Analysis Of Noninvasive Hemodynamics In Patients With Cardiac Function During Different Periods

Heart failure(HF)is a chronic progressive disease,Once it begins,it will continue to develop even if there is no new myocardial injury,it has poor prognosis.Although drug and device therapies continue to improve today,they are still unable to reverse.It is particularly important to prevent the early period of heart failure and early treatment.In 2001,the American College of Cardiology(ACC)/ American Heart Association(AHA)divided the development of heart failure into four phases according to the pathophysiology of HF,This stage emphasizes the irreversible progression of heart failure and is prevented.It is prevented that from the A phase of high hazards of heart failure to the B phase of structural modification,and prevented the progression of B phase to C clinical symptoms of heart failure.However,the A and B phase belong to subclinical heart failure,the major disease of the A phase of high hazards of heart failure included hypertension(HTN)and Coronary atherosclerotic heart disease(CAD),and is major pathogenis caused heart failure,these diseases damage to the cardiac function is relatively long,does not appear in hypertensive emergency or myocardial infarction before clinical symptoms are not obvious,however there is a lack of objective evaluation index of cardiac function of these diseases of heart failure progression.This study analyzes the change regulation of noninvasive hemodynamics index,B type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF)in development of chronic heart failure according to Guidelines for diagnosis and treatment of heart failure by ACC/AHA.The main objective of this study to explore the clinical significance of noninvasive hemodynamic parameters,Whether the change trend is consistent with the different stages of heart failure,and can be used to evaluate the cardiac function in the early stage of heart failure.This study is comprise of 119 patients who hospitalized because of chronic heart failure(CHF)and high hazards of heart failure during March 2014 to October 2016 in General Hospital of the Air Force PLA,76 patients were male and 43 female,64± 14.9 years old,According to the ACC/AHA criteria for the progression of heart failure,the patients with A were divided into A group,and the clinical stage of B was divided into B group,C stage and D refractory heart failure stage were C group.39 healthy subjects in our hospital were selected as the normal control group(O group).Then the patients in group A were divided into two subgroups according to the different hazards of heart failure coronary heart disease(group A1)and hypertension subgroup(group A2).Collection of clinical data and related examination,Clinical data and examination of all the patients were Collected,all the patients were examed with noninvasive hemodynamics,Noninvasive hemodynamic idexes were recorded,including stroke volume(SV),cardiac output(CO),cardiac index(CI),C wave amplitude,heart contractility index(HI),systolic function index(Q-B/B-X),pulmonary artery wedge pressure(PCWP),left ventricular end diastolic pressure(LVEDP),aortic compliance(AC)and total peripheral resistance(TPR).The serum levels of BNP and LVEF were recorded as reference.The change of hemodynamics idex? BNP and LVEF in all groups and the change tendency between these idexes and different stages of heart failure was to be analysised through the statistics,and to draw in the early stages of the receiver operating characteristic curve(ROC curve),in order to screen out the suitable for objective index for evaluation of cardiac function in the early progression of heart failure.There was a a significant linear correlation between noninvasive hemodynamics index of SV,CO,CI,C,HI,Q-B/B-X wave amplitude,PCWP,LVEDP,AC,TPR,BNP,LVEF and heart failure in different stages of development(P <0.05);C,CI,HI in the early stage of heart failure was significantly reduced,Q-B/ B-X significantly increased after comparing each other(P<0.05),There were not statistically significant difference of BNP,LVEF values in the early stage of heart failure(P>0.05);It demonstrated that HI,the sensitivity and specificity of Q-B/B-X was higher than that of the other index,area under the curve were better than other indicators through accept the receiver operating characteristic curve analysis.The changes of noninvasive hemodynamic parameters were consistent with the different stages of heart failure,and the heart function of patients with chronic heart failure(A)was affected to some extent.Noninvasive hemodynamic parameters HI and Q-B/B-X can provide objective reference for early evaluation of cardiac function.