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In this work, two non-fullerene small molecule acceptors (NFSMAs), named IFIC and IFIC-F, were designed and synthesized by introducing alkoxy-phenyl as the side chain and furan as π-bridge. This method enhances the intermolecular charge transfer between HFQx-T and IFIC-F (IFIC). Besides, IFIC and IFIC-F exhibit strong and broad absorption ranging from 550 nm to 800 nm. IFIC-F with alkoxy-phenyl exhibits an absorption peak at 702 nm, which has a redshift of 17 nm compared with IFIC (685 nm). The power conversion efficiency (PCE) of organic solar cell based on HFQx-T: IFIC is 6.28%, which is higher than the PCE of device based on HFQx-T: IFIC-F (5.87%). These results indicate that inserting alkoxy–phenyl side chain and furan π-bridge are a rational strategy for the synthesis of high-performance NFSMAs.

Aims To compare the efficacy and safety of a dual therapy (rivaroxaban and ticagrelor) with a triple therapy (aspirin, clopidogrel and warfarin) in Chinese elderly patients with nonvalvular atrial fibrillation (NVAF) undergoing percutaneous coronary intervention (PCI). Methods A total of 106 elderly Chinese patients with NAVF after PCI were randomly divided into a dual therapy group treated with ticagrelor 90 mg twice daily and rivaroxaban 15 mg once daily after PCI, and a triple therapy group treated with aspirin 100 mg and clopidogrel 75 mg once daily combined with the dose-adjusted vitamin K antagonist warfarin once daily. The mean follow-up time was 1 year. The primary endpoint was the composite death rate from cardiovascular causes, myocardial infarction, stroke or stent thrombosis. The safety endpoint was clinically significant bleeding (a composite value of major, minor and minimal bleeding). Results There were no significant differences between the 2 groups regarding the basic characteristics of the patients. The primary composite endpoint of the dual therapy group after 1 year was not significantly different from the triple therapy group (16.7% vs 15.2%, P = 0.86; HR 1.02; 95% CI: 0.82–1.24), but there was a significant difference in the incidence of hemorrhage (7.4% vs 26.9% P = 0.01; HR 0.71; 95% CI: 0.62–0.83) between the 2 groups. Conclusions In elderly Chinese patients with NVAF undergoing PCI, the efficacy of dual (ticagrelor plus rivaroxaban) treatments was comparable to the triple antithrombotic regime (warfarin plus dual antiplatelet therapy). The overall incidence of bleeding was significantly reduced with dual treatment compared to the triple treatment regime.

Objective: To explore the effect of PITX2 gene rs6843082 single nucleotide polymorphism on the efficacy and adverse reactions of warfarin in patients with atrial fibrillation and hypertension, and to provide a theoretical basis for individualized warfarin treatment. Methods: Data on 97 patients with atrial fibrillation and hypertension treated in our hospital were collected from September, 2018 to December, 2019. PCR and SNP genotyping techniques were used to measure the genotype at the rs6843082 locus (pituitary homeobox 2, PITX2) using DNA from the peripheral blood cells of all patients. We compared the efficacy of warfarin and the incidence of adverse reactions in patients of different genotypes. Results: (1) Among 97 subjects, 58 cases (59.79%), 32 cases (32.99%) and 7 cases (7.22%) of PITX2 (rs6843082) genotypes GG, GA and AA were identified respectively. The G and A allele frequencies were 76.29% and 23.71%, respectively. (2) After all patients took warfarin to achieve the standard, the GA group and AA group’s time to achieve the standard was significantly longer than that of the GG group (P0.05). Compared with the GG group, the maintenance dose of the AA group was increased (P0.05). Compared with the GG group, left ventricular ejection fraction (LVEF) of the AA group was significantly reduced (P

Development of high-performance donor–acceptor (D–A) copolymers has been indicated as a promising strategy to improve the power conversion efficiencies (PCEs) of organic solar cells (OSCs). In this work, a new medium bandgap conjugated D–A copolymer, HFAQx-T, based on 4,8-bis(5-(2-ethylhexyl)thiophen-2-yl)benzo[1,2-b:4,5-b′]dithiophene (BDT-T) as donor unit, 4-alkyl-3,5-difluorophenyl substituted quinoxaline (HFAQx) as the acceptor unit, and thiophene as the spacer, was designed and synthesized. HFAQx-T is a well-compatible donor polymer; OSCs based on HFAQx-T exhibit excellent performance in both fullerene and fullerene-free based devices. The optimized conventional single junction bulk heterojunction (BHJ) OSCs of HFAQx-T:PC71BM showed a PCE of 9.2%, with an open circut voltage (Voc) of 0.9 V, a short circuit current (Jsc) of 14.0 mA cm–2, and a fill factor (FF) of 0.74. Also, when blended with 3,9-bis(2-methylene-(3-(1,1-dicyanomethylene)indanone)-5,5,11,11-tetrakis(4-hexylphenyl)dithieno[2,3-d:2′,3′-d...

In this paper, the effect of Na substitution for La on Li ion conductivity in the well-known Li5La3Nb2O12 parents with the cubic garnet framework prepared by sol-gel process is reported. The optimum condition is at 750 °C for 6 h in air with 10% excess lithium salt. The power XRD patterns reveal that the partial substitutions of Na for La in Li5 + 2xLa3-xNaxNb2O12 electrolytes are isostructural. The cubic lattice parameters decrease as the molar fractions of Na increasing. Among the Li5 + 2xLa3-xNaxNb2O12 compounds investigated, the Na-substituted Li6.4La2.3Na0.7Nb2O12 exhibits the highest ionic conductivity of 1.6 × 10−4 S cm-1 at room temperature with an activation energy of 0.41 eV. The new solid state electrolyte is very stable in potential range of −0.8 to 5.0 V vs. Li/Li+, and is also chemically stable against LiMn2O4 and LiCoO2 compounds up to 900 °C, indicating that Li6.4La2.3Na0.7Nb2O12 is a promising solid state electrolyte for all-solid-state battery application.

Two medium bandgap polymers (ffQx-TS1, ffQx-TS2) were designed and synthesized to investigate the influence of different alkylthio side chain on the morphology and photovoltaic performance of non-fullerene polymer solar cells (PSCs). Both polymers exhibit similar molecular weights and comparable the highest occupied molecular orbital (HOMO) energy level. However, the polymer with straight alkylthio chain delivers a root-mean-square (RMS) of 0.86 nm, which is slightly lower than that with branched chain (1.40 nm). The lower RMS benefits the ohmic contact between the active lay and interface layer, thus enhanced short circuit current (Jsc) (from 13.54 mA cm−1 to 15.25 mA cm−1) could be obtained. Due to the enhancement of Jsc, better power conversion efficiency (PCE) of 7.69% for ffQx-TS2 could be realized. These results indicated that alkylthio side chain engineering is a promising method to improve photovoltaic performance.

Quinoxaline (Qx) has an easily modifiable structure, which allows for fine-tuning its properties through optimizing the length of side chains and the kinds of aromatic rings in conjugated side chains. Qx based polymer PBDTT-ffQx with alkoxy substituted fluorobenzene side chains shows a power conversion efficiency (PCE) of 8.47% in nonfullerene solar cells. In this work, we change the alkoxy substituted fluorobenzene side chains to alkyl substituted fluorothiophene in the Qx unit and employ the benzodithiophene (BDT) unit with different lengths of alkyl thiophene side chains to obtain two new Qx based polymers, named TTFQx-T1 and TTFQx-T2, respectively. The TTFQx-T1:ITIC blend film has clear nanoscale phase separation and a suitable domain size, and the device with the TTFQx-T1:ITIC blend film shows lower geminate recombination and higher charge mobility than those with TTFQx-T2:ITIC. Therefore, the TTFQx-T1:ITIC based device exhibits a higher PCE of 10.52% than that based on the TTFQx-T2:ITIC blend with a moderate PCE of 7.22%. The inverted devices from TTFQx-T1:ITIC blends with a larger active area of 16 mm2 than the conventional device (4.5 mm2) show a good PCE of 9.21%. The results highlight that the alkyl lengths and the kinds of aromatic rings in side chains are significant for the development of high performance photovoltaic polymers. Optimizing the conjugated side chains of Qx based polymers is an efficient way to improve photovoltaic properties, and Qx based polymers are potential candidates for fabricating highly efficient polymer solar cells.

In this work, a non-fullerene acceptor molecule (ITIC-FOR) based on heptacyclic (indacenodithieno[3,2-b]thiophene) IDTT as the core with F-phenylalkoxy (FOR) as a side chain was designed and synthesized. The photovoltaic properties of the HFQx-T:ITIC-FOR based non-fullerene polymer solar cells (NF-PSCs) were explored. By device optimization, a good power conversion efficiency (PCE) of 7.33% was obtained.

Solution-processed organic solar cells (OSCs) have been attracting more and more attention for a series of well-known advantages, and power conversion efficiencies (PCEs) of over 11% have been reported. However, the highest PCE of the OSCs based on small molecule donor/polymer acceptor blends is only 4.82%, which was much lower than those of other types of OSCs due to weak absorption of the polymer acceptor and the unbalanced charge carrier mobility of the small molecule donor and the polymer acceptor. Here, we fabricated small molecule donor/polymer acceptor-based OSCs using the wide bandgap SM1 and DR3TBDTT as the small molecular donor and the low-bandgap n-type conjugated polymer PZ1 as the polymer acceptor. With the treatment of a solvent additive, which can promote the absorption intensity, enhance the carrier mobility and suppress the charge carrier recombination, the SM1-based devices and the DR3TBDTT-based devices show PCEs of 3.97% and 5.86%, respectively. It is worth mentioning that the PCE of 5.86% is the state-of-the-art efficiency for OSCs based on the small molecular donor/polymer acceptor system.

A series of new polymer donors (PT-PP, PT-2 f PP and PT-4 f PP) were synthesized based on alkylthiophene substituted benzodithiophene (BDT-T) and pyrido[3,4- b ]pyrazine (PP) building blocks and the effects of fluorination on the polymer properties were explored. Photophysical properties, charge mobilities and morphologies of the three polymers have been intensively investigated. The results indicated that the introduction of the fluorine atom at meta - positions of phenyl substituted PP unit hardly affected their highest occupied molecular orbital (HOMO) level. More importantly, controlling the degree of side-chain fluorination in the polymers is crucial for optimizing the blend morphology. Three polymers showed different photovoltaic properties. The polymer solar cell (PSC) based on the single layer device structure of ITO/PEDOT:PSS/PT-4 f PP:PC71BM (1:1, w : w )/ZrAcac/Al demonstrates a high power conversion efficiency (PCE) of 7.61% under the illumination of AM 1.5G, 100 mW cm−2, which is the highest value for PP-based PSCs.

Two new donor (D) - acceptor (A) copolymers, named m -O- p -F-DFQx-BDT (OFQx-T) and m -EH- p -F-DFQx-BDT (EHFQx-T), which were based on meta -octyloxy- para -fluorophenyl and meta -ethylhexyloxy- para -fluorophenyl difluoroquinoxaline as acceptor units (O-DFQx/EH-DFQx) and alkylthienyl substituted benzodithiophene (BDT) as a donor unit, were designed and synthesized. EHFQx-T had higher absorption coefficient than OFQx-T which contributed to larger short-circuit current density ( J sc ). EHFQx-T showed a lower the highest occupied molecular orbital (HOMO) which is beneficial for the voltage open-circuit ( V oc ). The polymer solar cells (PSCs) based OFQx-T:PC 71 BM and EHFQx-T:PC 71 BM blended film as active layer showed high power conversion efficiency (PCE) of 7.60% and 8.44%, respectively, with 1,8-diiodooctane (DIO) solvent additive treatment. More importantly, OFQx-T:PC 71 BM and EHFQx-T:PC 71 BM had good fill factor (FF), especially the FF of OFQx-T:PC 71 BM was over 70%. The high FF contributed to obtain high PCEs for OFQx-T and EHFQx-T. The more balanced and higher charge mobility, smaller geminate recombination and suitable nanoscale phase separation size of EHFQx-T demonstrate that changing octyl chain to ethylhexyl chain in DFQx acceptor unit is efficient to improve photovoltaic properties in fullerene solar cells.

In this paper, the effects of sintering additives B 2 O 3 on sintering temperature, microstructure and transport properties of the Li 7 La 3 Zr 2 O 12 (LLZ) ceramics prepared by solid state reaction are reported. The optimized conditions to synthesize the LLZ-xB 2 O 3 (x = 0.2–0.35)ceramics is 950 °C for 30 h with 10% excess lithium salt, which is nearly 300 °C lower than that by the conventional solid state reaction. Qualitative phase analysis by X-ray powder diffraction patterns combined with the Rietveld method reveals garnet type compounds as major phases. Lithium ion conductivity of LLZ-0.3B 2 O 3 was studied by AC impedance method. LLZ-0.3B 2 O 3 ceramics exhibits the highest total ionic conductivity of 2.5 × 10 − 4 S cm − 1 at room temperature. All solid state batteries consisting of Li/LLZ-0.3B 2 O 3 /mixture of LiMn 2 O 4 and LLZ-0.3B 2 O 3 /LiMn 2 O 4 cell exhibit the capacity of 102.6 mAh g − 1 at a current density of 5 μAcm − 2 at the first discharge, which could run for 20 cycles with capacity retention of 94%.

In this paper, the effect of Ge substitution for Nb on Li ion conductivity in the well-known Li5La3Nb2O12(LLN)parents with the cubic garnet framework prepared by using metal Ge is reported. The optimum condition is at 950 °C for 8 h with 10% excess lithium salt in air. The XPS spectra indicate that the metal Ge is completely transformed into Ge4+ after sintering for 8 h. The power XRD patterns reveal that the partial substitutions of Ge for Nb in Li5+xLa3GexNb2-xO12 electrolytes are isostructural. The ionic conductivity of Li5+xLa3GexNb2-xO12 ceramics increases as the molar fractions of Ge increasing for x ≤ 0.75. Among these compounds investigated, the Li5.75La3Ge0.75Nb1.25O12 exhibits the highest ionic conductivity of 1.2 × 10−4 S cm−1 at room temperature. The result can be regarded as relatively high values among the element substituted LLN garnets reported up to now. The new solid state electrolyte is very stable in potential range of −0.6-6.0 V vs. Li/Li+, indicating that Li5.75La3Ge0.75Nb1.25O12 is a promising solid state electrolyte for all-solid-state battery application.

Effect of the quenching method on conductivity of Li 5 La 3 Bi 2 O 12 ceramics prepared by sol-gel process was studied. In a synthesis process, lithium hydroxide, acetic bismuth, and acetic lanthanum were used as starting materials, while water was used as solvent. The temperature to synthesize the high density Li 5 La 3 Bi 2 O 12 with cubic garnet type structure is 750 °C for 8 h in air with 10% excess lithium salt. The samples were prepared by the same synthesis route with the only difference from cooling methods. The samples were characterized by XRD, SEM, 6 Li MAS NMR and ionic conductivity measurement. The XRD patterns of Li 5 La 3 Bi 2 O 12 ceramics showed that there was a single phase oxides with garnet-like structure by the furnace cooling and the quenching method. The Li 5 La 3 Bi 2 O 12 electrolyte by the furnace cooling exhibits the highest total ionic conductivity of 2.0 × 10 − 5 S cm − 1 at 22 °C, and that by the quenching method exhibits the highest conductivity of 2.0 × 10 − 4 S cm − 1 with a motional activation energy of 0.36 eV, which is an order of magnitude higher than that by the furnace cooling. The reason is that the relative density of Li 5 La 3 Bi 2 O 12 by the quenching method is higher than that by the furnace cooling. The SEM images are also shown that the density of Li 5 La 3 Bi 2 O 12 is very high by the quenching method and there exists lots of pores by the furnace cooling. And the 6 Li-MAS-NMR results indicate the Li 5 La 3 Bi 2 O 12 samples by the quenching method possess high Li ion mobility.

Through introducing six fluorine atoms onto quinoxaline (Qx), a new electron acceptor unit-hexafluoroquinoxaline (HFQx) is first synthesized. On the basis of this unit, we synthesize a new donor–acceptor (D–A) copolymer (HFQx-T), which is composed of a benzodithiophene (BDT) derivative donor block and an HFQx accepting block. The strong electron-withdrawing properties of fluorine atoms increase significantly the open-circuit voltage (Voc) by tuning the highest occupied molecular orbital (HOMO) energy level. In addition, fluorine atoms enhance the absorption coefficient of the conjugated copolymer and change the film morphology, which implies an increase of the short-circuit current density (Jsc) and fill factor (FF). Indeed, the HFQx-T:ITIC blended film achieves an impressive power conversion efficiency (PCE) of 9.4% with large short-current density (Jsc) of 15.60 mA/cm2, high Voc of 0.92 V, and FF of 65% via two step annealing (thermal annealing (TA) and solvent vapor annealing (SVA) treatments). The exc...

Using solid state electrolyte instead of liquid electrolyte has been considered as a preferred alternative to the conventional liquid electrolyte. The safety and stability of electrolyte directly affects the lithium ion batteries. Lithium garnets Li 5 La 3 M 2 O 12 (M = Nb, Ta) in cubic phase exhibits higher ionic conductivity and good stability. How to continue to enhance the ionic conductivity of electrolyte is one of the key issues in development of solid state batteries. In this research, the synthesis and transport properties of the Li 5+x La 3 Hf x Nb 2-x O 12 (x = 0.2–1) samples with cubic garnet-structure type were reported by a solid state reaction for the first time. The optimized conditions to synthesize the Li 5+x La 3 Hf x Nb 2-x O 12 (x = 0.2–1) ceramics is 1100 °C for 30 h with 10% excess lithium salt. The lattice constants of Li 5+x La 3 Hf x Nb 2-x O 12 (x = 0.2–1) materials increase with increasing x due to the substitution of larger ionic radii Hf 4+ for the smaller Nb 5+ in the garnet structure. The Li 5+x La 3 Hf x Nb 2-x O 12 ceramics exhibits higher ionic conductivity than that of Li 5 La 3 Nb 2 O 12 electrolyte.

In order to improve the photovoltaic performance of pyrido[3,4-b]pyrazine (PP)-based polymers, a new fluoropyrido[3,4-b]pyrazine based D–A type polymer (BDT-S-fPP) was synthesized. The optical, electrochemical and photovoltaic properties were well investigated. A power conversion efficiency (PCE) over 6.0% with a single junction device was obtained, which is the highest PCE among the PP-based polymers reported to date.

A new small molecule, ITTC, bearing an indacenodithieno[3,2-b]thiophene core and a 2-(6-oxo-5,6-dihydro-4H-cyclopenta[c]thiophen-4-ylidene)malononitrile end group, was designed, synthesized and characterized as a non-fullerene electron acceptor. The ITTC possesses strong and broad light absorption, high and balanced charge mobility and a nanoscale interpenetrating morphology when blended with a recently synthesized hexafluoroquinoxaline based polymer donor-HFQx-T. HFQx-T was obtained from a Stille coupling copolymerization of a 2,6-bis(trimethyltin)-4,8-bis(5-(2-ethylhexyl)thiophene-2-yl)benzo[1,2-b:4,5-b′]dithiophene electron donating unit and a hexafluoroquinoxaline based electron accepting unit. The device employing HFQx-T as the donor and ITTC as the acceptor delivered a power conversion efficiency (PCE) of 8.19% without any post-treatment. After thermal annealing, an impressive PCE of 10.4% was obtained. This performance is among the highest PCEs reported for fullerene-free polymer solar cells up to date. This study demonstrates the great potential of ITTC as n-type materials for organic electronics.

Background: Metformin, an antidiabetic drug, has been reported to be involved in atherosclerosis (AS). In this study, the effects of metformin on oxidized low-density lipoprotein (Ox-LDL)-induced macrophage apoptosis were investigated, and the mechanisms involved in this process were examined. Methods: qRT-qPCR analysis was performed to detect the expression of miR-34a in macrophage cells. Cell proliferation was determined by MTT assays and colony formation assays. Cell apoptosis was assessed by the detection of apoptotic rate and caspase 3 activity. Western blot analysis was performed to evaluate the expression of Bcl2 protein. Results: Metformin treatment promoted proliferation and suppressed apoptosis in macrophages following the treatment of oxidized low-density lipoprotein (Ox-LDL). Metformin could inhibit miR-34a in macrophages. miR-34a overexpression could reverse the effect of metformin on proliferation and apoptosis in Ox-LDL-treated macrophages. Moreover, metformin could increase the expression of the miR-34a target gene Bcl2. Furthermore, metformin treatment exerted the pro-proliferation and anti-apoptosis effect through regulating Bcl2 expression in Ox-LDL-stimulated macrophages. Conclusion: Metformin facilitated proliferation and inhibited apoptosis of macrophages treated with Ox-LDL through the miR-34a/Bcl2 axis, indicating the potential value of metformin in AS therapy.

Background The RESOLUTE-DIABETES CHINA study was specifically designed to investigate the safety and efficacy of Resolute zotarolimus-eluting stents (ZES; Medtronic, Santa Rosa, CA, USA) in the treatment of diabetic coronary lesions in the Chinese population. Methods In all, 945 patients with de novo native coronary lesions and type 2 diabetes mellitus were recruited at 32 cardiac centers across the Chinese mainland and were implanted with Resolute ZES. The primary endpoint was target vessel failure (TVF); secondary endpoints were clinical outcomes, namely all-cause death, stroke, bleeding, target lesion revascularization (TLR), target vessel revascularization (TVR), non-TVR, and stent thrombosis (ST). The follow-up period for all endpoints was 12 months after the procedure. Results In all, 933 patients (98.73%) had clinical follow-up at 12 months. The rate of TVF was 11.60%, whereas the rate of occurrence of secondary endpoints was 5.47%, with four patients (0.43%) having subacute or late ST. There were no significant differences in TVF rates comparing patients with different HbA1c levels or receiving different glucose control treatments (all P > 0.05). Patients with multivessel lesions had higher TVF rates (95% confidence intervals) than those with single-vessel lesions (16.76% [12.10%-22.97%) vs 9.72% [7.79%-12.11%], respectively; P = 0.006). There were no significant differences in TVF rates in patients with or without small vessels, bifurcated lesions, or chronic total occlusions (all P > 0.05). [Correction added on 17 January 2019, after first online publication: in the second sentence of Results section, "TLF" was changed to "TVF".]. Conclusions Resolute ZES may perform well in the Chinese diabetic population, especially in those with poor glucose control, complex lesions, and certain unfavorable clinical features. Further studies are needed to determine why ZES perform well in this population.

A new small molecule acceptor, m‐ITIC‐OR, based on indacenodithieno[3,2‐b]thiophene core with meta‐alkoxyphenyl side chains, is designed and synthesized. The m‐ITIC‐OR film shows broader and redshift absorption compared to its solution and matched energy levels with a hexafluoroquinoxaline‐based polymer donor‐HFQx‐T. Here, polymer solar cells (PSCs) by blending an HFQx‐T donor and an m‐ITIC‐OR acceptor as an active layer deliver the power conversion efficiency (PCE) of 6.36% without any posttreatment. The investigations demonstrate that the HFQx‐T:m‐ITIC‐OR blend films possess higher and more balanced charge mobility, negligible bimolecular recombination, and nanoscale interpenetrating morphology after thermal annealing (TA) treatment. Through a simple TA treatment at 150 °C for 5 min, an impressive PCE of 9.3% is obtained. This efficiency is among one of the highest PCEs for additive free PSCs. This is the first time alkoxyphenyl side chain is introduced into nonfullerene electron acceptor; more interestingly, the new electron acceptor (m‐ITIC‐OR) in this work shows a great potential for highly efficient photovoltaic properties.

Ladder-type conjugated structures with rigid and coplanar molecular frameworks feature longer effective conjugation, affirmative optoelectronic properties and strong intermolecular π–π interactions, which are ideal characteristics for organic photovoltaics. Here, a new “zigzag” angular-fused naphthodifuran (zNDF) based on alkoxyphenyl side chains was designed and synthesized. The distannylated zNDF building block was copolymerized with 4,7-di(5-bromothiophen-2-yl)-5,6-dioctyloxybenzo[c][1,2,5]thiadiazole and 5,8-bis(5-bromothiophen-2-yl)-2,3-bis(4-(2-ethylhexyloxy)-3-fluorophenyl)-6,7-difloroquinoxaline (Br-BT and Br-ffQx) acceptor units by Stille cross coupling reaction to form two new medium bandgap donor–acceptor polymers PzNDFP-BT and PzNDFP-ffQx, respectively. The photovoltaic properties of the copolymers blended with [6,6]-phenyl-C71-butyric acid methyl ester (PC71BM) as an electron acceptor were investigated. A 6.9% efficiency was achieved from the single device based on the PzNDFP-BT : PC71BM (1 : 1.5, w/w) blend film with a 0.25% 1,8-diiodooctane (DIO) additive, which is among the highest efficiency for zNDF-based polymer solar cells.

Objective The aim of this study was to investigate the effects of a noninvasive positive pressure ventilation therapy on cardiac structure and function in patients with coronary heart disease combined with obstructive sleep apnea/hypopnea syndrome (OSAHS). Patients and methods Eighty patients with coronary heart disease OSAHS were divided randomly into treatment (n=40) and control (n=40) groups. Both groups received standard medications. The treatment group received additional noninvasive mechanical ventilation support for at least 3 h (3-6 h) every night. On the first day after selection and 3 months afterwards, participants were examined with echocardiograms, 24-h ambulatory blood pressure monitoring, and blood analyses. Primary endpoints were left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular ejection fraction, left atrial diameter as well as serum concentrations of N-terminal prohormone of brain natriuretic peptide, and high-sensitive C-reactive protein. Secondary endpoints included cardiac death, nonfatal myocardial infarction, and hospitalization. Results After the 3-month study period, patients in the treatment group showed significantly improved left ventricular end-diastolic diameter (P=0.02), left ventricular end-systolic diameter (P=0.035), left ventricular ejection fraction (P=0.05), and left atrial diameter (P=0.02) values, and their serum N-terminal prohormone of brain natriuretic peptide (P=0.01) and high-sensitive C-reactive protein (P=0.04) concentrations were significantly improved compared with the control group. During the 3 months, three cardiovascular complications occurred in the treatment group versus nine in the control group (P Conclusion For patients with coronary heart disease combined with OSAHS, noninvasive mechanical ventilation therapy can significantly improve heart functions and reduce the occurrence of cardiovascular complications.

Background To investigate the effects of a noninvasive positive pressure ventilation therapy on cardiac structure and function in patients with coronary heart disease combined with obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods 80 coronary heart disease OSAHS patients from three hospitals in Shanghai were randomly divided into treatment (n=40) and control (n=40) groups. Both groups received standard medications. The treatment group received an additional noninvasive mechanical ventilation support for at least 3 hours (3-6 hours) every night. On the first day after selection and 3 months afterwards participants were examined with echocardiograms, a 24-hour ambulatory blood pressure monitoring and blood analyses. Primary endpoints were left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVESd) and left ventricular ejection fraction (LVEF) as well as serum concentrations of N-terminal prohormone of brain natriuretic peptide (NT-ProBNP) and high sensitive C-reactive protein (hsCRP). Secondary endpoints included cardiac death, nonfatal myocardial infarction and hospitalization. Results After the 3 months study period, patients in the treatment group showed significant better improvements of LVEDd (p=0.02), LVESd (0.035) and LVEF (0.05) and their serum NT-ProBNP (p=0.01) and hsCRP (p=0.04) concentrations were significantly better improved than in the control group. During the 3 months, 3 cardiovascular complications occurred in the treatment group and 9 in the control group (p Conclusions For patients with coronary heart disease combined with obstructive sleep apnea/hypopnea syndrome, noninvasive mechanical ventilation therapy can significantly reduce left ventricular end systolic and end diastolic diameters, improve heart function and reduce the occurrence of cardiovascular complications.