Clinical Research About Dependability Between Serum Cardiac Troponin I And Myocardial Remodeling And Its Influence To Prognosis In Patients With Chronic Heart Failure

Objective: To investigate the correlation between serum cardiac troponin I and myocardial remodeling in patients with chronic heart failure, to approach clinical significance of serum cTnI level to prognosis inveatimation , to observe the difference of serum cTnI level,LVEDd and LVEDD in diffecent disease .Methods: Onc hundred and twenty–six patients with decompensated chronic heart failure were included.According to the thickness of serum cTnI , the patients were divided into cTnI normal group(cTnIn,n=68)and cTnI elevated group(cTnIe,n=60), left atrial dimension(LAD),left ventricular end diastolic diameter(LVEDD),interventricular septem thickness (IVST),left ventricular posterior wall thickness(LVPWT),left ventricular mass(LVM)were looked as the index of heart sructural change , left ventricular ejection fraction(LVEF),shortening fraction(FS),cardiac output (CO),stroke volume (SV) were regard as the index of heart function change ,to compare above-mentioned indexes between two groups ;to analyze correlation between serum cTnI and above-mentioned indexes ,Bivariate correlation analysis was applied to show the correlation of serum cTnIlevel with above indixes. Partial correlation analysis was performed followed by multivariate linear regression analysis;to follow-up visit clinical prognosis of two groups . According to the cause of a disease , the patients were divided into dilated cardiomyopathy group(CDM,n=53),coronary artery disease/coronary heart disease group(CAD/CHD,n=49),high blood pressure group(HBP,n=26) ,to compare cTnI,LVEDd,LVEF among three groups . 167 patients with CHF were grouped asⅡclass,Ⅲclass,Ⅳclass accordind to NYHA grading method , to analyze the diffence of cTnI level among three groups.Result: comparing with cTnI normal group , LAd,LVEDd in cTnI elevated group were obviously higher(P<0.05), LVPW,IVS,LVM,LVEF,FS in cTnI elevated group were significantly lower(P<0.05), and CO,SV were not statistical difference(P>0.05) . correlation analisis showed that serum cTnI was positively correlated with LAd LVd and inversely correlated with LVPW,IVS,LVM,LVEF,FS(P<0.05), correlation analisis also showed that serum cTnI was not correlated with CO,SV. The correlation persistent after adjustion with lasting time of heart failure,NYHA functional class and treatment. In multivariate regression modeling cTnI was positively associated with LAd LVd and the history of heart failure, and negatively related with the treatment with angiotcnsin-converting enzyme andβreceptor lock praeparatum . Follow-up visiting result showed that patients in cTnI elevated group had worse prognosis than patients in cTnInormal group . cTnI,LVEDd,LVEF were not statistical difference(P>0.05) among three groups.Conclusion:1 Scrum cTnI correlated with cardiac structure and function ,the correlation existing did not depend on lasting time of heart failure,NYHA functional class and treatment , and cTnI was positively associated with LAd LVd and the history of heart failure, and negatively related with the treatment with angiotcnsin-converting enzyme andβreceptor lock praeparatum .2 Etiopathogenisis of heart failure was not relative with cTnI,LVEDd,LVEF .3 The serum cTnI can be applied to estimate clinical feature and prognosis of patients with heart failure.4 cTnI,LVEDd increase and LVEF declince can reflect clinical cardiac functional grading .