Case report of severe coronary artery tortuosity with coexisting connective tissue disease.

Coronary artery tortuosity (CAT) is frequently detected during coronary angiography or coronary electron-beam computed tomography angiography by cardiovascular interventionalists. In this article, we described the case of a 69-year-old female patient with recurrent chest discomfort for 1 month and recurrence 1 week ago, accompanied by emaciation, gastrointestinal discomfort, and low skin temperature at the extremities. After a series of tests, the patient was finally diagnosed with severe CAT and coexisting connective tissue disease. Accordingly, she was treated with conventional medications, and diet and lifestyle modifications. The symptoms of the patient resolved gradually after 1 year of follow-up. Although there is no unanimous conclusion on the pathogenesis and clinical characteristics of CAT, this disease may provide a clue to the diagnosis of connective tissue disease, and warrants exploration through further research.

Personalized smart voice-based electronic prescription for remote at-home feedback management in cardiovascular disease rehabilitation: a multi-center randomized controlled trial.

Objective: To investigate the quality and efficacy of remote at-home rehabilitation for patients with cardiovascular disease (CVD) using personalized smart voice-based electronic prescription, and further explore the standardized health management mode of remote family cardiac rehabilitation. Trial design: A multicenter, randomized (1:1), non-blind, parallel controlled study. Methods: A total of 171 patients with CVD who were admitted to 18 medical institutions in China from April 2021 to October 2022 were randomly divided into a treatment group (86 cases) and a control group (85 cases) in a non-blinded experiment, based on the sequence of enrollment. The control group received routine at-home rehabilitation training, and the treatment group received remote feedback-based at-home cardiac rehabilitation management based on routine at-home rehabilitation training. The primary outcome was the difference in VO2peak (mL/min/kg) after 12 weeks. A linear mixed model was developed with follow-up as the dependent variable. Age and baseline data were utilized as covariates, whereas hospital and patient characteristics were adjusted as random-effect variables. As the linear mixed model can accommodate missing data under the assumption of random missing data, there was no substitute missing value for quantitative data. Results: A total of 171 participants, with 86 in the experimental group and 85 in the control group, were included in the main analysis. The analysis, which used linear mixing model, revealed significant differences in cardiopulmonary function indexes (VO2/kg peak, VO2peak, AT, METs, and maximum resistance) at different follow-up time (0, 4, and 12 weeks) in the experimental group (p < 0.05). In the control group, there was no significant difference in cardiopulmonary values at different follow-up time (0, 4, and 12 weeks; p > 0.05). VO2/kg peak (LS mean 1.49, 95%CI 0.09-2.89, p = 0.037) and other indicators of cardiopulmonary function (p < 0.05) were significantly different between the experimental group and the control group at week 12. The results were comparable in the complete case analysis. Conclusion: The remote home cardiac rehabilitation management mode using personalized smart voice-based electronic prescription provides several benefits to patients, including improvements in muscle strength, endurance, cardiopulmonary function, and aerobic metabolism. It also helps reduce risk factors for cardiovascular disease and enhances patients' self-management abilities and treatment compliance.Clinical trial registration: http://www.chictr.org.cn, identifier ChiCTR2100044063.

Effect of T'ai Chi Exercise on Hypertension in Young and Middle-Aged In-Service Staff.

OBJECTIVE: This study aims to investigate the effect of t'ai chi exercise on hypertension in young and middle-aged in-service staff. METHODS: A total of 208 subjects with grade 1 hypertension were enrolled into this study. These subjects were randomly divided into two groups: research group and control group (n = 104, each). On the basis of general daily lifestyle intervention, subjects in the research group underwent 24-Style Simplified t'ai chi exercise for 3 months, whereas subjects in the control group underwent general daily lifestyle intervention. All subjects were followed up at the first and third month of intervention. The body mass index (BMI), blood pressure, blood lipid, and other indexes were measured before and after the intervention, and quality of life was evaluated. RESULTS: (1) In the research group, after 1 month of exercise, systolic blood pressure (SBP), heart rate (HR), triglyceride (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) significantly decreased (p < 0.05), while BMI, blood glucose (Glu), diastolic blood pressure (DBP), and pulse pressure (PP) did not significantly change. Furthermore, after 3 months of exercise, BMI, HR, SBP, DBP, PP, TG, TC, LDL-C, and Glu all significantly decreased (p < 0.05). (2) Moreover, the quality of life of subjects in the research group obviously improved after 3 months of t'ai chi exercise (p < 0.05). CONCLUSIONS: t'ai chi exercise can reduce the level of blood pressure in young and middle-aged in-service staff with grade 1 hypertension, control weight, slow down the HR, improve metabolism, and improve quality of life. t'ai chi is an exercise suitable for in-service hypertension subjects.