Abstract: Objective  To explore the abnormality of top-down and bottom-up attention patterns in patients suffering from coronary heart disease (CHD) patients with heart-qi deficiency syndrome based on the theory of “five spirits”. Methods  From July 2024 to December 2024, 30   CHD patients with heart-qi deficiency syndrome were recruited, and 30 subjects without CHD  as the control group according to the principle of matching age, sex and years of education. Two groups of subjects were tested with top-down and bottom-up spatial cueing paradigm. Results  Compared with the control group, CHD patients  with heart-qi deficiency syndrome had longer valid reaction time(vRT) and lower average reaction time difference value  (△RT) in top-down test (P<0.05), and longer vSRT in bottom-up test. Correlation analysis showed that heart-qi deficiency syndrome score was positively correlated with top-down test indexes invalid reaction time (ivRT) (P<0.05)， negatively  correlated with △RT (P<0.01) and valid accurany（vAC ）(P<0.05). It was positively correlated with valid long reaction time (vLRT) (P<0.01) and invalid long reaction time (ivLRT) (P<0.01). Generalized linear model analysis showed that non-CHD subjects had shorter vRT (P<0.01) and larger △RT (P<0.05) than CHD patients for top-down test. For bottom-up tests, non-CHD subjects had shorter vSRT than CHD patients (P<0.05). Conclusion  The change of top-down and bottom-up attention patterns in CHD patients  with heart-qi deficiency syndrome provides a modern neuropsychological basis for the theory of “heart stores spirits ”.

Key words: heart-qi deficiency syndrome, coronary heart disease, top-down, bottom-up, attention