Multivariate Analysis Of The Risk Factors Influencing The Prognosis Of Chronic Heart Failure

Objective: To investigate the risk factors influencing the prognosis of chronic heart failure.Methods: We studied 413 patients with chronic heart failure in department of cardiology, 1st Affiliated Hospital of Soochow University(245 males, 168 females, aged 70.21±12.81 years). According to the different prognosis, the patients were divided into survival group(208 males, 147 females, aged 70.36±12.64 years)and death group(37 males, 21 females, aged 69.31±13.90 years). The potential risk factors between the two groups were compared including sex, age, etiology, NYHA classification, Cr, UA, TC, BNP, Hb, RDW, LA, LVEF, LVDd, LVDs, IVS, IVPW, SBP/DBP, HR and so on. The factors which could influence the prognosis were analyzed.Result: 1. Fatality rate of DCM was the highest, then CHD, then HTN, however, it did not reach statistical significance.2. Fatality rates of NYHA IV, III, II were 20.4%, 10.5%, 7.3%. Fatality rate was getting higher obviously as NYHA class upgrading(P=0.008).3. LVEF of death group(0.36±0.17) was significantly lower than survival group(0.52±0.18)(P<0.001).4. The value of BNP in death group(963.59±740.44 pg/ml) was significantly higher than survival group(439.68±806.76 pg/ml)(P<0.001). The value of BNP and the class of NYHA had an obvious positive correlation (Spearman r = 0.397, P<0.01).5. The value of UA in death group(458.30±151.92μmol/L)was significantly higher than that in survival group(409.52±141.93μmol/L)(P=0.017). The proportion of patients with proteinuria was larger in death group than that in survival group (P=0.023). 6. Patients in death group and in survival group had no significant differences in eGFR (P=0.188). There were 8 dead patients, 30.8% in eGFR<30ml/min/1.73m2 group. The proportion was obviously larger than other groups.7. Through Logistic regression analysis in 143 patients with whole data, we found two main risk factors of chronic heart failure: the level of BNP and LVEF.Conclusion: 1. Mortality was getting higher obviously as NYHA class upgrading, BNP increasing, LVEF decreasing. Logistic regression analysis showed the level of BNP and LVEF were main risk factors of chronic heart failure. NYHA classification, LVEF, BNP were useful factors to predict the prognosis of chronic heart failure.2. The proportion of patients with proteinuria and the value of UA were significantly higher in death group than those in survival group. The level of eGFR was lower in death group than that in survival group. eGFR, UA, proteinuria had some value in predicting the prognosis of chronic heart failure.