Koffas H, Dukes-McEwan J, Corcoran B M, Moran C M, French A, Sboros V, Simpson K, McDicken W N
Department of Veterinary Clinical Studies, University of Edinburgh, Scotland, UK.
J Vet Intern Med. 2006 Jan-Feb;20(1):65-77. doi: 10.1892/0891-6640(2006)20[65:ptdiin]2.0.co;2.
Myocardial motion was quantified in normal cats (n = 25) and cats with hypertrophic cardiomyopathy (HCM) (n = 23) using the pulsed tissue Doppler imaging (TDI) technique. A physiologic nonuniformity was documented in the myocardial motion of normal cats, which was detected as higher early diastolic velocities, acceleration, and deceleration in the interventricular septum compared with the left ventricular free wall (LVFW). HCM cats exhibited lower early diastolic velocities, acceleration, and deceleration and also prolonged isovolumic relaxation time compared with normal cats. These differences were detected mainly along the longitudinal axis of the heart. A cutoff value of E' in the LVFW along the longitudinal axis >7.2 cm/s discriminated normal from HCM cats with a sensitivity of 92% and a specificity of 87%. The physiologic nonuniformity of myocardial motion during diastole was lost in affected cats. Systolic impairment (decreased late-systolic velocities in most segments along the longitudinal axis and decreased early systolic acceleration in both mitral annular sites) was evident in HCM cats irrespective of the presence of left ventricular outflow tract obstruction and congestive heart failure. Postsystolic thickening was recorded in the LVFW along the longitudinal axis only in affected cats (n = 6) and was another finding indicative of systolic impairment in the HCM of this species. This study identified both diastolic and systolic impairment in cats with HCM compared with normal cats. The study also documents the normal physiologic nonhomogeneity in myocardial motion in cats and the subsequent loss of this feature in the HCM diseased state.
使用脉冲组织多普勒成像(TDI)技术对正常猫(n = 25)和肥厚型心肌病(HCM)猫(n = 23)的心肌运动进行了量化。记录到正常猫心肌运动存在生理性不均匀性,表现为与左心室游离壁(LVFW)相比,室间隔舒张早期速度、加速度和减速度更高。与正常猫相比,HCM猫舒张早期速度、加速度和减速度较低,等容舒张时间也延长。这些差异主要沿心脏纵轴检测到。LVFW沿纵轴的E'截止值>7.2 cm/s可区分正常猫和HCM猫,敏感性为92%,特异性为87%。患病猫舒张期心肌运动的生理性不均匀性消失。无论是否存在左心室流出道梗阻和充血性心力衰竭,HCM猫均存在收缩功能损害(沿纵轴大多数节段的收缩晚期速度降低,二尖瓣环部位的收缩早期加速度均降低)。仅在患病猫(n = 6)中记录到LVFW沿纵轴的收缩后增厚,这是该物种HCM收缩功能损害的另一项指标。本研究确定了与正常猫相比,HCM猫存在舒张和收缩功能损害。该研究还记录了猫心肌运动的正常生理性不均匀性以及在HCM疾病状态下该特征的后续丧失。