The Efection Of Pulmonary Presure In Ischemic Heart Disease

BackgroundHeart failure is Serious stage of various heart disease progress.So far clinicians to evaluate patients’ heart function still rely on the organic combination of judgment such as clinical symptoms, signs, laboratory indexes and ultrasonic data.Ejection fraction (LVEF) is one of the important indices for evaluating left ventricular systolic function.In the clinical work, we often found that the ejection fraction are significantly lower in the patients who with heart failure, even below 30%, but the patients had no obvious symptoms such as shortness of breath or breathing difficulties, they were able to do some appropriate activities.Meanwhile,we also observed that some patients with heart failure, although they had the normal ejection fraction, but their symptoms of the chest tightness, difficulty breathing is very obvious.The patient’s heart function is associated with the left ventricular diastolic dysfunction and the pulmonary arterial pressure in addition to the left ventricular systolic function.ObjectiveThis experiment was to observe the correlation of heart function and pulmonary artery pressure in the patients with ischemic heart disease,especially to discusses the relationship between the pulmonary artery pressure and the velocity of mitral valve regurgitation\heart cavity diameter size\the left ventricular ejection fraction and the plasma N-terminal brain natriuretic peptide. Which will guide the clinicians to predict the pulmonary artery pressure earlier, in order to take measures to prevent the pulmonary artery improved and improve the patients life quality.MethodsContinuous to select 118 cases of ischemic heart disease followed with heart failure in Dong E People’s Hospital in December 2013 to August 2014, On the day of admission we did ultrasonic cath,On the left shaft section beside the sternum, we measured the anteroposterior diameter of the left ventricular perpendicular to the mitral valve middle plane when the heart at the end-diastolic(Units:mm) and the anteroposterior diameter of the Right ventricular(Units:mm),meanwhile we measured the anteroposterior diameter of the left atrial on the left shaft section beside the sternum(Units:mm),In the four cavity aspect we measured EF applicated the Simpson’s method, Simultaneously we measured the velocity of mitral valve regurgitation and tricuspid regurgitation((uriit:cm/s),and basised on the difference of tricuspid regurgitation pressure to estimate the pulmonary artery systolic pressure (unit:mmHg).According to the cardiac function classification standard of New York Heart Association(NYHA) and the left ventricular ejection fraction,the patients were divided into three groups:Group A:normal EF+ NYHA grade Ⅰ～Ⅱ, A total of 36 petients; Group B:EF reduced+NYHA grade Ⅰ～Ⅱ, a total of 34 petients; group C: EF reduced+NYHA Ⅲ～Ⅳ, a total of 48 petients;Using statistical methods:the statistical methods using chi-square test and paired t test, correlation analysis, using the SPSS 17.0 statistical software to analyze the experimental results.ResultsIn the patients who had ischemic heart disease with heart failure, the pulmonary artery pressure increased significantly in the group of reduced ejection fraction and cardiac function grade Ⅲ～Ⅳ;the pulmonary artery pressure had no obvious rise in the 2 groups of EF normal+cardiac function grade Ⅰ～Ⅱ and EF reduce+ cardiac pulmonary Ⅰ～Ⅱ grade.Then we did the further analysis about the correlation of pulmonary artery pressure in the pulmonary hypertension group (group C),The result was that the pulmonary artery pressure had a positive relation with the anteroposterior diameter of the left atrial\the anteroposterior diameter of the left ventricular\the anteroposterior diameter of the right ventricular\the velocity of mitral regurgitation and the NT brain natriuretic peptide, it had a negative correlation with the ejection fraction.ConclusionIn the patients who had ischemic heart disease with heart failure, there clinical heart function decline associated with increased pulmonary artery pressure;In the patients who had ischemic heart disease with heart failure, there clinical heart function decline associated with increased pulmonary artery pressure;The above indicators can be used as the forecasting index of pulmonary artery pressure,Clinicians could give reperfusion or vascular reconstruction measures as soon as possible to prevent the pulmonary artery improved and improve patients’ life quality.