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[慢性心力衰竭患者心音图参数与脑钠肽、左心室射血分数及心功能分级的相关性]

[Correlation between the parameters of acoustic cardiography and BNP, LVEF and cardiac function grading in patients with chronic heart failure].

作者信息

Xie Q, Zhang F W, Chen M S, Zhang Y X, Ren L Q, Xing B, Li D Y

机构信息

Department of Cardiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570208, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2018 Jan 2;98(1):25-29. doi: 10.3760/cma.j.issn.0376-2491.2018.01.006.

Abstract

To explore the correlation between the parameters of the new generation of Acoustic Cardiography and brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and cardiac function grading in the diagnosis of heart failure. One hundred and sixty-eight inpatients, who were hospitalized in Department of Cardiology, Haikou People's Hospital from May 2016 to July 2017, were enrolled as heart failure group, including NYHA class Ⅰ(=29), NYHA class Ⅱ(=40), NYHA class Ⅲ(=64), NYHA class Ⅳ (=35). And eighty-seven patients with normal cardiac function were selected as healthy control group. The data of the two groups were analyzed after the Acoustic Cardiography test, BNP determination and LVEF examination. The differences in QRS duration, electromechanical activation time (EMAT), EMAT%, systolic dysfunction index (SDI), third heart sound (S3) and other indicators among the groups with different levels of cardiac function were statistically significant (<0.05). The difference in left ventricular systolic time (LVST) between the cardiac function grade Ⅰ and healthy group was not significant (>0.05), while the differences among the rest groups were significant. There was a positive correlation between QRS duration, EMAT%, SDI, S3 and BNP (=9.46, 11.38, 12.14, 9.67, respectively, <0.05); LVST and BNP were negatively correlated (=-14.27, <0.05). There was a negative correlation between QRS duration, EMAT%, SDI, S3 and LVEF (=11.24, -8.764, -2.393, -0.579, respectively, <0.05). There was a positive correlation between LVST and LVEF (=23.48, <0.05). There was a positive correlation between QRS duration, EMAT%, SDI, S3 and cardiac function grading (β=0.003, 0.234, 0.419, 0.352, respectively, <0.05). There was a negative correlation between LVST and cardiac function grade (β=-0.021, <0.05). The parameters of the Acoustic Cardiography test (EMAT%, EMAT, SDI, S3 ) are closely related to BNP, LVEF and cardiac function grading, and can be used as assistant indexes for the diagnosis and evaluation of heart failure.

摘要

探讨新一代心音图参数与脑钠肽(BNP)、左心室射血分数(LVEF)及心功能分级在心力衰竭诊断中的相关性。选取2016年5月至2017年7月在海口市人民医院心内科住院的168例患者作为心力衰竭组,其中纽约心脏病协会(NYHA)Ⅰ级(=29例)、NYHAⅡ级(=40例)、NYHAⅢ级(=64例)、NYHAⅣ级(=35例)。选取87例心功能正常的患者作为健康对照组。对两组患者进行心音图检查、BNP测定及LVEF检测后分析数据。不同心功能水平组间的QRS时限、机电激活时间(EMAT)、EMAT%、收缩功能障碍指数(SDI)、第三心音(S3)等指标差异有统计学意义(<0.05)。心功能Ⅰ级组与健康组的左心室收缩时间(LVST)差异无统计学意义(>0.05),其余组间差异有统计学意义。QRS时限、EMAT%、SDI、S3与BNP呈正相关(分别为=9.46、11.38、12.14、9.67,<0.05);LVST与BNP呈负相关(=-14.27,<0.05)。QRS时限、EMAT%、SDI、S3与LVEF呈负相关(分别为=11.24、-8.764、-2.393,-0.579,<0.05)。LVST与LVEF呈正相关(=23.48,<0.05)。QRS时限、EMAT%、SDI、S3与心功能分级呈正相关(β分别为0.003、0.234、0.419、0.352,<0.05)。LVST与心功能分级呈负相关(β=-0.021,<0.05)。心音图检查参数(EMAT%、EMAT、SDI、S3)与BNP、LVEF及心功能分级密切相关,可作为心力衰竭诊断和评估的辅助指标。

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