2021年 · 第01卷第02期

Cardiovascular disease is the leading cause of mortality in China. Primary prevention of cardiovascular disease with a focus on lifestyle intervention and risk factor control has been shown to effectively delay or prevent the occurrence of cardiovascular events. To promote a healthy lifestyle and enhance the detection, diagnosis, and treatment of cardiovascular risk factors such as hypertension, dyslipidemia, and diabetes, and to improve the overall capacity of primary prevention of cardiovascular disease, the Chinese Society of Cardiology of Chinese Medical Association has collaborated with multiple societies to summarize and evaluate the latest evidence with reference to relevant guidelines and subsequently to develop recommendations for primary cardiovascular disease prevention in Chinese adults. The guideline consists of 10 sections: introduction, methodology for developing the guideline, epidemiology of cardiovascular disease in China and challenges in primary prevention, general recommendations for primary prevention, assessment of cardiovascular risk, lifestyle intervention, blood pressure control, lipid management, management of type 2 diabetes, and use of aspirin. The promulgation and implementation of this guideline will play a key role in promoting the practice of primary prevention for cardiovascular disease in China.

Percutaneous renal denervation is a novel device therapy that modifies the circulatory regulatory system and has received considerable attention recently. This treatment partially blocks the renal sympathetic nervous system, which is an organ-connecting pathway between the brain and the kidney. Denervation techniques currently under clinical investigation include radiofrequency, ultrasonic, and chemical ablation with alcohol, all of which are executed through transcatheter access to the renal artery. All recently published randomized sham-controlled trials have shown a clear antihypertensive effect of renal denervation over 24 hours, including during the nighttime and early morning. This treatment has promise in the management of poorly controlled hypertension as well as in the prevention of the development or aggravation of arrhythmias and heart failure.

With continually improving reperfusion strategies and patient care, the overall mortality of acute myocardial infarction (AMI) has been significantly reduced during the past two decades. However, this success is a double-edged sword, as many patients surviving an AMI will progress towards ischemic heart failure (HF) over time. The pathologic causes of ischemic HF are undoubtedly multifactorial. However, the inflammatory response is considered one of the most important causes of pathological remodeling because it spans the whole process of HF development. The macrophage-mediated inflammatory response was once considered a purely harmful factor leading to pathological remodeling and HF. However, growing evidence demonstrates that multiple subgroups of macrophage exist and contribute differently to ischemic HF development. Understanding macrophage populations and how they contribute to post-MI remodeling and consequent ischemic HF is, therefore, critical to understanding and treating the disease. This review focuses on different macrophage populations that regulate post-MI cardiac injury and how immunoregulation therapy may benefit patients with ischemic HF.

Left atrial dissection is a rare complication of mitral valve replacement surgery. Here, a case of left atrial dissection followed by mitral valvular obstruction was presented. It is suspected that the dissection was caused by trematodiases infection. Cardiac surgery was finally performed, which not only confirmed the diagnosis but also acted as an effective treatment. Especially, surgery is of essential value to confirm the perforation locating at the basal posterior wall of the left ventricle, to repair the atrial dissection, and to relieve the mitral valvular obstruction.