Abstract:
Background: Pulse Rate and Respiratory Rate are main symptom of congestive heart failure
patients and the abnormal PR and RR are broad indicators of major physiological instability.
Congestive Heart Failure is a complex clinical syndrome that can result from any structural or
functional cardiac disorder that impairs the ability of ventricle to fill out or eject blood. The
main objective of this study is to identify the factor that affects Pulse Rate and Respiratory
Rate for CHF patients using joint random effect model.
Methods: Hospital based retrospective studies were conducted among adult congestive heart
failure patients. Separate and Joint random effect model were used to infer the effect of
bivariate longitudinal outcomes of Pulse Rate and Respiratory Rate for CHF patients. Data
management was done by SPSS 23 and SAS 9.2.
Results: A total of 153 CHF patients were enrolled for this study. Of which, 67(43.79%)
were biventricular heart failure type, 46(30.07%) were faced left sided heart failure and
40(26.14%) faced right sided heart failure. We compared the separate and joint model by
considering their estimates and corresponding significant values and then we found that joint
model having the most significant and precise estimates. Left Ventricle Ejection Fraction
(β = 0.1221, p=<0.0001), diagnostic history Coronary Heart Disease( β = 6.59, p=0.0241),
age with month interaction (β = 0.004894, p=0.0097), diagnostic history with month
interaction for Coronary Heart Disease (β = 0.0075, p = 0.0359 ) , New York Heart
Association class I with month interaction (β = 0.2838, p = 0.0024) and New York Heart
Association class II with month interaction β = 0.3216, p =< 0.0001 were positively
associated with Pulse Rate. Age ( β = −0.1995, p = 0.0013 ) New York Heart Association
class I (β = −17.57, p =< 0.0001), New York Heart Association class II (β = −15.6475,
p =< 0.0001), New York Heart Association class III (β = −5.7491, p = 0.0290) and Left
Ventricle Ejection Fraction with month interaction (β = −0.00635, p = 0.0162) were
negatively associated with Pulse Rate. Left Ventricle Ejection Fraction ( β = 0.1221, p =<
0.0001), diagnostic history of others with month interaction(β = 0.08018, p = 0.0203) and
Congestive Heart Failure type of left sided failure with month interaction β = 0.057, p =
0.0148 was positively associated with Respiratory Rate. While, month (β = −0.2009 p =
0.0244), Congestive Heart Failure type of Biventricular(β = −1.1839 p =< 0.0242) , New
York Heart Association class I (β = −2.09, p =< 0.0001), New York Heart Association
class II (β = −1.44 p =< 0.0001), New York Heart Association class III (β = −0.98 p =
0.0007 ) and Left Ventricle Ejection Fraction with month interaction ( β = −0.0032, p =<
0.0001) was negatively associated with Respiratory Rate.
Conclusions: Age, Left Ventricle Ejection Fraction, New York Heart Association class
,diagnosis history of Coronary Heart Disease,age with month interaction , month with New
York Heart Association class month with diagnostic history, month with Left Ventricle
Ejection Fraction were the predicting factors for the longitudinal change of Pulse Rate. Left
Ventricle Ejection Fraction,monthchftype Biventricular, New York Heart Association
class,month with diagnostic history,month with chftype and month with Left Ventricle
Ejection Fraction were the predicting factors for the longitudinal change of Respiratory Rate.