains to be defined. We aimed to compare the efficacy and safety of CLOSE protocol and lower AI protocol in paroxysmal AF. METHODS AND RESULTS:Patients with symptomatic, drug-resistant paroxysmal AF for first ablation were prospectively enrolled from September 2020 to January 2022. The patients were randomly divided into CLOSE group (AI ≥ 550 for anterior/roof segments and ≥400 for posterior/inferior segments) and lower AI group (AI ≥ 450 for anterior/roof segments and ≥350 for posterior/inferior segments). First-pass isolation, acute pulmonary vein (PV) reconnections, 1-year arrhythmia recurrence, and major complications were assessed. Of the 270 enrolled patients, 238 completed 1-year follow-up (118 in CLOSE group and 120 in lower AI group). First-pass isolation in left PVs was higher in CLOSE group (71.2% vs. 53.3%, p = .005). Acute PV reconnections were comparable between groups (9.3% vs. 14.2%, p = .246). At 1 year, 86.4% in CLOSE group versus 81.7% in lower AI group were free from atrial arrhythmia (log rank p = .334). The proportion difference was -4.8% (95% CI: -14.1% to 4.6%), and p = .475 for noninferiority. Stroke occurred in four patients of lower AI group, and no cardiac tamponade, atrioesophageal fistula, major bleeding or death occurred post procedure. CONCLUSION:For patients with paroxysmal AF and treated by AI-guided PV ablation, lower AI is not noninferior to CLOSE protocol.

BACKGROUND:Pulsed field ablation (PFA) has gained attention in cardiac electrophysiology, but data on its application to paroxysmal supraventricular tachycardia are limited. This study aimed to assess the feasibility and safety of PFA and its combination with radiofrequency ablation for treating paroxysmal supraventricular tachycardia.METHODS:A prospective, multicenter, single-arm study was conducted across 8 centers in China. Patients with atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, or Wolff-Parkinson-White syndrome underwent ablation using a focal point dual-mode PFA/radiofrequency ablation catheter. PFA was used to achieve acute ablation success, with consolidation using PFA for atrioventricular nodal reentrant tachycardia or near-His accessory pathways and radiofrequency ablation for far-His accessory pathways. Primary and secondary end points were acute ablation success and 180-day follow-up success, respectively.RESULTS:A total of 158 patients (77 with atrioventricular nodal reentrant tachycardia, 63 with atrioventricular reentrant tachycardia, 16 with Wolff-Parkinson-White, and 2 with both atrioventricular nodal reentrant tachycardia and atrioventricular reentrant tachycardia) completed the trial. Acute ablation was successful in 157 patients (99.37%). The skin-to-skin procedure time was 89.9 +/- 35.5 min. The median number of PFA discharges was 12 (8-19) with a median effective PFA discharge time of 4.6 (3.2-6.4) ms. Five patients (4 with atrioventricular reentrant tachycardia and 1 with Wolff-Parkinson-White syndrome) experienced paroxysmal supraventricular tachycardia recurrence during the 180-day follow-up period. One patient had a transient first-degree atrioventricular block resolving in 12 hours, and one patient had a transient third-degree atrioventricular block resolving in 24 hours. No permanent atrioventricular block or other adverse events occurred during the ablation procedure or 180-day follow-up period.CONCLUSIONS:PFA demonstrated the feasibility of the treatment of SVT. Reversible first- and third-degree atrioventricular blocks were observed following ablation in one patient each. The preliminary results indicated the safety and feasibility of a combination of PFA and radiofrequency ablation treatment for atrioventricular accessory pathways although it is impossible to determine the relative contribution of PFA.

Intracardiac echocardiography (ICE) has been used to guide radio-frequency catheter ablation (RFCA) for better catheter navigation and less radiation exposure in treating atrial fibrillation (AF). This retrospective cohort study enrolled 227 AF patients undergoing ICE- or traditional fluoroscopy (TF)-guided RFCA for AF in a tertiary hospital. ICE was used more often in patients with atrial tachycardia [odds ratio (OR) 3.692, p = 0.062], a higher score of Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly (OR 1.541, p = 0.050), or heart failure (OR 2.098, p = 0.156). Based on the comparisons of 47 propensity score-matched pairs from 156 patients only undergoing pulmonary vein isolation (PVI), patients using ICE exhibited a significantly higher success rate in the first transseptal puncture (100% vs. 87.2%, p = 0.041) and less radiation exposure [utilization of radiographic contrast agent (2.7 ml vs. 6.0 ml, p < 0.001), fluoroscopy time (5.7 min vs. 7.6 min, p = 0.026), and fluoroscopy dose (208.4 mGy vs. 332.3 mGy, p = 0.024)] than patients using TF. Other perioperative efficacy outcomes (PVI success, free from AF after RFCA and complications) showed no difference between the matched pairs. ICE can enhance procedural safety and efficiency of RFCA, particularly for more complex patient profiles, in real-world setting.

The ECG of a patient during sinus rhythm shows preexcited QRS pattern, with rS pattern in lead V1, transition in lead V2, and positive inferior leads. Following the stepwise algorithms, the location of accessory pathway (AP) was identified at anteroseptal region. However, the precordial transition in lead V2 indicates mid-septal or posteroseptal AP. The mismatch suggested multiple APs and 5 APs were identified by electrophysiologic study. This case highlights the importance of detailed analysis of ECG in order to achieve adequate ablation.

Objective:To analyse the characteristics and mortality of hypertrophic cardiomyopathy (HCM) patients with different body compositions.Methods:In this study, 530 consecutive patients with HCM at West China Hospital were studied from November 2008 to May 2016. An equation based on body mass index (BMI) was used to obtain the Percent body fat (BF) and lean mass index (LMI). Patients were divided into five sex-specific BMI, BF and LMI quintiles.Results:The average BMI, BF and LMI were 23.1 ± 3.2 kg/m2, 28.1 ± 7.3% and 16.5 ± 2.2 kg/m2, respectively. Patients with higher BMI or BF were older and had more symptoms and adverse cardiovascular conditions; those with higher LMI were younger and had less coronary artery disease and lower serum NT-proBNP and creatine. BF correlated positively with resting left ventricular (LV) outflow tract gradient, mitral regurgitation (MR) degree and left atrial diameter but was inversely associated with septal wall thickness (SWT), posterior wall thickness (PWT), LV mass, and E/A ratio; LMI was positively correlated with SWT, LV end diastolic volume and LV mass but was negatively associated with MR degree.48 all-cause deaths occurred during a median follow-up of 33.8 months. Reversed J-shape associations of BMI and LMI with mortality were observed. A lower BMI or LMI was significantly associated with high mortality, especially for low-moderate BMI and LMI. No significant difference in mortality was found across BF quintiles.Conclusions:The associations of BMI, BF and LMI with baseline characteristics and cardiac remodelling are different in HCM patients. In Chinese HCM patients, low BMI and LMI predicted mortality but not BF.

BACKGROUND We aimed to investigate whether the pressure injury risk mediates the association of left ventricular ejection fraction (LVEF) with all-cause death in patients with acute myocardial infarction (AMI) aged 80 years or older. METHODS This retrospective cohort study included 677 patients with AMI aged 80 years or older from a tertiary-level hospital. Pressure injury risk was assessed using the Braden scale at admission, and three risk groups (low/minimal, intermediate, high) were defined according to the overall score of six different variables. LVEF was measured during the index hospitalization for AMI. All-cause death after hospital discharge was the primary outcome. RESULTS Over a median follow-up period of 1,176 d (interquartile range [IQR], 722-1,900 d), 226 (33.4%) patients died. Multivariate Cox regression analysis showed that reduced LVEF was associated with an increased risk of all-cause death only in the high-risk group of pressure injury (adjusted hazard ratios [HR]=1.81, 95% confidence interval [CI]: 1.03-3.20; P=0.040), but not in the low/minimal- (adjusted HR=1.29, 95%CI: 0.80-2.11; P=0.299) or intermediate-risk groups (adjusted HR=1.14, 95%CI: 0.65-2.02; P=0.651). Significant interactions were detected between pressure injury risk and LVEF (adjusted P=0.003). The cubic spline with hazard ratio plot revealed a distinct shaped curve relation between LVEF and all-cause death among different pressure injury risk groups. CONCLUSIONS In older patients with AMI, the risk of pressure injury mediated the association between LVEF and all-cause death. The classification of older patients for both therapy and prognosis assessment appears to be improved by the incorporation of pressure injury risk assessment into AMI care management.

Transcatheter radiofrequency ablation has been widely introduced for the treatment of tachyarrhythmias. The demand for catheter ablation continues to grow rapidly as the level of recommendation for catheter ablation. Traditional catheter ablation is performed under the guidance of X-rays. X-rays can help display the heart contour and catheter position, but the radiobiological effects caused by ionizing radiation and the occupational injuries worn caused by medical staff wearing heavy protective equipment cannot be ignored. Three-dimensional mapping system and intracardiac echocardiography can provide detailed anatomical and electrical information during cardiac electrophysiological study and ablation procedure, and can also greatly reduce or avoid the use of X-rays. In recent years, fluoroless catheter ablation technique has been well demonstrated for most arrhythmic diseases. Several centers have reported performing procedures in a purposefully designed fluoroless electrophysiology catheterization laboratory (EP Lab) without fixed digital subtraction angiography equipment. In view of the lack of relevant standardized configurations and operating procedures, this expert task force has written this consensus statement in combination with relevant research and experience from China and abroad, with the aim of providing guidance for hospitals (institutions) and physicians intending to build a fluoroless cardiac EP Lab, implement relevant technologies, promote the standardized construction of the fluoroless cardiac EP Lab.

Background: To survey the unmet medical needs associated with atrium thrombus screening in Chinese patients with atrial fibrillation (AF) who underwent transesophageal echocardiography (TEE) for planned radio -frequency catheter ablation (RFCA).Methods: This cross-sectional survey study interviewed 300 patients who underwent their first TEE for planned RFCA. The surveyed information included patients' anxiety, oropharynx pain and discomfort, time expense, and patient satisfaction related to TEE examination. Patient preference for a new atrium thrombus screening tech-nology, hospital length of stay (LOS) of RFCA, and hospital costs of RFCA in these surveyed patients were collected as well. Descriptive statistical methods were used to summarize the collected survey information. Results: Of the 300 interviewed patients, 36.3% reported anxiety before TEE examination, 58.6% reported oropharynx pain related to TEE, and 76.2% reported oropharynx discomforts, mainly including foreign body sensation (54.3%), dry heaves (33.8%), nausea (31.9%), and bleeding (22.9%). Even though 62.3% were satisfied with TEE, 84.3% preferred a new technology to replace TEE. Conducting outpatient TEE took more wait time (4.4 days vs. 0.1 days, p = 0.016) but led to significantly shorter hospital LOS (3.8 days vs. 6.4 days, p < 0.001) and significant lower hospital costs for RFCA ( yen 74,097 vs. yen 85,843, p < 0.001) than conducting inpatient TEE.Conclusions: Most AF patients experienced oropharynx pain and discomfort during or after TEE. Although more than half of AF patients were satisfied with TEE, most AF patients preferred a new technology to replace TEE for atrium thrombus screening. TEE was associated with economic impact on RFCA irrespective of TEE conducting settings.

BACKGROUND Left ventricular hypertrophy (LVH) is prevalent in obese individuals. Besides, both of LVH and obesity is as-sociated with subclinical LV dysfunction. The study aims to investigate the interplay between body fat and LVH in relation to all-cause death in patients with coronary artery disease (CAD). METHODS In this retrospective cohort study, a total of 2243 patients with angiographically proven CAD were included. Body fat and LV mass were calculated using established formulas. Patients were grouped according to body fat percentage and pres-ence or absence of LVH. Cox-proportional hazard models were used to observe the interaction effect of body fat and LVH on all-cause death. RESULTS Of 2243 patients enrolled, 560 (25％) had a higher body fat percentage, and 1045 (46.6％) had LVH. After a median follow-up of 2.2 years, the cumulative mortality rate was 8.2％ in the group with higher body fat and LVH, 2.5％ in those with lower body fat and no LVH, 5.4％ in those with higher body fat and no LVH, and 7.8％ in those with lower body fat and LVH (log-rank P < 0.001). There was a statistically significant interaction between body fat percentage and LVH (P interaction was 0.003). After correcting for confounding factors, patients with higher body fat and LVH had the highest risk of all-cause death (HR =3.49, 95％ CI: 1.40–8.69, P = 0.007) compared with those with lower body fat and no LVH; in contrast, patients with higher body fat and no LVH had no statistically significant difference in risk of death compared with those with lower body fat and no LVH (HR =2.03, 95％ CI: 0.70–5.92, P = 0.195). CONCLUSION A higher body fat percentage was associated with a different risk of all-cause death in patients with CAD, strat-ified by coexistence of LVH or not. Higher body fat was significantly associated with a greater risk of mortality among patients with LVH but not among those without LVH.

PurposeThis meta-analysis aimed to explore the comparative short-term efficacy and safety of drug-coated balloon (DCB) vs. drug-eluting stent (DES) for treating small-vessel coronary artery lesions in diabetic patients.MethodsWe searched PubMed, EMBASE, the Cochrane Library, and China National Knowledgement Infrastructure (CNKI) for retrieving relevant studies regarding the comparison of DCB with DES in treating small-vessel coronary artery lesions in diabetic patients until May 31, 2022. Two independent authors screened study, extracted data, and assessed methodological quality. Then, the meta-analysis was conducted using RevMan software, version 5.4.ResultsWe included 6 studies with 847 patients in this meta-analysis. Pooled results showed that DCB was associated with fewer major adverse cardiac events (MACE) [RR, 0.60; 95% confidence interval (CI), 0.39–0.93; p = 0.02], myocardial infarction (MI) (RR, 0.42; 95% CI, 0.19–0.94; p = 0.03), target lesion revascularization (TLR) (RR, 0.24; 95% CI, 0.08–0.69; p < 0.001), target vessel revascularization (TVR) (RR, 0.33; 95% CI, 0.18–0.63; p < 0.001), binary restenosis (RR, 0.27; 95% CI, 0.11–0.68; p = 0.005), and late lumen loss (LLL) [mean difference (MD), −0.31; 95% CI, −0.36 to −0.27; p < 0.001], but was comparable technique success rate, death, minimal lumen diameter (MLD), and net lumen gain (NLG) to DES. There was no difference in long-term outcomes between these two techniques.ConclusionsThis meta-analysis shows that DCB is better than DES in the short-term therapeutic efficacy and safety of small-vessel coronary artery lesions in diabetic patients. However, more studies are required to validate our findings and investigate the long-term effects and safety of DCB.

目的 探讨影响急性心肌梗死合并左室射血分数降低患者远期死亡的危险因素,建立预测模型并进行验证.方法 这项回顾性队列研究共纳入1013例于2010年12月-2019年6月在四川大学华西医院住院并诊断为急性心肌梗死合并左室射血分数降低的患者,使用Excel软件的RAND函数将研究人群随机分为3组,其中2组合并为模型建立队列,1组为模型验证队列.终点事件为全因死亡,随访工作截至2021年1月20日.使用Cox比例风险模型筛选影响患者远期死亡的危险因素,建立基于这些因素的预测模型并进行验证.结果 中位随访时间为1377 d,共296例患者死亡.多因素Cox回归分析示年龄≥65岁[风险比(hazard ratio,HR)=1.842,95％置信区间(confidence interval,CI)(1.067,3.179),P=0.028]、Killip 分级≥Ⅲ级[HR=1.941,95％CI(1.188,3.170),P=0.008]、氨基末端脑钠肽前体≥5598 pg/mL[HR=2.122,95％CI(1.228,3.665),P=0.007]、未行经皮冠状动脉介入治疗[HR=2.181,95％CI(1.351,3.524),P=0.001]、未使用他汀类药物[HR=2.441,95％CI(1.338,4.454),P=0.004]、未使用β受体阻滞剂[HR=1.671,95％CI(1.026,2.720),P=0.039]是远期死亡的独立危险因素.建立预测模型,根据总分分为低危组(0～2分)、中危组(4～6分)、高危组(8～12分)3个风险组.受试者工作特征曲线[曲线下面积=0.724,95％CI(0.680,0.767),P＜0.001]和 Hosmer-Lemeshow 检验(P=0.108)、Kaplan-Meier 生存曲线(P＜0.001)结果表明该预测模型有良好的预测能力和拟合度,对不同组别也有良好的区分度.并于模型验证队列中得到验证[曲线下面积=0.758,95％CI(0.703,0.813),P＜0.001].结论 年龄≥65岁、Killip分级≥Ⅲ级、氨基末端脑钠肽前体≥5598 pg/mL、未行经皮冠状动脉介入治疗、未使用他汀类药物、未使用β受体阻滞剂是急性心肌梗死合并左室射血分数降低的患者远期死亡的独立危险因素,基于此建立的预测模型有良好的预测能力.