A prospective study of congestive cardiac failure and its prognostication with 3C: Reactive protein as a marker of severity
Dr. Ramesh B, Dr. Rangegowda KR, Dr. Chaithanya N
Background: C reactive protein (CRP), as a marker of inflammation, has been shown to be associated with an increased risk of various cardiovascular diseases. This study is mainly designed to evaluate the level of CRP in patients with chronic CHF and to examine the relation between the degree of CRP elevation and clinical outcome. Objectives 1. Clinical & Echocardiographic evaluation of patients with congestive cardiac failure. 2. To estimate CRP levels in these subjects. 3. To correlate the CRP levels with severity of the disease. Material and Methods: A cross sectional study was undertaken among the patients between 18-80 years with congestive cardiac failure who were admitted at ESIC MEDICAL COLLEGE & PGIMSR. A total of 100 cases admitted constituted the sample size. The data for this study was collected by evaluating the patient in the form of detailed history taking, clinical examination, and relevant investigations for this study. Baseline clinical evaluation, 2D echo screening, C-reactive protein estimation was conducted for all the patients. Patients with CCF were divided into two groups: mild CHF (NYHA class 1&2) and severe (CHF NYHA class 3 & 4) groups. Results: About 52% of the study subjects had Mild (NYHA class 1 & 2) of cardiac failure. Most of the study subjects in this study belonged to belonged to 51 – 60 years X of age group. About 53.8% of the patients with mild disease (NYHA class 1 & 2) were males and 64.6% of the patients with severe disease (NYHA class 3 & 4) were females as shown by this study. About 69.2% of the patients with mild disease (NYHA class 1 & 2) and 77.1% with the severe disease (NYHA class 3 & 4) had history of hypertension. Palpitation was present in 21.2% of the patients with mild disease (NYHA class 1 & 2) and 18.8% of the severe disease (NYHA class 3 & 4). Difficulty in breathing was present in 21.2% of the patients with mild disease and 16.7% of the patients with severe disease (NYHA class 3 & 4). S had positive and significant correlation and isovolumetric relaxation time had negative and significant correlation time in mild disease patients. In patients with severe disease, S and E/E was had negative and statistically significant correlation. XI Conclusion: This study had shown that most of the heart failure patients were aged above 50 years, males, with patients having comorbidities. The CRP had correlation with some echocardiographic parameters. This study had shown that CRP is an important prognostic marker in chronic heart failure.