Clinical Characteristics Of Heart Failure With Preserved Ejection Fraction With First Acute Myocardial Infarction

Objective:To investigate the clinical characteristics of heart failure with preserved ejection fraction with first acute myocardial infarctionMethods:1.A total of 185 patients who were admitted to our hospital from January 2016 to August 2018,they were diagnosed of acute myocardial infarction and developed heart failure in the study.Of which 127 HFpEF(EF?50%)with AMI were selected as a case group(Group 1),and 58 HFrEF(EF<40%)with AMI were selected as a case group(Group2).2.Collect patients gender,age,heart rate,blood pressure,white blood cells,neutrophils absolute value,absolute value of lymphocyte,hemoglobin,red blood cell distribution width,platelet,platelet distribution width,alanine aminotransferase,total bilirubin,albumin,prealbumin,triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),troponin,NT-pro BNP and other basic situation;The traditional risk factors of coronary heart disease such as hypertension,type 2 diabetes,smoking and drinking alcohol were collected.To explore the clinical features of heart failure with preserved ejection fraction.3.The results of coronary angiography were collected to analyze the number of coronary artery lesions(single-branch lesions,multi-branch lesions,etc.)and the type of myocardial infarction in heart failure patients with preserved ejection fraction.Collect cardiac color doppler ultrasound results;Arrhythmias occurred during hospitalization and medication in hospital were recorded.4.SPSS 20.0 statistical software was used for analysis.Measurement data of normal distribution were expressed as?X±s,and t-test was used for comparison between the two groups.Measurement data of non-normal distribution were represented by M(Q1,Q3),and rank sum test was used for comparison between the two groups.Enumeration data were represented by N(%),comparisons between groups were performed by X~2test,and comparisons between groups were performed by Wilcoxon rank sum test when the dependent variable was ordered multiple classification data.P<0.05 was considered statistically significant.Results:1.Compared with HFrEF patients,the heart rate of HFpEF patients was slower(P<0.05).Compared with HFpEF patients,HFrEF patients had higher LDL cholesterol(P<0.05).Compared with HFpEF patients,HFrEF patients had a higher erythrocyte distribution width(P<0.05).Compared with HFpEF patients,HFrEF patients had higher NT-Pro BNP(P<0.05).Compared with HFpEF patients,HFrEF patients had higher creatinine and urea levels(P<0.05).2.Compared with HFrEF patients,HFpEF has a smaller left ventricular end-loosening diameter(P<0.05).Compared with HFpEF patients,HFrEF had a larger left atrial diameter(P<0.05).3.Compared with HFrEF patients,the proportion of HFpEF group increased with the increase of creatinine clearance rate(P<0.05).Spearman linear regression showed a positive correlation between EF and creatinine clearance(R=0.24,P=0.002).4.According to the patient's angiography results,there was no statistical difference in the number of coronary lesions between HFpEF and HFrEF with acute myocardial infarction(P>0.05).5.There were statistically significant differences in the distribution of myocardial infarction sites in HFpEF and HFrEF(P<0.05).Compared with HFrEF patients,acute inferior wall myocardial infarction was more common in HFpEF patients(P<0.05).Acute anterior wall myocardial infarction was more common in HFrEF patients than HFpEF(P<0.05).6.Comparing the HFpEF and HFrEF in the use of anti-heart failure drugs for the"Golden Triangle",the utilization rate of spironolactone in the HFrEF group was higher(P<0.05).7.Compared the incidence of HFpEF and HFrEF arrhythmia,there was no statistical difference in the incidence of arrhythmia during hospitalization(P>0.05).Conclusions:1.Compared with HFrEF patients with AMI,HFpEF patients had a slower heart rate.2.Compared with HFrEF patients with AMI,HFpEF patients had a lower RDW.3.Compared with HFrEF patients with acute myocardial infarction,HFpEF patients had a smaller left ventricular end diastolic meridian.4.Acute inferior wall myocardial infarction is more common in HFpEF patients than in HFrEF patients with AMI;Acute anterior wall myocardial infarction was more common in HFrEF patients than in HFpEF patients with AMI.