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Objective:To detect the abnormal changes of myocardial blood perfusion in patients with hypertrophic cardiomyopathy(HCM) by myocardial contrast echocardiography (MCE) combined with adenosine stress test.Methods:Fifteen adult patients with HCM who were treated in Fuwai Central China Cardiovascular Hospital from May 2021 to March 2022 were prospectively selected as the HCM group, and eighteen healthy volunteers matched by gender, age and body surface area during the same period were chosen as the control group. All subjects underwent routine echocardiography, rest and adenosine stress MCE. The MCE images were analyzed by QLab software to obtain the myocardial perfusion parameters: peak signal intensity (A value), rising slope of the curve (β value) and A×β value, and the differences of above parameters between the two groups were compared.According to whether the end-diastolic wall thickness ≥12 mm, the myocardial segments in the HCM group were divided into hypertrophic segments and non-hypertrophic segments. The differences in myocardial perfusion parameters were compared among control group segments, hypertrophic segments and non-hypertrophic segments of the HCM group. The correlations of stress myocardial blood flow with maximal left ventricular wall thickness (MLVWT), left ventricular mass index (LVMI) and left atrial volume index (LAVI) in the HCM group were analyzed.Results:Compared with the control group, the A value, β value and A×β value of whole myocardium, hypertrophic segments and non-hypertrophic segments in the HCM group were significantly decreased in the rest and adenosine stress state, and the differences were statistically significant (all P<0.05). In the stress state, the A value, β value and A×β value of the hypertrophic segments were significantly lower than those in the non-hypertrophic segments in the HCM group, and the detection rate of abnormal perfusion segments in the HCM group was significantly higher than that in the rest state(all P<0.05). Compared with the control group, the myocardial blood flow reserve of whole myocardium, hypertrophic segments and non-hypertrophic segments in the HCM group were significantly decreased, and the differences were statistically significant(all P<0.05). The stress myocardial blood flow in the HCM group was negatively correlated with MLVWT, LVMI and LAVI ( r=-0.815, -0.805, -0.742; all P<0.05). Conclusions:Myocardial blood perfusion abnormalities can occur in both hypertrophic and non-hypertrophic myocardial segments in patients with HCM, and adenosine stress MCE can significantly improve the sensitivity of detecting myocardial perfusion abnormalities. The stress myocardial blood flow in patients with HCM is negatively correlated with MLVWT, LVMI and LAVI.
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Objective:To detect the abnormal changes of myocardial blood perfusion in patients with hypertrophic cardiomyopathy (HCM) by myocardial contrast echocardiography(MCE) combined with exercise stress test.Methods:Twenty-seven patients with clinically diagnozed of asymmetric HCM in Fuwai Central China Cardiovascular Hospital from May 2020 to April 2021 were selected as the HCM group, and 29 healthy subjects during the same period were selected as the control group. All patients underwent routine echocardiography, resting and exercise stress MCE. The myocardial perfusion parameters of each segment of interventricular septum in the 2 groups were quantitatively analyzed: the peak plateau intensity (A value), ascending slope of the curve(β value) and value of A×β. According to the end-diastolic myocardial thickness, the interventricular septum of the HCM group was divided into hypertrophic and non-hypertrophic segments, and the myocardial contrast parameters of the interventricular septum of the study group were compared with those of the control group. The myocardial blood flow reserve value of the two groups were calculated, and the correlation of myocardial blood flow reserve value with left ventricular mass index (LVMI) and left ventricular remodeling index (LVRI) were analyzed.Results:No matter at rest or under stress, the A value, β value and A×β value of ventricular septal hypertrophic and non-hypertrophic segments in the hypertrophic cardiomyopathy group were lower than those in the control group, and the differences were statistically significant (all P<0.05). Under stress, the A value, β value and A×β value of interventricular septal hypertrophic segments were lower than those in non-hypertrophic segments in the HCM group, and the differences were statistically significant (all P<0.05). The myocardial blood flow reserve in the HCM group was negatively correlated with LVMI and LVRI( r=-0.899, -0.676; all P<0.001). Conclusions:In patients with HCM under resting and exercise stress, microcirculation disorders were found in both hypertrophic and non-hypertrophic segments of the ventricular wall, and the myocardial blood flow reserve was negatively correlated with LVMI and LVRI.
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Objective:To explore the clinical value of adenosine stress myocardial contrast echocardiography in detecting myocardial blood perfusion abnormalities in patients with type 2 diabetes mellitus.Methods:Twenty-six patients with type 2 diabetes mellitus clinically diagnosed from May 2019 to January 2020 in the endocrinology department of Fuwai Central China Cardiovascular Hospital and 28 healthy examinees with gender and age matched during the same period were enrolled. Routine echocardiography, rest and adenosine stress myocardial contrast echocardiography were performed, the plateau signal intensity(A value), curve rising slope(K value) and A×K value of the myocardial perfusion time-intensity curve were obtained by offline analysis. And general data such as age, gender, disease course, body mass index and glycated hemoglobin were collected, and results of the two groups were compared statistically.Results:In the rest state, the A value of the myocardial perfusion parameter in the diabetic group was not significantly different from that of the control group, both in whole and in segments ( P>0.05), while the K value and A×K value of the myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group ( P<0.05). In the stress state, the A value, K value and A×K value of myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group, both in whole and in segments ( P<0.05). The detection rate of myocardial perfusion abnormality in the stress state was significantly higher than that in the rest state, and the difference was statistically significant ( P<0.05). The myocardial blood flow reserve in the diabetic group was negatively correlated with the course of disease and the level of glycated hemoglobin ( r=-0.580, P=0.020; r=-0.481, P=0.013). Conclusions:Adenosine stress myocardial contrast echocardiography can be used for detection of left ventricular myocardial perfusion abnormalities in patients with type 2 diabetes mellitus, which has great clinical application value.
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Tumor stem cells are responsible for metastasis and relapse of cancer.Transforming growth factor-β1 (TGF-β1) plays an important role in the proliferation and differentiation of tumor stem cells.In many cancers such as breast carcinoma,hepatocellular carcinoma,pancreatic carcinoma,lung carcinoma,glioma and gallbladder carcinoma,the epithelial-mesenchymal transition (EMT) induced by TGF-β1 can inhibit proliferation of cancer cell,enrich tumor stem cells and increase invasive capability and drug resistance of cancer.