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Objective:To observe the influence of erythropoietin (EPO)combined adjuvant iron treatment on cardiac function,exercise capacity and anemia in patients with diastolic heart failure (DHF)complicated anemia.Methods:A total of 94 DHF + anemia patients were randomly divided into routine treatment group (n=46)and combined treatment group (n=48,received EPO combined adjuvant iron treatment based on routine treatment).Patients re-ceived 6min walking test,levels of hemoglobin (Hb)and N-terminal pro brain natriuretic peptide (NT-proBNP), transmitral early diastolic peak velocity deceleration time (DT),early diastolic peak flow velocity (E),late diastolic peak flow velocity (A)and E/A etc.were measured and compared between two groups before and after six-month treatment.Results:Compared with before treatment,after treatment,NT-proBNP and DT significantly reduced, E/A and 6min walking distance significantly rose in both groups,P <0.05 or <0.01;compared with routine treat-ment group after treatment,there were significant reductions in NT-proBNP level [(368.4±110.7)pg/ml vs.(239 ±89.7)pg/ml]and DT [(257.5±73.4)ms vs.(208.9±59.1)ms],and significant rise in Hb level [(83.3±9.2) g/L vs.(122.1±13.6)g/L],E/A [(0.87±0.3)vs.(1.07±0.27)]and 6min walking distance [(367.54±21.08) m vs.(438.63±20.35)m]in combined treatment group,P <0.05 all.Conclusion:Erythropoietin combined iron treatment can better improve heart function and exercise capacity in patients with diastolic heart failure complicated anemia.
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Objective: To explore change of hemoglobin (Hb) concentration, the relationship between anemia and left ventricular function and the influence of anemia on prognosis in patients with diastolic heart failure (DHF). Methods: According to NYHA classification, a total of 176 DHF patients were divided into class Ⅱ group (n=78), class Ⅲ group (n=50) and class Ⅳ group (n=48), then Hb level and morbidity rate of anemia were analyzed in each group. According to diagnostic standard of anemia, patients were divided into anemia group (n=58, , occupied 33.0%) and non anemia group (n=118, occupied 67.0% ). Left ventricular diastolic function, mortality rate and rehospitalization rate during follow-up were compared and analyzed between two groups. Results: Along with cardiac function class rose (from class Ⅱ to class Ⅳ), Hb level showed a decreasing trend [(130±6) g/L vs. (108±4) g/L vs. (96±12) g/L], while morbidity rate of anemia gradually rose (8.97% vs. 36.0% vs. 68.8%), P<0.05 all in anemia group；Compared with non-anemia group, there were significant rise in percentages of patients with coronary heart disease (55.1% vs. 65.5%), levels of creatinine [(87.6±39.2) μmol/L vs. (113.7±59.8) μmol/L] and N terminal pro B type natriuretic peptide [NT-proBNP, (578.0±136.7) pg/ml vs. (886.0±174.8) pg/ml], and early-diastolic peak velocity deceleration time [(137±15)ms vs. (196±13)ms], and significant reduction in mitral early/late diastolic peak flow velocity [E/A, (0.87±0.32) vs. (0.62±0.29)], P<0.05 all. Compared with non-anemia group, there were significant rise in mortality rate (9.3% vs. 20.7%) and rehospitalization rate (18.6% vs. 32.8%) in anemia group during follow-up, P<0.05 all. Conclusion: DHF patients often complicate with anemia. Along with heart failure aggravates, their morbidity rate of anemia rises, and anemia may aggravate cardiac diastolic dysfunction. Mortality rate and rehospitalization rate rise in DHF patients complicated with anemia.
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Objective: To evaluate the predictive value of plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) on short term prognosis in patients with acute coronary syndrome (ACS). Methods: Plasma NT-proBNP levels were measured in ACS patients within 24 h after admission with ELISA method. The 600 ACS patients were divided into two groups: event group （n=108）and no-event group （n=492）according to occurrence of cardiovascular events（including cardiac death, cardiac shock and heart failure）, The NT-proBNP levels were compared between two groups. Single factor and multiple factor Logistic regression analyses were used to evaluate if NT-proBNP was an independent predictor for short term prognosis. Results: The plasma NT-proBNP levels of event group were significantly higher than those of no-event group [1361.2 (965.3, 2088.6) pmol/L vs.605.7 (274.5, 1177.8) pmol/L, p<0.01]. Multiple factor Logistic regression analyses demonstrated that plasma NT-proBNP was an independent predictor for short term prognosis (OR=1.000, p<0.01) in ACS patients. Conclusion: Plasma NT-proBNP was an independent predictor for short term prognosis in ACS patients.