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Emergency and Critical Care Medicine 2022年第3期2卷 105-108页

作者： Alexandra Skovran Mason Hinke Shelly N.B.Sloan Greg Stahl Kerry Johnson Scott Goade Robert Arnce Kansas City University–College of Medicine JoplinMOUSA Freeman Health System JoplinMOUSA Missouri Southern State University JoplinMOUSA

Background:Sepsis is the leading cause of death in hospitalized patients and significant effort has been made to facilitate early diagnosis and management.However,aggressive treatment can have negative effects,especially in patients with unstable volume status,such as those with congestive heart failure.Methods:We used electronic medical records to perform a retrospective study looking at hospital outcomes in patients from Southwest Missouri who were admitted with sepsis and had a comorbid diagnosis of hypertensive heart failure.Our primary outcome was in-hospital mortality.Results:We studied a total of 184 patients with the diagnosis of hypertensive heart failure with sepsis,and 348 patients with the diagnosis of sepsis that served as the baseline group.There was a total of 37(20%)deaths in the hypertensive heart failure group and a total of 94(27%)deaths in the baseline group.Conclusion:Our study showed no significant difference between the baseline group and those with hypertensive heart disease with heart failure.

关键词： congestive heart failure Hypertension Hypertensive heart disease Sepsis

Chinese Medicine Syndromes in congestive heart failure:A Literature Study and Retrospective Analysis of Clinical Cases

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Chinese Journal of Integrative Medicine 2016年第10期22卷 738-744页

作者：李小茜何建成黄品贤曹雪滨 Department of Diagnostics of Chinese Medicine Shanghai University of Traditional Chinese Medicine Department of Cardiology 252 Hospital of PLA

Objective： To discuss the characteristics of Chinese medicine （CM） syndrome factors and distribution of congestive heart failure （CHF）, and provide a basis for the diagnosis criteria of essential syndromes. Methods： Based on databases of China National Knowledge infrastructure （CNKI, 1980--2012） and Chinese Journal of Chongqing VlP Database （1989-2012）, the eligible studies in CHF and extracted factors associated with compound syndromes were analyzed. All the syndromes were classified into deficiency, excess, and deficiency-excess in complexity syndrome were classified. Compound syndromes were separated into syndrome factors including single, double, three or four factors, along with the frequency of occurrence. The relation of CHF syndromes with age, gender, primary disease, brain natriuretic peptide （BNP） and cardiac functional grade was studied in 1,451 CHF cases （between December 2010 and September 2012）, and the clinical distribution of common CHF syndromes was summarized. Results： The literature study involved 6,799 CHF cases in 66 literatures after screening. Of the different factors affecting CHF, qi deficiency was the most important one. In deficiency syndrome, Xin （heart）-qi-deficiency was the most common single factor, and deficiency of both qi and yin was the most common double factor. The retrospective analysis involved 1,451 CHF cases （431 cases with test results of BNP）. The xin blood stasis and obstruction and deficiency of both qi and yin syndrome were mostly seen in female patients, and phlegm-blocking-Xin-vessel and qi-deficiency-blood-stasis syndrome mostly in males. Xin-qi-deficiency and qi-deficiency-blood-stasis syndrome were mostly seen in patients aged 50--60 years. Patients aged over 60 years likely manifest deficiency of both qi and yin and Xin blood stasis and obstruction syndrome. The severity of syndrome is aggravated with increased BNP and cardiac functional grade. Conclusions： The essential syndromes of CHF include qi-deficiency-blood-stasis and deficiency of both qi and yin. The c

关键词： congestive heart failure literature study retrospective analysis of clinical cases Chinese medicine syndrome discipline

Effects of Traditional Chinese Medicine Shensong Yangxin Capsules on heart Rhythm and Function in congestive heart failure Patients with Frequent Ventricular Premature Complexes：A Randomized, Double-blind, Multicenter Clinical Trial

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Chinese Medical Journal 2017年第14期130卷 1639-1647页

作者： Xi Wang Dan HU Song Dang He Huang Cong-Xin Huang Ming-Jie Yuan Yan-Hong Tang Qing-Shan Zheng Fang Yin Shu Zhang Bo-Li Zhang Run-Lin Gao Department of Cardiology Cardiovascular Research Institute Renmin Hospital of Wuhan University Wuhan University Wuhan Hubei 430060 China Department of Cardiology Cardiovascular Research Institute Renmin Hospital of Wuhan University Wuhan University Wuhan Hubei 430060 China Department of Experimental Cardiology Masonic Medical Research Laboratory Utica NY 13501 USA Center for Drug Clinical Research Shanghai University of Traditional Chinese Medicine Shanghai 201203 China National Center for Cardiovascular Disease Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China State Key Laboratory of Modern Chinese Medicine College of Traditional Chinese Medicine Tianjin University of Traditional Chinese Medicine Tianjin 300193 China

Background：Pharmacological therapy for congestive heart failure （CHF） with ventricular arrhythmia is limited.In the study,our aim was to evaluate the effects of Chinese traditional medicine Shensong Yangxin capsules （SSYX） on heart rhythm and function in CHF patients with frequent ventricular premature complexes （VPCs）.Methods：This double-blind,placebo-controlled,multicenter study randomized 465 CHF patients with frequent VPCs to the SSYX （n =232） and placebo groups （n =233） for 12 weeks of treatment.The primary endpoint was the VPCs monitored by a 24-h ambulatory electrocardiogram.The secondary endpoints included the left ventricular ejection fraction （LVEF）,left ventricular end-diastolic diameter,N-terminal pro-brain natriuretic peptide （NT-proBNP）,New York heart Association （NYHA） classification,6-min walking distance （6MWD）,Minnesota Living with heart failure Questionnaire （MLHFQ） scores,and composite cardiac events （CCEs）.Results：The clinical characteristics were similar at baseline.SSYX caused a significantly greater decline in the total number of VPCs than the placebo did （-2145 ± 2848 vs.-841 ± 3411,P 〈 0.05）.The secondary endpoints of the LVEE NYHA classification,NT-proBNP,6MWD,and MLHFQ scores showed a greater improvements in the SSYX group than in the placebo group （ALVEF at 12th week：4.75 ± 7.13 vs.3.30 ± 6.53;NYHA improvement rate at the 8th and 12th week：32.6% vs.21.8%,40.5% vs.25.7%;mean level of NT-proBNP in patients with NT-proBNP 〉125 pg/ml at 12th week：-122 [Q1,Q3：-524,0] vs.-75 [Q1,Q3：-245,0];A6MWD at 12th week：35.1 ± 38.6 vs.17.2 ± 45.6;AMLHFQ at the 4th,8th,and 12th week：-4.24 ± 6.15 vs.-2.31 ± 6.96,-8.l 9 ± 8.41 vs.-3.25 ± 9.40,10.60 ± 9.41 vs.-4.83 ± 11.23,all P 〈 0.05）.CCEs were not different between the groups during the study period.Conclusions：In this 12-week pilot study,SSYX was demonstrated to have the benefits of VPCs suppression and cardiac function improvement with good compliance on a background of standard treatment for CHF.

关键词： congestive heart failure Randomized ControlledTrial Shensong Yangxin Capsules Ventricular PrematureComplexes

Transforming growth factor β1 is a differentially expressed candidate protein of congestive heart failure with Qi-deficiency-blood-stasis syndrome

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Journal of Traditional Chinese Medicine 2020年第2期40卷 311-316页

作者： Li Xiaoqian Huang Pinxian Wang Shijun Cao Xuebin He Jiancheng Research Centre on Application of Classical Prescriptions Basic Medical CollegeShanghai University of Traditional Chinese MedicineShanghai 201230China Department of Cardiology Shanghai Institute of Cardiovascular DiseasesZhongshan HospitalFudan UniversityShanghai 200032China Department of Cardiology The PLA 252 HospitalBaoding 71000China

OBJECTIVE: To investigate the role of tongue coating fluid protein in regulation of congestive heart failure(CHF) in Qi-deficiency-blood-stasis syndrome.METHODS: We studied patients with CHF(3 patients with Qi-deficiency-blood-stasis syndrome and 3 without Qi-deficiency-blood-stasis syndrome) to investigate differentially expressed proteins. We also included a control group. A biotin label-based antibody array was used for testing tongue coating fluid samples from patients. Net-work analysis of these differentially expressed proteins was conducted using the STRING database,which can predict the relations between differentially expressed proteins and CHF with Qi-deficiency-blood-stasis syndrome.RESULTS: A total of seven differentially expressed proteins were identified, and among these, transforming growth factor β1(TGF-β1) gets a particular attention for us has drawn specific attention.Network analysis showed a homologous relationship of TGF-β1 with bone morphogenetic protein15, which is associated with myocardial fibrosis.CONCLUSION: Occurrence and development of CHF may result from certain DE-proteins and associated signaling pathways. TGF-β1 protein may be a candidate marker for assessing the risk of CHF in Qideficiency-blood-stasis syndrome.

关键词： congestive heart failure Qi-deficiency blood-stasis Transforming growth factorβ1 Bone morphogenetic protein 15 Differentially expressed protein

Computerized lung sound analysis following clinical improvement of pulmonary edema due to congestive heart failure exacerbations

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Chinese Medical Journal 2010年第9期123卷 1127-1132页

作者： WANG Zhen XIONG Ying-xia Department of Emergency Medicine Beijing Shijitan HospitalBeijing 100038China

Background Although acute congestive heart failure （CHF） patients typically present with abnormal auscultatory findings on lung examination, lung sounds are not normally subjected to rigorous analysis. The goals of this study were to use a computerized analytic acoustic tool to evaluate lung sound patterns in CHF patients during acute exacerbation and after clinical improvement and to compare CHF profiles with those of normal individuals.Methods Lung sounds throughout the respiratory cycle was captured using a computerized acoustic-based imaging technique. Thirty-two consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created, geographical area of the images and lung sound patterns were quantitatively analyzed.Results The geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were （67.9±4.7） and （60.3±3.5） kilo-pixels, respectively （P 〈0.05）. In CHF patients without and with radiographically evident pulmonary edema （REPE）, after clinical improvement the geographical area of vibration energy image of lung sound increased to （74.5±4.4） and （73.9±3.9） kilo-pixels （P 〈0.05）, respectively. Vibration energy decreased in CHF patients with REPE following clinical improvement by an average of （85±19）% （P 〈0.01）. Conclusions With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image. Lung sound analysis may be useful to track in acute CHF exacerbations.

关键词： lung sounds vibration energy of lung sound exacerbation congestive heart failure

Characterization of congestive heart failure by the Pattern of Diurnal Rhythm Based on heart Rate Variability

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Chinese Journal of Biomedical Engineering(English Edition) 2022年第2期31卷 47-55页

作者： WANG Zhi-gang ZHANG Zheng-guo PENG Yi Institute of Basic Medical Sciences Chinese Academy of Medical SciencesBeijing 100005China School of Basic Medicine Peking Union Medical CollegeBeijing 100005China

The impaired autonomic nervous system(ANS) has a close relationship to morbidity and mortality for congestive heart failure(CHF). This study is aimed to investigate the possibility to characterize CHF by the pattern of diurnal rhythm based on heart rate variability(HRV). Two datasets of CHF(n=44) were from Physio Net. And the datasets of the normal from THEW(n=189). Two 2 h episodes representing day and night in resting state were selected in each Holter record. Measures concerning time domain, AR model-based analysis, symbol dynamic analysis, and non-Gaussian indexes(λ) were calculated in each episode. The diurnal rhythm was represented by the ratio of an index in the day to that at night. Results demonstrated different patterns of diurnal rhythm among the normal, mild CHF(NYHAI-Ⅱ) and severe CHF(NYHA Ⅲ-Ⅳ),reflecting the changes in sympathetic and vagal interaction from reciprocal function to accentuated antagonism due to CHF. Furthermore, using RRIn,(LFnu)d/(LFnu)nand λd/λn,the sensitivity and specificity for discriminating the normal and CHF reached 95.45%and 95.24%;And for discriminating between mild CHF and severe CHF were 84.38%and 91.67%. Our proposed method is promising in assessing the ANS state and monitoring therapeutic effects for CHF patients.

关键词： heart rate variability congestive heart failure diurnal rhythm

Rural congestive heart failure mortality among US elderly, 1999-2013: Identifying counties with promising outcomes and opportunities for implementation research

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Family Medicine and Community Health 2015年第2期3卷 27-38页

作者： Maria C.Mejia de Grubb Robert S.Levine Barbara Kilbourne Baqar A.Husaini Tyler Skelton Lisa Gittner Michael A.Langston George E.Rust Department of Family and Community Medicine Baylor College of MedicineHoustonTXUSA Department of Sociology Tennessee State UniversityNashvilleTennesseeUSA Center for PreventionResearch Tennessee State University College of AgricultureNashvilleTennesseeUSA Department of Political Science Texas Tech UniversityLubbockTXUSA Department of Electrical Engineering and Computer Science University of TennesseeKnoxvilleTennesseeUSA Department of Family Medicine National Center for Primary CareMorehouse School of MedicineAtlantaGeorgiaUSA

Objective:Describe modern trends in congestive heart failure(CHF)among elderly(>65 years of age)in the United States,to identify potentially successful rural areas.Compare CHF mortality using multiple-(MCOD)versus underlying-(UCOD)cause of death data.Methods:U.S.Centers for Disease Control and Prevention mortality files(WONDER internet site).Results:Using MCOD data,overall mortality rates/100,000 population(and 95%confidence intervals)for CHF among persons>65 years of age(1999-2013)were 482.0(481.2-482.8)for large central and large fringe metropolitan(LCLF)counties,549.6(548.6-550.7)in small and medium metropolitan(SM)counties,and 652.6(650.9-654.0)in micropolitan and non-core,non-metropolitan(MNCNM)counties.Twenty positive deviance NCNM counties(collectively including 198,581 residents>65 years of age)had an overall CHF rate of 300.9(275.0-326.9)in 2013.This was significantly lower than the LCLF rate for 2013(482.0[481.2-482.8]),and rep-resented a reduction of 47%since 1999.Overall CHF occurrence as estimated with MCOD was 3.4-fold higher than that obtained with UCOD.Conclusion:These data illustrate underestimation of CHF by UCOD data and the importance of correct death certification.Rural CHF mortality rates are higher than urban rates,but some positive deviance counties demonstrate that this is not inevitable.Further research is needed to understand the relative contribution of research innovation,medical care,and public health to rural-urban disparities and the relative success of positive deviance counties.

关键词： congestive heart failure elderly mortality rural

Reversible congestive heart failure associated with hypocalcemia:A case report

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World Journal of Clinical Cases 2021年第34期9卷 10659-10665页

作者： Chu Wang Li-Wen Dou Tian-Bing Wang Yang Guo Trauma Rescue&Treatment Center Peking University People's HospitalBeijing 100044China Emergency Department Peking University People's HospitalBeijing 100044China

BACKGROUND Hypoparathyroidism is a rare disease that may occur due to primary or secondary etiologies.The estimated incidence in the United States is 24–37/100000 personyears.congestive heart failure associated with hypocalcemia due to hypoparathyroidism is an even rarer presentation.CASE SUMMARY Here,we present a 64-year-old woman with congestive heart failure following hypocalcemia.The patient was transferred to our emergency department with complaints of rapidly progressive dyspnea,shortness of breath and heaviness of the chest for 4 d.She had a history of undergoing thyroidectomy and partial tracheotomy 2 years prior due to a malignant thyroid tumor.Muscle spasms had been present 1 year ago,and cataracts were treated with intraocular lens replacement in both eyes.Most tests were within normal ranges,except serum calcium at 1.33 mmol/L(2.20–2.65 mmol/L),ionized calcium at 0.69 mmol/L(1.15–1.29 mmol/L),and parathyroid hormone at<1.0 pg/mL(12–88 pg/mL).Echocardiography revealed an ejection fraction of 28.48%.Cardiac function was quickly reversed by restoring the serum calcium concentration.Significant improvements were noted with an ejection fraction of up to 48.50%at follow-up.CONCLUSION For patients with potential hypocalcemia,monitoring calcium levels and dealing with hypocalcemia in time to avoid serious complications are important.

关键词： Hypoparathyroidism congestive heart failure Cardiomyopathy Parathyroid hormone Calcium Echocardiography Case report

Effect of dyspnea and clinical variables on the quality of life and functional capacity in patients with chronic obstructive pulmonary disease and congestive heart failure

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Chinese Medical Journal 2008年第7期121卷 592-596页

作者： Hale Karapolat Sibel Eyigor Alev Atasever Mehdi Zoghi Sanem Nalbantgil Berrin Durmaz Ege University Medical Faculty Physical Medicine andRehabilitation Department Turkey Ege University Medical Faculty Pulmonary Medicine Department Turkey Ege University Medical Faculty Cardiology Department Turkey

Background Chronic obstructive pulmonary disease （COPD） and congestive heart failure （CHF） are two chronic diseases that affect negatively the functional condition and quality of life of patients. We assessed the effect of symptoms and clinical variables on the functional capacity and quality of life in COPD and CHF patients. Methods The study included 42 COPD and 39 CHF patients. In both patient groups, dyspnea was assessed using Borg scale; functional capacity by shuttle-walk and cardiopulmonary exercise test and quality of life by short form-36 （SF36）. Results No statistically significant difference was found in neither of the two disease groups regarding the dyspnea score, shuttle-walk test and the majority of subgroup scores of SF36 （P〉0.05）. A statistically significant difference was observed in peak VO2 in favor of COPD group （P〈0.05）. No significant relationship was established between dyspnea score and forced expiratory volume in one second （FEV1） in COPD patients, and left ventricular ejection fraction （LVEF） in CHF patients （P〉0.05）. A significant negative correlation was observed between dyspnea score and functional capacity tests in both disease groups （P〈0.05）. On the other hand, no relationship was found between LVEF and FEV1 and quality of life and functional capacity （P〉0.05）. Conclusions It was revealed that symptoms have an impact on functional capacity and quality of life in both disease groups, however, objective indicators of disease severity do not show a similar relationship. Therefore, in addition to the objective data related to the disease, we recommend that symptoms should also be taken into consideration to assess cardiopulmonary rehabilitation program and during following-up.

关键词： chronic obstructive pulmonary disease congestive heart failure dyspnea disease severity quality of life functional capacity

Efficacy of adaptive servoventilation in patients with congestive heart failure and Cheyne-Stokes respiration

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Chinese Medical Journal 2006年第8期119卷 622-627页

作者： ZHANG Xi-long YIN Kai-sheng LI Xin-li JIA En-zhi SU Mei Department of Respiratory Diseases First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China Department of Cardiology First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China

Background congestive heart failure （CHF） is associated with Cheyne-Stokes respiration （CSR）, which may hasten CHF. Adaptive servoventilation （ASV） is a novel method of ventilatory support designed for removal of CSF in CHF patients. This study compares the efficacy of ASV in patients with CHF and CSR with the efficacy of oxygen therapy. Methods Fourteen patients with CHF and CSR were recruited. During sleep, nasal oxygen therapy and ASV treatment were each performed for two weeks. Comparison before and after each treatment was made for the following items： a） parameters of sleep respiration, sleep structure and quality; b） left ventricle ejection fraction （LVEF） and 6-minute walk distance. Results Compared with the baseline levels of apnoea hypopnoea index of 34.5±6.1 before treatment, the apnoea hypopnoea index significantly decreased following oxygen therapy to 27.8±8.2, P〈0.05 and further reduced following ASV treatment to 6.5 ±0.8, P〈0.01. The minimal pulse oxygen saturation markedly increased following oxygen therapy from a baseline of （84.3±2.6）% to （88.6±3.7）%, P〈0.05 and further increased following ASV treatment （92.1 ±4.9）%, P〈0.01. Stages Ⅰ ＋Ⅱ sleep as percentage of total sleep time decreased from （81.9±7.1）% to （78.4±6.7）% following oxygen therapy and further to （72.4±5.0）% following ASV treatment. Stages Ⅲ＋Ⅳ sleep as percentage of total sleep time decreased from （8.4±5.5）% to （6.0±3.0）% following oxygen therapy and but increased to （11.9 ± 5.4）% following ASV treatment. The arousal index of 30.4 ±8.1 before treatment significantly decreased following oxygen therapy to 25.6±5.7, P〈0.05 and further declined following ASV treatment to 18.2±6.1, P〈0.01. No significant difference was shown in above percentages between day 14 of oxygen therapy and before treatment （P 〉 0.05）. LVEF was significantly higher on day 14 of ASV treatment （37.2 ±4.1）% than on day 14 of oxygen therapy （33.2 ± 5.1）% and before treatment （30.2±4.6）% （all P〈0.05）. Six-minute walk distance was the shortest before treatment （226±28

关键词： Cheyne-Stokes respiration congestive heart failure ventilation oxygen therapy