BNP, Lvef Value Correlation Between TCM Syndromes And Heart Failure

Purpose:to discuss the change rule between the different TCM symptom types in congestive heart failure( CHF)patients and the cardiac function index(NYHA class,LVEF value and BNP value), and to study whether the cardiac function index has referential value in dialectical type of heart failure.Methods:Through the retrospective investigation of 104 cases of illness that conformed to the inclusion criteria among the hospitalized patients in cardiovascular wardⅠof affiliated hospital of LNUTCM during 2008-12 to 2009-12, the database was set up after gathering the materials including symptom, physical sign and laboratory inspection results, etc. from the cases for data management. According to the TCM symptom classification, the cases were classified into six groups: syndrome of qi deficiency, blood stasis and stagnant water; syndrome of qi deficiency of heart and lung and blood stasis, etc. The numerical data was analyzed by statistical analysis such as variance analysis.Results:1. The evolution of TCM syndromes of heart failure: as the syndrome progressed from syndrome of qi deficiency, blood stasis and stagnant water, syndrome of qi deficiency of heart and lung and blood stasis, syndrome of deficiency of both qi and yin, syndrome of yang deficiency, syndrome of pathogenic water attacking heart to syndrome of sudden loss of heart yang, the disease was gradually deteriorating. Clinical syndromes of heart failure mainly consist of syndrome of deficiency of both qi and yin, syndrome of yang deficiency and syndrome of pathogenic water attacking heart.2. The syndromes of heart failure are closely related with BNP values and LVEF values. As the TCM symptom types change from light to serious, BNP values increase accordingly, while LVEF values correspondingly decline (P <0.05 or 0.01). And the relationship of symptom types with cardiac function classification is not significant (P>0.05).3. BNP values and LVEF values are significantly different (P <0.05or 0.01) among groups with different cardiac function levels, and with the increased level of heart failure, BNP values increase accordingly while LVEF values are significantly lower.4. LVEF values are a negative correlation with BNP values, but the way of correlation is not strong (R2 was 0.175, Pearson R was 0.419). This study does not support the results of BNP values predicted by LVEF values.Conclusion:1. The evolution of TCM syndromes of heart failure: as the syndrome progressed from syndrome of qi deficiency, blood stasis and stagnant water, syndrome of qi deficiency of heart and lung and blood stasis, syndrome of deficiency of both qi and yin, syndrome of yang deficiency, syndrome of pathogenic water attacking heart to sudden loss of heart yang syndrome, the disease was gradually deteriorating. As the TCM symptom types change from light to serious, BNP values increase accordingly, while LVEF values correspondingly decline. The relationship of symptom types with cardiac function classification is not significant. All the above shows that the BNP and LVEF have referential value in dialectical type of heart failure.2. Along with the progress from NYHAⅡto NYHAⅣ, BNP values increase significantly and show a positive correlation, but LVEF values are significantly lower and show a negative correlation. LVEF values are a negative correlation with BNP values, but the way of correlation is not strong. The study does not support the results of BNP values predicted by LVEF values.