Correlation between Noninvasive Cardiac Function Assessment Indexes and NYHA Classification in Patients with Acute Exacerbation of Chronic Heart Failure
ZHANGjinlong, GUOjingtao, SUNnina, et al
The Second Clinical College of Chengde Medical University, Hebei Chengde 067000, China
Abstract:Objective: To investigate the correlation between noninvasive cardiac output (CO), cardiac index (CI), stroke volume (SV), left ventricular work (LCW), and NYHA cardiac function classification in patients with acute exacerbation of chronic heart failure (Chronicheartfailure, CHF). Methods: One hundred and forty-four patients with acute exacerbation of CHF admitted to the Department of Cardiology of Chengde City Central Hospital from November 2021 to October 2022 were selected and categorized into class IV (50 patients), class III (48 patients), and class II (46 patients) according to the cardiac function grading criteria of NYHA (American College of Cardiology). All patients underwent noninvasive hemodynamic cardiac function index testing and B-type natriuretic peptide (BNP) and cardiac ejection fraction (EF) testing, comparing the levels of CO, CI, SV, LCW, BNP, and EF in each group, and analyzing the correlation between CO, CI, SV, and LCW and the NYHA cardiac function classification of patients with acute exacerbation of CHF. Results: The values of CO, CI, SV, LCW, and EF in class Ⅱgroup were higher than those in class Ⅳgroup (P<0.05). The values of CO, CI, SV, LCW, and EF in class Ⅲ group were higher than those in class Ⅳ group (P<0.05). The values of CO, CI, SV, LCW, and EF in class Ⅱgroup were higher than those in the class Ⅲgroup. The BNP of the cardiac function class Ⅲ and Ⅳ groups was higher than that of the cardiac function class Ⅱgroup, but there was no significant difference in BNP between the cardiac function grade Ⅲ and Ⅳ groups (P>0.05). Spearman correlation analysis showed that CO, CI, SV, and LCW were negatively correlated with NYHA cardiac function grade in patients with acute exacerbation of CHF (r=-0.426, -0.368, -0.419, -0.348, P<0.05). Conclusion: As NYHA cardiac function classification worsened, CO, CI, SV, LCW, and EF values decreased, and noninvasive hemodynamic cardiac function assessment indexes were all negatively correlated with NYHA classification, and noninvasive hemodynamic cardiac function assessment indexes were helpful in guiding the assessment of cardiac function classification.
[1] Hao Guang,Wang Xin,Chen Zuo,et al.Prevalence of heart failure and left ventricular dysfunction in China:the China Hypertension Survey,2012-2015[J].European journal heart failure,2019,21(11):1329-1337. [2] 王华,李莹莹.慢性心力衰竭加重患者的综合管理中国专家共识2022[J].中国循环杂志,2022,37(3):215-225. [3] 郁莉莉,钱何布,刘军等.无创心输出量监测的临床应用进展[J].临床急诊杂志,2020,21(11):923-926. [4] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会.中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志,2018,46(10):760-789. [5] McDonagh Theresa A,Metra Marco,Adamo Marianna,et al.2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure[J].European heart journal,2021,42(36):3599-3726. [6] 李晨洋,叶继伦,张旭,等.基于胸阻抗法的心排量检测系统研制[J].中国医学物理学杂志,2019,36(7):818-825. [7] Cheung Hoiyin,Dong Quan,Dong Rong,et al.Correlation of cardiac output measured by non-invasive continuous cardiac output monitoring (NICOM) and thermodilution in patients undergoing off-pump coronary artery bypass surgery[J].Journal of anesthesia,2015,29(3):416-420. [8] Waldron Nathan H,Miller Timothy E,Thacker Julie K,et al.A prospective comparison of a noninvasive cardiac output monitor versus esophageal doppler monitor for goal-directed fluid therapy in colorectal surgery patients.[J].Anesthesia and analgesia,2014,118(5):966-975. [9] Xaime Garcia,Peter Simon,Francis X,et al.Noninvasive assessment of acute dyspnea in the ED[J].Chest,2013,144(2):610-615.