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患骨髓增生性疾病时心脏功能及形态学的改变(临床研究)

Functional and morphological cardiac cha-nges in myeloproliferative disorders(clinical study)
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摘要 Purpose: Cardiac involvement is not well defined in myeloproliferative disorders(MPD). The purpose of this study was to evaluate the cardiac involvement by transthoracic echocardiography in MPD. Materials and methods: The study groups were 36 patients(mean age: 58±15 years, 20 female and 16 male)-with MPD and 30 age-matched healthy controls. MPD group included 15 essential thrombocythemia (ET), eight chronic phase chronic myelogenous leukemia(CML), seven idiopathic myelofibrosis(MF) and six polcythemia vera patients. Results: Valvular regurgitations were present in 14 patients (39%) and eight controls (27%), (P >0.05). Mitral regurgitation(MR)-was more prominent in CML compared to controls (P=0.044). The rates of annular calcifications, valvular thickening, and vegetation like lesions were not different between MPD and control groups. Pulmonary hypertension(PHT) was present in six(17%) patients, but none of the controls(P=0.021). The rates of PHT in CML and MF were significantly higher than controls(P< 0.05). The rate of PHT was not different in-between MPD patients with and without thromboembolic events, however, in MPD cases with thromboembolic events PHT was more common compared to controls (P=0.037). Conclusion: This study showed that valvular lesions were not more prevalent in MPD. PHT was the most prominent cardiac pathology in MPD(especially in CML,MF and thromboembolic events subgroups) compared to controls. Further evaluation of the cardiac changes in MPD subgroups with extended studies including trans-oesophageal echocardiography and longer follow-up periods would be appropriate. Purpose: Cardiac involvement is not well defined in myeloproliferative disorders(MPD). The purpose of this study was to evaluate the cardiac involvement by transthoracic echocardiography in MPD. Materials and methods: The study groups were 36 patients(mean age: 58±15 years, 20 female and 16 male)-with MPD and 30 age-matched healthy controls. MPD group included 15 essential thrombocythemia (ET), eight chronic phase chronic myelogenous leukemia(CML), seven idiopathic myelofibrosis(MF) and six polcythemia vera patients. Results: Valvular regurgitations were present in 14 patients (39%) and eight controls (27%), (P >0.05). Mitral regurgitation(MR)-was more prominent in CML compared to controls (P=0.044). The rates of annular calcifications, valvular thickening, and vegetation like lesions were not different between MPD and control groups. Pulmonary hypertension(PHT) was present in six(17%) patients, but none of the controls(P=0.021). The rates of PHT in CML and MF were significantly higher than controls(P< 0.05). The rate of PHT was not different in-between MPD patients with and without thromboembolic events, however, in MPD cases with thromboembolic events PHT was more common compared to controls (P=0.037). Conclusion: This study showed that valvular lesions were not more prevalent in MPD. PHT was the most prominent cardiac pathology in MPD(especially in CML,MF and thromboembolic events subgroups) compared to controls. Further evaluation of the cardiac changes in MPD subgroups with extended studies including trans-oesophageal echocardiography and longer follow-up periods would be appropriate.
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