The association study of serum total bilirubin, plasma N-terminal proBNP and invasive hemodynamic parameters in patients with heart failure / 中华内科杂志

Objective To explore the correlation among serum total bilirubin (TBil) , invasive hemodynamic parameters, plasma N-terminal proBNP (NT-preBNP) and C reactive protain (CRP)in patients with heart failure. Methods Invasive hemodynamic parameters derived from Swan-Ganz catheter, TBil, plasma NT-proBNP and CRP within 12 hours after hospital admission were analyzed in 130 patients with chronic heart failure [Now York Heart Association (NYHA) class Ⅱ -Ⅳ]. Results Compared with those in non-hyperbilirubinemia group, pulmonary capillary wedge pressure (PCWP), NT-proBNP and left ventriculure ejection fraction were different significantly in total hyperbilirubinemia group [(26. 09 vs 16.00) mm Hg(1 mm Hg =0. 133 kPa), (3.36 vs2.91) pmol/L, (34. 12 vs 28.92)%, P<0. 05]. The serum TBil increased significantly in higher PCWP, right atrial pressure and NT-proBNP groups than those in lower level groups [(32. 22 vs 24. 17), (37.52 vs 24. 19), (32. 14 vs 16. 74) pmol/L, P < 0.05]. Partial correlation analysis showed serum TBil was associated with PCWP, right atrial pressure, pulmonary vascular resistance index and NT-proBNP respectively (r = 0. 21, P = 0. 02; r = 0. 33, P < 0. 01 ; r = 0. 20, P =0. 04;r = 0. 37, P <0. 01, respectively). Multiple linear regression analysis showed both right atrial pressure and NT-proBNP correlated independently with serum TBil(β= 0. 39, P < 0. 01 ;β = 0. 29,P = 0. 01, respectively). Conclusion For patients with heart failure, serum TBil correlated well with right atrial pressure, PCWP and NT-proBNP; it is a reliable indicator for exact clinical evaluation of heart failure.

Efficacy and safety of intravenous cediland and esmolol and daltiazem for controlling rapid atrial arrhythmias / 中国实用内科杂志

ObjectiveTo evaluate the efficacy of intravenous cediland(lanatoside C) and esmolol and daltiazem for controlling rapid atrial arrhythmias.MethodsA total of 94 patients with rapid atrial arrhythmias were randomized to receive intravenous cediland(n=29) and esmolol(n=30) and daltiazem(n=35),respectively.ResultThe total efficacy rate were 86%,83% and 85%,with a mean decrease in heart rate by 30.4%,29.3 and 27.6% compared to baseline,and mean response times was 34.3?21.0min、8.1?2.1min and 11.3?3.8min,respectively.ConclusionThree drugs are all effective、rapid and safe in slowing rapid ventricular rate in patients with rapid atrial arrhythmias.