The Significance Of CTnI, BNP And Sbp Level On Admission To Hospital In AHF Detection And Its Prognostic Values

AHF is a clinical syndrome caused by the sharp decline in cardiac output in a short time due to various reasons. With rapid onset, quick progress, various changes, a high rate of clinical relapse and mortality, the disease becomes an urgent problem threatening to human health and the focus of scholars from many countries. Great efforts have been made in studying various indexes valuable to AHF diagnosis and prognosis in recent years.Objective: The thesis aims to determine the cTnI, BNP and SBP level on admission of AHF patients, and discuss their significance in AHF detection and the value to prognosis.Methods:Select 60 patients definitely diagnosed as AHF (case group) and 20 patients with non-heart diseases (control group). 60 patients definitely diagnosed as AHF: collect the cTnI value and BNP value respectively on admission and at the fourth or fifth day after the symptom has been controlled.; collect patients'systolic value on admission; test left ventricular structure and function of the patients by heart Doppler ultrasonic diagnosis apparatus, and record the LVEF value; record the cases of in-hospital mortality and recurrent cardiac events (including recurrent AHF, malignant arrhythmia and sudden cardiac death) in the next six months since hospital discharge. 20 patients in control group: collect cTnI value and BNP value on admission once for each. The data collected from the 60 AHF patients and 20 patients in control group will be treated by retrospective analysis. The data will be processed by SPSS 19.0 statistical software.Result:The cTnI level of AHF patients on admission is higher than that of the patients in control group, with significance of difference(P<0.05); the BNP level of AHF patients on admission is higher than that of the patients in control group, with great significance of difference(P<0.01). AHF patients can be grouped according to the cTnI level on admission as follows: cTnI positive group(0.04 ng/mL 0.44 ng/mL) with 9 patients, its average cTnI value is (1.8922±2.3004)ng/mL, accounting for 15.0%. AHF patients can be grouped based on the BNP level on admission as follows: BNP positive group (>300 pg/mL) with 45 patients, the average BNP value in this group is (1460.9±718.1)pg/mL, accounting for 75.0%; BNP negative group (≤300 pg/mL)with 15 patients, its average BNP value is (243.8±49.6)pg/mL,accounting for 25.0%. The patients in cTnI positive group (compared with patients in cTnI negative group): LVEF is relatively low, with great significance of difference (P<0.01); mortality rate is relatively high, with no significance of difference(P>0.05); reoccurrence rate of out-of-hospital cardiac event is relatively high, with significance of difference (P<0.05). The patients in BNP positive group (compare with patients in BNP negative group): LVEF is relatively low, with great significance of difference (P<0.01); mortality rate is relatively high, with no significance of difference (P>0.05); reoccurrence rate of out-of-hospital cardiac event is relatively high, with significance of difference (P<0.05); reoccurrence rate of out-of-hospital cardiac event is relatively high, with significance of difference (P<0.05). AHF patients can be grouped according to the different systolic levels on admission: group A (systolic pressure on admission≤100mmHg), group B (100mmHg< systolic pressure on admission≤140 mmHg)and group C (systolic pressure on admission >140mmHg). With the increased level of SBP on admission of the patients in three groups, the LVEF value rises, with the significance of difference(P<0.05); the in-hospital mortality rate drops, with significance of difference(P<0.05); reoccurrence rate of out-of-hospital cardiac event falls, with significance of difference (P<0.05). As for patients in cTnI positive group, with symptoms of heart failure being better controlled, their cTnI level falls compared with the level on admission, with great significance of difference (P<0.01). Regarding patients in BNP positive group, with symptoms of heart failure being better controlled, their BNP level falls compared with the level on admission, with great significance of difference (P<0.01). When the patients in cTnI positive group discharge, their cTnI level returns to normal compared with that of groups not recovered. After their discharge, the reoccurrence rate of cardiac event in the next six month is low, with great significance of difference (P<0.01). When the patients in BNP positive group discharge, their BNP level returns to normal compared with that of groups not recovered. After their discharge, the reoccurrence rate of cardiac event in the next six month is low, with great significance of difference (P<0.01).Conclusion: In AHF attack, the cTnI level and BNP level increase significantly. With the fall of SBP level, AHF patients'LVEF gradually drops and their in-hospital mortality rate and reoccurrence rate of cardiac event after discharge gradually rise, indicating the aggravation of cardiac function and prognosis. The severity of AHF patients can be assessed in light of SBP level on admission. The cTnI level, BNP level and SBP level on admission can be used as the indexes in assessing AHF, with great significance in AHF detection and prognosis.