Objective To investigate the efficacy of metoprolol(Met) combined with irbesartan(IB) in treating hypertension complicated with heart failure(HF) and its impact on cardiac function. Methods A total of 112 patients with hypertension complicated with HF accepted by Department of Cardiology of Yan'an People's Hospital from November 2022 to December 2023 were as the research subjects, they were divided into Met group(56 cases) and IB group(56 cases) according to the random number table method. The Met group received oral metoprolol tartrate tablets, while the IB group received irbesartan tablets in addition to the Met group. Two groups were compared in terms of efficacy, blood pressure(BP), heart rate changes, cardiac function, endothelial function, serum inflammatory indicators, and adverse reactions. Results The total effective rate of the IB group was 91.07%, which was prominently higher than the 73.21% of the Met group( χ2/P=6.087/0.014). After treatment, SBP, DBP, and heart rate decreased in both groups, and the IB group was prominently lower than the Met group( t/P=2.172/0.032, 5.706/<0.001, 4.641/<0.001). After treatment, the left ventricular end systolic diameter(LVESD), left ventricular end diastolic diameter(LVEDD), plasma endothelin(ET), angiotensin Ⅱ(Ang Ⅱ), cardiac troponin I(cTnI), high-sensitivity C-reactive protein(hs-CRP), N-terminal pro-brain natriuretic peptide(NT-proBNP), and tumor necrosis factor(TNF)-α decreased in both groups, and the IB group was prominently lower than the Met group( t/P=9.060/<0.001, 10.173/<0.001, 9.560/9.187/<0.001, 4.337/<0.001, 10.377/<0.001, 7.036/<0.001, 9.837/<0.001, 9.841/<0.001). After treatment, left ventricular ejection fraction(LVEF), nitric oxide(NO), and calcitonin gene-related peptide(CGRP) all increased, and the IB group was prominently higher than the Met group( t/P=9.187/<0.001, 4.460/<0.001, .="" the="" total="" incidence="" of="" adverse="" reactions="" in="" met="" group="" and="" ib="" was="" there="" no="" statistically="" significant="" difference="" between="" two="" p="">0.05). Conclusion Met combined with IB has good efficacy in treating patients with hypertension complicated with HF. It can regulate BP and heart rate, enhance cardiac function, maintain vascular homeostasis, improve endothelial function, inhibit inflammatory response, control disease progression, and has high safety.

Objective To investigate the relationship between systemic immune-inflammation index(SII) and ambulatory arterial stiffness index(AASI) and left ventricular hypertrophy(LVH) in elderly patients with essential hypertension. Methods A total of 101 elderly patients with essential hypertension admitted to the Geriatric Medicine Department of Xuanwu Hospital, Capital Medical University from January 2022 to December 2023 were selected and divided into LVH group( n=35) and non-LVH group( n=66) according to whether LVH occurred. Baseline data, indicators of the first laboratory examination and echocardiographic characteristics of the patients at admission were collected. Multiple Logistic regression analysis was conducted to analyze the influencing factors of LVH in elderly patients with essential hypertension, and ROC curve was used to analyze the predictive value of SII and AASI in elderly patients with essential hypertension. Results Compared with LVH group, LVEDD, LVESD, LVM and LVMI in non-LVH group were decreased( t/P=5.633/<0.001, 2.249/0.027, 8.289/<0.001, 11.493/<0.001), and="" there="" was="" no="" significant="" difference="" in="" lvef="" between="" the="" two="" p="">0.05). Compared with LVH group, the levels of SII and AASI in non-LVH group were decreased( t/P=13.824/<0.001, 8.290/<0.001). The levels of SII and AASI were higher than those of LVEDD( r/P=0.456/<0.001, 0.523/<0.001), LVESD( r/P=0.287/0.019, 0.345/0.003) and LVM( r/P=0.563/<0.001, 0.612/<0.001), respectively There was positive correlation between SII and LVEF( r/P=0.621/<0.001, 0.689/<0.001), and="" negative="" correlation="" between="" sii="" p="" but="" no="" significant="">0.05). High SII, high AASI, high LVEDD and high LVM are all independent influencing factors for LVH in elderly patients with essential hypertension [OR(95%CI)=1.136(1.068-1.208),1.174(1.025-4.697),1.425(1.215-1.670),1.039(1.024-1.055)];The AUC of AASI, SII and their combination in predicting LVH in elderly patients with essential hypertension was 0.753, 0.782 and 0.812, respectively. The combined value of AASI, SII and their combination was superior to each other( the difference was compared by DeLong method)( Z=2.594, 2.109, P=0.010, 0.034). Conclusion SII and AASI are independent predictors of left ventricular hypertrophy in elderly patients with essential hypertension, and their combination has a high predictive efficacy.

Objective To investigate the changes of serum cathepsin B(cathepsin B) and CBL proto-oncogene-like 1(CBLL1) levels in patients with coronary heart disease and their predictive value for major adverse cardiovascular events(MACE).Methods A total of 196 patients with coronary heart disease admitted to the Department of Cardiovascular Medicine, Yan'an University Affiliated Hospital from January 2019 to July 2023 were selected as the research objects. After 12 months of follow-up, 3 cases were lost to follow-up. According to the occurrence of MACE, the patients with coronary heart disease were divided into MACE group(46 cases) and non-MACE group(147 cases). The level of serum cathepsin B was detected by enzyme-linked immunosorbent assay, and the relative expression of serum CBLL1 was detected by real-time fluorescent polymerase chain reaction; Pearson was used to analyze the correlation between serum cathepsin B and CBLL1 levels and the degree of coronary artery disease and myocardial injury; Multivariate Logistic regression analysis was used to analyze the influencing factors of MACE in patients with coronary heart disease; the receiver operating characteristic(ROC) curve was used to analyze the predictive value of serum cathepsin B and CBLL1 levels for MACE in patients with coronary heart disease. Results The levels of serum cathepsin B and CBLL1 in the MACE group were higher than those in the non-MACE group( t/P=19.522/<0.001,22.809/<0.001); the levels of serum cathepsin B and CBLL1 in patients with coronary heart disease were positively correlated with the number of coronary artery lesions, coronary stenosis rate, Gensini score, troponin I(cTnI) and B-type brain natriuretic peptide(BNP)(cathepsin B: r/P=0.462/<0.001,0.391/<0.001,0.501/<0.001,0.341/0.001,0.329/0.003; cBLL1: r/P=0.377/<0.001,0.320/0.008,0.419/<0.001,0.322/0.006,0.306/0.013); Multivariate Logistic regression analysis showed that coronary multivessel disease, high cathepsin B, and high CBLL1 were independent risk factors for MACE in patients with coronary heart disease during follow-up[OR(95%CI)=2.125(1.133-3.987),1.997(1.121-3.562),1.685(1.126-2.524)];the AUC of serum cathepsin B, CBLL1 levels and their combined prediction of MACE during follow-up in patients with coronary heart disease were 0.764, 0.790 and 0.887, respectively. The AUC of the combined prediction was greater than that of the single prediction( Z/P=2.591/<0.001,2.170/0.005). Conclusion The increase of serum cathepsin B and CBLL1 levels in patients with coronary heart disease is related to the occurrence of MACE during follow-up, and the combination of the two can effectively predict the risk of MACE.

Objective To analyze the predictive value of serum circular RNA(circRNA) roundabout homolog 2(ROBO2), circRNA solute carrier family 8 member A1(SLC8A1), and circRNA cerebellar degeneration related protein 1 antisense(CDR1as) for major adverse cardiovascular events(MACE) in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI). Methods Between January 2020 and December 2020, 140 AMI patients who underwent PCI surgery in our hospital were included as AMI group, and 140 healthy individuals who underwent physical examination were included as control group. AMI patients were assigned into MACE group and non-MACE group based on whether MACE occurred after PCI. Real-time fluorescence quantitative PCR(qRT-PCR) was used to detect serum circRNA ROBO2, circRNA SLC8A1, and circRNA CDR1as. Logistic regression was used to analyze the influencing factors of postoperative MACE. ROC curve was used to evaluate the predictive value of serum circRNA ROBO2, circRNA SLC8A1, and circRNA CDR1as for postoperative MACE in AMI patients. Results The AMI group had higher serum circRNA ROBO2, circRNA SLC8A1, and circRNA CDR1as than control group( t/P=9.192/<0.001,10.903/<0.001,11.152/<0.001). The MACE group had higher serum circRNA ROBO2, circRNA SLC8A1, and circRNA CDR1as than non-MACE group( t/P=5.655/<0.001,7.935/<0.001,5.797/<0.001). There was a statistically conspicuous difference in the number of coronary artery lesions and no reflow during surgery between MACE group and non-MACE group( χ2/P=14.799/<0.001,8.057/<0.001). Logistic regression analysis revealed that the number of coronary artery lesions ≥2, no reflow during surgery, serum circRNA ROBO2, circRNA SLC8A1, and circRNA CDR1as were the influencing factors for MACE in AMI patients after PCI [OR(95%CI)=4.639(1.970-10.925), 4.722(1.917-11.633), 5.337(1.949-14.616), 5.082(1.798-14.361), 4.734(1.925-11.640)]. The AUC predicted by the joint of the three was conspicuously greater than that predicted by circRNA ROBO2, circRNA SLC8A1, and circRNA CDR1as alone( Z=2.660, 2.321, 2.740, P=0.008, 0.020, 0.006). Conclusion Serum circRNA ROBO2, circRNA SLC8A1, and circRNA CDR1as are conspicuously elevated in AMI patients, and the joint of the three has good predictive value for MACE after PCI in patients.