Discussing The Clinical Significance Of Monitoring Cardiac Reserve Function

ObjectiveCardiac reserve refers to the important ability that body against stress. The decline of Cardiac reserve increased risks of cardiovascular accidents. The lower of cardiac reserve is difficult to detect and also lack a reliable standard, which makes the early diagnosis of heart and pulmonary disease in patients delayed, missed the best time of treatment. This study is exploring a new way and new indexes to detect the cardiac reserve, aimed at evaluating the change trend of cardiac reserve of cardiac reserve indexes in normal crowd and formulating normal reference range and researching the relationship between cardiovascular risk factors and the cardiac reserve, and to discuss the clinical significance of this new method of cardiac reserve detecting.MethodUsing exercise cardiac reserve monitor developed by Chongqing Bojing Medical Information Research Institute to conduct this study. Combined with treadmill exercise to conduct phonocardiogram exercise test (PGCET) on objects of study, selecting objects includes two parts:1.select the normal population who are search for medical examination in the Gien outpatient service of Qilu Hospital during2011.9to-2012.3as healthy group, using the phonocardiogram exercise test to detect the cardiac reserve function and assess the change trend of cardiac reserve indexes in different age groups of normal crowd and formulating normal reference range of cardiac reserve indexes.2. Select the patients who are seeing doctor in the Gien outpatient service of Qilu Hospital during2011.9to-2012.3as sick group, who have diseases including clinical or imaging diagnosis of coronary heart disease, hypertension, diabetes and hyperlipidemia. Using the phonocardiogram exercise test to detect the cardiac reserve function and assess the change trend of cardiac reserve indexes in different age groups of normal crowd and formulating normal reference range of cardiac reserve indexes. Statistics related clinical material, gather clinical data of health group and sick group, use multiple linear regression to analysis the doubtful risk factors and cardiac reserve indexes, and discusses the relationship between cardiovascular risk factors and new cardiac reserve indexesResults1.CRI1have obvious difference between every age group of normal crowd. The result shows that the heart rate reserve reach the highest in30-39age group, and then decrease with age increasing.2. CRI2、CRI3、CRI don’t show any difference in each age group of normal crowd. Drawing linear figure shows that with age increasing, CRI2and CRI are increasing to the highest in30-39age group, and then decreasing; CRI3decreasing to the highest in30-39age group, and then increasing. 3. CRI1, CRI2, CRI3, CRI in Health group do not meet normal distribution, and n>100,using Percentile method to take bilateral95%reference range of CRI1, CRI2,CRI3is0.294～5.323、1.06～5.748、0.420～1.501respectively. Using Percentile method to take bilateral95%reference range of CRI is CRI>4.273.4. CRI1is obviously correlated with age only:the heart rate increasing degree decrease as age increasing.5. CRI2is influenced by coronary heart disease, age, gender, pulse pressure difference, reaching the standard athletic intensity or not, among them, having coronary heart disease, age increasing, increased pulse pressure difference, men are all lead to the decline of increasing degree of the amplitude of heart sounds, and keeping the standard athletic intensity weekly standard is the protection factor obviously.6. CRI3isn’t influenced by Disease factors, but is influenced by age, BMI, reaching the standard athletic intensity or not, among them, increased age, increased BMI can lead to the more shorten of the diastolic period, and keeping the standard athletic intensity weekly standard is a protection factor.7.CRI is influenced by age、DM history and reaching the standard athletic intensity or not. Among them, suffering DM is the most Adverse effect, the protection effect of increasing athletic intensity is secondary, and increased age still has adverse effect to the decline of CRI.Conclusion1. Phonocardiogram Exercise Testing has good feasibility in the evaluation function normal heart reserves, all participants in according to the requirements to cooperate to complete the experiment, sports in no serious adverse events.2. Heart rate reserve reaches the highest in30-39age group, and then decrease with age increasing.3. CRI1, CRI2, CRI3, CRI in Health group do not meet normal distribution, and n>100,using Percentile method to take bilateral95%reference range of CRI1, CRI2,CRI3is0.294～5.323、1.061～5.748、0.420～1.501respectively. Using Percentile method to take bilateral95%reference range of CRI is CRI>4.273.5. CRI1is obviously correlated with age only:the heart rate increasing degree decrease as age increasing.6. Increasing degree of the amplitude of heart sounds is influenced by coronary heart disease, age, gender, pulse pressure difference, reaching the standard athletic intensity or not, among them, having coronary heart disease, age increasing, increased pulse pressure difference, men are all lead to the decline of increasing degree of the amplitude of heart sounds, and keeping the standard athletic intensity weekly standard is the protection factor obviously.7. CRI3isn’t influenced by Disease factors, but is influenced by age, BMI, reaching the standard athletic intensity or not, among them, increased age, increased BMI can lead to the more shorten of the diastolic period, and keeping the standard athletic intensity weekly standard is a protection factor8. CRI is influenced by age、DM history and reaching the standard athletic intensity or not. Among them, suffering DM is the most Adverse effect, the protection effect of increasing athletic intensity is secondary, and increased age still has adverse effect to the decline of CRI.9. Increased age causes decline of HR reserve, cardiac contraction force reserve and Diastolic blood perfusion time reserve comprehensively, which led to the decline of cardiac reserve. Improving the exercise intensity function appropriately increases myocardial contraction force and relative extends diastolic blood perfusion time to protect the heart reserve.