| Objectives:To explore the varying pattern in chronic heart failure(CHF)group of serum b-type natriuretic peptide(BNP),high-sensitivity cardiac troponin(HS-cTn)level and duration of QRS,and compare with normal control group.Meanwhile analyze to the correlation among the BNP,HS-cTn,QRS duration and cardiac function classification.Validate the application value of the BNP diagnosing CHF.Finally,in the above three indicators of comprehensive evaluation of CHF,by the method of joint diagnosis,to compare the sensitivity,specific degree with BNP diagnosis.Methods:112 hospitalized patients were selected as experimental group and 110 hospitalized pat ients as control group who were all from the Cardiovascular Department in Second Hospita l of Shanxi Medical University between January 2016 and December 2016 and had been te sted by routine tests like ECG,HS-cTn and BNP.The experimental group were suffering fro m HF and ejection fraction(EF)value were 50% or less,including 61 male and 51 female,a nd the average age was 62.39±7.57 years old,and they were divided into ?,?,? groups according to the New York Heart Association(NYHA)cardiac function classification meth od.The control groups were accompanied by HF risks but without any HF symptom,includi ng 51 male and 59 female,and the average age is 62.87±6.29 years old.Illness should be e xcluded in all the groups as acute coronary syndrome,severe infectious disease,severe liver and kidney disease,bundle branch block,the pre-excitation syndrome,malignant tumors,acute cerebrovascular disease,pulmonary hypertension,acute myocarditis,severe anemia,hypert hyroidism,autoimmune disease,etc.Result:1.Compared with the control group,serum BNP,HS-cTn,QRS duration level of experimental group was higher,the difference was statistically significant(P<0.05).2.In CHF groups,the BNP level of NYHA IV patients was higher than the one in NYHA II or III patients(P<0.05);the BNP level of NYHA III patients was higher than the one in NYHA II patients(P<0.05);the HS-cTn level of NYHA III or NYHA IV patients were higher than the one in NYHA II patients(P<0.05);the HS-cTn level of NYHA IV patients was higher than the one in NYHA III patients(P>0.05);the QRS duration level of NYHA III patients was higher than the one in NYHA II patients(P < 0.05);the QRS duration level of NYHA IV patients was higher than the one in NYHA II patients,but the difference was not statistically significant(P>0.05);the QRS duration level of NYHA IV patients was lower than the one in NYHA III patients(P>0.05).3.BNP was positively correlated with NYHA classification(r=0.823,P=0.000),HS-cTn was positively correlated with NYHA classification(r=0.667,P=0.000),QRS duration was positively correlated with NYHA classification(r=0.422,P=0.000).4.the results of BNP measured by ROC curve indicated that area under the curve was0.957,the standard error was 0.014,the cut-off point was 166.47pg/ml,the sensitivity was89.3% and the specificity was 95.5%.5.the cut-off points for CHF diagnosis were BNP less than 100 pg/ml,HS-cTn less than 0.04 pg/ml and QRS duration less than 100 ms,the BNP individual detection sensitivity was 92.0%,specificity was 83.6%,the three-indicators comprehensive evaluation sensitivity was 36.6%,specificity was 98.2%.Conclusions:1.In heart failure group,the levels of BNP,HS-cTn,QRS duration are significantly higher than normal group,and the trend of rising are following the rising of NYHA heart function classification,and are positively correlated with NYHA classification,and have higher reference value in the diagnosis of CHF,but the HS-cTn,duration of QRS wave in cardiac function classification are less sensitivity.2.The three-indicators(BNP,HS-cTn and duration of QRS wave)combined evaluation specificity of CHF is higher than the BNP individual evaluation. |
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