| Objective The clinical data of patients with chronic heart failure in the Department of Cardiology at the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 1,2015 to January 1,2017 were collected to investigate the changes in admission heart rate levels and related factors that did not meet the heart rate,and analysis the relationship between different doses of beta-blockers and the discharge resting heart rateMethods This study used a retrospective analysis method to record in detail the clinical baseline data(sex,age,resting heart rate,history,cardiac function classification,medication status,etc.)of each patient,using multivariate logistic regression and multivariate linear regression analysis.Screening out independent factors affecting the discharge of resting heart rate,and using SPSS 22.0 software for statistical analysis of relevant data.Results(1)A total of 271 patients with heart failure were included in this study.Their average hospital discharge rate was 66.31±10.06 beats/min,and the average heart rate compliance rate was 34.32%.(2)Multivariate logistic regression analysis showed:atrial fibrillation(OR=0.34,95%CI:0.171-0.575,P=0.000)and NYHA II(OR=2.059,95%CI:1.150-3.688,P=0.015)and age(OR=0.031,95%CI:1.030-1.058,P=0.031)is the relevant influencing factor of heart rate in CHF patients.The results of single factor linear regression analysis showed that admission heart rate was the relevant factor affecting the discharge heart rate(correlation coefficient r=0.330,P=0.000).(3)There was a statistically significant difference(P<0.012<0.05)between the use ofβ-blockers and the absence ofβ-blockers in the change of admission heart rate(15.19±18.16 vs 8.25±14.98).(4)The rate of heart rate compliance for each dose of metoprolol was 12.5 mg(0%),23.75 mg(39.4%),47.5 mg(33.77%),71.25 mg(31.25%),95 mg(47.62%),142.5 mg(50%));bisoprolol for each dose of heart rate compliance rate was 1.25mg(16.67%),2.5mg(33.33%),5mg(33.33%),10mg(66.67%);usingχ~2test analysis,the results show:There was no statistical significance between the groups(P>0.05).However,it was observed that the heart rate compliance rate increased with the increase of beta-blocker dose.(5)Possible causes of 51 intolerances of beta-blockers included:sinus bradycardia(56.86%)with COPD(15.69%),hypotension(10%),II degree atrioventricular block(5.9%)with asthma(2%).(6)Using theχ~2 test analysis,the results showed that the rate of heart rate achieved in the heart failure patients collected by the six doctors selected in the undergraduate room was not statistically significant(χ~2=1.982,P=0.852>0.05).Conclusions 1)The level of heart rate control in hospitalized patients with chronic heart failure is better than the domestic average(83bpm,CHINA-HFstudy).(2)The clinical characteristics of patients(atrial fibrillation,NYHA III-IV,age less than 70 years,and rapid admission heart rate)and tolerance toβ-blockers are related factors affecting heart rate in patients with heart failure.(3)The rate of heart rate compliance in patients with chronic heart failure is dependent on the dose of beta-blockers.(4)Overall doctors in the undergraduate department have more uniform heart rate control for heart failure patients,but they still need to pay attention to and strengthen heart rate management in hospitals and after discharge. |
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