The Clinical Diagnostic Value For Heart Function Of Patients With Valvular Heart Disease With Series Of Parameters Of Echocardiography

Objective:This article aims to evaluate synthetically the diastolic and systolic function of patients with valvular heart disease, applying heart failure echocardiography index (HFEI) that synthesizes the multinomial parameters of echocardiography, and to discuss the effect that the factors of valve has on cardiac function.Methods:Prospectively we studied 107 patients with valvular heart disease, of which 68 patients'left ventricular ejection fraction(LVEF)≥50% and the rest of them LVEF<50%, 37 normal controls, and 35 heart failure that is not caused by valvular heart disease. All the subjects were scored by HFEI, graded by NHYA and measured by simultaneously BNP and Tei respectively. The details are as follows: 1. Analyzing the sensitivity, specificity, positive predictive value and negative predictive value of HFEI, as a brand new indicator, in patients with valvular disease. 2. Analyzing the correlation between HFEI and NYHA class. 3. Analyzing the correlation between HFEI and BNP. 4. Studying the correlation of BNP with echocardiographic parameters. 5. Exploring the influence that the valve factor on the whole heart function at different stages of valvular heart disease.Results:1. The HFEI was significantly higher in valvular heart disease group than that in control group (p<0.00). When HFEI≥3, the sensitivity, specificity, positive predictive value and negative predictive value of HFEI for diagnosing heart failure in patients with chronic AF were 94.2%, 87.8%, 95.6% and 72.7% respectively. 2. HFEI increased with the worsened NYHA class (p<0.05). According to Spearman correlation, there was remarkable positive correlation between HFEI and NYHA class, which was higher than that of LVEF or Tei.3. There was remarkable positive correlation between HFEI and LgBNP by Spearman correlation.4.There was remarkable correlation between LgBNP and the multinomial parameters of echocardiography which reflected the cardiac systolic and diastolic function, in the multiple stepwise regression analysis, only LVEF, LVDd,PAP,valve factor were independent correlative makers for LgBNP in valvular heart disease group.5. The valvular heart disease group was grouped into two subgroups: one with LVEF<50% and the other with LVEF≥50%. Compared to the latter, LAD and LVDd was dilated obviously, HFEI and BNP were increased, the proportion of NHYAⅢandⅣwere enlarged significantly in the former (p<0.05). When the two subgroups were contrasted to their control groups, there was remarkable positive correlation between HFEI and LgBNP, which was higher than that of LVEF or Tei.Conclusion:It is feasible to evaluate the global heart function of patients with valvular heart disease applying HFEI. There was higher correlation of HFEI with NYHA class or BNP than that of LVEF or Tei with them.