Coronary Angiographic Features In Patients With Coronary Heart Disease And Heart Failure Correlative Analysis Of Cardiac Function

Objective: To explore the relationship between coronary angiography and cardiac function in patients with coronary heart disease complicated with different types of heart failure.Provide a basis for the prevention and treatment of such patients.Methods: Using retrospective analysis methods.Taking "coronary heart disease" and "heart failure" as the search terms,the electronic medical record system of the First Affiliated Hospital of Guangxi Medical University was reviewed.The medical records of patients with coronary heart disease and heart failure who were hospitalized in the Department of Cardiology of our hospital from January 01,2017 to June 30,2018 were collected.After screening by inclusion criteria and exclusion criteria,112 patients were eventually enrolled.According to the patient's left ventricular ejection fraction(LVEF)values,the heart failure(HFrEF)group with reduced ejection fraction,the heart failure(HFmrEF)group with median ejection fraction,and the heart failure(HFpEF)group with ejection fraction retention.All data were statistically analyzed by SPSS 21.0 software.Compare the basic data of three groups ofpatients [age,gender,smoking history,comorbidities(hypertension,diabetes),NYHA cardiac function grading,NT-proBNP] ? Echocardiographic indicators[LVEF,left atrial diameter(LAD),left ventricular end-sectional diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),SV,CO] ?Characteristics of coronary angiography(number of coronary lesions,Gensini score);Correlation between coronary angiographic features and cardiac function was analyzed for each group of patients.Results:There were 112 patients with coronary heart disease complicated with heart failure in this study,including 30 patients in the HFrEF group,40 patients in the HFmrEF group,and 42 patients in the HFpEF group.1.There were significant differences in NYHA cardiac function grading between the three groups(P<0.01),NYHA(Class ? and ?)in the HFrEF group,and NYHA(Class ? and ?)in the HFmrEF group.In the HFpEF group,NYHA(Class ?,Class ?)accounted for a relatively high proportion.There were significant differences in NT-proBNP levels between the three groups(P<0.01).NT-proBNP was highest in the HFrEF group and lowest in the HFpEF group,and the HFmrEF group was between the two groups.The gender and smoking history of the patients in the three groups were different(P<0.05),and pairwise comparison among the three groups showed that the male proportion and smoking history in the HFmrEF and HFrEF groups were higher than those in the HFpEF group(P<0.0167).There was no difference in age,comorbidity(hypertension,diabetes)among the three groups(P>0.05).2.Echocardiography:there were differences in left ventricular end diastolic dimension,left ventricular end systolic diameter,left atrial diameter,and CO between the three groups(P<0.05).Pairwise comparison among the three groups: there were significant differences in left ventricular end diastolic dimension and left ventricular endsystolic diameter between the two groups,among which HFrEF group was the largest,HFmrEF group was the second,and HFpEF group was the smallest.In addition,the left atrial diameter and CO of the HFmrEF group were larger than those of the HFpEF group.3.Coronary angiographic characteristics: the number of coronary artery lesions was different among the three groups(P<0.05),the proportion of multi-vessel lesions was higher in the HFrEF group,the proportion of single-vessel lesions was higher in the HFpEF group,and the number of coronary artery lesions was basically balanced in the HFmrEF group.The Gensini scores of patients in the HFrEF group,HFmrEF group and HFpEF group were 63.45±35.60?53.39±30.12?35.37±28.84,respectively,with statistically significant differences(P<0.05)and pairwise comparisons between the three groups.4.correlation analysis: Gensini integral and NT-proBNP,NYHA classification,LVEF,SV,CO Spearman correlation analysis,Gensini integral and LVEF were negatively correlated,and NT-proBNP,NYHA classification was positively correlated(P<0.05).Further multiple linear regression analysis showed that Gensini score was negatively correlated with LVEF and positively correlated with NYHA classification(P<0.05).Conclusion: Patients with coronary heart disease and different types of heart failure have different degrees of coronary artery disease.The coronary artery of patients with coronary heart disease and HFrEF is more common with multi-vessel disease.The more severe and complicated the coronary artery disease,the higher the grade of NYHA cardiac function.The coronary artery of patients with coronary heart disease and HFpEF is more common with single-vessel disease.