Campbell F E, Kittleson M D
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA, USA.
J Vet Intern Med. 2007 Sep-Oct;21(5):1008-15. doi: 10.1892/0891-6640(2007)21[1008:teohso]2.0.co;2.
Diagnosis of cardiomyopathy of cats is based on 2-dimensional (2D) echocardiography. However, circulating fluid volume largely determines diastolic cardiac chamber dimensions, and reduced diastolic volume in other species results in what has been called "pseudohypertrophy of the ventricular myocardium."
Altered hydration produces changes on 2D echocardiography that may confound the diagnosis or severity assessment of cardiomyopathy of cats.
Ten normal colony-sourced mixed breed cats were included.
Cats were examined by echocardiography at baseline and at completion of 3 protocols (volume depletion and maintenance-rate and anesthetic-rate IV fluid administration) applied in randomized crossover design with a 6-7 day washout period.
Volume depletion increased diastolic left ventricular interventricular septal (IVSd) and free wall diameter (4.5 +/- 0.4 to 5.8 +/- 0.6 mm; P < .001) with wall thickness exceeding 6 mm in 4 cats. Diastolic left ventricular internal diameter (LVIDd) decreased, and reduction in systolic left ventricular internal diameter (LVIDs) produced end-systolic cavity obliteration in 7 cats. Left-atrial-to-aortic-root ratio (LA: Ao, 1.4 +/- 0.2 to 1.2 +/- 0.1, P < .05) and left atrial area in diastole (LAAd) decreased with volume depletion. Maintenance-rate IV fluid administration increased LAAd and fractional shortening (FS%). Anesthetic-rate IV fluid administration increased LVIDd, FS%, LAAd, and LA:Ao ratios (to 1.7 +/- 0.1, P < .01), producing an LA: Ao ratio above normal limits in 6 cats. A systolic heart murmur developed with administration of fluid at maintenance (n = 1) and anesthetic rates (n = 6).
Altered hydration status produces changes in the echocardiographic examination of normal cats that may lead to an erroneous diagnosis of cardiomyopathy or mask its presence. Hydration status should be considered during echocardiographic examination in cats.
猫心肌病的诊断基于二维(2D)超声心动图。然而,循环血容量在很大程度上决定了心脏舒张期腔室大小,而其他物种舒张期容量减少会导致所谓的“心室心肌假性肥厚”。
水合状态改变会使二维超声心动图出现变化,这可能混淆猫心肌病的诊断或严重程度评估。
纳入10只来自普通种群的混种猫。
对猫在基线时以及在采用随机交叉设计且洗脱期为6 - 7天的3种方案(容量耗竭、维持速率和麻醉速率静脉输液)完成后进行超声心动图检查。
容量耗竭使舒张期左心室室间隔(IVSd)和游离壁直径增加(从4.5±0.4毫米增加到5.8±0.6毫米;P <.001),4只猫的室壁厚度超过6毫米。舒张期左心室内径(LVIDd)减小,收缩期左心室内径(LVIDs)减小使7只猫出现收缩末期腔室闭塞。容量耗竭时左心房与主动脉根部比值(LA: Ao,从1.4±0.2降至1.2±0.1,P <.05)和舒张期左心房面积(LAAd)减小。维持速率静脉输液使LAAd和缩短分数(FS%)增加。麻醉速率静脉输液使LVIDd、FS%、LAAd和LA: Ao比值增加(至1.7±0.1,P <.01),6只猫的LA: Ao比值超过正常范围。在维持速率(n = 1)和麻醉速率(n = 6)输液时出现了收缩期心脏杂音。
水合状态改变会使正常猫的超声心动图检查出现变化,这可能导致对心肌病的错误诊断或掩盖其存在。在对猫进行超声心动图检查时应考虑水合状态。