The Research On Clinical Characteristics Of Heart Failure With Mid-range Ejection Fraction And Distribution Characteristics Of TCM Syndrome Types

Objective:To study the clinical features of HFmr EF and the distribution of TCM syndromes according to the medical records of patients with HFmr EF.Methods:The cases of heart failure with mid-range ejection fraction hospitalized in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from September2018 to August 2019 were screened and collected through the digital hospital information management system.The inclusion and exclusion were according to "China Heart Failure Diagnosis and Treatment Guide 2018","Internal Medicine of Chinese Medicine" diagnostic criteria and "Chronic Heart Failure Chinese Medicine Diagnosis and Treatment Expert Consensus 2014" for Chronic Heart Failure,General data(age,sex,onset season,smoking and drinking history,past history,course of chronic heart failure,hospitalization ratio),NYHA classification,Doppler ultrasound data(left/right atrial/indoor diameter,left ventricular ejection fraction,degree of valve shunt,E/A),Laboratory test and TCM syndrome data,establish Excel database,and use SPSS 26 for statistical analysis.Results:A total of 159 cases of heart failure with the standard mid-range ejection fraction were collected,and their general data(age,sex,onset season,smoking and drinking history,past history,course of chronic heart failure,hospitalization ratio),cardiac function classification(NYHA),and cardiac color Doppler ultrasound data(left/right atrial/ventricular diameter,left ventricular ejection fraction,degree of valve regurgitation,E/A)were analyzed.The results are as follows:1 general data: there are more males than females in HFmr EF patients.Mainly in autumn;The ages mainly ranged from 60 to 89 years old.Most of them were accompanied by cardiovascular and cerebrovascular diseases,diabetes,CKD,anemia,lung infection,and 4-7kinds of them were complicated;The course of chronic heart failure is less than 1 year,and the rate of readmission is high,but the prognosis is good.2 NYHA: Patients with HFmr EF is mostly NYHA grade III.The LVEF was 40%.3 Changes in cardiac structure: Most patients have no or mild regurgitation in aortic valve,mitral valve,tricuspid valve and pulmonary valve;E/A value is obviously abnormal;The average diameter of LA and LV increased obviously,and the average diameter of RA and RV were all in the upper limit of normal value.4 Laboratory test: BNP of patients increased,mostly accompanied by decreased hemoglobin,albumin and high density lipoprotein,and mostly accompanied by increased fasting blood glucose;Male anemia is more than female anemia,and most of female anemia is normal.5 Distribution law of TCM syndrome: Qi deficit and blood stasis syndrome and Qi Yin deficit and blood stasis syndrome are the most.6 There are differences in age,season,readmission ratio,cardiac function grade,left ventricular diameter,BNP,HGB and ALB among different syndromes.(1)the average age of qi and yin deficit and blood stasis combined with phlegm retention is the oldest.(2)Except Yang Qi blood stasis syndrome combined with phlegm drink and Qi Yin deficit blood stasis syndrome,the other syndromes mostly occurred in autumn.(3)The proportion of readmission in each syndrome type is high;The proportion of readmission Qi deficit and blood stasis syndrome is the highest.(4)The heart function of Qi deficit blood stasis syndrome,Qi deficit blood stasis with phlegm retention syndrome are mostly Grade III.(5)The average diameter of the left ventricle of Qi Yin deficit blood stasis syndrome is the smallest.(6)The average value of BNP of Yang-qi deficit blood stasis is the highest.(7)The average value of hemoglobin(HGB)of Yang Qi deficit blood stasis and phlegm drink syndrome is the lowest.(8)The average value of albumin(ALB)of yang-qi deficit blood stasis with phlegm-yin syndrome is the higest.It can be seen from the relatively more cardiac function grade IV,the highest average left ventricular diameter,the highest average BNP,the lowest average HGB and the lowest average ALB,that the symptoms of yang deficit and blood stasis and phlegm retention are the most serious.Conclusion:According to the data of 159 cases,the clinical features of HFmr EF are as follows: many cases occur in autumn,elderly men,with cardiovascular and cerebrovascular diseases,arrhythmia,diabetes,CKD,anemia,lung infection,old myocardial infarction and previous PCI,poor heart function and enlarged left heart;Qi deficit and blood stasis syndrome are the main syndrome types.