RESUMO
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.
RESUMO
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.