ABSTRACT
Objective To analyze the correlation between the pressure volume parameters and cardiac function in terms of New York Heart Association(NYHA) classification in patients with pulmonary arterial hypertension. Methods Among 36 patients with pulmonary hypertension admitted in our center between April 2015 to June 2016, right heart catheterization recording right atrial pressure curve,right ventricular pressure curve,pulmonary arterial pressure and oxygen saturation curve in different parts was performal.All patients recived underwent cardiac MRI examination to obtain a single cardiac cycle and the use of Mass software to measure right ventricular volume continuously and right ventricular pressure-volume loop parameters were then obtained. Patients were divided into different groups according to the NYHA functional classification, and the correlation between the parameters of each group and the cardiac function classes a were analyzed. Results Compare to patients with NYHA class Ⅰheart function,patients with NYHA heart function class Ⅱ and class Ⅲ had significantly higher right ventricular end diastolic pressure(P < 0.05)and higher right ventricular systolic pressure (P < 0.01). Spearman correlation analysis showed that cardiac function of NYHA classⅠ,Ⅱ and Ⅲhad position correlation with RVESV,RVEDP and RVESP wheras negative correlation with RVEDV. ROC curve analysis showed that,when the patients were divided into 2 groups as NYHAⅠvs. NYHA class Ⅱ + Ⅲ,NYHA classification for predicting the outcome of the NYHA class Ⅱ + Ⅲ level, pulmonary artery elasticity and right ventricular end systolic pressure had larger area under curves respectively. Conclusions Pressure-volume parameters of right ventricles are more objective indicators for cardiac function assessment for pulmonary hypertension patients and evaluation of disease progression especialy in patients with mild symptoms.
ABSTRACT
Objective To analyze the correlation between the pressure volume parameters and cardiac function in terms of New York Heart Association(NYHA) classification in patients with pulmonary arterial hypertension. Methods Among 36 patients with pulmonary hypertension admitted in our center between April 2015 to June 2016, right heart catheterization recording right atrial pressure curve,right ventricular pressure curve,pulmonary arterial pressure and oxygen saturation curve in different parts was performal.All patients recived underwent cardiac MRI examination to obtain a single cardiac cycle and the use of Mass software to measure right ventricular volume continuously and right ventricular pressure-volume loop parameters were then obtained. Patients were divided into different groups according to the NYHA functional classification, and the correlation between the parameters of each group and the cardiac function classes a were analyzed. Results Compare to patients with NYHA class Ⅰheart function,patients with NYHA heart function class Ⅱ and class Ⅲ had significantly higher right ventricular end diastolic pressure(P < 0.05)and higher right ventricular systolic pressure (P < 0.01). Spearman correlation analysis showed that cardiac function of NYHA classⅠ,Ⅱ and Ⅲhad position correlation with RVESV,RVEDP and RVESP wheras negative correlation with RVEDV. ROC curve analysis showed that,when the patients were divided into 2 groups as NYHAⅠvs. NYHA class Ⅱ + Ⅲ,NYHA classification for predicting the outcome of the NYHA class Ⅱ + Ⅲ level, pulmonary artery elasticity and right ventricular end systolic pressure had larger area under curves respectively. Conclusions Pressure-volume parameters of right ventricles are more objective indicators for cardiac function assessment for pulmonary hypertension patients and evaluation of disease progression especialy in patients with mild symptoms.
ABSTRACT
Objective To investigate the changes of B type natriuretic peptide(BNP) and interleukin(IL)-33 levels and their clinical diagnostic values in different heart function classification of patients with heart failure.MethodsFrom January 2016 to January 2017,286 patients with heart failure in our hospital were selected as the heart failure group,while 106 healthy people were selected as the control group.The heart failure group was divided into New York Heart Association(NYHA)Ⅰ(n=76), NYHA Ⅱ(n=129), NYHA Ⅲ(n=61) and NYHA Ⅳ(n=20) according to the NYHA heart function classification criteria.The BNP and IL-33 levels were compared between heart failure group and control group,as so as the different heart function classification groups.And analyzed the factors related to heart failure by single factor and multivariate logistic regression.The diagnostic value of BNP and IL-33 in heart failure were analyzed by receiver operating characteristic(ROC) curve.ResultsThe level of BNP in heart failure group was significantly higher than that in control group(P<0.05),while IL-33 level was significantly lower than that in control group (P<0.05).The BNP levels in heart function classification groups had significant difference(P<0.05),but there was no significant difference in IL-33 level among them.Univariate analysis showed that both BNP and IL-33 were associated factors of heart failure, but multivariate logistic analysis showed that only BNP was an independent factor of heart failure.ROC curve showed that the area under the curve(AUC) of heart failure diagnosed of BNP was bigger than that of IL-33,the difference was statistically significant (P<0.05).ConclusionBNP and IL-33 can both effectively diagnose heart failure, but BNP is more diagnostic value.Besides, BNP can effectively reflect the cardiac function, the degree of disease and prognosis, witch can more scientifically guide the clinical treatment.