The Prediction Of Prognosis Of The Acute Left Heart Failure (ALHF) Patients In The Hospital By The Dynamic Observationes Of Serum BNP Levels And ECG

Objective:To investigate the value of the serial observationes of serum BNP levels,QRS prolongation and QTc duration on standard ECG in predicting the prognosis of the acute left heart failure(ALHF) patients in the hospital.Methods:Serum B-type natriuretic peptide(BNP)levels,QRS and QTc duration on 12-lead ECG were measured at baseline,after 24 and 72 hours in 221 consecutive patients with ALHF.The descending rates of BNP,QRS and QTc duration between different time points were calculated..The left ventricular end- diastolic diameter(LVEDD) and the left ventricular ejection fraction(LVEF) were measured by echocardiography.The patients were divided into three groups according to NYHA class when the patients left hospital:well-prognosis group (NYHA improved>â…¡),poor-prognosis group(NYHA improved<â… ) and death group.Then the correlative indexes for different diagnosis of ALHF were analyzed by logistic regression.The death risk for the patients was analyzed by ROC curve.Results:1,Serum BNP levels at three measuring points showed a significant downward trend in the patients among three groups.There was a statistically significant difference in the descending rate of BNP level between the groups.The rate of decline was as follows: well-prognosis group>poor-prognosis group>death group.2,There was a statistically significant difference in serum BNP levels at the same point in the patients between both of the groups.3,Dynamic observation at three measuring points demonstrated QRS duration and QTc interval were statistically significant downward trend in a good prognosis group;and there was no obvious difference in poor prognosis group or death group.4,Regression analysis showed that four variables:BNP3,RATE_BNP3, RATE_QRS3 and RATE_QTc3,had a statistically significant effect on the prognosis in the patients with acute left heart failure.The higher the level of BNP3 plasma and the smaller rate of decline RATE_BNP3,RATE_QRS3 and RATE_QTc3,the higher the risk of death.5,ROC curve showed the four variables had better diagnostic sensitivity and specificity for prognosis of ALHF.Conclusions:BNP3,RATE_BNP3,RATE_QRS3 and RATE_QTc3 had a good predictive value for prognosis of patients with ALHF.