Cardiology

The Department of Cardiovascular Medicine of the Affiliated Hospital of Qingdao University originated as the cardiovascular group of the Department of Internal Medicine. It was established in 1960 by the renowned internist Dr. Yang Dehao, with 25 beds. In 1978, Professor Zhu Zhen, a nationally renowned cardiovascular specialist, served concurrently as group leader. Six examination units were established: the ECG Unit, founded in 1952, which began double two-step exercise testing in 1955, atropine and propranolol tests in 1952, and bicycle ergometry in 1986; the Cardiac Catheterization Unit, established in 1979 by Associate Professor Zhu Zhen and attending physician Chen Houxia, which carried out catheter examinations for cardiovascular diseases and was then at the forefront of the province; the Echocardiography Unit, which introduced an M-mode cardiac ultrasound diagnostic instrument in 1979; the ECG Monitoring Unit, used for monitoring and treating patients with acute myocardial infarction and severe arrhythmias; the External Counterpulsation Unit, used to treat angina pectoris due to coronary heart disease and retinal atrophy; and the ECG Spectrum Analysis Unit. In the 1970s, the department was among the earliest in China to perform electrical defibrillation, electrical cardioversion, and cardiac pacing. The 7711 rapid cardiac pacemaker developed by attending physician Zhu Zhen in 1977 won the 1979 Brussels International Medical Invention Award and achieved good results in clinical rescue of critically ill patients.

In 1979, Associate Professor Zhu Zhen and physicians Chen Houxia and Ren Guizhi, with the cooperation of attending physicians Zhang Zhengsheng and Ma Huanlie of Cardiac Surgery, completed China’s first portable epicardial pacing treatment for a patient with third-degree atrioventricular block. Endocardial pacing was subsequently introduced, saving many patients with bradyarrhythmia. Transesophageal cardiac pacing for patients with sinoatrial node dysfunction and cardiac-function testing for patients with cardiovascular disease were also developed.

In 1978, with State Council approval, Cardiology became one of the first authorized units for master’s-degree education and began admitting master’s students. In 2010 it was approved as a doctoral degree site for clinical professional degrees, a key clinical discipline of Shandong Province and a key discipline of Qingdao. In 2008 it became one of the first Ministry of Health training bases for interventional treatment of cardiovascular disease. During the 1970s and 1980s, Cardiology at the Affiliated Hospital of Qingdao University had become a medical, teaching, and research center in eastern Shandong. Since 2000 it has undertaken standardized residency training and continuing medical education. It now integrates medical care, teaching, research, standardized training, and continuing education and enjoys a high reputation nationwide. Through the unremitting efforts of several generations, it has achieved leapfrog development in scale, services, professional organization, academic standards, personnel training, and equipment, with remarkable achievements in all of these areas.

2. Professional Team

The department has strong technical capacity and abundant talent. Led by renowned senior experts with both professional integrity and ability, it has formed a high-level medical, teaching, and research group with highly qualified young and middle-aged professionals as its backbone and with complete subspecialties. It currently has 46 full-time physicians: 30 with doctoral degrees and 16 with master’s degrees, meaning that 100% hold a master’s degree or higher; 15 have senior professional titles and 8 associate-senior titles. There are 2 doctoral supervisors and 20 master’s supervisors. One physician is an editorial-board member of the Chinese Journal of Arrhythmia, and 4 are executive editorial-board or editorial-board members of core journals including the Chinese Journal of Cardiovascular Research and the Journal of Cardiovascular Rehabilitation Medicine.

Academic leaders serve on national and provincial committees and hold chair or vice-chair positions in the Chinese Medical Association’s branches of internal medicine, cardiac electrophysiology and pacing, heart failure device therapy (CRT), and cardiovascular disease; the Chinese Medical Doctor Association’s Cardiovascular Physicians Branch; the Chinese Societies of Electrocardiology and Cardiology; the China Arrhythmia Alliance; and corresponding Shandong and Qingdao cardiovascular, interventional, electrophysiology, pacing, and cardiac-rehabilitation organizations. The talent structure is sound. Academic leaders are energetic, highly accomplished senior specialists recognized in their fields and capable of leading the discipline toward its goals. Subspecialties include electrophysiology and pacing; interventional diagnosis and treatment of coronary heart disease; hypertension and arteriosclerosis; and heart failure and structural heart disease. Their leaders serve as members of national societies or study groups and vice-chairs of Shandong organizations. Overall strength ranks among the country’s advanced departments.

3. Professional Features

(1) Electrophysiology and Pacing

The group has strong technical and research capacity and has made substantial progress in pacing and electrophysiology. Cardiac pacing has remained at an advanced national and leading provincial level. More than 350 ICD, CRT, and pacing procedures are performed annually, with physiological pacing accounting for 75%. Clinical research includes selective-site pacing, such as right-ventricular-outflow-tract septal pacing, atrial-septal pacing, high right-atrial pacing, and His-bundle pacing. Clinical application of implantable cardioverter-defibrillators (ICDs) for primary and secondary prevention of malignant arrhythmias is at a leading provincial and advanced national level, with extensive experience in preventing and treating arrhythmic sudden death, especially sudden death from coronary heart disease. More than 500 catheter radiofrequency ablations for tachyarrhythmias are performed annually; ablation for atrial fibrillation and complex ventricular arrhythmias has been actively developed with significant results. Research on cardiac synchrony in chronic heart failure and device therapy, especially cardiac resynchronization therapy (CRT), is actively pursued. Each year the department conducts provincial continuing-medical-education programs on physiological pacing, sudden cardiac death, and CRT for chronic heart failure. In 2008 it became one of the first Ministry of Health training bases for interventional diagnosis and treatment of arrhythmia.

(2) Interventional Diagnosis and Treatment of Coronary Heart Disease

More than 6,000 patients with coronary heart disease are treated annually, including patients with unstable angina and acute myocardial infarction receiving interventional and medical treatment. Interventional diagnosis and treatment began relatively early in China in 1991; in 1998 the department pioneered transradial PCI in Shandong, now a routine technique that avoids complications related to bed rest. More than 2,500 PCI procedures are performed annually, including treatment of unprotected left-main, bifurcation, chronic total-occlusion, and severely calcified lesions. Intravascular ultrasound (IVUS) and fractional flow reserve (FFR) are used to optimize diagnostic and treatment strategies. Procedural success exceeds 98%, mean hospitalization is 3.5 days, and follow-up is 95%; the level of coronary-heart-disease care is nationally advanced. The department has long assisted and guided qualified hospitals in surrounding areas in coronary angiography and intervention, promoting regional development. During the past decade it has participated in multiple domestic and international multicenter trials and undertaken numerous national and provincial research projects. The subspecialty combines bedside, molecular, and interventional cardiology. In cooperation with Emergency Medicine and the interventional operating room, it has used the chest-pain center to establish a 24-hour green pathway for acute myocardial infarction, saving many lives and earning an excellent social reputation. Research focuses on the basis of coronary heart disease and in-stent restenosis after coronary stent implantation. It currently undertakes 2 National Natural Science Foundation projects and more than 10 provincial, ministerial, and municipal projects, and has published more than 30 SCI-indexed papers. Staff provide patients with prevention, health care, early detection, comprehensive treatment, and vascular rehabilitation through excellent skills and high ethical standards. In 2008 it became one of the first Ministry of Health training bases for interventional diagnosis and treatment of coronary heart disease.

(3) Hypertension and Arteriosclerosis

The Qingdao Key Laboratory of Hypertension is located in Cardiology at the Affiliated Hospital of Qingdao University and, together with the department, forms a specialized unit integrating medical care, teaching, and research. It has a highly qualified clinical and research team and has established an integrated hypertension prevention and treatment system covering health education, consultation, outpatient care, hospitalization, and outpatient follow-up. It has distinctive expertise in diagnosing and treating resistant hypertension, highly variable hypertension, severe and complicated hypertension, and various forms of secondary hypertension, earning broad patient recognition.

(4) Heart Failure and Structural Heart Disease

Structural heart disease generally refers to cardiac diseases characterized mainly by congenital or acquired structural abnormalities of the heart and great vessels, including conventionally defined congenital heart disease, valvular disease, and cardiomyopathy. Treatment, especially intervention, has developed rapidly. In 1991 the department was among the earliest in China to perform percutaneous closure of patent ductus arteriosus; in 1992 it began percutaneous balloon mitral and pulmonary valvuloplasty; and in 2001 it began interventional closure of congenital heart defects and balloon aortic valvuloplasty. It now performs 80–120 procedures annually for atrial-septal, ventricular-septal, and patent-ductus-arteriosus closure.

In 2018 the department began left atrial appendage occlusion for patients with atrial fibrillation who require anticoagulation but cannot take anticoagulants, providing effective stroke prevention. In 2019 it began transcatheter aortic valve replacement (TAVR), offering minimally invasive treatment for severe aortic stenosis.

Heart failure is the terminal stage of cardiovascular disease, with high incidence and disability rates. Drug therapy progresses slowly, while new device research has substantially advanced device-assisted treatment and improved symptoms and prognosis. The department diagnoses and treats several thousand heart-failure patients annually and achieves good results through optimized medication. Chemical ablation and right-ventricular pacing for hypertrophic cardiomyopathy began in 1997. For dilated cardiomyopathy and advanced severe heart failure, ventricular resynchronization therapy and implantable cardioverter-defibrillators are used; more than 50 CRTP and CRTD devices are implanted annually.

(5) Cardiac Rehabilitation

Cardiac rehabilitation serves patients in the stable phase after acute myocardial infarction, after coronary stent implantation or coronary artery bypass surgery, after other cardiac surgery, and those with stable heart failure, stable cardiomyopathy, hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Through rehabilitation assessment, exercise, diet and psychological therapy, lifestyle improvement, regular medication, periodic monitoring, and health guidance, it provides comprehensive care throughout the course of illness, addresses postoperative and post-discharge recovery, improves quality of life, supports return to normal social life, and prevents cardiovascular disease. The hospital currently serves as vice-chair unit of the Shandong Cardiac Rehabilitation Society and chair unit of Qingdao cardiac rehabilitation. It is improving the rehabilitation system, promoting rehabilitation concepts, and completes cardiac rehabilitation for more than 100 patients annually.

4. Research and Teaching

In recent years the department has undertaken 4 National Natural Science Foundation projects and more than 20 research projects commissioned by provincial and municipal governments and public or private institutions; received more than 10 provincial and municipal research awards; and edited or co-edited 10 books. It has published more than 200 papers in publicly issued domestic journals, with more than 80 indexed by SCI, MED, or ISTP. Three projects were appraised as internationally advanced or domestically leading. More than RMB 5 million in research funds is available. Long-term stable cooperation has been established with renowned hospitals in the United States, Germany, Israel, Japan, and South Korea. More than 10 person-times of staff have studied or visited abroad and contributed actively to discipline development.

Teaching practice emphasizes innovation. Relying on the National Demonstration Center for Basic Medical Education, the department was the first on campus to introduce multimedia and bilingual teaching, with remarkable results. Taking advantage of its provincial key clinical-discipline, doctoral-degree, and postdoctoral-fellowship-station status, it has trained 2,500 undergraduates, more than 300 master’s students, and 15 doctoral students. It has repeatedly organized continuing-medical-education courses and national and provincial academic conferences and exchange activities. Three papers received the “Outstanding Bachelor’s Thesis of Qingdao University” award. In recent years, several members have been named “Outstanding Graduate Supervisor of Qingdao University” and “Outstanding Teacher of Qingdao University.”