| Objectives Fundamental etiologies and clinic characteristics of patients with different types of chronic heart failure(CHF), including reduced and preserved ejection fractions.Level of NT-pro-BNP and multiple organ dysfunctions like hepatorenal dysfunctions were evaluated. Besides, associations between level of NT-pro-BNP and hepatorenal dysfunctions were discussed.Methods Firstly, CHF patients hospitalized in the North China university of science and technology affiliated hospital from June 2013 to October 2014 were selected as respondents through retrospective studies. According to inclusion and exclusion standards,284 patients were included in this study to record their clinic characteristics respectively when they were firstly admitted by the hospital, including general information,fundamental etiologies of diseases, combined diseases, clinic manifestations, laboratory indicators and results of ultrasonic cardiograms. Secondly, patients selected were divided into two groups based on LVEF to comparatively analyze their fundamental etiologies of diseases, clinic characteristics, level of NT-pro-BNP, blood-lipid level, blood glucose level and hepatorenal functions. Besides, multiple organ dysfunctions such as hepatorenal dysfunctions and renal insufficiency were assessed. Thirdly, a database was constructed in this study with Epidate, and data were analyzed by statistical software known as SPSS17.0.All measurements of normal distribution were indicated in the form of mean ± SD.Independent-samples T tests were conducted between two groups, while one-way ANOVAs were performed among multiple groups. The measurements were indicated by percentage(%). X tests and Mann-Whitney U tests were carried out for inter-group comparison, while the results were presented like M(Q1-Q3). In analyzing correlations,Pearson correlation coefficients were used for multivariate linear stepwise regression analysis. It meant that the difference was statistically significant as long as the value of P was below 0.05 on both sides.Results 1. Among 284 CHF patients whose mean age was within 66.92±12.25, there were 152 males(53.56%) and 132 females(46.5%). They were divided into two groups,including HF-REF Group where there were 148 cases(52.1%) and HF-PEF Group where there were 136 cases(47.9%). 92 patients(62.6%) were male in the former group, where patients’ mean age was within 66.20±11.54, and 60 patients(44.1%) were male in the latter group, where the mean age was within 67.69±12.93. Concerning grading of cardiac functions, there were 26 II grade(9.2%), 124 III grade(43.7%) and 134 IV grade(47.2%) cases. 2. After analysis, coronary heart disease(206 cases, 72.5%) and hypertensive heart disease(44 cases, 15.5%) were found to be fundamental etiologies ofCHF. Besides, it would be caused by others, such as myocardial disease(18 cases, 6.3%),valvular vitium(14 cases, 4.9%) and congenital heart disease(2 cases, 0.7%). Combined diseases such as old myocardial infarction(152 cases, 53.9%), hypertension(209 cases,73.6%) and diabetes(146 cases, 51.4%) were etiologies of CHF as well. There were 114(77.0%) and 92(67.6%) cases with coronary heart disease in the HF-REF Group and the HF-PEF Group respectively(P>0.05). 16(10.8%) and 28(20.6%) cases with high altitude heart disease were found in the HF-REF Group and the HF-PEF Group respectively(P<0.05). 3. The median level of NT-pro-BNP was 9377.23(5784.72~19579.73) in the former group, and 1714.25(197.48~3562.87) in the latter group(P<0.05). 4. Among patients with multiple organ dysfunctions, there were 41patients(14.4%) with hepatic dysfunctions and 146 cases(51.4%) suffering from renal insufficiency. 19.6% and 59.5% of patients suffered from hepatic dysfunctions and renal insufficiency respectively in the HF-REF Group, but 18.8% and 26.4% respectively in the HF-PEF Group(P<0.05). The levels of Cr, BUN, TBIL, DBIL, ALT and AST were higher in the HF-REF Group, whereas the levels of ALB and GFR were higher in the HFPEF Group(P<0.05). Pearson correlation analysis was conducted by considering level of NT-pro-BNP as dependent variable and hepatorenal function indicators as independent variables. Level of NT-pro-BNP was found to be positively correlated to levels of TBIL,ALT, AST and Cr(P<0.05), but had negative correlations with level of GFR(P<0.05).By analyzing all indicators through multivariate linear stepwise regression, level of NTpro-BNP was discovered to be positively correlated to levels of TBIL and Cr(P<0.05).Conclusions First of all, the most fundamental etiology of patients with different types of CHF was coronary heart disease, followed by hypertensive heart disease. Secondly,level of NT-pro-BNP was higher in the HFREF Group than that in the HF-PEF Group. In the former group, there was a higher possibility of hepatorenal dysfunctions and renal insufficiency. Thirdly, it was somewhat valuable for evaluating severity of heart failure with TBIL and Cr. |
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