Efficacy and Safety of Xinyue Capsule in the Treatment of Heart Failure With Preserved Ejection Fraction

The mitral annular e' velocity is measured using tissue Doppler imaging (TDI) at the lateral or septal side of the mitral annulus during early diastole. It reflects the relaxation capacity of the left ventricle (LV). Reduced e' velocity is a key indicator of impaired LV diastolic function.

A simple, non-invasive clinical test used to evaluate cardiopulmonary function and exercise tolerance. The patient walks as far as possible on a flat, hard surface for 6 minutes, with the total distance recorded. Longer 6MWD correlates with higher survival rates and lower hospitalization risks, especially in chronic heart or lung disease patients.

The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is a validated, patient-reported outcome measure specifically designed to assess the impact of heart failure on a patient's quality of life. It consists of 21 items that evaluate physical, emotional, and social limitations caused by heart failure over the preceding 4 weeks.

The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is a validated, patient-reported outcome measure specifically designed to assess the impact of heart failure on a patient's quality of life. It consists of 21 items that evaluate physical, emotional, and social limitations caused by heart failure over the preceding 4 weeks.

The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is a validated, patient-reported outcome measure specifically designed to assess the impact of heart failure on a patient's quality of life. The total score ranges from 0 to 105, with higher scores indicating poorer quality of life.

The Patient Health Questionnaire-9 (PHQ-9) is a widely used screening tool for assessing the presence and severity of depressive symptoms. It consists of 9 questions, each corresponding to a symptom of major depressive disorder as defined by the DSM-5. Scores ≥10 typically indicate clinically significant depression requiring further evaluation. High scores (≥15) or suicidal ideation necessitate urgent referral to mental health professionals.

The E/e' ratio is calculated by dividing the peak early diastolic mitral inflow velocity (E-wave, measured by pulsed-wave Doppler) by the average of the septal and lateral mitral annular e' velocities (from TDI). This ratio is used to estimate left ventricular filling pressure. An elevated E/e' ratio (typically >14) suggests increased diastolic filling pressure and possible heart failure with preserved ejection fraction (HFpEF).

The left atrial volume index is a measurement of left atrial size, calculated by dividing the left atrial volume (measured via the biplane method of disks on echocardiography) by the patient's body surface area (BSA). Elevated LAVI (>34 mL/m²) indicates left atrial enlargement, which is associated with chronic diastolic dysfunction, atrial fibrillation, and adverse cardiovascular outcomes.

The peak velocity of the tricuspid regurgitation jet is measured using continuous-wave Doppler. It reflects the pressure gradient between the right ventricle and right atrium during systole. Elevated TR Vmax (>3.4 m/s) is used to estimate pulmonary artery systolic pressure (using the simplified Bernoulli equation: 4V²) and may indicate pulmonary hypertension.

The left ventricular eccentricity index assesses the geometric shape of the LV in short-axis view at end-diastole. It is calculated as the ratio of the anteroposterior diameter to the septolateral diameter of the LV. An index >1.0 indicates LV eccentric remodeling, often seen in volume overload states (e.g., mitral/aortic regurgitation) or adaptive changes in dilated cardiomyopathy. In pressure overload (e.g., aortic stenosis), concentric remodeling typically predominates.

The Generalized Anxiety Disorder-7 (GAD-7) is a validated screening tool used to assess the presence and severity of generalized anxiety symptoms. It contains 7 questions that align with DSM-5 criteria for generalized anxiety disorder (GAD). Scores ≥10: Refer for further evaluation (e.g., psychological assessment, diagnosis). Scores ≥15 or suicidal thoughts: Prioritize urgent mental health intervention. Monitor patients with chronic conditions (e.g., chronic pain, cancer) who may experience overlapping anxiety symptoms.