| BackgroundChronic heart failure (CHF) is the final result of many internal diseases and is often characterized by severe conditions, high hospitalized rate and recurring. It can be diagnosed in Traditional Chinese Medicine(TCM) as "edema","gasp syndrome"," Bi syndrome of heart",'palpitation" and etc. It is considered that the six important syndrome elements named deficiency of heart qi, deficiency of heart blood, deficiency of heart yang, deficiency of heart yin, blood stagnation in heart and phlegm obstructing heart combine with and influence each other so as to form the clinical features and signs. In recent years, there has been a great progress in the field of the syndrome elements which may help us to treat CHF with TCM.Cardiac remodeling which is the basic mechanism of CHF may have certain influence on the formation of the six syndrome elements.PurposeThe purpose of this study is to invest the influencing factors on CHF patients with cardiac remodeling of the six syndrome elements.MethodWe collected193cases of CHF patients who were hospitalized in Guang Anmen Hospital from June2006to August2011. Then they were divided into four groups by the size of the atrium and ventricle and six groups by the syndrome elements. The four groups are atrial remodeling, ventricular remodeling, atrial and ventricular remodeling and no remodeling. The six groups are deficiency of heart qi group, deficiency of heart blood group, deficiency of heart yang group, deficiency of heart yin group, blood stagnation in heart group and phlegm obstructing heart group. Then we compared the differences of general conditions, ECG and biomarkers between the four groups and the six groups.Result1. The four groups are apparently different in sex and age (P<0.001), and distribute differently in the deficiency of heart yin group (P<0.005). The deficiency of heart yin group has a clear statistical significance with atrial remodeling after checked by logistic regression (P<0.01).2. The four groups are apparently different in LVEF, FS and NT-pro BNP (P<0.001), the atrial and ventricular remodeling group is apparently lower in LVEF and FS (PO.01) and higher in NT-pro BNP (P<0.05) than the atrial remodeling group and no remodeling group.3.The four groups are not apparently different in Cr, BUN, ALT, AST, TBIL, DBIL and IBIL (P>0.05). But the atrial and ventricular remodeling group is apparently higher than the other groups in UA (P<0.01). After a linear correlation analysis between UA and LVEF? NT-pro BNP, it is seen that the correlation is apparent (p<0.01, p<0.05).4. The four groups are different in mitral regurgitation (P<0.01), tricuspid regurgitation (P<0.05) and pulmonary regurgitation (P<0.01).5. The four groups are different in HR max (P<0.05). The atrial remodeling group has a clear statistical significance with HR max after checked by logistic regression (P<0.01).6. The four groups are different in premature ventricular contractions (P<0.05).7. The four groups are different in RBC?HGB and GLU (P<0.01) but are all in the normal range.8. The six groups are different in the course of disease (P<0.05). And the deficiency of heart yang group is much longer than the other five groups.9. The six groups are different in Cr (P<0.05).The deficiency of heart yang group is the highest group while the deficiency of heart blood group is the lowest group.10. The six groups are apparently different in UA (P<0.01). The deficiency of heart yang group is much higher than the deficiency of heart blood group.11. The six groups are apparently different in LVEDD (P<0.05) with the deficiency of heart yang group has the biggest left ventricle. After checked by logistic regression, we see the deficiency of heart yang group has a clear correlation with LVEDD.Conclusion1. Atrial and ventricular remodeling happens more in men than in women.2. Cardiac remodeling is the structural change of the decline of heart function. The atrial and ventricular remodeling is the late stage of CHF and is much severer than the atrial remodeling and ventricular remodeling.3. The valves of heart get worse as the condition of CHF worsens.4. Atrial remodeling has close link with tachycardia of CHF patients while ventricular is more effective in ventricular arrhythmia.5. Uric acid has a close relationship with heart function, it may shows the severity of CHF together with LVEF?FS and NT-pro BNP.6. Cardiac remodeling may lead to a worse liver and kidney function.7. The deficiency of heart yin has a clear relationship with atrial remodeling with unclear mechanism.8. The deficiency of heart yang which is the late stage of CHF has a apparent correlation with LVEDD and may promote the elevation of UA and Cr. |
PDF Full Text Request