RÉSUMÉ
Objective:To explore the assessment value of echocardiogram combined with serum high-sensitivity C-reactive protein(hs CRP)and N-terminal pro brain natriuretic peptide(NT proBNP)levels on cardiac function of patients with coronary heart failure.Methods:A total of 306 patients with coronary heart failure admitted to Beijing Daxing District People's Hospital from November 2021 to November 2022 were selected as the study group.Among of them,144 cases were grade Ⅱ,103 cases were grade Ⅲ and 59 cases were grade Ⅳ as the classification of New York Heart Association(NYHA)for cardiac function.A total of 108 healthy examinees who underwent physical examinations in our hospital during the same period were selected as the healthy control group.All examinees were classified as the NYHA for cardiac function,and left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF),peak ejection rate(PER)and peak filling rate(PFR)of them were measured by echocardiogram.The NT proBNP and hs CRP levels of all examinees were measured.Receiver operating characteristic(ROC)curve was used to analyze the values of single LVEDV,LVESV,LVEF,PER,PFR,hs CRP and NT-proBNP,and the combination of them.Results:LVEDV(122.69±18.24)ml and LVESV(70.79±10.03)ml of the study group were significantly higher than(92.27±15.22)ml and(33.16±7.22)ml of the healthy control group,and the LVEF(42.26±5.13)％,PER(2.49±0.22)EDV/s and PFR(1.79±0.26)EDV/s of the study group were significantly lower than(69.34±5.27)％,(3.56±0.27)EDV/s,and(2.59±0.23)EDV/s of the healthy control group,with statistical significances(t=15.526,35.837,46.828,40.825,28.302,P<0.05),respectively.The levels of hs CRP and NT proBNP of the study group were significantly higher than those of the healthy control group,with statistical significance(t=88.000,29.099,P<0.05),respectively.The LVEDV and LVESV of grade Ⅱ/Ⅲ patients were significantly lower than those of grade Ⅳ patients,while LVEF,PER and PFR of grade Ⅱ/Ⅲ patients were significantly higher than those of grade Ⅳ patients,with statistically significant differences(t=53.391,92.658,32.140,240.474,116.921,P<0.05),respectively.The levels of hs CRP and NT proBNP of grade Ⅱ/Ⅲ patients were significantly lower than those in grade Ⅳ patients,with statistical significance(t=41.037,5.955,P<0.05),respectively.The results of ROC curve analysis showed that the sensitivities of single LVEDV,LVESV,LVEF,PER,PFR,hs CRP,NT proBNP and the combined examination of them were respectively 45.00％,50.00％,70.00％,70.00％,75.00％,70.00％and 90.00％,and the specificities of them were respectively 76.70％,57.00％,82.60％,44.20％,58.10％,52.30％and 96.50％.The area under curve(AUC)values of LVEDV,LVESV,LVEF,PER,PFR,hs CRP,NT proBNP and the combined examination of them were 0.592(95％CI:0.441-0.743),0.615(95％CI:0.468-0.761),0.766(95％CI:0.634-0.899),0.717(95％CI:0.575-0.860),0.674(95％CI:0.536-0.812),0.734(95％CI:0.592-0.876),0.581(95％CI:0.469-0.694)and 0.978(95％CI:0.947-1.000),respectively.Conclusion:The serum hs CRP,NT proBNP levels and function parameters of left heart in patients with coronary heart failure have occurred corresponding changes,and the above indicators have higher assessment value for the heart function of coronary heart failure,and the value of combined assessment is higher.
RÉSUMÉ
ObjectiveTo investigate the clinical effect of Guanxin Shutong capsules （GXSTC） on coronary heart failure with heart blood stasis. MethodA total of 98 coronary heart failure patients with heart blood stasis who visited the expert clinics of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from June 2020 to August 2022 were selected. They were randomized into a control group and an observation group， with 49 in each group. The two groups were given standardized treatment according to the guidelines for coronary heart failure. On this basis， the observation group was treated with Chinese patent medicine GXSTC. The cardiac structural and functional indicators， total effective rate of symptoms， exercise tolerance， heart rate variability （HRV）， quality of life and inflammatory factor levels of the two groups before and after treatment were compared. ResultBefore treatment， there was no notable difference in high-sensitivity C-reactive protein （hs-CRP）， six minute walk test （6MWT）， minnesota living with heart failure questionnaire （MLHFQ） score， left ventricular ejection fraction （LVEF）， tumor necrosis factor-α （TNF-α）， left ventricular end-diastolic diameter （LVEDD）， N-terminal pro-brain natriuretic peptide （NT-proBNP） and HRV between the two groups， and thus the data were comparable. After treatment， the observation group had higher effective rates of traditional Chinese medicine （TCM） symptoms （Z=-2.362， P<0.05） and New York heart association class （NYHA） functional classes （Z=-2.175， P<0.05） than the control group. The two groups presented decreased LVEDD， TNF-α， NT-proBNP and hs-CRP （P<0.05， P<0.01） while increased MLHFQ， 6MWT and HRV（P<0.05，P<0.01） after treatment as compared with those before treatment， and the observation group had more decrease or increase than the control group （P<0.05， P<0.01）. ConclusionGXSTC combined with standardized treatment relieves the physical symptoms of coronary heart failure patients with heart blood stasis， improves exercise tolerance and quality of life， reduces inflammatory reaction， increases HRV， and improves cardiac structure and function.