Research On The Characteristics Of Impulse Cardiogram Of Different TCM Syndromes In Chronic Heart Failure And Its Correlation With Heart Function

Heart failure is the severe or terminal period of various heart diseases,which severely impacts the qulity of patients' life.In recent years,with the growing prevalence of coronary heart disease and hypertensive disease,the component radio of HF has changed in our country.The quotients of coronary heart disease and hypertensive disease are raised.By the improvement of medical care,average lifetime is lengthened.The prevalence of HF is high in old people.When prevalences of coronary heart disease and hypertensive disease are raised year by year,it makes HF patients more.It is estimated that it has 4.5million HF patients in our country.With so many HF patients,it is vital to assess the patients' condition quickly and accurately,then give the effective treatment.TCM has certain characteristics and advantages in the treatment of HF.The research on the objectification of TCM syndromes is also being carried out actively.The measures are used recently to evaluate the cardiac function and make TCM syndrome objective,which are New York heart function classification,natriuretic peptide,echocardiography and hemodynamic monitoring.The measures have its application and shortcoming.When the technology is advanced,the ballistocardiogram which combined with modern sensor technology is researched by medical physicist.In the previous studies,the ballistocardiogram could detect heart rate.RJ period may predict the prognosis of HF patient.RJ period also had some correlation with TCM syndrome.Based on the studies,the research aims to find the rules between the main index of ballistocardiogram and TCM syndrome.We tries to find a new way to evaluate cardiac function and make TCM syndrome objective.Objectives:1.Find the difference of the main index(H,I,J,K.tHI,tIJ,tJK)of ballistocardiogram between HF patients and non-HF patients.Explore the rules in the main index about HF patients.2.Find the difference of the main index(H,I,J,K,tHI,tIJ,tJK)of ballistocardiogram between different TCM syndromes.Try to find a new way to make TCM syndrome objective3.Find the correlation between NYHA classification,NT-proBNP,LVEF and the main index of ballistocardiogram,TCM syndromes.Methods:The participants were the patients in department of cardiology or CCU in Dongfang Hospital Affiliated to BUCM,from June 2019 to January 2020.According to the inclusion and exclusion criteria,there were 111patients whose were diagnosed HF.At the same time,30 non-HF patients were included for control.Two doctors with the title of deputy director or above in the department diagnosed the patients according to the diagnostic criteria of chronic heart failure,and according to the inclusion and exclusion criteria,the qualified patients were included in the chronic heart failure group and non-heart failure group.The patients in the chronic heart failure group were divided into 6 TCM syndrome groups by two doctors with the professional title of at least one Chinese medicine or the deputy director of integrated traditional Chinese and western medicine.They were cardiopulmonary qi deficiency syndrome,Qi and Yin deficiency syndrome,deficiency of heart and kidney Yang syndrome,deficiency of qi and blood stasis,extensive syndrome of Yang deficiency and water,phlegm turbidity obstruction lung syndrome,respectively,et al.Collected the general information,NT-proBNP,echocardiography and ballistocardiogram of the patients in groups.Filled the clinical report forms.And organized the data,then analyzed the data with SPSS 20.0.Results:1.The research had included 144 patients,111 patients had HF,30 patients had non-HF.The age and gender distribution had no differences between HF group and non-HF group.2.There were obvious dfferences in HF group and non-HF group about the H,tHI,tJK.There was no difference about I,J,K and tIJ in two groups.3.In HF group,the H related with the change of TCM syndromes.When the H was from small to large,the TCM syndromes changed by Cardiopulmonary qi deficiency syndrome,Deficiency of heart and kidney Yang syndrome,Deficiency of qi and blood stasis,Qi and Yin deficiency syndrome,Extensive syndrome of Yang deficiency and water,Phlegm turbidity obstruction lung syndrome.The H of Phlegm turbidity obstruction lung syndrome group was significantly larger than Qi and Yin deficiency syndrome group,Deficiency of qi and blood stasis group,Cardiopulmonary qi deficiency syndrome group and Deficiency of heart and kidney Yang syndrome group.TCM syndromes had general positive correlation with the H(r 0.248,P<0.05).There was no difference about I,J,K,tHI,tIJ,UK in TCM syndromes.4.There were significant differences in the H between different NYHA classifications.Compared with the H of NYHA ? and NYHA ?,?,the difference was statistically significant.Compared NYHA ?,NYHA ?,with NYHA ?,Hs were significantly different.The H had general positive correlation with NYHA classifications(r=0.250,P<0.05).The H increased with the increase of heart function level.5.The distribution of TCM syndromes differed between different levels of cardiac function.NYHA ? were mainly Cardiopulmonary qi deficiency syndrome;NYHA ? were mainly virtual syndromes like Deficiency of heart and kidney Yang syndrome,Qi and Yin deficiency syndrome,and Cardiopulmonary qi deficiency syndrome.NYHA ? were mainly Deficiency of qi and blood stasis.NYHA ? were mainly Extensive syndrome of Yang deficiency and water.The TCM syndromes and NYHA classifications had a high positive correlation(r=0.609,P<0.05).6.The difference of NT-proBNP between the groups of different TCM syndromes was significant,and the order of the changes of NT-proBNP concentration from low to high among the groups of TCM syndromes was Cardiopulmonary qi deficiency syndrome<Deficiency of heart and kidney Yang syndrome<Qi and Yin deficiency syndrome<Deficiency of qi and blood stasis<Phlegm turbidity obstruction lung syndrome<Extensive syndrome of Yang deficiency and water.The TCM syndromes and NT-proBNP had a high positive correlation(r=0.457,P<0.05).7.The LVEF of different TCM syndrome groups were significantly different.The order of change of LVEF values from high to low in each syndrome group was Cardiopulmonary qi deficiency syndrome>Deficiency of heart and kidney Yang syndrome>Qi and Yin deficiency syndrome>Deficiency of qi and blood stasis>Phlegm turbidity obstruction lung syndrome>Extensive syndrome of Yang deficiency and water.The TCM syndromes and LVEF had a negative correlation(r=-0.262,P<0.05).8.The levels of NT-proBNP in all levels of NYHA classifications had significant differences,and the concentration of NT-proBNP increased with the level of NYHA classifications.NYHA classifications had a high positive correlation(r=0.740,P<0.05).9.The LVEF was significantly different among different cardiac function grades.When comparing NYHA ? with NYHA ?,?,and ?,LVEF was significantly different;when comparing NYHA ? with NYHA I,LVEF was significantly different.NYHA classifications and LVEF had a negative correlation(r=-0.414,P<0.05).10.The H was generally negatively correlated with LVEF(r=-0.180,P<0.05),and there was no correlation with NT-proBNP.Conclusion:1.The H,tHI and tJK of ballistocardiogram of the chronic HF group and the non-HF group were significantly different,but there was no significant difference in the I,J and tIJ between the two groups.2.The H was positively correlated with the TCM syndrome and NYHA classification,but negatively correlated with LVEF.3.There is no correlation between the H and NT-proBNP.4.The H of ballistocardiogram,NYHA classification,NT-proBNP and LVEF were all related to TCM syndromes,or may become the objective research basis of TCM syndromes.