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Objective To examine cardiotoxicity of anthracyclines and trastuzumab in patients with breast cancer by two dimensional speckle tracking imaging. Methods Fifty-eight human epidermal growth factor receptors-2 (HER2) positive patients with breast cancer treated by anthracyclines and trastuzumab were monitored by echocardiography before treatment (Group A), after completion of anthracyclines (Group B), and at follow-up of 3 months (Group C) and 12months (Group D) after using trastuzumab. LVEDD, IVSTD, PWTD, LVEDV, LVESV were measured in the apical four- and two-chamber views. Left ventricular ejection fraction (LVEF) was measured using a modified Simpson's biplane method. Global longitudinal strain (GLS) and longitudinal strain rate (LSR) were calculated via Qlab8.0 analysis software off-line. Results LVEDDs in A-D groups were (47.95 ±4.12), (48.45 ±4.02), (48.91 ±3.83) and (49.98 ±3.72) mm, respectively, and LVEDVs were (108.70 ±21.26), (111.90 ±20.91), (113.50 ±20.25) and (119.20 ±20.02) ml, respectively. LVEDD, PWTD [(9.14 ±0.76) mm vs. (9.00 ±0.82)mm], LVEDV, LVESV [(54.60 ±14.58) ml vs. (50.97 ±14.35) ml] were increased in group B compared with those in A group (all P<0.05). LVEDD and LVEDV were increased in group C(P<0.05) compared with those in group B. CLVEDD, LVEDV, LVESV [(59.18±13.88) ml vs. (55.23± 13.81) ml] were increased in group D compared with group (P<0.05). Differences of LVEF between group C and group D were statistically significant[(59.48±2.62) % vs. (62.00±1.40) %, P<0.001]. Differences of GLS [(-21.16±2.33)%, (-19.76±1.98) %, (-19.22±1.89) % and (-18.74±1.79) %, respectively, P<0.001] and LSR [(-1.27±0.11), (-1.22±0.09), (-1.17±0.07) and (-1.14±0.06) /s, respectively, P<0.001] among four groups had all statistically significant. Conclusions Longitudinal left ventricle systolic function are impaired in patients with breast cancer treated by anthracyclines and trastuzumab. GLS and LSR of myocardium traced by two dimensional speckle tracking imaging would be useful for early evaluation of the severity.
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Objective To observe the correlation between cardiac two-dimension global strain-speckle tracking imaging (2D-STI) and coronary artery disease index (CADi) scores in patients with acute myocardial infarction(AMI). Methods Eighty patients with AMI were chosen and given myocardial motion analysis using 2D-STI. The global longitudinal strain (GLS), global radial strain (GRS) and global circumferential strain (GCS) was calculated. All patients were given scoring according to CADi scores standard by coronary angiography. The correlations between 2D-STI indexes and CADi scores were analyzed. The area under curve(AUC) of the receiver operating characteristic curve (ROC) of critical coronary stenosis was calculated. Results GLS, GRS and GCS was all correlated to CADi scores (r=0.670, -0.621, 0.525, all P < 0.01). The sensitivity, specificity and AUC of GLS for critical coronary stenosis was 82.35%, 80.43% and 0.831. The sensitivity, specificity and AUC of GCS for critical coronary stenosis was 76.47%, 76.09% and 0.797. The sensitivity, specificity and AUC of GRS for critical coronary stenosis was 97.06%, 78.26% and 0.880. The AUC of GLS and GRS was larger than that of GCS, and the sensitivity, specificity for critical coronary stenosis was larger. Conclusions 2D-STI indexes have correlation with CADi scores. GLS and GRS has correlation with coronary artery stenosis.
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ObjectiveTo examine whether DNA extracted from free edge fingernails specimens from patient after hematopoietic stem cell transplantation (allo-HSCT) could be used for short tandem repeat (STR) genotyping and chimerism analyzing,and to observe the chimerism status in fingernails after allo-HSCT.MethodsPeripheral blood,bone marrow,oral mucosa and free edge fingernail specimens were collected from 25 patients which allo-HSCT were performed in Beijing Dao-pei Hospital during Jul.2009 to Sep.2011 and their donor.Genomic DNA was extracted and 15 STR loci genotyping and chimerism analysis were performed.For the first group which including 12 patients,pairs of fingernail and oral mucosa specimens were collected within one month after allo-HSCT and were comparative analyzed.For the second group which including 13 patients,chimerism status in fingernail samples were analyzed 3 months or longer after allo-HSCT,and 3 patients underwent repeated testing at different times.ResultsFor the first group,4 oral mucosa specimens showed donor chimerism with varying degrees,but no donor chimerism was detected.in all of 12 fingernail specimens.For the second group,6.7％ to 82.6％ donor chimerism was detected in fingernail specimens in 5 out of 13 patients.For the 3 patients underwent repeated testing,donor chimerism was continued negative in one cases,but continued positive in the other 2 cases.ConclusionsFree edge fingernail samples of patients within one month after allo-HSCT can be used for STR typing and chimerism analysis,and it is better than oral mucosa samples.There are cells in allo-HSCT donor graft can differentiate into skin cells,donor derived skin cells chimerism can be formed and persist in some patients.Med,2012,35:23-26)
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Objective To analyze the clinical and laboratory features of acute pulmonary embolism for diagnosis as possible as early.Methods For 15 patients of pulmonary embolism,who have not history of heart-lung disease and have been diagnosed by high speed multislice CT, the clinical and other laboratory data of these patients were retrospectively analyzed.Results The clinical manifestations were dyspnea ,chest distress, palpitation;the signs including tachypnea, systole murmur, tachycardia etc. The examinations were mainly color Dopple echocardiography and blood gas analysis. In some cases of embolism were found in their pulmonary artery; in all cases tricuspid regurgitation were found by color Dopple echocardiography and their pulmonary systole pressure were all over normal value(42～76mmHg).The blood gas analysis showed that PaO 2 was obviously lower than normal value(30～65mmHg).Conclusions The patient who has symptoms of dyspnea and palpitation must be examined by high speed multislice CT , color Dopple echocardiography and other measurements to get an immediate diagnosis . The first choice is color Dopple echocardiography when there is no high speed multislice CT. The patients can get exact diagnosis and prompt treatment by manifestation of pulse spectral of pulmonary artery, increase of pulmonary artery pressure, right ventricular enlargement.
