| Chronic heart failure refers to the inability of the heart to maintain cardiac output sufficient to meet the body's metabolic needs or if adequate cardiac output can only be achieved with elevated filling pressures. This definition also includes the inability of the heart to clear venous return, resulting in vascular congestion and a secondary drop in cardiac output. In recent years, not only the case rate of heart failure which is the performance of end-stage cardiovascular disease is increasing, but also the mortality and morbidity rate are increasing. Latest data show that there are 15 million patients who with a history of chronic heart failure in the worldwide and there are at least 4 million patients in our country. It is considered to be the only cardiovascular disease which its prevalence rate is still increased with a poor prognosis. Therefore, it is important to prevent and treat heart failure.Objective: To investigate and analyze the patients with chronic heart failure at department of cardiology in our hospital from 2008.5-2011.5 to understand①the constituent ratio of ages, gender, etiology and the risk factors for heart failure;②the situation of drug therapies for heart failure in recent years.Method: A retrospective survey analysis method to evaluate 1258 patients with a history of chronic heart failure that was carried out from May 2008 to May 2011 at the first clinical hospital Jilin University.Result: A total of 1258 patients were enrolled in the study.①The patient's age range was 37-85 years old and the average age was 67.5±12.7. There were 89 patients(7.1%) in <50years, 323 patients(25.7%) in 50-60years, 612 patients(48.6%) in 60-70years, 234patients(18.6%) in≥70 years; Female patients age (mean 71±13.4) older than men (mean 63±10.3) in patients with chronic heart failure; The average age of NYHAⅡwas 57.1±11.3, NYHAⅢwas 65.3±10.7 and NYHAⅣwas 72.2±13.5.②The ratio of man with woman was 1:1.05, There were man 615(48.9%)and women 643 (51.1%).③Phase A and B heart failure patients didn't receive hospital treatment, so There were 1153(91.7%) patients in stage C and 105 (8.3%)patients in stage D; There were 289 patients(23.0%), 623 patients(49.5%), 346 patients(27.5%) in NYHA classⅡ,Ⅲ,Ⅳgroup repectively.④Common cases of heart failure were primary coronary heart disease 557 patients (44.3%), hyperension 415 patients (33.0%), rheumatic valvular heart disease 123 patients (9.8%), congenital heart disease 54 patients (4.3%), cardiomyopathy 62 patients (4.9%) and else 47 patients (3.7%). There was no distinct difference of the general condition among the groups.⑤Hypertension, Hyperlipidemia, Diabetes,Coronary heart disease and Obesity were the major risk factors of heart failure.In the study, there were 807 patients with hypertension(64.1%), 715 patients with diabetes (56.8%), 623 patients with hyperlipidemia(49.5%), 354 patients with smoke(28.1%) which women lower than men, 107 patients with obesity (8.5%) which women higher than men and 113 patients with family history of heart disease (9.0%).⑥The usage rate ofβ-blocker was 68.2%, 40.4% and 12.4% in NYHA classⅡ,Ⅲ,Ⅳgroup repectively; The usage rate of ACEI/ARB was 79.9%, 98.7% and 100% in NYHA classⅡ,Ⅲ,Ⅳgroup repectively; The usage rate of diuretics was 40.1%, 99.7% and 100% in NYHA classⅡ,Ⅲ,Ⅳgroup repectively; The usage rate of digitalis was 99.4% and 98.3% in NYHA classⅢ,Ⅳgroup repectively; The usage rate of aldosterone receptor antagonist was 80.4% and 69.1% in NYHA classⅢ,Ⅳgroup repectively; The usage rate of nitrate was 34.2% and 36.7% in NYHA classⅢ,Ⅳgroup repectively; The usage rate of nitrate was 80.4% and 69.1% in NYHA classⅢ,Ⅳgroup repectively;⑦The usage rate of BNP was 10.2% in patients with decompensated heart failure.Conclusion: In the study, we can conclusion that the age of onset was mainly in 60-70 years and women older than men, moreover, the patients age was gradually increased in NYHA classⅡ,ⅢandⅣ. Female patients were more than male patients, and the ratio of man with woman was 1:1.05. The major cases of heart failure was primary coronary heart disease, second was hyperension, and there was no distinct difference of the general condition among the groups.The major risk factors of heart failure was hypertension, second was diabetes, third was hyperlipidemia, the female patients with obesity were more than the male and the female patients with smoke were less than the male. The drug treatment is still the traditional drug-based diuretics and digitalis preparations, however, the usage of ACEI / ARB andβ-blocker were lower than guidelines.has been part of clinical patients with decompensated heart failure benefit of recombinant human brain natriuretic peptide treatment, but usage is low. Although the usage rate of rhBNP was low, it was used to treat patients with decompensated heart failure. |
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