Cardiologia

1、Disciplinary Overview

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 internal medicine expert Dr. Yang Dehao, with 25 beds. In 1978, Professor Zhu Zhen, a nationally renowned expert in cardiovascular diseases, concurrently served as group leader. Six examination rooms were established: the Electrocardiography Room was formed in 1952, began double two-step exercise testing in 1955, conducted atropine and propranolol tests in 1952, and began bicycle ergometer testing in 1986. The Cardiac Catheterization Room was established in 1979 by Associate Professor Zhu Zhen and Attending Physician Chen Houxia; it conducted catheter examinations for cardiovascular diseases and was at the leading level in the province at that time. The Echocardiography Room introduced a cardiac M-mode ultrasound diagnostic instrument in 1979. The ECG Monitoring Room was used for monitoring and treating patients with acute myocardial infarction and severe arrhythmias. The External Counterpulsation Room was used to treat angina pectoris due to coronary heart disease and retinal atrophy. The ECG Spectral Analysis Room was among the earliest in China to perform electrical defibrillation, electrical cardioversion, and cardiac pacing in the 1970s. In 1977, Attending Physician Zhu Zhen successfully developed the Model 7711 rapid cardiac pacing device, which received the 1979 Brussels International Medical Invention Award. This instrument achieved good results in the 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, performed the first portable epicardial pacing treatment in a patient with third-degree atrioventricular block. Endocardial pacing treatment was subsequently introduced, saving the lives of many patients with bradyarrhythmias. Transesophageal cardiac pacing for patients with sick sinus syndrome and cardiac function testing for patients with cardiovascular diseases were also introduced.

In 1978, with the approval of the State Council, the Department of Cardiovascular Medicine became one of the first authorized institutions for master's degree education and began admitting master's students. In 2010, it was approved as a doctoral degree-granting site for clinical professional degrees, a key clinical discipline in Shandong Province, and a key discipline in Qingdao. In 2008, it became one of the first cardiovascular disease interventional treatment training bases authorized by the former Ministry of Health. During the 1970s and 1980s, the Department of Cardiovascular Medicine of the Affiliated Hospital of Qingdao University had already become a medical, teaching, and research center in eastern Shandong. Since 2000, it has undertaken standardized training for residents and continuing medical education. It has now integrated medical care, teaching, research, standardized residency training, and continuing medical education, and enjoys a high reputation nationwide. Through the unremitting efforts of several generations, the Department of Cardiovascular Medicine has achieved leapfrog development in construction scale, medical services, professional organization, academic standards, talent cultivation, and medical equipment, and has made remarkable achievements in medical care, teaching, research, standardized residency training, and continuing medical education.

2、Talent Structure

The Department of Cardiovascular Medicine has strong technical capabilities and an abundance of talented professionals. It has formed a high-level medical, teaching, and research team with comprehensive subspecialties, led by a group of renowned senior experts of both integrity and ability from China and the province, and supported by highly qualified young and middle-aged technical professionals. The department currently has 46 full-time physicians, including 30 with doctoral degrees and 16 with master's degrees; 100% hold a master's degree or higher. There are 15 personnel with senior professional titles and 8 with associate senior professional titles. There are 2 doctoral supervisors and 20 master's supervisors. One member serves on the editorial board of the Chinese Journal of Arrhythmia, and 4 serve as executive editorial board members or editorial board members of core journals, including the Chinese Journal of Cardiovascular Research and the Journal of Cardiovascular Rehabilitation Medicine.

The department's academic leaders serve as members of the Cardiovascular Medicine Committee of the Chinese Medical Association's Branch of Internal Medicine, the Chinese Society of Pacing and Electrophysiology, the Cardiovascular Physicians Branch of the Chinese Medical Doctor Association, the Chinese Society of Electrocardiology, and the Chinese Society of Heart Rhythm; standing committee members of the Chinese Alliance of Arrhythmia; members of the Electrophysiology and Pacing Group of the Chinese Medical Association; and members of the Cardiac Resynchronization Therapy (CRT) Group of the Chinese Medical Association's Heart Failure Device Therapy Group. They also serve as chairpersons or deputy chairpersons of the Cardiovascular Disease Branch of the Shandong Medical Association, the Interventional Cardiovascular Disease Branch of the Shandong Medical Association, the Electrophysiology and Pacing Professional Committee of the Shandong Medical Doctor Association, the Cardiac Rehabilitation Branch of the Shandong Medical Association, the Interventional Cardiovascular Disease Branch of the Qingdao Medical Association, the Qingdao Society of Electrophysiology and Pacing, and the Cardiac Rehabilitation Branch of the Qingdao Medical Association. The discipline has a rational talent structure, and its academic leaders are in the prime of their careers. They are senior-title professionals recognized in their respective academic fields for their high academic attainments and outstanding achievements, and capable of leading the discipline toward its established goals. The subspecialties are cardiac electrophysiology and pacing, interventional diagnosis and treatment of coronary heart disease, hypertension and arteriosclerosis, and heart failure and structural heart disease. Their respective leaders include national society or group committee members and deputy chairpersons of relevant Shandong provincial organizations. Overall strength ranks among the advanced level nationwide.

3、Professional Features

（1）Cardiac Electrophysiology and Pacing

The subspecialty has strong technical and research capabilities and has made substantial progress in cardiac pacing and electrophysiology over the years. Cardiac pacing therapy has consistently remained at an advanced level nationally and a leading level within the province. More than 350 cases of ICD, CRT, and cardiac pacing therapy are completed annually, with physiological pacing accounting for 75%. In recent years, the subspecialty has focused on clinical research into the application of physiological pacing and has conducted clinical studies of selective-site pacing, including right ventricular outflow tract septal pacing, interatrial septal pacing, high right atrial pacing, and His-bundle pacing. In the primary and secondary prevention of malignant arrhythmias, the clinical application of implantable cardioverter-defibrillators (ICDs) has reached a leading level domestically and an advanced level nationally. The department has accumulated extensive clinical experience in preventing and treating sudden arrhythmic death, particularly sudden death due to coronary heart disease. More than 500 catheter radiofrequency ablation procedures for various tachyarrhythmias are performed annually. In recent years, ablation treatment for atrial fibrillation and complex ventricular arrhythmias has been actively conducted, with significant results. In recent years, the department has actively conducted research on the characteristics of cardiac synchrony in chronic heart failure and has achieved notable results in device therapy, particularly cardiac resynchronization therapy (CRT). Each year, provincial continuing medical education programs are held on the clinical application of physiological pacing, sudden cardiac death, and resynchronization therapy for chronic heart failure, with significant achievements. In 2008, the department was included among the first batch of arrhythmia interventional diagnosis and treatment training bases authorized by the Ministry of Health.

（2）Interventional Diagnosis and Treatment of Coronary Heart Disease

More than 6,000 patients with coronary heart disease are treated annually, including patients receiving interventional and pharmacological treatment for unstable angina and acute myocardial infarction. Interventional diagnosis and treatment techniques for coronary heart disease were introduced relatively early in China in 1991. In 1998, the department was the first in the province to perform transradial coronary intervention (PCI), which has now become a routine technique and avoids complications associated with prolonged bed rest. More than 2,500 PCI procedures are completed annually, including procedures for various complex lesions such as unprotected left main coronary artery lesions, bifurcation lesions, chronic total occlusions, and severely calcified lesions. Intravascular ultrasound (IVUS) and fractional flow reserve (FFR) measurement are used to optimize strategies for the diagnosis and treatment of coronary artery disease. The procedural success rate exceeds 98%, the average length of hospital stay is 3.5 days, and the follow-up rate is 95%; the level of coronary heart disease diagnosis and treatment ranks among the advanced level nationally. For many years, the department has assisted and guided qualified hospitals in surrounding areas in performing coronary angiography and interventional treatment, promoting the dissemination and development of coronary intervention diagnosis and treatment technology in the region. Over the past 10 years, it has participated in multiple domestic and international multicenter clinical trials of interventional treatment for coronary heart disease, while undertaking and completing numerous national and provincial/ministerial research projects. This subspecialty adheres to a development model that closely integrates bedside cardiology, molecular cardiology, and interventional cardiology, and its academic standing and social reputation continue to improve. In recent years, the department has worked closely with Emergency Medicine, the Interventional Operating Room, and other departments. Using the construction of a chest pain center as a platform, it has established a 24-hour green channel for acute myocardial infarction, saving the lives of numerous patients with acute myocardial infarction and earning a strong social reputation. The department currently focuses its basic research on the pathogenesis of coronary heart disease and in-stent restenosis after coronary stent implantation. It currently undertakes 2 National Natural Science Foundation of China projects and more than 10 provincial/ministerial and municipal research projects, and has published more than 30 SCI-indexed academic papers. All members of this subspecialty will provide patients with coronary heart disease with high-quality health services, including prevention and health care, early detection, comprehensive treatment, and vascular rehabilitation, with superb medical skills and noble professional ethics. In 2008, the department was included among the first batch of coronary heart disease interventional diagnosis and treatment training bases authorized by the Ministry of Health.

（3）Hypertension and Arteriosclerosis

The Qingdao Key Laboratory of Hypertension is located in the Department of Cardiovascular Medicine of the Affiliated Hospital of Qingdao University and, together with the department, forms a specialized center integrating medical care, teaching, and research. The subspecialty has a highly qualified clinical and research team and has established a hypertension prevention and diagnosis-and-treatment system integrating health education, health consultation, outpatient care, inpatient treatment, and outpatient follow-up. Professional features: the subspecialty has achieved distinctive accomplishments in the diagnosis and treatment of refractory hypertension, highly fluctuating hypertension, severe and complicated hypertension, and various forms of secondary hypertension, earning widespread recognition from patients.

（4）Heart Failure and Structural Heart Disease

Structural heart disease broadly refers to a large category of cardiac diseases primarily manifested by congenital or acquired structural abnormalities of the heart and great vessels, such as conventionally defined congenital heart disease, valvular heart disease, and cardiomyopathy. Treatment of structural heart disease, particularly interventional treatment, has developed rapidly in recent years. Our department was among the earliest in China to perform percutaneous transcatheter closure of patent ductus arteriosus in 1991, and performed percutaneous balloon mitral valvuloplasty and pulmonary valvuloplasty in 1992. In 2001, it began performing interventional closure of congenital heart disease and balloon aortic valvuloplasty. Currently, 80–120 procedures are performed annually, including closure of atrial septal defects, ventricular septal defects, and patent ductus arteriosus.

In 2018, the Department of Cardiovascular Medicine began performing left atrial appendage occlusion, providing an effective preventive measure against stroke for patients with atrial fibrillation who require anticoagulation but cannot take anticoagulant drugs. In 2019, it began performing transcatheter aortic valve replacement (TAVR), providing a minimally invasive treatment option for patients with severe aortic stenosis.

Heart failure is the terminal stage of cardiovascular disease progression and has high incidence and disability rates. Advances in pharmacological treatment have been slow, but with the development of new devices in recent years, device-assisted treatment has advanced considerably, improving patients' symptoms and prognosis. The Department of Cardiovascular Medicine diagnoses and treats several thousand patients with heart failure annually. Ideal treatment outcomes have been achieved through optimized pharmacological therapy. For patients with hypertrophic cardiomyopathy, chemical ablation and right ventricular pacing have been performed since 1997. For patients with dilated cardiomyopathy and advanced severe heart failure, cardiac resynchronization therapy and implantation of automatic cardioverter-defibrillators have been performed. More than 50 CRTP and CRT-D devices are currently implanted annually.

(5)Cardiac Rehabilitation

Cardiac rehabilitation is intended for people with cardiovascular conditions, including those in the stable phase after acute myocardial infarction, after coronary stent implantation, after coronary artery bypass grafting or other types of cardiac surgery, as well as those with stable heart failure, stable cardiomyopathy, hypertension, diabetes, or hyperlipidemia. Through a series of rehabilitation assessments, exercise therapy, dietary therapy, psychological therapy, lifestyle improvements, regular medication use, regular monitoring of various indicators, and health guidance, it provides comprehensive care throughout the entire process. It focuses on patients' postoperative and post-discharge symptom progression, improves their quality of life, helps them return to normal social life, and prevents the occurrence of cardiovascular disease. Our hospital currently serves as the deputy chair institution of the Shandong Cardiac Rehabilitation Society and the chair institution of the Qingdao Cardiac Rehabilitation Society. It is progressively improving its cardiac rehabilitation system, promoting cardiac 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 of China projects and more than 20 research projects commissioned by local governments and public institutions at the provincial and municipal levels; it has received more than 10 provincial and municipal scientific research awards and has served as chief editor or associate chief editor of 10 books. In recent years, it has published more than 200 academic papers in publicly available domestic academic journals, of which more than 80 have been indexed by SCI, MED, or ISTP; 3 projects have been appraised as reaching an internationally advanced or domestically leading level. It has more than RMB 5 million in available research funding and has successively established long-term, stable cooperative relationships with renowned hospitals in the United States, Germany, Israel, Japan, South Korea, and other countries. More than 10 person-trips have been made abroad for study and academic visits, making positive contributions to the development of the discipline.

The department adheres to innovation and development in teaching practice. Relying on the National Demonstration Teaching Center for Basic Medicine, it was the first on campus to introduce multimedia teaching and bilingual teaching, achieving significant results. Taking advantage of the substantial strengths of a provincial key clinical discipline, doctoral program, and postdoctoral research station, it has pursued development diligently and made unremitting efforts, cumulatively training 2,500 undergraduate students, more than 300 master's students, and 15 doctoral students. It has hosted numerous continuing medical education courses at various levels, as well as national and provincial academic conferences and exchange activities. Three papers received the “Outstanding Bachelor's Thesis of Qingdao University” award. In recent years, several individuals have been named “Outstanding Graduate Student Supervisor of Qingdao University” and “Outstanding Teacher of Qingdao University,” among other honors.