Study on Apoptosis and Expression of P53, Bcl-2,Bax in Cardiac Myocytys of Congestive Heart Failure Induced by Ventricular Pacing

The apoptosis and the expression of p53, bcl-2 and Bax in myocytes of chronic rapid ventricular pacing-induced congestive heart failure (CHF) in rabbits were investigated. The CHF rabbit model (P, n=7) was established by chronic rapid ventricular pacing for 3 weeks. By using TUNEL technique the apoptosis in the myocytes in the rabbit model was studied and the expression of p53, bcl-2 and Bax in myocytes was detected by using immunohistochemical method. Sham-operated (C, n=9) group served as control group. The results showed that there were about 4033± 884.56 apoptotic cells/10 6 myocytes in P group, but no apoptotic cells were found in C group. Myocytes positive for p53 immunoreactivity (18.86±8.48 vs 5.06±0.87, P<0.01) and positive for Bax immunoreactivity (7.15±1.91 vs 0.43±0.09, P<0.01) were increased in P group as compared with those in C group, while the myocytes positive for bcl-2 immunoreactivity (7.08±1.05 vs 14.97±4.47, P<0.01) and the ratio of bcl-2/Bax were decreased in P group as compared with those in C group. Apoptosis was involved in the development of CHF induced by continuously rapid ventricular pacing in rabbit. The expression of p53 and Bax was increased, while the expression of bcl-2 was inhibited. These might play an important role in the acceleration of the apoptosis.

Clinical Study on Chronopharmacokinetics of Digoxin in Patients with Congestive Heart Failure

Fluorescence polarization immunoassay was used to study the chronopharmacokirietics of digoxin in 10 patients with congestive heart failure (CHF) who also served as self-controls. Our results showed that the serum digoxin concentration reached peak value 1h after taking digoxin at 7: 00 a. m.,but the serum digoxin concentration reached the peak value 2 h after taking digoxin at 4: 00 p. m.. The average serum digoxin concentration area under curve was greater and the best maintainable time of serum concentration within 24 h after taking digoxin at 4 p. m. longer than those at 7: 00 a. m.. The heart rates were obviously lower and the cardiac function was significantly improved in 4:00 p. m.group.

Echocardiographic Evaluation of Cardiac Dyssynchrony in Patients with Congestive Heart Failure

The present study investigated the application of echocardiography to evaluation of cardiac dyssynchrony in patients with congestive heart failure（CHF）. A total of 348 consecutive CHF patients who were admitted for cardiac resynchronization（CRT） and presented with low ejection fraction（EF） and wide QRS duration were enrolled in this study, along with 388 healthy individuals. Dyssynchrony was assessed based on filling time ratio（FT/RR）, left ventricular pre-ejection delay（PED）, interventricular mechanical delay（IVMD）, longitudinal opposing wall delay（LOWD） and radial septal to posterior wall delay（RSPWD）. Response to CRT was defined as a ≥15% increase in EF. The results showed that FT/RR was decreased while PED, IVMD, LOWD and RSPWD were increased in the CHF group compared with the control group（P〈0.01）. In the CHF group, FT/RR was negatively correlated with the QRS duration, LV end-diastolic diameter（LVESd）, LV end-diastolic volume（LVEDV） and LV end-systolic volume（LVESV）（P〈0.01）, but positively with the LVEF（P〈0.01）. Additionally, PED, IVMD, LOWD and RSPWD were positively correlated with the QRS duration, LVESd, LVEDV and LVESV（P〈0.01）, but negatively with the LVEF（P〈0.01）. The CHF group was divided into three subgroups according to the varying degrees of LVEF. FT/RR decreased successively from the LVEF-1 group to the LVEF-2 group to the LVEF-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order（P〈0.01）. The CHF group was divided into three subgroups according to the varying degrees of QRS duration, and FT/RR decreased successively in a sequence from the QRS-1 group to the QRS-2 group to the QRS-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order（P〈0.01）. Speckle tracking radial dyssynchrony ≥130 ms was predictive of an EF response in patients in QRS-1 group（78% sensitivity, 83% specificity）, those in QRS-2 group（83% sensitivity, 77% specificity） and in QRS-3 group（89% sensitivity, 79% specificity）. In conclusion, echocardiography is a convenient and sensitive method for evaluating cardiac dyssynchrony in patients with CHF.

Clinical study of recombinant human brain natriuretic peptide in patients with acute myocardial infarction complicating congestive heart failure

Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.

Improved Cardiac Contractility of Human Recombinant Growth Hormone on the Congestive Heart Failure of Pig

The enhanced cardiac contractility effect of human recombinant growth hormone (hr-GH) on the congestive heart failure (CHF) was studied on the pig. To build a pig model of congestive heart failure, a temporary artificial cardiac pacemaker was implanted in the pig’s body and paced at 220 beats to 240 beats per minute for 1 week. After the model of congestive heart failure was successfully set up, the frequency of the pacemaker was changed to 150 beats to 180 beats per minute to maintain the CHF model stable. Pigs were divided into three groups: The hr-GH group in which 0.5 mg/kg per day of hr-GH was administrated intramuscularly for 15 days, the injection control group in which an equal amount of physiological saline was injected intramuscularly, and a normal control group. The left ventricular diastolic end pressure was (10.60±2.41) mmHg in the hr-GH group, but (19.00±3.81) mmHg in the saline control group (P<0.01); Cardiac output was (1.86±0.13) L/min in the hr-GH group, but (1.56±0.18) L/min in the saline control group (P<0.05); Peripheral vascular resistance was (56.88±7.51) mmHg·(L/min) -1 in the hr-GH group, whereas (70.30±11.59) mmHg·(L/min) -1 in the saline control group (P<0.05); +dp/dt max was (2900±316.23) and (2280±286.36) in the hr-HG group and the saline control group respectively (P<0.05). The results show that hr-GH enhances myocardial contractility of CHF, and the CHF model built by a temporary artificial cardiac pacemaker at a high rate of stimulation is reasonable and applicable.

Congestive heart failure masquerading as acute abdomen:A case report

Rationale:As an uncommon manifestation of congestive heart failure,congestive hepatopathy requires an early diagnosis in order to render appropriate care.Misdiagnosis as intraabdominal sepsis may lead to erroneous initial intervention,such as fluid boluses,that can potentially tip an already sick patient with poor reserves over into an extreme state.Patient’s Concern:A 65-year-old man was brought to the emergency department for excruciating abdominal pain,vomiting and jaundice.He also had lower limb pitting edema and was hypotensive en route.Diagnosis:Congestive hepatopathy.Interventions:Intravenous furosemide and fluid restriction.Outcomes:The patient declined admission to the cardiology ward and discharged himself against medical advice after his condition was improved in the emergency department.Lessons:It is important to pay attention to acute abdominal pain induced by extraabdominal pathologies.In this case of acute decompensated congestive heart failure,early recognition of the cause makes a difference to the management.

The Administration and Effect of Sodium Nitroprusside in the Treatment of Chronic Congestive Heart Failure

To prove the effectiveness and safety of sodium nitroprusside (SNP) in the treatment of chronic congestive heart failure, 58 patients with heart failure and normal renal and hepatic function were selected and divided into 3 groups and treated differently. Group A was treated with routine vasodilators; Group B was treaeted intermittently with SNP (12. 5 -75mg/24hrs); Group C was treated continuously with SNP (continuous infusion of 100 - 300mg/24hrs) Positively inotropie agents and diuretic agents were used in each group. The results showed that the highly effective rates of the three groups were 46. 9% (15/32), 90. 5% (19/21) and 100% (12/12) respectively. The effective rates were 81.3% (26/32), 100% (21/21), 100% (12/12) respectively. The highly effective rates of group B and C were much higher than that of group A ( P < 0. 005, P < 0. 005) . The reduction of blood pressure of group B and C was greater than that of group A ( P < 0. 025) . Among the patients we studied, no body had severe side effects. We concluded that the use of SNP in the treatment of chronic congestive heart failure is safe, with better effect than routine treatment, and continous infusion of SNP is the best choice.

Safety and predictors of adherence of a new rehabilitation program for older women with congestive heart failure

ObjectivesTo 与充血的心失败(CHF ) 为老妇人估计一个心脏的康复节目的安全并且决定有 CHF 的超过 65 岁的某些因素影响 adherence.MethodsWomen 是否出席了 physiotherapist 监督的一个锻练节目。生活的质量被纽约心协会(NYHA ) 班被明尼苏达生活与心失败问询表(MLHFQ ) 和疾病的严厉测量。题目会议被分类进出席了 90% 的那些或更多，出席了不到 90%sessions.ResultsFifty 一个题目的那些被学习。八个题目没出席任何会议。43 个参加者，出席的会议的平均百分比是 87% 。在年龄， MLHFQ 或 NYHA 班的二个组之间没有重要差别。仅仅从有的 280 参加者 attendances.ConclusionsThe 节目有一个不利事件在这张人口的坚持的高水平。班没在会话出席上影响的年龄， MLHFQ 或 NYHA。我们的数据建议这个节目为这张人口是安全的。进一步的研究被需要决定出席的另外的预言者和安全问题和长期的坚持的考试在这张人口锻练。

Relationship of Intralymphocytic Cyclic Nucleotide and Calcium Ion Changes with Cardiac Function in Congestive Heart Failure Patients Treated with Amrinone

The contents of intralymphocytic cyclic nucleotide（cAMP and cGMP）and cal-cium ions(Ca++)were determined in 20 patients with refractory congestive heart failure be-fore and after the treatment of Chinese-made amrinone,and their cardiac index was alsomcasured with the thermodilution technique.It was found that the cAMP andCa++contents were markedly elevated while the cardiac index increased under amrinonctreatment,and that both the cAMP and Cacontents were in positive correlation withthe cardiac index before and after amrinone administration.It is suggested that amrinone is likcly to exert its positive inotropic effect on themyocardium through augmenting the cAMP and Ca++contents in myocardial cells,andthat the determination of intralymphocytic cyclic nuclcotidc and Ca++might bc of signifi-canoe to assess the impairment of cardiac function and the cfficacy of a thcrapcuticagent.

Effects of 6-minute walk test on the QT dispersion in patients with congestive heart failure

Objective: To investigate the clinical value of QT dispersion (QTd) and the effects of 6-minute walk test (6-MWT) mimicking the patients' daily activities on QTd in patients with congestive heart failure (CHF).Methods: Twenty-eight CHF patients and 22 normal subjects participated these study, who all completed 6-MWT without developing severe arrhythmias.Before and after 6-MWT, standardized 12-lead surface ECGs were obtained to measure QTd and corrected QTd (QTcd).Results: Both before and after 6-MWT, the QTd and QTcd in CHF patients were longer than those in the controls (P<0.001), and QTd and QTcd after 6-MWT were significantly shorter than those before 6-MWT in CHF patients (P=0.007, and 0.018).There was no significant difference in the measurement in the control group.Conclusion: QTd and QTcd are longer in CHF patients than in normal subjects.Moderate exercise may improve the inhomogeneity of ventricular repolarization dispersion in CHF patients.

Relationship Between Serum Leptin Concentration and Lipids & Body Mass Index in Patients With Chronic Congestive Heart Failure

Objectives To investigate the relationship of serum leptin concentration with the lipids and body mass index （BMI） in patients with chronic congestive heart failure（CHF）. Methods The serum concentration of leptin in 39 patients with CHF （14 in cardiac function class Ⅱ , 21 in class Ⅲ, 4 in classⅣ , NYHA） and in 46 patients with cardiac function class Ⅰ （NYHA） were assessed by radioimmunoassay. Results The serum concentration of leptin were 9.018±4.519 μg/l in CHF group （cardiac function class Ⅱ 11.492±5.649 μg/l, class Ⅲ 7.763±3.321 μg/l, class Ⅳ 6.100±2.657 μg/l）; 11.674± 6.911 μg/l in class Ⅰ group. The serum concentrations of leptin were significantly lower in CHF group, as compared with class Ⅰ group （P〈 0.05）. Moreover, the decrease of serum leptin concentration was significantly correlated with the decreased serum concentrations of total cholesterol, triglyceride, body mass index and left ventricular ejection fraction in CHF group, respectively （P 〈 0.05）. Conclusions The significance of the decrease in serum leptin in CHF patients needs further study.

Intervention Effect of Jianxin Decoction (健心汤) on Serum Cytokine Level of Congestive Heart Failure Patients

Objective: To investigate the intervention effect of Jianxin Decoction (健心汤, JXD) on the cytokine level in serum of patients with congestive heart failure (CHF). Methods; Sixty-six patients with CHF were randomly divided into the control group (n = 33) and the trial group (n = 33). The control group received conventional treatment, and the trial group was treated with conventional therapy plus JXD for 4 weeks. Before and after treatment, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and nitrogen monoxide (NO) in serum and cardiac function were determined. Results: After treatment, the levels of TNF-α, IL-6 and NO were significantly lower than those before treatment (P<0.05, or P<0.01) in the two groups, and the lowering degree of the indices in the trial group was more significantly reduced than that in the control group (P<0.05). And cardiac functions in both groups were improved significantly (P<0.05, or P< 0.01). Conclusion: JXD could prevent and reverse ventricular remodeling so as to ameliorate cardiac function through regulating the levels of cytokines.

Reversible congestive heart failure associated with hypocalcemia:A case report

BACKGROUND Hypoparathyroidism is a rare disease that may occur due to primary or secondary etiologies.The estimated incidence in the United States is 24–37/100000 personyears.Congestive heart failure associated with hypocalcemia due to hypoparathyroidism is an even rarer presentation.CASE SUMMARY Here,we present a 64-year-old woman with congestive heart failure following hypocalcemia.The patient was transferred to our emergency department with complaints of rapidly progressive dyspnea,shortness of breath and heaviness of the chest for 4 d.She had a history of undergoing thyroidectomy and partial tracheotomy 2 years prior due to a malignant thyroid tumor.Muscle spasms had been present 1 year ago,and cataracts were treated with intraocular lens replacement in both eyes.Most tests were within normal ranges,except serum calcium at 1.33 mmol/L(2.20–2.65 mmol/L),ionized calcium at 0.69 mmol/L(1.15–1.29 mmol/L),and parathyroid hormone at<1.0 pg/mL(12–88 pg/mL).Echocardiography revealed an ejection fraction of 28.48%.Cardiac function was quickly reversed by restoring the serum calcium concentration.Significant improvements were noted with an ejection fraction of up to 48.50%at follow-up.CONCLUSION For patients with potential hypocalcemia,monitoring calcium levels and dealing with hypocalcemia in time to avoid serious complications are important.

The Thinking on TCM Differential Treatment of Congestive Heart Failure

Congestive heart failure(CHF),the manifestationat the late stage of cardiovascular diseases,is a commonand critical illness.Traditional Chinese medicine showsa good therapeutic effectiveness in treatment of CHF,especially for latent heart failure,refractory heart failureand digitalis poisoning.The thinking on treatment ofCHF by traditional Chinese medicine on the basis ofclinical practice is described below.

Clinical Study on Effect of Shenmai Injection in Treating Congestive Heart Failure

Objective: To observe the therapeutic effect of Shenmai Injection (SI) in treating congestive heart failure (CHF). Methods: The changes in cAMP, cGMP, serum cardiac troponin T (cTnT, a specific marker reflecting myocardial injury), creatine kinase (CK) and creatine kinase isoenzyme (CK-

The change of plasma leptin level and its correlation study with insulin resistance or TNF-αin patients with congestive heart failure

Objectives To determine thechange of plasma leptin levels and the correlation be-tween hyperleptinaemia and insulin resistance orTNF -α in patients with congestive heart failure(CHF). Methods The levels of plasma leptin, fastingplasma insulin (FINS) and TNF-α in 64 male patientswith CHF and 30 healthy male people were measuredby ELISA. Body mass index (BMI), waist/hip ratio(WHR) and insulin resistance index (Homa-IR) werecalculated respectively. Results The plasma leptinlevels in CHF group were higher compared with con-trol group (P<0.00l). There was a increased trend ofplasma leptin levels in CHF group with the increaseof NYHA class (r_s=0.884, P<0.001), according to dif-ferent etiology,there was no significant difference ofplasma leptin levels in CHF group (P>0.05); FINS,Homa-IR and TNF-α levels in CHF group were high-er than in control group (all P<0.001); in CHF groupplasma leptin levels correlated with FINS (r=0.652, P<0.001),Homa-IR (r=0.561,P<0.001) and TNF-α (r=0.629,P<0.001); in multiple stepwise regression anal-ysis BMI, FINS and TNF-α were isolated factors af-fecting plasma leptin levels in CHF group, Y=-3.466+0.456 (BMI)+ 0.162 (FINS)+4.487(TNF-α), F=38.405,P<0.001. Conclusions plasma leptin levels wereraised and correlated with disease severity in patientswith CHF; FINS and TNF-α were isolated factor af-fecting plasma leptin level in CHF patients; hyper-leptinaemia may play a role in the pathophysiology ofCHF such as catabolic process and activation of neu-rohormonal.

Comparison of Ventricular Electrophysiological Effects of Amiodarone in Canine Models With Congestive Heart Failure and Normal Dogs

Objectives This study compared the effects of amiodarone on ventricular electrophysiological properties in normal dogs and CHF dogs. Methods Dogs （n=44） were randomized into four groups： Group 1 （n=10） was the control. Group 2 （n=10） was given amiodarone orally 300 mg·d^-1 for 4 to 5 weeks. Group 3 （n=12） was the congestive heart failure （CHF） models induced by right ventricular rapid pacing （240 pulses·min^-1 for 4 to 5 weeks）. Group 4 （n=12） was the CHF models given amiodarone orally 300 mg·d^-1 for 4 to 5 weeks. The ventricular electrophysiological variables were evaluated by standard electric stimulation and monophasic action potential （MAP） recording. Results Amiodarone prolonged sinus cycle length （SCL）, intra-ventricular conduction time （IVCT）, MAP duration （MAPD90）, ventricular effective period （VERP）, ventricular activation time （VAT） and ventricular recovery time （VRT） without significant effects on the ratio of VERP to MAPD90 （VERP/MAPD90）, ventricular fibrillation threshold （VFT）, the dispersion of VRT （VRT-D）, and ventricular late repolarization duration （VLRD） in normal dogs. However, amiodarone did not further prolong the prolonged SCL, MAPD90, VERP, VAT and VRT, but further prolonged IVCT in CHF dogs. Amiodarone normalized the abnormal ventricular electrophysiological properties in CHF dogs as manifested by increasing the decreased VERP/MAPD90 and VFT, shortening the prolonged VLRD, and decreasing the increased VRT-D. Amiodarone did not worsen the hemodynamic parameters in normal and CHF dogs. Conclusions Amiodarone had different effects on ventricular electrophysiological properties in normal and CHF dogs. The favorable effects of amiodarone in normalizing some abnormal cardiac electrophysiological properties in CHF models may have potential value on the prevention and treatment of ventricular arrhythmias and sudden cardiac death in CHF.

Comparison of the Frequency-dependent Effects of Amiodarone on Ventricular Electrophysiology in Congestive Heart Failure Canine Models and Normal Dogs

Objectives To compare the frequency-dependent effects of amiodarone （Ami） on ventricular electrophysiology in fight ventricular rapid pacing-induced congestive heart failure （CHF） canine models. Methods Thirty-two dogs were randomized into four groups： the control group, the Ami group in which the normal dogs were given Ami orally 300 mg a day for 4 -5 weeks, the CHF group induced by right ventricular rapid pacing （240 pulses, min^- 1 for 4 -5 weeks ）, and the group of CHF dogs fed with Ami orally 300 mg a day for 4 - 5 weeks. The techniques of electrical stimulation and monophasic action potential （MAP） recording were used in the electrophysiology studies. Results The effects of Ami on ventricular MAP duration （MAPD90） and effective refractory period （VERP） were not frequency-dependent in CHF dogs. There was also no frequency-dependent effect on the increase in the ratio of VERP to MAPD90 （ VERP/MAPD90 ）. The prolongation of ventricular conduction time was frequencydependent. Conclusions The frequency-dependent effects of Ami on ventricular electrophysiology in CHF dogs were similar to that in normal dogs.

The Serum Levels of Soluble Fas Ligand and Soluble Fas Receptor in Patients with chronic congestive heart failure

Objectives To investi gate the association of soluble Fas ligand( sFasL) and soluble Fas receptor( sFas) with human chronic con gestive heart failure( CHF) . Methods The serum level of sFasL and sFas in 33 patients with CHF (13 in cardiac function class Ⅱ, 17 in class Ⅲ, 3 in class Ⅳ, NYHA) was assessed with enzyme - linked immunosorbent assay, and was compared with that of 18 age - , blood pressure - matched patients with car diac function class Ⅰ (NYHA). Results There was no difference in the level of sFasL between the two groups [CHF group: 231. 50 + / - 84. 50 (cardiac function class Ⅱ216. 50 + / - 96. 00 , class Ⅲ 226. 80 + / - 85. 70, class Ⅳ 244. 00 + / - 73. 00) vs. cardiac function class I group: 217. 50 + /-89. 00 pg/mL, P>0. 05]. However, the level of sFas was significantly higher in the patients with CHF than those of cardiac function class I group [CHF group: 1353. 30 +/-507. 71 (cardiac function class Ⅱ 1154. 85 + /-371. 20 , class Ⅲ1412.88 + /-493. 62, classⅣ1875. 67 + / - 806. 10) vs. cardiac function class I group: 983. 11+/ -461. 26 pg/mL, P<0. 05 ] . Conclusions sFasL was not associated with human CHF. However, the elevation of serum level of sFas was proportion to the severity of human CHF. sFas may play an important role in the patho- genesis of human CHF.

Clinical impact of portal vein pulsatility on the prognosis of hospitalized patients with acute heart failure

BACKGROUND Heart failure(HF)causes extracardiac organ congestion,including in the hepatic portal system.Reducing venous congestion is essential for HF treatment,but evaluating venous congestion is sometimes difficult in patients with chronic HF.The portal vein(PV)flow pattern can be influenced by right atrial pressure.Ultrasound images of the PV are quite easy to obtain and are reproducible among sonographers.However,the association between PV pulsatility and the condition of HF remains unclear.We hypothesize that PV pulsatility at discharge reflects the condition of HF.AIM To evaluate the usefulness of PV pulsatility as a prognostic marker for hospit-alized patients with acute HF.METHODS This observational study was conducted from April 2016 to January 2017 and April 2018 to April 2019 at Shinko Hospital.We enrolled 56 patients with acute HF,and 17 patients without HF served as controls.PV flow velocity was mea-sured by ultrasonography on admission and at discharge.We calculated the PV pulsatility ratio(PVPR)as the ratio of the difference between the peak and minimum velocity to the peak velocity.The primary endpoint was cardiac death and HF re-hospitalization.The observation period was 1 year from the first hospitalization.The Kaplan-Meier method was used to determine the stratified composite event-free rates,and the log-rank test was used for comparisons between groups.RESULTS On admission,the PVPR was significantly higher in patients with acute HF than controls(HF:0.29±0.20 vs controls:0.08±0.07,P<0.01).However,the PVPR was significantly decreased after the improvement in HF(admission:0.29±0.20 vs discharge:0.18±0.15,P<0.01)due to the increase in minimum velocity(admission:12.6±4.5 vs discharge:14.6±4.6 cm/s,P=0.03).To elucidate the association between the PVPR and cardiovascular outcomes,the patients were divided into three groups according to the PVPR tertile at discharge(PVPR-T1:0≤PVPR≤0.08,PVPR-T2:0.08<PVPR≤0.21,PVPR-T3:PVPR>0.21).The Kaplan-Meier analysis showed that patients with a higher PVPR at discharge had the worst prognosis among the groups.CONCLUSION PVPR at discharge reflects the condition of HF.It is also a novel prognostic marker for hospitalized patients with acute HF.