Study On The Relationship Between Blood Homocysteine And Ventricular Premature Beats In Patients With Chronic Heart Failure

Objective: Measuring cardiac function in normal group、the normal cardiac function without premature ventricular premature beat group、without ventricular premature beat but chronic heart failure and chronic heart failure patients with ventricular premature beat group of blood homocysteine(Hcy)levels,preliminary discussion of ventricular premature beat(hap)in patients with chronic heart failure and the relationship between blood Hcy levels,exploring in patients with heart failure risk predictors of ventricular arrhythmias.Methods: From December 2016 to January 2018,135 patients who were admitted to the department of cardiology and outpatient department of the department of cardiology of fenyang hospital of Shanxi Province due to chest tightness,shortness of breath,edema of lower limbs and other uncomfortable symptoms were successively collected,based on 24 hours dynamic electrocardiogram test results,it can be divided into the following three groups:chronic heart failure and ventricular premature beat group 45 cases(group A)and chronic heart failure group(group B)47 cases without ventricular premature beat,ventricular premature beat group without heart failure(group C)43 cases,During the same time,45 patients with no heart failure and no ventricular premature beat(control group D)were continuously collected who take for health examination and 24-hour dynamic examination.The patients with chronic cardiac dysfunction were selected from class III-IV according to the functional classification(NYHA).All patients were enrolled in general clinical data,complete the blood test and cardiac ultrasound examination,and recorded the left ventricular ejection fraction(LVEF),left ventricular diastolic inner diameter(LVDd).Patients were selected for 24-hour electrocardiogram and recorded the frequency of PVC(BPM).Statistical methods to analysis using SPSS 23.0 software package,and P <0.05 was considered statistically significant,the selection of measurment data obey the normal distribution using single factor analysis of variance,and LSD was compared between groups,measurment data do not obey normal distribution with two independent sample card square test to compare difference.The relationship between Hcy level and ventricular premature beats,LVEF,LVDd and other indicators was analyzed by Person.Multivariate analysis was performed using binary Logistic regression.To e valuate the predictive value of Hcy level for ventricular premature beats in patients with chronic heart failure,and to select ROC curve analysis.Results: 1.Four groups of patients in the general clinical data,related to a blood test to compare: age,gender,BMI,smoking history,drinking history,history of coronary heart disease,hypertension and type 2 diabetes,K +,Na +,Ca 2+,FBG,LDL,HDL,TC,TG,CK,CK-Mb,LDH comparison differences have no statistical significance(P > 0.05).2.Blood Hcy levels of group A(26.57 ± 2.86)umol/L > group C blood Hcy levels(22.10 ± 3.12)blood Hcy umol/L > group B(19.54 ±1.79)umol/L > group D blood Hcy levels(13.47 ±1.48)umol/L,group A compared with group B,C,D of LSD was statistically significant difference(P < 0.05),group B and C compared with group D of LSD,the difference was statistically significant(P < 0.05),group B compared with group C of LSD,there was no statistically significant difference(P > 0.05).3.LVEF(%)of group A(26.57 ± 2.86)< LVEF(%)of group B(46.02 ± 11.08)< LVEF(%)of group C(63.04±5.55)< LVEF(%)of group D(67.61± 5.19),group A compared with group B,C,D of LSD was statistically significant difference(P < 0.05),group B compared with group C and D of LSD,the difference was statistically significant(P < 0.05),group C compared with group D of LSD,there was no statistically significant difference(P > 0.05).4.Group A LVDd(56.21±6.85)mm > group B LVDd(50.59±6.87)mm> group C LVDd(48.34± 5.10)mm > group D LVDd(46.44 ±4.24)mm,group A compared with group B,C,D of LSD was statistically significant difference(P < 0.05),compared between group B,C,D,there was no statistically significant difference(P > 0.05).5.Blood Hcy level was positively correlated with the number of premature beats(BPM)(r=0.821,P=0.000),and the difference was statistically significant(P < 0.01).The blood Hcy level was negatively correlated with LVEF(%)(r=-0.374,P=0.011),and was positively correlated with LVDd(mm)(r=0.510,P=0.000),and the difference was statistically significant(P < 0.01).6.In the case of chronic heart failure combined with ventricular premature beat group,the area under ROC curve of serum Hcy was 0.722,95% confidence interval 0.532 to 0.911,which was statistically significant(P < 0.05).Conclusion: The level of Hcy in blood is closely related to ventricular premature beats in chronic heart failure.This indicates that Hcy is a risk factor for ventricular premature beats in heart failure.