Objective

2

To explore the differences in the cardiac function and quality of life （QOL） in patients with chronic heart failure （CHF） of different traditional Chinese medicine （TCM） syndrome， as well as the factors associated with QOL.

Methods

2

Using quota sampling， 538 CHF patients from 12 hospitals， such as the First Affiliated Hospital of Guangzhou University of Chinese Medicine， were stratified into three groups according to age， gender and cardiac function level， which were

qi

deficiency and blood stasis syndrome group （235 cases），

yang

qi

depletion and blood stasis syndrome group （135 cases） and

qi

and

yin

deficiency and blood stasis syndrome group （168 cases）. The general demographic and sociological characteristics， cardiac function grades， heart failure stratification condition including heart failure with reduced ejection fraction （HFrEF）， heart failure with preserved ejection fraction （HFpEF） and heart failure with mid-range ejection fraction （HFmrEF）， and cardiac function indicators including left ventricular end-diastolic diameter （LVDD）， left ventricular ejection fraction （LVEF）， brain natriuretic peptide （BNP） and N-terminal pro brain natriuretic peptide （NT-proBNP） were collected from each group. The Chinese version of the Brief Health Scale-36 （SF-36） was used to investigate QOL in eight aspects including physical functioning （PF）， role-functioning physical （RP）， body pain （BP）， general health （GH）， vitality （VT）， social functioning （SF）， role-functioning emotional （RE）， and mental Health （MH）. The correlation between cardiac function indicators and SF-36 scores was analyzed.

Results

2

There were statistical differences in the dcardiac function grades and heart failure stratification of three TCM syndromes （

P

＜0.05）. From the perspective of cardiac function grades，

qi

deficiency and blood stasis syndrome had the largest proportion in grade Ⅲ patients （59.1%）， while

yang

qi

depletion and blood stasis syndrome was most frequently seen in both grade Ⅱ and Ⅳ patients （21.5% and 37.0%）. For heart failure stratification，

qi

and

yin

deficiency and blood stasis syndrome had the largest proportion in patients with HFrEF （39.9%） and HFpEF （49.4%）， and

qi

deficiency and blood stasis syndrome was mostly frequent in HFmrEF patients （24.3%）. There was no statistical differences in the levels of LVEF， LVDD and BNP among three TCM syndromes （

P

＞0.05）， while the level of NT-proBNP was statistically significantly different （

P

＜0.05）. Regarding the SF-36 scores，

qi

deficiency and blood stasis syndrome group had the the highest PF score （

P

＜0.05）， while the

qi

and

yin

deficiency and blood stasis syndrome group had the lowest GH score （

P

＜0.05）. Besides， VT score was significantly higher in the

qi

deficiency and blood stasis syndrome group than in the

qi

and

yin

deficiency and blood stasis syndrome （

P

＜0.05）. Correlation analysis showed that cardiac function grade was negatively correlated to the scores of the eight aspects of SF-36 and the total score （

P

＜0.05）， and the correlation coefficient of PF and VT was greater than 0.3.

Conclusion

2

Qi

deficiency and blood stasis syndrome belongs to a relatively stable stage of CHF， commonly with cardiac function grade Ⅲ， and low level of NT-proBNP. With the transformation into

yang

qi

depletion and blood stasis syndrome and

qi

and

yin

deficiency and blood stasis syndrome， the proportion of grade Ⅳ of cardiac function increases， and the level of NT-proBNP tends to increase. Cardiac function grades and TCM syndromes may affect the QOF of patients with CHF.