ABSTRACT
Objective To evaluate the subclinical dysfunction of left ventricle (LV) induced by anthracycline(ATC) in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) by two-dimensional speckle tracking echocardiography (2DSTE) as well as real-time three-dimensional echocardiography (RT3DE).Methods Traditional echocardiography images and RT3DE images were acquired from 59 patients with DLBCL before,after the completion of two cures(100 mg∕m 2)and four cures of the regimen(200 mg∕m 2).LV global longitudinal strain(GLS),global circumferential strain(GCS),LV apical rotation and basal rotation,LV end-diastolic volume (EDV),end-systolic volume (ESV),stroke volume(SV) and ejection fraction(EF)were calculated simultaneously.Results Compared with baseline, LV apical rotation and basal rotation reduced significantly after two cures and four cures of therapy [LV apical rotation:(5.34±1 .80)°vs (3.80±1 .45)°vs (2.96±1 .1 8)°;LV basal rotation:(-3.32±1 .14)°vs (-2.65±1 .12)°vs (-2.56±1 .19)°;both P 0.05 for all). Conclusions Cardiotoxicity during the early phase of anthracycline treatment can be detected via 2DSTE prior to the traditional echocardiographic expression of ventricular systolic function.The left ventricular rotation index seems to be more sensitive than strain parameters for the estimation of early cardiac injury in patients with ATC chemotherapy.There is no safe dose for anthracycline in all patients with DLBCL treated with anthracycline even at lower doses.
ABSTRACT
ObjectiveTo determine the serum vitamin D levels of patients with primary hypertension to provide a basis for prevention and control of the hypertension in Kashgar prefecture.Methods The clinical data of 200 patients with hypertension in Kashgar prefecture admitted to the Second People's Hospital from January 2014 to December 2015 were retrospectively analyzed. According to risk factors, the 200 patients with primary hypertension were divided into three groups: 60 patients were selected as low risk group (hypertension 1 grade and no risk factors), 64 patients were arranged into an intermediate risk group (hypertension 2 grade or hypertension 1 grade accompanied by 1-2 risk factors) and 76 patients were assigned in a high risk group (hypertension 3 grade or hypertension 1-2 grade accompanied by ≥3 risk factors or hypertension of any grade accompanied by 1 target organ damage or 1 kind of clinical disease). In the same period, 66 healthy subjects having taken physical systemic medical examination with normal blood pressure in this hospital were grouped into a healthy control group. The levels of blood pressure and vitamin D in serum were measured, and the correlations between vitamin D and systolic blood pressure (SBP), diastolic blood pressure (DBP) were analyzed by pearson correlation analysis in the four groups.Results The SBP and DBP were significantly higher in low, intermediate and high risk group than those in healthy control group [SBP (mmHg, 1 mmHg = 0.133 kPa): 142±6, 161±5, 173±12 vs. 112±12, DBP (mmHg): 89±7, 101±4, 103±11 vs. 74±8], and their levels of vitamin D were lower in low, intermediate, high risk group than the level in healthy control group (μg/L: 24±6, 26±5, 20±4 vs. 30±7, allP < 0.05). Correlation analysis showed that the level of vitamin D was negatively correlated with SBP, DBP (r value was -0.373, -0.324, allP < 0.01).Conclusions The serum level of vitamin D is decreased in Uighur patients with blood hypertension in Kashgar prefecture, especially in the patients with high risk factors, the descent of the serum level is more significant. It is suggested to appropriately use vitamin D supplement to prevent blood hypertension.
ABSTRACT
Objective Both right and left ventricular function should be taken into account in the assessment of anthracycline (ATC)-induced cardiotoxicity.The aim of this study was to assess the subclinical dysfunction of right cardiac system in patients with newly diagnosed lymphoma who received ATC treatment by echocardiography.Methods A total of 74 patients with lymphoma who received ATC treatment were enrolled.Each patient underwent transthoracic echocardiographic examination before chemotherapy as well as after two,four and six cycles of ATC remedy.Right atrial (RA) and right ventricular (RV) end-diastolic area (EDA) and end-systolic area (ESA) were calculated.RV end-diastolic volume (EDV) and end-systolic volume (ESV),as well as RV ejection fraction (EF) were measured simultaneously.Tissue Doppler imaging (TDI) measurements of systolic and early or late diastolic myocardial velocities of RV free wall at tricuspid annuals were also analyzed.Two-dimensional speckle tracking echocardiography (2DSTE) was conducted to evaluate RV free wall strain along with strain rate.Results None of the echocardiographic parameters showed significant alteration after two and four cycles of chemotherapy compared with those at baseline (P＞0.05).At the end of the therapy (i.e.after six cycles of ATC treatment),there was still no statistical difference on TDI data aswell as 2DSTE measurements (P＞0.05).An unexpected finding was that the RAEDA((6.6±1.9) cm2 vs (7.7±2.4) cm2) and RAESA ((8.8±2.5) cm2 vs (10.8±2.8) cm2) revealed obvious dilatation after six cures of the regimen compared with those at baseline (P＜0.01).Similar morphologic characteristics displayed on the RVEDA ((14.1 ±3.4) cm2 vs (16.2±3.7) cm2) and RVESA ((7.9±1.9) cm2 vs (9.0±2.2) cm2) (P＜0.01)simultaneously.Furthermore,RVEDV ((29.8±10.5) ml vs (37.0±12.7) ml) and RVESV ((12.7±4.4) ml vs (15.0±5.2) ml),as well as RVEF ((59.4±5.8)％ vs (56.4±5.8)％),in patients with lymphoma presented statistically significant difference between basic state and the level after six cycles of chemotherapy (P＜0.01).Meanwhile,no marked change was detected on left ventricular ejection fraction(LVEF) throughout the follow-up period (P＞0.05).Conclusions Echocardiography can be used easily and noninvasively to assess right cardiac system subclinical dysfunction.ATC-induced cardiotoxicity of right cardiac system is firstly manifested as morphological changes than the measurements with novel echocardiographic techniques.In addition,RVEF expresses as a valuable parameter for assessing subtle RV impaired performance in patients with lymphoma received ATC therapy.