Clinical Characteristics Of Diastolic Heart Failure In 421 Children

Objective:Discussing the clinical features, examination, diagnosis and teatment of diastolic heart failure (DHF), and comparing it with systolic heart failure (SHF) to improve awareness, guide the knowledge of DHF.Methods:Collected 421 cases of DHF from October 2006 to December 2014,42 cases of SHF from January 2013 to December 2014 and 98cases of merge DHF and SHF hospitalized in Cardiology Department of Children’s Hosptal of Chongqing Medical University. Restrospectively analyzed the data of the two groups of children in general information, basic diseases, clinical manifestations, echocardiogram, electrocardiogram, chest radiography, BNP, treatment and efficacy. We collected 245 cases of Kawasaki Disease (KD),320 cases of Arrhythmia, 139 cases of Cardiomyopathy,63 cases of Myocarditis from January 2013 to December 2014, restrospectively analyzed the comparison of various heart disease trigger DHF and SHF. We collected 1046 cases of inpatients examined brain natriuretic peptide (BNP) from the same department and time, analysis the diagnostic value of BNP for DHF.Results:The age of DHF and SHF group were 1.81±3.29 years old, 4.65±4.9 years old respectively, the difference of the age, sex and basic diseases was statistically significant (P<0.05); the difference of the occurrence rate in cardiomyopathy, KD, myocarditis, secondary DHF was statistically significant (P<0.05); but the difference was not statistically significant about family history (x2=0.28, P>0.05), chest radiography (P>0.05) and BNP (P>0.05). The clinical manifestations of first admission were similar between two groups, such as poor spirit and appetite, dyspnea, cyanosis, hydrosis, oliguria, feeding interruption, abdominal pain, abdominal distension and vomit, as well as hepatomegaly, but venous engorgement was not obvious. In DHF group, the ejection fraction (EF) was more than 45%, the fastest blood flow velocity of rapid ventricular filling (E) was less than healthy children, E/A was less than 1 or more than 2, the isovolumic relaxation time (IRT) was less than 40ms or more than 80ms. In SHF group, EF were all less than 50%, E was normal,1≤E/A≤2, 40ms≤IRT≤80ms. The difference of the treatment between two groups was statistically significant (P<0.05). In DHF group, the difference of the echocardiogram parameters between pretherapy and post-treatment was statistically significant (P<0.05).Conclusions:Children’s DHF and SHF are secondary onset of all kinds of heart disease. The clinical manifestations of them are so similar as not to identify easily. BNP is very important to diagonose DHF of children. In addition, echocardiogram is a necessary method. DHF may be controlled via treating basic diseases conbined with treatment against heart failure.