Comparative study of non-invasive hemodynamics and echocardiography on heart failure with preserved ejection fraction patients:one year follow-up / 中国医师进修杂志

ABSTRACT

Objective:A comparative study of non-invasive hemodynamics and echocardiography in 139 cases of heart failure patients with preserved ejection fraction (HFpEF) at baseline and one year follow-up to explore its value on diagnosis, monitoring and prognosis in patients with HFpEF.Methods:The baseline and one year follow-up data of 139 patients with HFpEF in Affiliated Zhongshan Hospital of Dalian University patients who had been enrolled in the China PEACE 5P-HF from June 2016 to May 2018 were analyzed retrospectively. The general data were collected which contented age of the study subjects is (30 - 80) y, average age (64.0 ± 12.3) y, and 63.31% male, (88/139) and 36.69% female (51/139), 56.8% smokers (79/139). t-test way was used to analyze the baseline and one year follw-up data, The indexs included blood pressure (BP), estimated glomerular filtration rate (eGFR) and 6-munites walk test (6MWT). Non-invasive hemodynamic indicators included stroke volume (SV), ejection fractions (EF), cardiac index (CI), index of contratility (IC), pulmonary artery wedge pressure (PCWP), maximum angiectatic velocity(AMPC), left ventricular ejection time (LVET), left ventricular isovolumetric relaxation time (LVLVIVRT), pre-ejection period/left ventricular ejection fractions (PEP/LVET), left ventricular end diastolic pressure (LVEDP) and left cardiac work index (LCWI). Hemodynamic indicators included left ventricular end diastolic dimension(LVEDd), left ventricular end systolic dimension (LVEDs), interventricular septal thickness at diastole (IVSD), left ventricular ejection fractions (LVEF) and E/e′.Results:There was no significant difference between the baseline and one year follow-up data in SBP, DBP, NT-proBNP, eGFR, 6MWT ( P>0.05). There were significant increase in SV, EF, CI, IC in one year′ follow-up compared with that in baselinee [(73.39 ± 29.47) ml vs. (63.39 ± 30.08) ml, (64.87 ± 9.16)% vs. (61.81 ± 9.02)%, (3.06 ± 1.10) ml/(min·m 2) vs. (2.62 ± 1.06) ml/(min·m 2), (0.039 ± 0.037) L/s vs. (0.028 ± 0.015) L/s] ( P<0.05). PCWP in one year′ follow-up was significantly decreased compared with that in baselin [(9.21 ± 3.34) mmHg (1 mmHg = 0.133 kPa) vs. (9.87 ± 3.13) mmHg]( P<0.05), However, AMPC, LVE, LVLVIVRT, PEP/LVET, LVEDP, LCWI in baseline and one year′ follow-up showed no significant difference ( P>0.05). The Hemodynamic indicators in baseline and one year′s follow-up were as followed: LVEF in one year′ follow-up was significantly elevated compared with that in the baseline [(63.53 ± 8.39)% vs. (61.02 ± 7.16)%]; E/e′ in one year′s follow-up was significantly decresed compared with that in the baseline [12.89 ± 5.86 vs. 14.32 ± 6.61]( P<0.05); there were no significant differences in LVEDd, LVEDs and IVSD in baseline compared with those in one year′s followed-up ( P>0.05). Conclusions:Hemodynamic indicators including SV, EF, CI, IC and PCWP could be new reflections of early diagnosis, monitoring and prognosis on HFpEF. The combination of non-invasive hemodynamics and echocardiography on HFpEF can be more significant in reflecting the changes of myocardial remodeling and cardiac function.