The Using Of Myocardial Perfusion Imaging Of Myocardial Ischemia In Elderly Patients With Coronary Heart Disease And Trimetazidine Intervention Study

Objective 1. Contrasting the differences of myocardial ischemia,heart function and the serological indicators in elderly patients with coronary heart disease (CHD) complicated with essential hypertension and/or type 2. diabetes mellitus by 99mTc-MIBI myocardial perfusion imaging. Analysis of severity of myocardial ischemia on cardiac function and heart rate variability.2.Evaluation the improving effect of trimetazidine in coronary heart disease in elderly patients with myocardial ischemia and cardiac function by 99mTc-MIBI myocardial perfusion imaging.Method 1. All cases were sampled from the Hospital from January to December in 2006,and the main parts are as following.178 cases of elderly patients with coronary heart disease are divided into four groups according to their pathogenetic condition .To Statistics the date of SSS,SDS,SRS,LVEF,D-D,vWF,hs-CRP,TCH,TG,HDL-C,LDL-C of each group. Collecting 36 patients with normal myocardial perfusion imaging in clinical data over the same period.According to the results of SPECT they were divided into three groups:A(No perfusion defect group);B(Completely reversible perfusion defect group);C(Not fully reversible perfusion defect group),And through two-dimensional Doppler ultrasound evaluation of their cardiac function parameters.2. 30 patients has selected randomly,using for the study of Trimetazidine intervention.After arrangement of adenosine load and rest myocardial perfusion imaging, 20mg Trimetazidine were oraled three times a day for 6 months.Then Re-arrangement of myocardial perfusion imaging,Assessing the improvement of myocardial perfusion, cardiac function .Results 1.Compared with CHD group ,the other three groups had significantly higher SSS,SDS,D-D,vWF,hs-CRP and lower LVEF, but compared with CHD with EH and T2DM group, other groups had lower SSS,SDS,D-D,vWF,hs-CRP and higher LVEF (p<0.05); There was no differences between patients complicating type T2DM and patients complicating EH; These four groups were commom in TCH,TG,HDL-C,LDL-C; There was a positive correlation between the level of D-D,vWF,hs-CRP and SSS,SDS. Compared with A group,the level of ESV,EDV,LVEF is higher in B and C group,(p<0.05)。The level of LVESV,LVEDV is similar in B and C group,but Compared with B group,LVEF is lower in C group.Compared with A group the level of SDNN,SDANN Index,SDNN Index,rMSDD,PNN50 is lower in B and C group(p<0.05),but there is no defreneces between B and C group. 2. Compared with the pre-test,SSS,SDS,LVEF level is lower,P<0.05,and SRS was similar.Conclusion 1.Radionuclide myocardial perfusion imaging can be an effective evaluation of the coronary myocardial ischemia; Elderly patients with coronary heart disease CHD complicating T2DM or EH had severe myocardial ischemia and poor heart function,which was more significant in elderly patients with CHD complicating T2DM and EH. The level of D-D,vWF,hs-CRP may reflect the degree of myocardial ischemia.Severity of myocardial ischemia can significantly affect cardiac function and heart rate variability.The more severe myocardial ischemia, cardiac function and heart rate variability decreased more obvious.Radionuclide myocardial perfusion imaging and ultrasound have a good correlation in the measurement of cardiac function.2.Trimetazidine can be effective in improving myocardial perfusion and cardiac function in in elderly patients with coronary heart disease.