Study About Uremic Cardiomyopathy Left Heart Function In Patients With Diastolic Heart Failure As Evaluation To Measure MPI And NT-proBNPOF Blood Plasma By QTVI

ObjectiveTo apply QTVI to measure time period of different positions in left ventricular mitralvalve ring the office wall, and calculate MPI to evaluate partial and overall myocardialfunctions, meanwhile to combine NT-proBNPof blood plasma level to scientificallyevaluate left heart function for uremic myocardioparthy cardiomyopathy in patients withdiastolic heart failure, this will provide a new testing way and theoretical basis to instructclinical therapy and improve prognosis.MethodsTo detect bood plasma level of NT-proBNPwhich were from33patients with Uremicmyocardioparthy in Kidney disease internal medicine of my hospital, in the meantimecombined ultrasonic cardiogram and clinical manifestation to diagnosis diastolic heartfailure, and campared with30persons who were as the control grouPfor detecting. Wemeasured two groups (case-control) in2-D model including left atrial diameter (LAD), leftventricular dimension（LVd), interventricular septum (IVS), left ventricular posterior wallthickness (LVPW), and measured left ventricular ejection fraction(LVEF) by biplaneSimpson’s method, and E peak speed of mitral valve mouth early diastolic by spectraldoppler, to calculate E/A ratio. We also detectedE’ value by tissue Doppler imaging, tocalculate E/E’ratio. Imultaneously differently displayed movement curve of side wall,posterior the interval, inferior wall, anterior wall, back wall of left ventricular mitral valvering by TVI model. Meantime measuring isovolumetric contraction time(ICT), isovolumicrelaxation time (IRT), ejection time(ET) and calculated part and whole myocardial functionindex, namely MPI=(ICT+IRT)/ET, with comprehensive assessment Uremicmyocardioparthy cardiomyopathy in patients with diastolic heart failure. Results(1) Compared with control group, uremic myocardioparthy cardiomyopathygrouPSBPwas(136±26mmHg VS108±20mmHg), the level heighten significantly(p<0.01); DBPwas (88±15mmHg VS76±11mmHg); HR was (79±12per/min VS60±7per/min), the level increased (p<0.05); creatinine (SCR) was (711.6±305.8μmol/L VS54.6±12.3μmol/L), urea nitrogen(BUN) was (36.4±12.5mmol/L VS4.1±2.8mmol/L),the level rose, too (p<0.01).(2) Compared with ultrasonic cardiogram：Comparing with normal control grouP, LAdvalue built uPfor uremic myocardioparthy cardiomyopathy patients of33cases. IVSthickening24cases, differences between the two groups all were significant (P<0.01); LVdincreased12cases, LVPW thickening9cases, differences between the two groups all weresignificant(P<0.05). There were33patients in uremic myocardioparthy cardiomyopathygroup, E/A ratio of18-cases was more than1and E/E’was less than8, pointed out impairedleft ventricular relaxation, E/A ratio of15-cases was more than2and E/E ratio was greaterthan8, differences between the two groups all were significant (P<0.05). And to compareuremic myocardioparthy cardiomyopathy with normal control grouPequally was more than50percents, there was no statistical significance (p>0.05).(3) Comparastion of Myocardial function index (MPI) with left heart function: tocompare with normal control group, IRT left ventricular mitral valve ring6loci ofmyocardioparthy cardiomyopathy grouPextent obviously (p<0.01), ICT equallylengthen(p<0.05), and ET even shorted (p<0.05), MPI rose obviously(p<0.01), promptedleft ventricular regional myocardial diastolic function damage of myocardioparthycardiomyopathy group; mean of left ventricular whole myocardial performance index ofmyocardioparthy cardiopathy grouPwas（0.69±0.27VS0.46±0.15）obviously enhanced(p<0.01), prompted left ventricular myocardial diastolic as a whole and Systolic function isdamaged. Uremic cardiomyopathy in patients with left ventricular relaxation damagegrouPand left ventricular restrictive filling disorder grouPIRT and ICT extension of thetrend, ET shorted tendency and MPI increased tendency, but there was no statistcalsignificance between two groups.(4) Comparation of blood plasma NT-proBNP: To compare with normal control group,uremic myocardioparthy grouPwas (1134.65±821.79pg/ml VS40.57±21.53pg/ml)，obviously rose (p<0.01). Blood plasma NT-proBNPof uremic cardiomyopathy in patientswith impaired left ventricular relaxation grouPwas（998.34±685.59）pg/ml, left ventricular restrictive filling grouPlimited grouPwas（1180.75±673.68）pg/ml, there was obviouslyincreasing (p<0.01).Conclusion(1) Uremic cardiomyopathy patients in early stage could result in cardiac structuralabnormality, especially left atrial enlarged ventricular septal thickened obviously.(2) Myocardial performance index was index of ultrasonic cardiogram, the evaluationof Uremia heart diastolic heart failure of the left cardiac function showed in early stage leftheart function damage, and the main part was left ventricular diastolic dysfunction. Alongwith progression of disease, and diastolic function aggravated, in the meantime function ofcontraction of varying degrees reduced.(3)There were a lot of symptoms of heart failure, for example dyspnea, turemicmyocardiopathy patients clinically, and blood plasma was increased, that could be asbiochemical markers of diastolic heart failure.(4) Left ventricular function of uremic cardiomyopathy in patients with diastolic heartfailure would be judged accurately, measured MPI by QTVI rapidly, qualitatively,quantitatively. Lots of advantages including user-friendly control, noninvasive and operationrepeatability, there was a good positive correlation with blood plasma NT-proBNPlevel,could instruct therapy clinically by the two combined, and improved one kind of detectionmeans and theoretical foundation, which provided strong practical value.