Application Of Heart Function Echocardiographic Multi-Parameter Score (HF- EMPS) In Assessment Of Response To The Guideline-recommended Treatments Of Chronic Heart Failure (CHF)

【Objective】: To study the value of Heart Function Echocardiographic Multi-Parameter Score (HF-EMPS) in assessment of the heart function of Chronic Heart Failure( CHF ) patients and their response to the guideline- recommended treatment .【Method】: We selected 83 patients with Chronic Heart Failure (CHF) ,measured their HF-EMPS which was composed of multiple basic echocardiography parameters, and plasma BNP, and the New York Heart functional class; treated them according to the 2009 AHA heart failure guidelines; made follow-up visits regularly via the telephone or clinic visit ; rechecked HF-EMPS score and BNP level within 6 months, 12 months after the first diagnosis. And then: 1.Analyzed the relationship between HF-EMPS and plasma BNP level, and New York heart function class. 2. Analyzed the changes of HF-EMPS before and after the optimal treatments. 3. Analyzed the distribution of HF-EMPS among CHF patients with different causes and course, and the impact on the effect of treatment via HF-EMPS. 4. Analyzed the usefulness of HF-EMPS in evaluating prognosis and effect of treatments of CHF patients. 5. Use Logistic regression analysis to recognize the risk factors contributing to the sustained elevated BNP level among HF-EMPS and its constituent parameters.【Results】: 1. HF-EMPS values increased as the New York heart function class progressed and there was significant difference between every two class; and plasma BNP levels were positively correlated with HF-EMPS (r = 0.43 P value < 0.05). 2. HF-EMPS values and all its constituent parameter values decreased stepwise with follow-up, but the reduction extent and significance was not consistent. Both HF-EMPS values and parameters of pulmonary artery pressure reduced with significant difference between every examinations (P value <0.05); Although the left ventricular remodeling parameters had a decreasing trend too, but the differences were not statistically significant. 3. The degree of left ventricular remodeling was the most powerful factor impacting the treatment effect. 4. The HF-EMPS value of the death group was higher than the readmission group and the survival group. The parameter of pulmonary artery pressure of the death group was significantly higher than other groups, which was statistically significant. 5. The HF-EMPS values differ in CHF causes; With the duration of treatment, the HF-EMPS values of all causes and course showed a decreasing trend, but the degree was not same. The course of CHF disease was negatively correlated with the effect of treatment. 6. Both Left ventricular remodeling and increased pulmonary artery pressure were strong risk factor of persistently elevated BNP level.【Conclusions】: Heart function Echocardiographic Multi-Parameter Score (HF-EMPS) is valuable for the assessment of cardiac function overall of CHF patients, treatment evaluation and prognosis prediction. Among HF-EMPS and its 5 constituent parameters, hemodynamic parameters would be improved through short-time treatment, while parameters of ventricular remodeling needed more time. Both Left ventricular remodeling and increased pulmonary artery pressure were strong risk factor of adverse cardiovascular events.