The Value Of D/S Ratio Of Phonocardiogram Evaluate Cardiac Function In Patients With Conventional Treatment CHF

Objective： Using the D/S ratio of phonocardiogram、 NYHAclassification、6MWT、and LVEF of echocardiography measured index tofollow-up the patients with CHF who have accepted regular anti-heartfailure drug therapy, aims to study the value of the D/S ratio ofphonocardiogram in evaluating the heart function of patients with regularanti-heart failure drug therapy,and the significance of reaching targetresting heart rate.Methods: Collection37patients with heart failure of left ventricularejection fraction less than45%in our hospital, NYHA cardiac functiongrade with I~III,being given angiotensin converting enzyme inhibitor(ACEI) or angiotensin II receptor blocker (ARB), β-blocker(β-B),anddiuretics, digoxin,aldosterone receptor antagonist in necessary, follow-upfor3months. In different treatment time recording the resting heart rate(RHR), D/S ratio of phonocardiogram, Six-minutes walk test (6MWT),and reinspection Left ventricular ejection fraction(LVEF) byechocardiography. Comparative the value of the evaluation of the aboveindex on cardiac function between before and after treatment. After3months of treatment, resting heart rate of65times as the boundary, divided the heart failure patients into the reaching and non-reaching target restingheart rate group, to explore the relationship between resting heart rate andthe improvement of the heart function. Do the correlation analysis ofNYHA classification and D/S ratio、6MWD、LVEF.Results: CHF patients with regular anti-heart failure treatment at1months，those indexs have no obvious change; After3months treatment,D/S ratio、6MWD、LVEF index improved obviously, NYHA classificationreduced obviously, LVEDd lessened obviously, the difference wasstatistically significant(P<0．05).There is no statistically difference of totaleffect in the non-reaching target resting heart rate group, each index of thetwo groups before treatment and after1months treatment is no statisticalsignificance; after3months treatment,in reaching target resting heart rategroup,the RHR slowed obviously， D/S ratio and LVEF improvedobviously,there is statistical significance(P<0．05); In the reaching targetresting heart rate group with1months of treatment, RHR slowedobviously，D/S ratio improved obviously, there is statistical significance(P<0．05),but at this time the6MWD、LVEDd and LVEF index have nostatistically difference; After3months of treatment, RHR furtherdecreased, D/S ratio further improved,6MWD、LVEDd and LVEF indexhave obvious improvement (P<0．05). In the non-reaching target restingheart rate group,with1and3months of treatment,there is only RHRdecreased Significantly(P<0．05); Both before and after treatment，D/S ratio、6MWD and NYHA classification are Significant negativecorrelation,and the correlation between LVEF and NYHA classification ispoor.Conclusion: After the regular treatment, the heart function of heartfailure patients are obviously improved; There was a significant differencebetween before and after treatment in RHR、D/S ratio、6MWT、LVEDd、LVEF index. There was a significant difference between reaching andnon-reaching target resting heart rate group in RHR、D/S ratio、LVEF index.The D/S ratio of phonocardiogram earlier than6MWD、LVEDd、LVEF toreflect the improvement of heart function of the reaching target resting heartrate patients.There is a good correlation between D/S ratio、6MWD andNYHA classification.D/S ratio can be used as a supplementary index for thediagnosis of chronic heart failure.