Background: The objective of this study was to carry out a retrospective analysis of the progression of electrocardiographic (ECG) findings over time, based on biomarkers for myocardial injuries in patients with coronavirus disease 2019 (COVID-19). Also, the ECG observations were assessed for possible prognostic use. Methods: Diagnostic criteria provided by the Coronavirus Pneumonia Diagnosis and Treatment Program of the Chinese National Health Commission were used. We conducted a retrospective analysis of 31 COVID-19 cases diagnosed as positive by high-throughput sequencing of nasopharyngeal nucleic acid test

BACKGROUND Prevention of heart failure (HF) has been recognized as an urgent public health need. International guidelines recommend natriuretic peptide biomarker-based screening for patients at high HF risk to allow early detection and intervention to delay HF progression and mortality. Little has been reported the incorporation of screening procedure to existing clinical practice. The objective of the study was to describe the opportunistic screening of left ventricular dysfunction in patients with type 2 diabetes mellitus (DM). METHOD This was a prospective screening study at the DM complication screening center. RESULTS Between 2018 and 2019, 1,132 consecutive DM patients with no prior history of HF or atrial fibrillation (AF) attending regular complication screening were invited to participate. Of these, 89 patients refused or failed to complete the screening. The final analysis included 1,043 patients (age: 63.7±12.4 years; male: 56.3%). The mean HbA1c was 7.25±1.34%. There were 81.8% patients with concomitant hypertension, 31.1% with coronary artery disease, 8.0% with previous stroke, and 5.5% with peripheral artery disease. Furthermore, 45.7% patients had diabetic retinopathy, 33.6% had peripheral neuropathy, and 30.7% had chronic kidney disease (CKD) stage 3-5. At the screening session, 43 patients (4.1%) had an elevated NT-proBNP concentration above the age-specific diagnostic thresholds for HF, and 43 patients (4.1%) had newly detected AF. The prevalence of elevated NT-proBNP concentration increased with age from 0.85% in patients aged <50 years to 7.14% in those aged 70-79 years and worsening kidney function from 0.43% in patients with CKD stage 1 to 42.86% in CKD stage 5. In multivariate logistic regression, male gender (OR: 3.67 (1.47-9.16), p =0.005*), prior stroke (OR: 3.26 (1.38-7.69), p= 0.007*), CKD ( p <0.001*), and newly detected AF (OR: 7.02 (2.65-18.57), p <0.001*) were significantly associated with elevated NT-proBNP concentration. Amongst patients with elevated NT-proBNP concentration, their mean left ventricular ejection fraction (LVEF) was 51.4 ± 14.7%, and 45% patients had a LVEF <50%. CONCLUSION Both NT-proBNP and ECG screening could be easily implemented. Our findings demonstrate systemic screening allows detection of early phase HF and asymptomatic AF in patients with DM, thereby facilitating the implementation of preventive measure to improve the long-term outcomes.

Background: Lipid and inflammatory molecules play a key role in the development of coronary atherosclerosis. Hypersensitive C-reactive proteins are used as markers of inflammation duration, and HDL-C is used as an anti-atherosclerosis component. However, few studies have combined the two indicators to explore coronary stenosis. We suggested that Hypersensitive C-reactive proteins as a marker of inflammation persistence and HDL-C as an anti-atherosclerosis component should be integrated into a single biomarker , so as to explore the correlation of Hypersensitive C-reactive protein HDL-C ratio with the severity of coronary stenosis and to predict the severity of coronary stenosis in CAD patients.Methods: We examined 360 eligible patients who underwent coronary angiography. Based on the results of coronary angiography, patients with any major coronary arteries (the left anterior descending artery, the left circumflex artery, the left main coronary artery, the right coronary artery) whose lumen diameter reduced by more than 50% were defined as CAD + group (n = 139) .Patients with luminal stenosis but no more than 50% were defined as CAD- group (n = 41), and patients without luminal stenosis (n = 180) were regarded as control group. The relationship between various serum markers and the severity of coronary stenosis was examined by Spearman correlation analysis. Logistic regression analysis was performed to identify the influencing factors of the severity of coronary artery disease.Results: The modified Gensini score was positively correlated with Hypersensitive C-reactive protein HDL-C ratio . Multiple regression analysis showed that Hypersensitive C-reactive protein HDL-C ratio were significantly associated with CAD. Hypersensitive C-reactive protein HDL-C ratio is an independent predictor of CAD. The ROC analysis provided a cut-off value of 1.17 for Hypersensitive C-reactive protein HDL-C ratio to predict CAD with 83.9% specificity and 0.242 Yoden index, and area under the ROC curve of 0.632 (95%CI 0.571-0.694, P <0.001).At the same time, the area under the ROC curve of Neutrophil HDL-C ratio was 0.620, indicating that Hypersensitive C-reactive protein HDL-C ratio as a predictor of CAD has better diagnostic performance than Neutrophil HDL-C ratio.Conclusion: Hypersensitive C-reactive protein HDL-C ratio is not only closely related to coronary artery stenosis, but also an independent predictor of severe coronary stenosis.

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