RESUMO
OBJECTIVE: To investigate the predictive value of PTEN and echocardiography in the treatment of heart failure with trimetazidine combined with metoprolol. METHODS: A total of 100 patients with coronary heart disease and HF who admitted to our hospital from August 2018 to August 2020 were enrolled into research. All patients received routine treatment according to the guidelines and were treated with trimetazidine and metoprolol for a total course of 6 months. Echocardiographic parameters and PTEN levels were measured at baseline and after treatment. The patients were divided into groups according to the quartile of basic PTEN level, and the total effective rates were compared. The echocardiographic parameters of patients with different prognosis were analyzed. Bivariate correlation analysis was used to evaluate the correlation between PTEN, echocardiography and treatment effect. RESULTS: Compared with that before treatment, the level of PTEN increased significantly after treatment (P < 0.01). According to the quartile of basic PTEN level, the total effective rate of patients with different levels of basic PTEN was was statistically different (P < 0.01). There was a linear correlation between the level of basic PTEN and the treatment effect, and the total effective rate of patients with high level of basic PTEN was higher than that of patients with low level of PTEN. Compared with before treatment, LVEF, SV, E/A and lvfs increased significantly after treatment (P < 0.01). There was a correlation between the basic echocardiographic parameters and the treatment effect of patients. The basic echocardiographic parameters of patients with poor prognosis were worse than those with good prognosis. PTEN expression in patients' serum was only positively correlated with E/A, but not with LVFE, SV and LVFS (P < 0.01). CONCLUSION: PTEN and echocardiographic parameters serve as a good method to evaluate the short-term therapeutic effect of trimetazidine combined with metoprolol in patients with heart failure.
RESUMO
OBJECTIVE: To evaluate the echocardiographic features of apical hypertrophic cardiomyopathy (ApHCM). METHODS: Twenty-seven patients with ApHCM including 21 men and 6 women, average age (42.7 +/- 5.1) years old were followed up from 1995 to 2008 to investigate the clinical, electrocardiographic and echocardiographic features. RESULTS: The major features of ECG were increased R amplitude (V(4) > V(5) > V(3)) and inverteted T wave (especially in V(3-5) leads and the voltage of the inverteted T waves may be up to >/= 10 mm). The major feature of echocardiography was the thickening of left ventricular apical wall to 15 - 37 (18.0 +/- 3.3) mm. The final follow up showed that the mean thickness of the apical wall was (19.7 +/- 3.7) mm. The ratio of the thickness of left ventricular apical wall to posterior wall before and after the follow up was 1.7 +/- 0.3 and 1.9 +/- 0.9 respectively, with significant statistical difference (P < 0.05). There was no difference in the left ventricular end-diastolic dimension and left ventricular ejection fraction. The main cardiovascular events were atrial fibrillation (16 cases), heart failure of NYHA III-IV class (3 cases), anterior wall myocardial infarction (1 case) and sudden death (1 case). CONCLUSIONS: The final diagnosis of ApHCM depends on the characteristic inverteted T wave in ECG and apical hypertrophy in echocardiography. The prognosis of ApHCM is rather good for its progression is relatively slow.