Objective To screen out sensitive heart rate variability (HRV) index reflecting left ventricular(LV) stiffness in patients with heart failure with preserved ejection fraction (HFpEF), and to assess its prognostic evaluation value for HFpEF patients. Methods We selected 150 patients with normal LVEF who had undergone 24hour ambulatory electrocardiography and routine echocardiography examinations. The enrolled patients were divided into normal control group (68 cases) and HFpEF group (82 cases). The receiver operating characteristic curve analysis was used to screen out the sensitive HRV index associated with LV stiffness in HFpEF patients. The primary endpoint events were followed up. Results Among HRV indexes, the area under curve (AUC) of SDANN was the largest in the prediction of HFpEF (AUC=0.68, P<0.01); the cutoff value was 90 ms. SDANN was negatively associated with LV diastolic wall strain. The higher the SDANN was, the higher the LV stiffness was. According to the cutoff value of SDANN, the patients with HFpEF were divided into highSDANN group (cutoff value≥90 ms, 44 cases) and lowSDANN group (cutoff value<90 ms, 38 cases). In the lowSDANN group, the LV stiffness was lower. The survival curve analysis revealed that in the highSDANN group the incidence of major adverse cardiac events and total mortality were significantly higher than those in the lowSDANN group (P<0.05). Conclusion SDANN could be served as a sensitive indicator for making clinical diagnosis and prognostic evaluation among patients with HFpEF.

Objective To investigate the correlation between different degrees of coronary stenosis and protein factors such as human early growth response 3 (EGR3) and vascular endothelial growth factor (VEGF), and to screen out the protein factors with the strongest correlation with EGR3 and VEGF. To explore the potential new biomarkers for rapid diagnosis of coronary heart disease (CHD) and assessment of coronary stenosis degree in plateau area. MethodsA total of 172 patients hospitalized in the Department of Cardiology, Qinghai Provincial Peoples Hospital (2 260 m above sea level) were selected, and divided into case group (n=126, including 38 cases in the atherosclerosis group, 71 cases in the moderate stenosis group and 17 cases in the severe stenosis group) and control group (n=46) according to the degree of coronary stenosis. Protein factors such as EGR3 and VEGF were detected, and statistically analyzed. By using Kyoto Encyclopedia of Genes and Genomes (KECG) analysis, the potential new biomarkers for rapid diagnosis of CHD and evaluation of coronary stenosis degree in plateau area were explored. ResultsThe indexes of human monocyte/megakaryocyte major histocompatibility complex receptor 1 (MMR1), EGR3, human thromboxane B2 (TXB2), human serum response factor (SRF), human platelet activating factor (PAF), VEGF, human cyclicAMP response element binding protein (CREB), human thrombopoietin (TPO), thrombospondin 1 (THBS1) all significantly varied from the atherosclerosis group, moderate stenosis group or severe stenosis group to the control group (all P<005). Spearman correlation analysis showed that serum VEGF was positively correlated with TXB2, SRF, PAF, EGR3, CREB, TPO and THBS1 (r=0.460, 0.644, 0.539, 0.462, 0.740, 0.702, 0.673, all P<0.05). Among them, the correlation between serum CREB and VEGF was the strongest. Serum EGR3 was positively correlated with MMR1, TXB2, SRF, PAF, VEGF, CREB, TPO and THBS1 (r=0.405, 0.682, 0.780, 0.700, 0.462, 0.686, 0.551, 0.245, all P<0.05). Among them, the correlation between serum SRF and EGR3 was the strongest. KEGG analysis showed that SRF regulated proliferation and differentiation in the downstream of VEGF in the pathway hsa04010. In the pathway hsa04926, CREB regulated angiogenesis in the upstream of VEGF. In the pathway hsa04066, hypoxia inducible factor regulated angiogenesis in the upstream of VEGF. ConclusionThe factors of MMR1, EGR3, TXB2, SRF, PAF, VEGF, CREB, TPO and THBS1 are correlated with the severity of coronary stenosis. VEGF, CREB, SRF and EGR3 may be come new biomarkers for the diagnosis of CHD in plateau area.