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Previous findings have indicated the potential benefits of the Chinese traditional medicine Qiliqiangxin (QLQX) in heart failure. Here we performed a double-blind, randomized controlled trial to evaluate the efficacy and safety of QLQX in patients with heart failure and reduced ejection fraction (HFrEF). This multicenter trial, conducted in 133 hospitals in China, enrolled 3,110 patients with HFrEF with NT-proBNP levels of ≥450 pg ml−1and left ventricular ejection fraction of ≤40%. Participants were randomized to receive either QLQX capsules or placebo (four capsules three times daily) alongside standard heart failure therapy. The trial met its primary outcome, which was a composite of hospitalization for heart failure and cardiovascular death: over a median follow-up of 18.3 months, the primary outcome occurred in 389 patients (25.02%) in the QLQX group and 467 patients (30.03%) in the placebo group (hazard ratio (HR), 0.78; 95% confidence interval (CI), 0.68−0.90; P< 0.001). In an analysis of secondary outcomes, the QLQX group showed reductions in both hospitalization for heart failure (15.63% versus 19.16%; HR, 0.76; 95% CI, 0.64−0.90; P= 0.002) and cardiovascular death (13.31% versus 15.95%; HR, 0.83; 95% CI, 0.68−0.996; P= 0.045) compared to the placebo group. All-cause mortality did not differ significantly between the two groups (HR, 0.84; 95% CI, 0.70−1.01; P= 0.058) and adverse events were also comparable between the groups. The results of this trial indicate that QLQX may improve clinical outcomes in patients with HFrEF when added to conventional therapy. ChiCTR registration: ChiCTR1900021929.

BackgroundThe optimal salt restriction in patients with heart failure (HF), especially patients with heart failure with preserved ejection fraction (HFpEF), remains controversial.ObjectiveTo investigate the associations of cooking salt restriction with risks of clinical outcomes in patients with HFpEF.MethodsCox proportional hazards model and subdistribution hazards model were used in this secondary analysis in 1713 participants with HFpEF from the Americas in the TOPCAT trial. Cooking salt score was the sum of self-reported salt added during homemade food preparation. The primary endpoint was a composite of cardiovascular death, HF hospitalisation and aborted cardiac arrest, and secondary outcomes were all-cause death, cardiovascular death and HF hospitalisation.ResultsCompared with patients with cooking salt score 0, patients with cooking salt score >0 had significantly lower risks of the primary endpoint (HR=0.760, 95% CI 0.638 to 0.906, p=0.002) and HF hospitalisation (HR=0.737, 95% CI 0.603 to 0.900, p=0.003), but not all-cause (HR=0.838, 95% CI 0.684 to 1.027, p=0.088) or cardiovascular death (HR=0.782, 95% CI 0.598 to 1.020, p=0.071). Sensitivity analyses using propensity score matching baseline characteristics and in patients who prepared meals mostly at home yielded similar results. Subgroup analysis suggested that the association between overstrict salt restriction and poor outcomes was more predominant in patients aged ≤70 years and of non-white race.ConclusionOverstrict cooking salt intake restriction was associated with worse prognosis in patients with HFpEF, and the association seemed to be more predominant in younger and non-white patients. Clinicians should be prudent when giving salt restriction advice to patients with HFpEF.

Data on sex difference in response to cardiac resynchronization therapy (CRT) remain controversial. We conducted a meta-analysis to summarize all published studies to determine whether sex-based differences in response to CRT exist.

The 2-D time-stepping finite element method is adopted to systematically analyze the effect of DC supply voltage of inverter on eddy current loss in permanent magnet of PMSM for EV application. The finite element model and inverter model are built to calculate the winding currents, eddy current losses in permanent magnet and air-gap flux densities with different DC supply voltages when the motor runs in flux-weakening area. Analysis shows that, the eddy current increases significantly with the increase of DC supply voltage, although the fundamental winding current decreases. The temperature-rise experiment of permanent magnet is carried out, proving the validity of analysis.

Aims: ADVISEwas a 12‐week, multicenter, randomized, prospective, open‐label, parallel‐group study comparing combination therapy of nifedipine GITS30 mg plus valsartan 80 mg (N + V) with high‐dose valsartan (160 mg) monotherapy (V160) in Asian patients with hypertension. Methods: Patients with hypertension inadequately controlled with valsartan 80 mg for at least 4 weeks were randomized. The coprimary endpoints were the mean changes in clinic systolic and diastolic blood pressures (SBPand DBP, respectively) at Week 12. Other endpoints included blood pressure (BP) control rate, response rate, and adverse events. Results: The full analysis set (FAS) comprised 359 patients. Least squares (LS) mean changes in SBPwere −18.3 mmHg (N + V; n = 177) and −16.5 mmHg (V160; n = 182) (difference: −1.9 mmHg; P =0.0998). DBP LSmean changes were −9.8 mmHg (N + V) and −7.4 mmHg (V160) (difference: −2.4 mmHg; P =0.0011). BPcontrol rates were significantly higher in the N + V group (Week 4: 51.2% vs. 38.4%, P =0.0138; Week 8: 68.3% vs. 50.3%, P =0.0004; and Week 12: 71.2% vs. 55.5%, P =0.0024). Similar findings were observed when patients were stratified according to smoking status, SBPbaseline quartiles, and ESC/ESHguideline‐defined added‐risk category. The BPresponse rate was also higher in the N + V group compared with the V160 group. Rates of adverse drug reactions (all mild‐to‐moderate) were similar: 4.5% (N + V) and 4.4% (V160). Conclusions: Although one of the coprimary endpoints did not reach statistical significance,combination treatment with N + V provided a greater early and more consistent BP‐lowering effect than monotherapy with V160, including superior reduction in DBPand BPcontrol rates.