应用心-踝血管指数评估射血分数中间范围型心衰患者心衰严重程度

Clinical Value of Heart-ankle Vascular Index in the Evaluation of the Severity of Heart Failure in Patients with Middle Range Ejection Fraction

目的:探讨心-踝血管指数(CAVI)对射血分数中间范围型心力衰竭(HFmrEF)患者心力衰竭严重程度评估的应用价值。方法:收集160例本院收治的HFmrEF患者为心衰组,按NYHA分级分为II级78例(II级组)、III级56例(III级组)和IV级26例(IV级组)。另选取160例年龄匹配的本院健康体检者作为对照组。对所有入选者进行CAVI评估及检测血浆N末端脑钠肽前体(NT-proBNP)水平。比较各组各指标水平的差异,并采用受试者工作特征(ROC)曲线评价CAVI和血浆NT-proBNP对HFmrEF患者心衰严重程度的评估价值。结果:心衰组CAVI和血浆NT-proBNP均较对照组升高,差异有统计学意义(P<0.05),且不同NYHA分级患者CAVI水平和NT-proBNP水平均呈Ⅱ级组<Ⅲ级组<Ⅳ级组(P<0.05或P<0.01)。CAVI和血浆NT-proBNP与NYHA心功能分级均呈正相关(r=0.65、r=0.69,P<0.05),CAVI与血浆NT-proBNP水平亦呈正相关(r=0.66,P<0.05)。CAVI和血浆NT-proBNP对HFmrEF患者均具有较强诊断价值。结论:HFmrEF患者CAVI水平升高,且CAVI能较好地评估HFmrEF患者心力衰竭严重程度。

Objective： To evaluate the value of heart-ankle vascular indexes in assessing the severity of heart failure in patients with mid-range ejection fraction （HFmrEF）. Method： We collected 160 patients with HFmrEF who were admitted to our hospital as heart failure group. According to NYHA classification, they were divided into 78 cases of grade II, 56 cases of grade III, and 26 cases of grade IV. Another 160 age-matched healthy examinees were selected as control groups. All enrollees were evaluated for a cardio-ankle vascular index （CAVI） and plasma NT-proBNP levels were measured. Results： The CAVI and plasma NT-proBNP in the heart failure group were higher than those in the control group, and the difference was statistically significant （P〈0.05）, and the level of CAVI and NT-proBNP in different NYHA grading patients was in grade II Group〈grade Ⅲ group〈 grade IV group （P〈0.05 or P〈0.01）. There was a positive correlation between CAVI and plasma NT-proBNP and NYHA cardiac function classification （ r=0.65, r=0.69, P〈0.05）, and CAVI was also positively correlated with the level of plasma NT-proBNP （r=0.66, P〈0.05）. The diagnostic value of CAVI and plasma NT-proBNP was very strong for HFmrEF patients. Conclusion： Heart-ankle vascular indexes can well assess the severity of heart failure in patients with HFmrEF.