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Objective: To assess blood levels of renal function related influencing factors with baseline clinical parameters for predicting the risk of 8-year survival in patients with chronic heart failure (CHF). Methods: A total of 293 CHF patients admitted in our hospital from 2006-07 to 2009-11 were enrolled. The patients were followed-up until 2014-6-30, the end point was death. According to followed-up results, they were divided into 2 groups: Survival group,n=107 and Death group,n=186. All patients received routine renal function and electrolytes examination including blood levels of urea nitrogen, creatinine, uric acid, sodium, potassium, chloride, calcium, anion gap and phosphorus; GFR was calculated by MDRD formula. Baseline clinical parameters as left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) were measured by echocardiography; blood pressure (BP) and heart rate (HR) were recorded. The risk factors for 8-year survival in CHF patients were analyzed. Results: Compared with Survival group, Death group had increased LVEDD, urea nitrogen, creatinine and uric acid, while decreased LVEF, HR, GFR, blood sodium and calcium, allP<0.05. Univariate analysis indicated that LVEDD, LVEF, GFR, urea nitrogen, creatinine, uric acid, blood sodium, calcium and phosphorus had the better predictive value for the risk of 8-year survival in CHF patients, allP<0.05. Multivariate analysis presented that LVEDD, GFR and blood sodium had the highest predictive value for the risk of 8-year survival, allP<0.001; the next one was blood calcium,P<0.01. Conclusion: LVEDD, GFR, blood sodium and calcium were the independent predictors for the risk of 8-year survival in CHF patients.
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Objective: To analyze and to predict the 1 year re-admission risk in patients of chronic heart failure with reduced left ventricular ejection fraction (HFrEF) by echocardiography. Methods: A total of 313 HFrEF patients in our hospital community from 2007-01 to 2008-12 were studied. The patients were followed-up for (6-7) years and the end point was 1 year re-admission. All patients received routine echocardiography and the parameters included left ventricular ejection fraction of (LVEF), left ventricular diameter (LVd), pulmonary artery systolic pressure (PASP), mitral regurgitation (MR), tricuspid regurgitation (TR) and pericardial effusion. Based on the above 6 parameters, the risk factors for 1 year re-admission were analyzed. Results: Univariate analysis indicated that MR (HR=1.437, 95%CI 1.190-1.737, P=0.000), TR (HR=1.288, 95%CI 1.056-1.572, P=0.013) and pericardial effusion (HR=1.560, 95%CI 1.050-2.318, P=0.028) had better predictive value for 1 year re-admission. Multivariate analysis presented that MR (HR=1.404, 95%CI 1.159-1.701, P=0.001) took ifrst place for predicting the 1 year re-admission and pericardial effusion took second place (HR=1.410, 95%CI 1.030-1.928, P=0.032). Conclusion: MR, TR and pericardial effusion were the independent predictors for 1 year readmission in HFrEF patients;while MR and pericardial effusion were the independent risk factors for 1 year re-admission.
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Objective To investigate the influence of the cardiac function on the prognosis in the patients with acute myocardial infarction(AM I) complicating multivessel disease (M VD ) treated by revascularization .Methods 152 cases of AM I complicating MVD treated by routine percutaneous coronary intervention (PCI) were divided into the normal group(94 cases ,LVEF≥50% ) and the lower group(58 cases ,LVEF<50% ) according to the left ventricular ejection fraction (LVEF) ,and the influence of the cardiac function on the prognosis was analyzed .Results The myocardial infarction history ,history of atrial fibrillation ,NYHA classifica-tion ,hs-CRP ,LADp ,ISR ,left ventricular structure and function had statistically significant difference between the two groups (P<0 .05) .The multivariate Logistic regrossion analysis showed that NYHA classification ,LVEF ,LVMI and LVEDd were the inde-pendent risk factors affecting the prognosis after PCI .Conclusion The reduced cardiac function is a risk factor affecting the prog-nosis of AMI complicating MVD treated by PCI ,the improvement of the cardiac function will be beneficial to the prognosis of the patients .
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Objective To investigate the effects of physical exercises on cardiac function and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in hypertensive patients combined with diastolic cardiac dysfunction.MethodsA total of 66 essential hypertension patients who had abnormal left ventricular relaxation and normal systolic function were assigned to the intervention group ( n =33 ; doing physical exercises once a day,5 days a week) or control group (n =33 ).All the patients received standard treatment.At 6 months,body weight,blood pressure,heart rate,NT-proBNP,and echocardiography were measured.ResultsAt 6 months,body weight [ (68 ± 7 ) kg vs (72 ± 8 ) kg ],systolic blood pressure [ (135.4 ±5.1) mm Hg (1 mm Hg =0.133 kPa) vs (141.9 ±5.2) mm Hg ],diastolic blood pressure [ (81.1 ±4.0) mm Hg vs (84.7 ±4.6) mm Hg],New York Heart Association class (1.4 ±0.3 vs 1.8 ±0.4),NT-proBNP level [ (526 ± 126 ) ng/L vs (741 ± 189 ) ng/L] were significantly decreased in the intervention group when compared with the control group ( all P ＜ 0.05 ) although left ventricular ejection fraction (LVEF) (62.9 ±6.7 vs 59.0 ±5.6) and E/A ratio ( 1.1 ±0.3 vs 0.9 ±0.3) were significantly increased ( both P ＜ 0.05).ConclusionPhysical exercises could play a role in reduced blood pressure and body weight and improved cardiac function in hypertensive patients with diastolic cardiac dysfunction.