Combined QRS Duration And H-FABP Levels To Evaluate The Prognosis In Chronic Heart Failure

ObjectiveTo investigate the role of QRS duration and heart-type acid binding protein(H-FABP)in the prognosis assessment of chronic heart failure patients.MethodPatients diagnosed with chronic heart failure in the affiliated central hospital of shenyang medical college from September 30,2017 to February 28,2018 were selected as the study subjects.The prospective follow-up period was 12 months,and the follow-up endpoint was the occurrence of major adverse cardiovascular events(cardiogenic death and worsening heart failure readmission).Research methods:Recording the clinical data of the objects(gender;age;weight;previous medication:ACEI,beta-blocker,calcium channel blocker,diuretic,statins;disease diagnosis:atrial fibrillation,diabetes,hypertension,dyslipidemia).12-lead Electrocardiogram was performed 24 hours after admission.The QRS duration was the mean of 12 leads.Intravenous blood was collected within 24 hours of admission for measurements of H-FABP levels.Ejection fraction was determined by echocardiography within 24 hours of admission.The curve of cardiovascular events were demonstrated by Kaplan-Meier method.Log-rank test was used to compare the survival of cardiac events between groups.ROC curve and AUC region were used to evaluate the accuracy of prediction factors.ResultsPatients had major adverse cardiovascular events,with an average age of(79.00±1.536)years,including 11 males and 12 females.All objects were divided into four groups according to the QRS duration(?120ms)and H-FABP levels(?3.5ng/ml):normal group(H-FABP<3.5ng/mL and QRS<120ms),QRS prolongation group(H-FABP<3.5ng/mL and QRS?120 ms),high H-FABP group(H-FABP?3.5ng/mL and QRS<120 ms),and abnormal group(H-FABP>3.5ng/mL and QRS?120 ms).There were no significant differences in sex,EF,atrial fibrillation,hypertension,diabetes,dyslipidemia,ACEI,?-blockers,calcium channel blockers and statins between the patients of with and without cardiac events(P>0.05).There were significant differences in QRS prolongation(P=0.029),BNP levels(P=0.001),H-FABP levels(P=0.022)and glomerular filtration rate(P=0.016).Multivariate analysis showed that combining QRS prolongation(HR = 7.330,P<0.000)and high H-FABP levels[risk ratio(HR)?8.539,P<0.000]were independent predictors of CHF.Kaplan-Meier analysis showed that the combination of H-FABP levels and QRS prolongation could be used to predict reliably cardiovascular events in chronic heart failure(Log-rank test,P<0.0001).The ROC curves of QRS duration and H-FABP levels reveal the areas of AUC were 0.7098 and 0.7913,respectively.It suggested that QRS duration and H-FABP levels were both great predictors of cardiovascular events in CHF.ConclusionQRS duration and H-FABP levels can be used as independent predictors of cardiac events in CHF.The probability of cardiovascular events in patients with prolonged QRS duration and high H-FABP levels is significantly higher than that in patients with normal or only one abnormal index.Therefore,it is feasible to combine H-FABP and QRS duration in risk stratification of CHF patients.