| Objective: To analyze the clinical characteristics,diagnosis and treatment of heart failure patients with different ejection fraction in the first affiliated Hospital of Shihezi University.Methods: Patients with chronic heart failure diagnosed in the first affiliated Hospital of Shihezi University from January 2017 to April 2019 were divided into ejection fraction reduced heart failure group(HFrEF),ejection fraction median heart failure group(HFmrEF),ejection fraction retention heart failure group(HFpEF)according to(HFpEF).Through the electronic medical record system and medical record room of our hospital,the social demographic data,past medical history,main etiology,auxiliary examination and hospital therapeutic drugs of the three groups of patients were compared.Results:(1)The main results are as follows:(1)A total of 1015 patients with heart failure were enrolled in this study,including 630 patients(62.1%)with class ? cardiac function in New York and 623 males(61.4%),with an average age of(69 ±13)years.(2)The common diseases of heart failure in hospital are coronary heart disease(81.5%)and hypertension(67.1%).The common complications are pulmonary infection(34.6%),anemia(31.6%)and diabetes(31.4%).(3)There were 376 cases in HFrEF group(37.0%),HFmrEF group)and 383 cases(37.7%)in 25.2%),HFpEF group.Compared with HFmrEF group and HFpEF group,HFrEF group had lower average age,lower systolic blood pressure,higher proportion of male and New York cardiac function class IV,higher levels of NT-proBNP,serum uric acid and free T4,higher proportion of dilated cardiomyopathy and previous myocardial infarction,and lower proportion of atrial fibrillation and COPD.Compared with HFrEF group and HFmrEF group,HFpEF group had older age,lower admission heart rate,lower proportion of male and New York cardiac function class IV,lower levels of hemoglobin,NT-proBNP and uric acid,higher proportion of hypertension,pulmonary infection and COPD,and lower proportion of previous myocardial infarction,dilated cardiomyopathy and diabetes mellitus(all P<0.05).(4)Compared with HFmrEF group and HFpEF group,left atrial diameter and left ventricular end-diastolic diameter in HFrEF group were larger,EF and EF were lower,and the proportion of diffuse weakening of wall motion was higher in HFrEF group.Compared with HFrEF group and HFmrEF group,the left ventricular end-diastolic diameter of HFpEF group was smaller,FS and EF were larger(all P<0.05).The left ventricular end-diastolic diameter,FS and EF of HFmrEF group were between HFrEF and HFpEF(all P<0.05).(5)The utilization rate of beta blockers in 1015 patients with heart failure during hospitalization was 64.7%(76.6% in HFrEF group,65.2% in HFmrEF group,52.7% in HFpEF group),69.7% in ACEI/ARB group(72.1% in HFrEF group,69.1% in HFmrEF group,67.6% in HFpEF group),and 82.4% in aldosterone receptor antagonist(91.0% in HFrEF group,83.2% in HFmrEF group,73.4% in HFpEF group),The utilization rate of digoxin was 25.0%(HFrEF group 42.3%,HFmrEF group17.2%,HFpEF group 13.3%).(6)Of the 1015 patients with heart failure in this study,24(2.4%)died in hospital.Hospital death occurred in 12 cases(3.2%),8 cases(3.1%)and 4 cases(1.0%)in HFrEF,HFmrEF and HFpEF groups,respectively.There was no significant difference in all-cause mortality among the three groups.Conclusion:1.The main CHF patients in our hospital are HFrEF and HFpEF.There are more elderly patients,and there are more males than females.The main causes are coronary heart disease and hypertension.2.The clinical characteristics of patients with different types of heart failure are different,and many clinical features of HFmrEF are between HFrEF and HFpEF.3.There is still a certain gap between the drug treatment of CHF patients in our hospital and the drug treatment guided by the guidelines. |
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