Clinical Characterization Of114Infants With Heart Faliure

Objective: To analysis the etiology,clinical characterization andassistant examinations in infants with heart failure,in order to sum up theexperience of diagnosis and therapies, reduce misdiagnosis.Method: A retrospective study of114patients hospitalized from June2012to January2014was performed in Chongqing Medical Universityaffiliated children’s hospital,whose age under1year-old.This retrospectiveanalysis include etiology, clinical manifestation, cardiac creatine, troponin,B-type natriuretic peptide, echocardiography,electrocardiogram.Result：Congenital heart disease is the major etiology in the114infants,especially ventricular septal defect and complex deformities,theseond is the cardiomyopathy,especially the endocardialfibroelastosis,then the arrhythmia and pneumonia,but myocarditis relativelyless.The most common clinical manifestations are increased heartrate,shortness of breath,cyanosis,cardiac enlargement,and liverenlargement.There have no significant difference in incidence betweenincreased heart rate,liguria,sweating due to different etiologies.Theincidence of dyspnea and cyanosis in arrhythmia group were significantlylower than those in CHD group(P<0.05).The incidence of feeding difficultin myocardial disease group was significantly lower than that in CHDgroup,while the incidence of lung rules in CHD group and pneumonia group was obviously higher than that in myocardial group and arrhythmiagroup.The incidence of liver swelling in myocardial disease group is higherthan that in CHD group,the differences have statistically significant(P<0.05).This group of patients with mild to moderate heart failure weremore common,but severe heart failure was relatively less (15.8%).Thehs-cTnI and BNP check out positive rates in infants with severe heart failureare higher than these with mild or moderate heart failure infants,thedifferences had statistically significant(P<0.05).In this case BNP detectedpositive rate was36.8%,while echocardiography detected in the incidence ofcardiac dysfunction was29.8%,they had no significant difference.Thedetected positive rate of serum BNP had some differences between differentcauses of heart failure,pneumonia were lower than other groups,but therehad no statistically significant differences.The echocardiography promptedcardiac enlargement was significantly higher in cardiomyopathy, CHD,pneumonia groups than these in arrhythmia group(P<0.05), while the EF andFS decreased were significantly higher in cardiomyopathy group thanCHD,pneumonia,cardiac arrhythmia group(P<0.05). Chest X-rayexamination abnormalities were95.1%(97/101). ECG abnormalities were88.6%(70/79),There are25cases have radical surgical treatment,24caseswere successes,and the cardiac function improved significantly aftersurgery.There were71patients improved and discharged,while40patientsauto-discharged,and3patients dead.Conclusion:Congenital heart disease was the most common etiology ininfants heart failure.Most patients with tachyon, tachycardia, cyanosis,enlargement of the liver,cardiac enlargement, pulmonary rales,but thereismarkedly differene in the clinical manifestations with HFcaused by differentetiologies.Dyspnea and cyanosis were not comman in arrhythmia,but poorouter peripheral perfusion easily to happen.While liver enlargement was more common in cardiomyopathy,but feeding difficulties relativelyless.And lung rules was common in CHD, but edema was less.So we shouldbe attention on the clinical practice.It is necessary to have theechocardiography,chest X-ray,BNP,hs-cTnI examinations which can helpthe diagnosis of heart failure and to analyze its etiologies.