A Study On The Diagnosis Value Of Noninvasive Cardiac Reserve Detection In Chronic Heart Failure

Objective: Based on the New York Heart Association functionalclassification (NYHA FC), six-minute walk test (6MWT), and leftventricular ejection fraction (LVEF) measurement, our study combined anoninvasive method for evaluating the cardiac reserve function (based on therelation between cardiac contractility and heart sound) to explore acomprehensive evaluation of chronic heart failure.Methods:136patients with chronic heart failure were enrolled asexperimental group.78male and58female were included in this study withthe average age of （62.20±12.39）years (ranged from50to85years).According to the cardiac function standard of NYHA,35patients were gradeⅠ,52patients were grade Ⅱ,36patients were grade Ⅲ,13patients weregrade Ⅳ.46healthy persons were enrolled as control group. There were nosignificant deference among age, sex, and BMI between experimental group and control group. LVEF and six-minute walk distance (6WMD) weremeasured by color Doppler echocardiography and6WMT, respectively,the ratio of diastolic to systolic duration (D/S ratio) was detected by a cardiacreserve detector, the diagnostic value of D/S ratio,6WMD and LVEF forchronic heart failure (CHF) was assessed, respectively.Results: D/S ratio, LVEF and6WMD were significantly lower inexperimental group than that in control group, respectively (P<0.05); D/S ratio was successively decreased with NYHA from FCⅠ t oⅣ (P<0.05).6MWD was successively decreased with NYHA from FC Ⅰt o Ⅲ (P<0.05). LVEF in NYHA Ⅳgroup was heavily lower than those in other groups (P<0.05). D/S ratio and6MWD had a negative correlation with NYHA FC, r=-0.659, P<0.01and r=-0.561, P<0.01， respectively, LVEF was positive correlation with NYHA FC (r=0.203, P<0.05). the areaunder the receiver operating characteristic(ROC) of D/S ratio in evaluation of chronic heart failure from NYHA FC Ⅰ to Ⅳ was0.84，0.80，0.95,1.00, respectively;95%confidence interval:0.74-0.94，0.70-0.91,0.00-1.00,0.00-1.00, respectively. The area under the ROC of6WMD in evaluation of chronic heart failure from NYHA FC Ⅰt o Ⅲ was0.64，0.92,0.98, respectively.95%confidence interval:0.50-0.79,0.86-0.99,0. 00-1.00, respectively. The area under the ROC of LVEF in evaluation of chronic heart failure from NYHA FC Ⅰ to Ⅳ was0.45,0.41,0.50,0.96, respectively.95%confidence interval:0.26-0.63,0.21-0.57,0.32-0.68,0.00-1.00, respectively.Conclusion: There was significant difference of D/S ratio betweenpatients with CHF and control group, D/S ratio was successively decreased with NYHA from FCⅠ t oⅣ. D/S ratio had a good correlation with NYHA FC, D/S ratio has a great value in diagnosis of patients withCHF, It can be a new effective index for diagnosis of chronic heart failure.