Advanced Search

Journal of Traditional Chinese Medicine >

2023 , Vol. 43 >Issue 6: 1243 - 1251

DOI: https://doi.org/10.19852/j.cnki.jtcm.20230904.004

Research Articles

Mirror-like tongue is an important predictor of acute heart failure: a cohort study of acute heart failure in Chinese patients

  • Yunhu CHEN ,
  • Moqing YIN ,
  • Lihua FAN ,
  • Xuechun JIANG ,
  • Tao ZHANG ,
  • Xingyu ZHU ,
  • Hongfeng XU
Expand
  • 1 Department of Cardiology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215400, China
    2 Department of Cardiology, Changzhou Hospital affiliated with Nanjing University of Chinese Medicine, Changzhou 213003, China
    3 Department of Clinical Pharmacy, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215400, China

Received date: 2022-08-11

  Accepted date: 2022-12-14

  Online published: 2023-09-04

Supported by

2019 Suzhou Science and Technology Development Plan (the Fourth Batch of Basic Research on People's Livelihood, Science and Technology, and Medical and Health Applications): Applied Research on Diuretic Resistance of Zhuling Decoction(SYSD2019201)

Fold

Abstract

OBJECTIVE: To reveal that mirror-like tongue, observed via a noninvasive inspection, is a powerful indicator of the severity and prognosis of patients with acute heart failure (AHF).
METHODS: This was an observational, prospective study. A total of 408 patients who met the inclusion criteria and were diagnosed with AHF for the first time at Taicang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from August 2019 to January 2021 were selected as the research subjects. According to their tongue fur, the patients were divided into group A (mirror-like tongue group) and group B (non-mirror-like tongue group). The clinical characteristics and incidence of major adverse cardiovascular events (MACEs) within 1 year of follow-up were systematically compared between the two groups.
RESULTS: Sixty-five patients were included in group A, and 343 patients were included in group B. There were 32 males and 33 females in group A and 168 males and 175 females in group B. The average age of the overall population was 64 years old, and the average age of group A was significantly higher than that of group B (74 vs 62 years, P < 0.001). Compared with that in group B, the left ventricular ejection fraction (LVEF) in group A was significantly lower (35% vs 42%, P < 0.001), and the log N-terminal pro B-type natriuretic peptide (NT-proBNP) level was significantly higher (4.0 vs 3.4, P < 0.001). The proportion of the combined application of vasoactive drugs in group A was significantly higher than that in group B (64% vs 38%, P < 0.001). Group B had a higher proportion of coronary angiography (29.5% vs 16.9%, P = 0.038). Group A was more inclined to require mechanical ventilation than group B (33.9% vs 22.5%, P = 0.049). The length of hospital stay in group A was significantly longer than that in group B (13.1 vs 7.6, P < 0.001). The incidence of MACEs, such as recurrence of AHF, new myocardial infarction and stroke, in group A within one year was higher than that in group B (P = 0.007, 0.009, < 0.001). The incidence of cumulative MACEs in group A was significantly higher than that in group B [hazard ratio = 2.76, 95% confidence interval (1.73, 4.41), P < 0.001]. Univariate and multivariate Cox regression analyses showed that mirror-like tongue, age, length of stay, LVEF and log NT-proBNP were independent predictors of MACEs in patients with AHF within one year.
CONCLUSIONS: Noninvasive tongue inspection technology can be used as a powerful tool for assessing the severity of illness and predicting prognosis in patients with AHF. A mirror-like tongue is an independent risk factor for MACEs in patients with AHF during the first year and has a combination effect with age, length of hospital stay, ejection fraction and NT-proBNP on the occurrence of MACEs.

Key words： heart failure; risk factors; fur; Yin deficiency; cohort studies

Cite this article

Yunhu CHEN , Moqing YIN , Lihua FAN , Xuechun JIANG , Tao ZHANG , Xingyu ZHU , Hongfeng XU . Mirror-like tongue is an important predictor of acute heart failure: a cohort study of acute heart failure in Chinese patients[J]. Journal of Traditional Chinese Medicine, 2023 , 43(6) : 1243 -1251 . DOI: 10.19852/j.cnki.jtcm.20230904.004

References

1. Joseph P, Leong D, McKee M, et al. Reducing the global burden of cardiovascular disease, Part 1: the epidemiology and risk factors. Circ Res 2017; 121: 677-94.
2. Leong DP, Joseph PG, McKee M, et al. Reducing the global burden of cardiovascular disease, Part 2: prevention and treatment of cardiovascular disease. Circ Res 2017; 121: 695-710.
3. Arrigo M, Jessup M, Mullens W, et al. Acute heart failure. Nat Rev Dis Primers 2020; 6: 16.
4. Mentz RJ, O'Connor CM. Pathophysiology and clinical evaluation of acute heart failure. Nat Rev Cardiol 2016; 13: 28-35.
5. Dharmarajan K, Hsieh AF, Kulkarni VT, et al. Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study. BMJ 2015; 350: h411.
6. Kitakata H, Kohno T, Kohsaka S, et al. Prognostic implications of early and midrange readmissions after acute heart failure hospitalizations: a report from a Japanese multicenter registry. J Am Heart Assoc 2020; 9: e014949.
7. Njoroge JN, Teerlink JR. Pathophysiology and therapeutic approaches to acute decompensated heart failure. Circ Res 2021; 128: 1468-86.
8. Roger VL. Epidemiology of heart failure: a contemporary perspective. Circ Res 2021; 128: 1421-34.
9. Parenica J, Spinar J, Vitovec J, et al. Long-term survival following acute heart failure: the acute heart failure database main registry (AHEAD Main). Eur J Intern Med 2013; 24: 151-60.
10. Wang H, Chai K, Du M, et al. Prevalence and incidence of heart failure among urban patients in China: a national population-based analysis. Circ Heart Fail 2021; 14: e008406.
11. Liang X, Wang Q, Jiang Z, et al. Clinical research linking Traditional Chinese Medicine constitution types with diseases: a literature review of 1639 observational studies. J Tradit Chin Med 2020; 40: 690-702.
12. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the european society of cardiology (ESC). developed with the special contribution of the heart failure association (HFA) of the ESC. Eur J Heart Fail 2016; 18: 891-975.
13. Li ZG. Comparative study on WHO western pacific region and world federation of Chinese medicine societies international standard terminologies on traditional medicine: diseases in internal medicine (part 1). Zhong Xi Yi Jie He Xue Bao 2012; 10: 471-6.
14. Bing Z, Hongcai W. Diagnostics of Traditional Chinese Medicine. Beijing: People's Military Medical Press, 2010: 47.
15. Ojo A, Tariq S, Harikrishnan P, Iwai S, Jacobson JT. Cardiac resynchronization therapy for heart failure. Interv Cardiol Clin 2017; 6: 417-26.
16. Chatterjee NA, Poole JE. Cardiac resynchronization therapy in nonischemic cardiomyopathy: To D or P? JACC Heart Fail 2021; 9: 450-2.
17. Cai J, Zeng DJB. Sample size/power calculation for case-cohort studies. Biometrics 2004; 60: 1015-24.
18. Truby LK, Rogers JG. Advanced heart failure: epidemiology, diagnosis, and therapeutic approaches. JACC Heart Fail 2020; 8: 523-36.
19. Baman JR, Ahmad FS. Heart failure. JAMA 2020; 324: 1015.
20. Adamo L, Rocha-Resende C, Prabhu SD, Mann DL. Reappraising the role of inflammation in heart failure. Nat Rev Cardiol 2020; 17: 269-85.
21. Boorsma EM, Ter Maaten JM, Damman K, et al. Congestion in heart failure: a contemporary look at physiology, diagnosis and treatment. Nat Rev Cardiol 2020; 17: 641-55.
22. Chen YH, Fan LH, Zhang T, Liu XQ. Effectiveness of Zhuling decoction on diuretic resistance in patients with heart failure: a randomized, controlled trial. J Tradit Chin Med 2022; 42: 439-45.
23. Lo LC, Cheng TL, Chen YJ, Natsagdorj S, Chiang JY. TCM tongue diagnosis index of early-stage breast cancer. Complement Ther Med 2015; 23: 705-13.
24. Song AY, Lou YN, Yang QX, et al. Diagnosis of early esophageal cancer based on TCM tongue inspection. Biomed Environ Sci 2020; 33: 718-22.
25. Hsu PC, Wu HK, Huang YC, et al. The tongue features associated with type 2 diabetes mellitus. Medicine (Baltimore) 2019; 98: e15567.
26. Yin HH. Basic theories of Chinese medicine. Shanghai: Shanghai science and technology press, 1984: 44-5.
27. Shang B, Zhang H, Lu Y, et al. Insights from the perspective of Traditional Chinese Medicine to elucidate association of lily disease and Yin deficiency and internal heat of depression. Evid Based Complement Alternat Med 2020; 2020: 8899079.
28. Park YJ, Cho SW, Lee BH, Park YB. Development and validation of the Yin deficiency scale. J Altern Complement Med 2013; 19: 50-6.
29. Li H, Sun J, Wang X, Shi J. Oral microbial diversity analysis among atrophic glossitis patients and healthy individuals. J Oral Microbiol 2021; 13: 1984063.
30. Chiang CP, Chang JY, Wang YP, Wu YH, Wu YC, Sun A. Atrophic glossitis: etiology, serum autoantibodies, anemia, hematinic deficiencies, hyperhomocysteinemia, and management. J Formos Med Assoc 2020; 119: 774-80.
31. Hsu MF, Tang PL, Pan TC, Hsueh KC. Different traditional Chinese medicine constitution is associated with dietary and lifestyle behaviors among adults in Taiwan. Medicine (Baltimore) 2022; 101: e30692.
32. Liu J, Xu F, Mohammadtursun N, Lü Y, Tang Z, Dong J. The analysis of constitutions of Traditional Chinese Medicine in relation to cerebral infarction in a Chinese sample. J Altern Complement Med 2018; 24: 458-62.
33. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. J Altern Complement Med Lancet 2020; 395: 709-33.
34. Ponikowski P, Jankowska EA. Targeting iron deficiency in heart failure: existing evidence and future expectations. Circ Heart Fail 2021; 14: e008299.
35. Parahiba SM, Spillere SR, Zuchinali P, et al. Handgrip strength in patients with acute decompensated heart failure: accuracy as a predictor of malnutrition and prognostic value. Nutrition 2021; 91-92: 111352.
36. Jeejeebhoy KN. Malnutrition in patients with heart failure. Am J Clin Nutr 2021; 113: 501-2.
37. Arnold SV, Khunti K, Bonnet F, et al. Type2 diabetes and heart failure: insights from the global DISCOVER study. ESC Heart Fail 2021; 8: 1711-16.
38. Merino-Merino A, Gonzalez-Bernal J, Fernandez-Zoppino D, Saez-Maleta R, Perez-Rivera JA. The role of galectin-3 and ST2 in cardiology: a short review. Biomolecules 2021; 11: 1167.
Options
Outlines

/

〈 〉