Objective To investigate the correlation between serum lipopolysaccharide(LPS), lysyl oxidase-like 2(LOXL2) and recurrence after radiofrequency catheter ablation(RFCA) in patients with paroxysmal atrial fibrillation(PAF). Methods One hundred and ninety-seven patients with PAF who underwent RFCA in the Department of Emergency Cardiovascular Medicine of the People's Hospital of the Inner Mongolia Autonomous Region from May 2020 to May 2022(the PAF group) and 78 physically examined healthy people in the same time period(the control group) were selected, and were divided into the recurrent subgroup(63 patients) and the non-recurrent subgroup(134 patients) according to whether or not they had relapsed at the one-year follow up. Serum LPS and LOXL2 levels were measured by enzyme-linked immunosorbent assay. The factors of postoperative recurrence of RFCA in PAF patients were analyzed by multifactorial Logistic regression, and the predictive value of serum LPS and LOXL2 levels for postoperative recurrence of RFCA was analyzed by ROC curve. Results Serum LPS and LOXL2 levels were elevated in the PAF group compared with the control group(Z=5.575,6.903, all P<0.001). The 1-year recurrence rate of RFCA in 197 PAF patients was 31.98%(63/197). Serum LPS and LOXL2 levels were elevated in the recurrent subgroup compared with the non-recurrent subgroup(Z=6.431, 6.543, all P<0.001). Prolonged disease duration, increased LAD, elevated LPS, and elevated LOXL2 were independent risk factors for recurrence after RFCA in patients with PAF[OR(95%CI)=2.335(1.450-3.761), 1.289(1.049-1.586), 1.025(1.014-1.035), 1.004(1.002-1.006)]. The AUCs predicted by serum LPS, LOXL2 and the combination of the two were 0.784, 0.789, and 0.859, and the AUCs of the combination of the two were greater than the AUCs predicted by serum LPS and LOXL2 levels alone(Z=2.549, 3.000, P=0.011, 0.003). Conclusion Elevated serum LPS and LOXL2 levels in patients with PAF are independent risk factors for recurrence after RFCA in patients with PAF, and the combination of serum LPS and LOXL2 levels has a high predictive value for recurrence after RFCA in patients with PAF.

Objective To explore the application value of electrocardiogram P-wave parameters combined with body mass index(BMI) for predicting the recurrence of paroxysmal atrial fibrillation(PAF) patients after radiofrequency ablation.Methods A total of 109 patients after PAF ablation admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2021 to December 2022 were retrospectively selected as the study objects, and they were separated into a recurrence group(n=24) and a non-recurrence group(n=85) based on their postoperative recurrence within one year. 109 patients with PAF underwent 12-lead electrocardiogram before and within 24 hours after surgery. Clinical data such as preoperative BMI and left atrial diameter(LAD) were collected and a multivariate Logistic regression model was applied to analyze the influencing factors of postoperative recurrence in patients with PAF. ROC curve was used to analyze the predictive value of P wave parameters combined with BMI in postoperative recurrence of PAF patients. Results Among 109 patients with PAF, 24 experienced recurrence within one year after surgery, with a recurrence rate of 22.02%. Duration of atrial fibrillation, proportion of hypertension, LAD, ratio of neutrophil/lymphocyte count(NLR) and BMI in the relapsed group were higher than those in the non-relapsed group(t/χ2/P=2.559/0.012,5.827/0.016,4.557/<0.001,5.254/<0.001,4.436/<0.001). The preoperative P-wave duration(PWD), maximum PWD(Pmax), and P-wave dispersion(Pd) in the recurrence group were greatly higher than those in the non-recurrence group(t=5.617, 4.005, 9.078, all P<0.001). Multivariate Logistic analysis showed that BMI, LAD, NLR, hypertension, PWD, Pmax and Pd were the risk factors for postoperative recurrence in PAF patients[OR(95%CI)=1.163(1.008-1.342), 1.256(1.024-1.540), 1.458(1.106-1.922), 1.435(1.045-1.971), 1.509(1.136-2.005), 1.157(1.005-1.332), 1.714(1.308-2.246)].The combined prediction of AUC in PAF patients was better than PWD, Pmax and BMI(Z/P=2.017/0.044, 2.476/0.013, 2.788/0.005), and compared with the AUC predicted by Pd alone, the difference was not statistically significant(Z/P=1.946/0.052). Conclusion BMI, LAD, NLR, hypertension, PWD, Pmax, and Pd are influencing factors for postoperative recurrence in patients with PAF. Preoperative PWD, Pmax, and Pd combined with BMI have high predictive value for postoperative recurrence in PAF patients.

Objective To explore the clinical efficacy of sacubitril-valsartan on patients with acute anterior wall ST segment elevation myocardial infarction(STEMI) who undergoing emergency PCI. Methods Eighty patients with acute anterior wall STEMI who underwent emergency PCI treatment in our hospital from March 2022 to March 2023 were selected as the study subjects, and they were grouped into a observation group(40 cases) and a control group(40 cases) using a random number table. The control group was treated with conventional drugs and enalapril, and the observation group was treated with sacubitril-valsartan sodium tablets on the basis of the control group. The efficacy, serological indicators, left ventricular function, incidence of major adverse cardiac events(MACE), and adverse reactions during treatment were compared before and after treatment. Results The total clinical effective rate of the observation group was obviously higher than that of the control group(97.50% vs. 77.50%, χ2/P=7.314/0.007). Compared with the same group before treatment, the N-terminal pro-brain natriuretic peptide(NT-proBNP), cardiac troponin I(cTnI), hypersensitive C-reactive protein(hs-CRP), left ventricular end diastolic volume(LVEDV), left ventricular end systolic volume(LVESV) in both groups obviously decreased after treatment, left ventricular ejection fraction(LVEF) obviously increased, and the changes in various indicators in the observation group were greater than those in the control group(t/P=5.507/<0.001, 11.006/<0.001, 5.287/<0.001, 4.297/<0.001, 6.647/<0.001, 2.330/0.022). The incidence of MACE in the control group was higher than that in the observation group(5.00% vs. 20.00%, χ2/P=4.114/0.043). Conclusion Sacubitril-valsartan has an obvious efficacy on patients with acute anterior wall ST segment elevation myocardial infarction undergoing emergency PCI, it can improve cardiac function and the incidence of MACE, and is relatively safe.

Objective To investigate the influencing factors of adverse cardiovascular events 6 months after PCI in patients with heart failure with acute myocardial infarction and decreased ejection fraction.Methods One hundred and twelve patients with acute myocardial infarction(AMI) complicated with decreased ejection fraction who were admitted to the Cardiology Department of Chengdu Third People's Hospital from January 2019 to January 2022 were selected as the study objects. All the patients included in the study were treated by PCI in the cardiology department of the hospital. After the operation, the general clinical data of the patients were counted, and the incidence of adverse vascular events and the prognosis of the patients were followed up, Single factor analysis combined with multivariate Logistic regression analysis was used to analyze the related factors affecting the occurrence of cardiovascular events.Results The incidence of cardiovascular adverse events in patients included in the study mainly included arterial dissection, local hematoma, local bleeding, pseudoaneurysm, upper limb swelling and pain, and infection. The incidence of adverse events was 36.61%(41/112), and patients with vascular adverse events were generally older, The proportion of patients with a history of unhealthy life style(78.05% vs. 40.85%), non-standard use of anticoagulant drugs after surgery(68.29% vs 28.17%), and with concomitant underlying diseases(56.10% vs 26.76%) were significantly higher. Through multivariate Logistic regression analysis, it was found that older age, a history of unhealthy life style, non-standard use of postoperative anticoagulants, concomitant underlying diseases, were important influencing factors for the occurrence of adverse neovascular events in patients, After treatment, a retrospective comparison of the prognosis of patients with and without cardiovascular adverse events found that the readmission rate and mortality rate of patients with cardiovascular adverse events were significantly higher than those without cardiovascular adverse events. The difference was statistically significant. Through ROC analysis, it can be seen that age(AUC=0.837), non-standard use of anticoagulant drug(AUC=0.701), unhealthy life style history(AUC=0.691), with underlying diseases(AUC=0.647) were of high predictive value for cardiovascular adverse events(P<0.05).Conclusion The patient's age, basic medical history, unhealthy life style history, non-standard use of anticoagulant drugs are all influencing factors for the occurrence of adverse cardiovascular events after PCI. Therefore, after PCI, it is necessary to timely adjust the treatment plan according to the patient's corresponding conditions to reduce the incidence of adverse cardiovascular events.

Objective To evaluate the safety and feasibility of transcatheter aortic valve replacement(transcatheter aortic valve replacement, TAVR) in patients with aortic valve regurgitation(aortic regurgitation, AR). Methods Retrospective analysis of 35 patients with severe AR in the Second Hospital of Hebei Medical University from August 2019 to August 2022, including 25 male and 10 female, aged 59 to 83(70.03±1.07). Surgical success rate, mortality rate, incidence of surgical complications and left heart function changes of postoperative patients were analyzed. Results All 35 patients underwent successful transfemoral TAVR procedures with the self-expanding interventional valve, with a 100% success rate and no deaths.17 patients(48.6%) completed the procedure with cardiopulmonary bypass assistance, with the mean time of cardiopulmonary bypass assistance(32.5±14.6) min.5 patients(14.3%) were treated with concurrent percutaneous coronary intervention(percutaneous coronary intervention, PCI). Fourteen(40.0%) patients used the medium valve technique. Preoperative LVEF(48.01 ± 12.20)%, 1 week LVEF(50.22±15.11)%(t=0.552,P>0.05), preoperative left ventricular end diastolic diameter(65.04±10.10) mm, and ventricular end diastolic diameter(63.44±11.03) mm(t=0.710, P>0.05). Before surgery, 5 patients had medium or above mitral regurgitation, and postoperative mitral regurgitation was reduced compared with preoperative patients. Among them, 2 patients turned to small and medium regurgitation, and 3 patients turned to small regurgitation. Immediately after surgery, 14 cases(40.0%) and 1 third degree block(2.9%) were transferred to cardiology with permanent pacemaker. One intraoperative pericardial effusion(2.9%) was recovered after implantation of the pericardial drainage tube in the median sternal subxiphoid incision. Low and moderate paravalvular leakage was 3(8.6%); the remaining minor and trace regurgitation was 32(91.4%). Conclusion TAVR with self-expansive valve via femoral artery is safe for patients with severe aortic regurgitation. It has the advantages of less trauma, fewer complications and faster recovery, and is worthy of clinical application.