Prognostic value of cardiac color ultrasound combined with B-type natriuretic peptide in patients with chronic heart failure
Objective To evaluate the prognostic value of color Doppler ultrasound combined with B-type natriuretic peptide in patients with chronic heart failure.Methods The general data of 105 patients with chronic heart failure were collected by clinical self-made clinical data collection table,including gender(male,female),age,body mass index,cardiac function grading(grade Ⅱ,Ⅲ,Ⅳ),diabetes(no,yes),hypertension(no,yes),B-type natriuretic peptide,left ventricular ejection fraction,left atrial diameter,left ventricular diameter,and interventricular septal thickness.The patients were divided into a good prognosis group(no adverse cardiovascular events)and a poor prognosis group(adverse cardiovascular events).The differences in clinical data was compared between the poor prognosis group and the good prognosis group.The correlation between the above indicators and the prognosis of patients with chronic heart failure was analyzed,and the receiver operating characteristic(ROC)curve was drawn to evaluate the value of each indicator in evaluating the prognosis of heart failure.Results In the 105 patients with chronic heart failure followed up for 12 months,26 patients had end-point events(poor prognosis group),including 21 readmissions of adverse cardiovascular events,5 all-cause deaths,and 79 cases had no end-point events(good prognosis group),including 21 readmissions of adverse cardiovascular events,5 all-cause deaths,and 79 cases had no end-point events(good prognosis group).The cardiac function grading in the good prognosis group(29.11%in grade Ⅱ,45.57%in grade Ⅲ,and 25.32%in grade Ⅳ)was better than that in the poor prognosis group(11.54%in grade Ⅱ,38.46%in grade Ⅲ,and 50.00%in grade Ⅳ);in the good prognosis group,the B-type natriuretic peptide was(338.34±95.26)pg/ml,the left atrial diameter was(39.12±4.24)mm,the left ventricular diameter was(62.04±3.12)mm,and the interventricular septal thickness was(10.22±0.42)mm,which were significantly less than(955.68±100.38)pg/ml,(46.08±4.53)mm,(65.06±2.38)mm,and(10.98±0.38)mm in the poor prognosis group;the left ventricular ejection fraction was(48.12±3.88)%in the good prognosis group,which was significantly higher than(41.36±4.06)%in the poor prognosis group(P<0.05).There was no significant difference between the two groups in terms of gender,age,body mass index,diabetes status,and comorbid hypertension(P>0.05).Multiple Logistic regression analysis showed that cardiac function grading[OR=3.121,95%CI=(1.673,5.820)],B-type natriuretic peptide[OR=2.425,95%CI=(1.371,4.290)],left ventricular ejection fraction[OR=2.421,95%CI=(1.136,5.158)],left atrial diameter[OR=2.504,95%CI=(1.271,4.934)],left ventricular diameter[OR=2.147,95%CI=(1.156,3.988)],and interventricular septal thickness[OR=2.522,95%CI=(1.177,5.406)]were the independent factors influencing the prognosis of chronic heart failure(P<0.05).ROC curve analysis of left ventricular ejection fraction,left atrial diameter,left ventricular diameter,interventricular septal thickness,B-type natriuretic peptide and a combination of all five tests for assessing the prognosis of chronic heart failure showed an area under the curve of 0.884,0.873,0.776,0.862,0.892 and 1,with sensitivities of 85.5%,93.7%,62.6%,87.6%,92.1%and 100.0%,and specificity of 12.6%,73.0%,89.7%,70.9%,71.4%and 97.8%.Conclusion Cardiac color ultrasound parameters(left ventricular ejection fraction,left atrial diameter,left ventricular diameter,and intraventricular septal thickness)combined with B-type natriuretic peptide detection have high clinical value in evaluating the prognosis of patients with chronic heart failure.Patients with poor prognosis of chronic heart failure show increased left atrial diameter,left ventricular diameter,interventricular septal thickness,B-type natriuretic peptide,and decreased left ventricular ejection fraction.
Chronic heart failureCardiac color ultrasoundB-type natriuretic peptidePrognosis
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