Correlation Analysis Between Serum Bilirubin Level And Chronic Heart Failure

Objective: CHF is a clinical syndrome of all types of heart disease.NT-pro BNP is a blood index for the severity of heart failure in recent years,when ventricular tension increases or the ventricular loadis too high,it rapidly released into the blood through the ventricular muscle,but because of its expensive and complex laboratory conditions,at present in china has not universal,especially many grass roots hospitals still don't carry out this check.Echocardiography is an examination to evaluate cardiac morphology and cardiac function,LVEF and LVEDD are commonly used to reflect the function of ventricular systolic function,the results are easy to be affected by the factors such as clinical skills and subjectivity.So,it is urgent to find a simple,easy to popularize,objective and reasonable price blood index to evaluate the severity of chronic heart failure.The purpose of this study is research the relationship between BIL level and NYHA classification in patients with chronic heart failure;the relationship between serum bilirubin and NT-proBNP,LVEF and LVEDD,which are commonly used to reflect the severity of cardiac function.To discuss the relationship between chronic heart failure and serum bilirubin level.To determine whether bilirubin could be used as an objective index for evaluating the severity of chronic heart failure.Methods: 120 patients in cardiac suffering from heart failure for at least 3 months were selected as study group.According the NYHA,divided into three groups: NYHA II,NYHA III,NYHA IV.A total of 50 healthy subjects with normal cardiac function were selected as the control group in the Medical Examination Dept.On the day of admission or physical examination,fasting venous blood was taken to measure NTproBNP and bilirubin[(TBIL),(DBIL),(IBIL)].Within 24 hours of admission or physical examination day routine echocardiography,calculate LVEF and measure LVEDD.Compare the changes of serum bilirubin,NT-proBNP,LVEF and LVEDD between different NYHA levels and different groups;Analysis relationship between serum bilirubin level and NT-pro BNP,LVEF and LVEDD.Results:(1)The serum levels of total bilirubin,direct bilirubin,indirect bilirubin,NT-proBNP in CHF were higher than those in the control group,LVEF was lower than that in the health group,LVEDD was higher than that in the health group,significant difference(P<0.05).The level of total bilirubin: the study group 24(13.80,50.50)mol/L,the control group 7.55(6.00,10.20)mol/L;The level of direct bilirubin: the study group(11.39±4.10)mol/L,the control group(4.42±0.73)mol/L;indirect bilirubin level: the study group(20.37±5.56)mol/L,the control group(4.54±0.80)mol/L;NT-proBNP: the study group(3667.21±1178.56)pg/mL,the control group(181.43±24.88)pg/m L;LVEF: the study group 42(25,50)%,the control group 62(58,67)%;LVEDD: the study group 58(42,66)mm,and the control group 40(37,47)mm.(2)The levels of serum total bilirubin,direct bilirubin,indirect bilirubin,NTproBNP,LVEF and LVEDD in patients with chronic heart failure in different NYHA levels were statistically significant(P<0.05).The serum bilirubin level increased with the increase of NYHA levels,the levels of total bilirubin: NYHA II(22.42 ±4.74)mol/L,NYHA III(25.70±5.58)mol/L,NYHA IV(29.72±7.76)mol/L;The levels of direct bilirubin: NYHA II(8.40±1.74)mol/L,NYHA III(10.70±3.23)mol/L,NYHA IV(14.61±4.04)mol/L;The levels of indirect bilirubin: NYHA II(16.94±2.75)mol/L,NYHA III(20.01±4.76)mol/L,NYHA IV(23.68±6.19)mol/L.NT-proBNP levels increased with the increase of NYHA levels.NYHA II(2197.57±284.88)pg/mL,NYHA III(3635.49±370.64)pg/mL,NYHA IV(4961.30± 346.69)pg/mL.LVEF levels decreased with NYHA levels,NYHA II(47.81±1.39)%,NYHA III(42.65±1.21)%,NYHA IV(33.33±3.98)%.LVEDD levels increased with the increase of NYHA levels,NYHA II(52.32±4.01)mm,NYHA III(57.73±2.92)mm,NYHA IV(61.47±3.41)mm.(3)Pearson correlation analysis showed that,serum level of DBIL(r=0.815),of IBIL(r=0.845),was positived correlated with serum NT-proBNP level,respectively(P<0.05).Spearman rank correlation analysis showed that,serum TBIL level was positively with serum NT-proBNP level(rs= 0.798)and LVEDD(rs= 0.755),respectively,was negatively correlated with LVEF(rs=-0.775)(P<0.05),serum level of DBIL(rs=-0.863),of IBIL(rs=-0.794)was negatively correlated with LVEF,respectively,was positively correlated with LVEDD(rs=0.835,0.745),respectively(P<0.05).Conclusion: The relationship between chronic heart failure and serum bilirubin level at different groups and different NYHA levels showed positive correlation,serum bilirubin level has good correlation with NT-proBNP,LVEF and LVEDD,which could be used as an objective index to evaluate the severity of chronic heart failure.