Paige Christopher F, Abbott Jonathan A, Elvinger François, Pyle R Lee
Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute, Blacksburg, VA 24061, USA.
J Am Vet Med Assoc. 2009 Jun 1;234(11):1398-403. doi: 10.2460/javma.234.11.1398.
To determine the prevalence of cardiomyopathy and the relationship between cardiomyopathy and heart murmurs in apparently healthy cats.
Cross-sectional study.
103 privately owned, apparently healthy domestic cats.
Cats were physically and echocardiographically examined by 2 investigators independently. Left ventricular wall thickness was determined via 2-dimensional echocardiography in short-axis and long-axis planes. Left ventricular hypertrophy was identified when end-diastolic measurements of the interventricular septum or posterior wall were > or = 6 mm. Cats with left ventricular hypertrophy but without left ventricular dilatation were considered to have hypertrophic cardiomyopathy (HCM). The associations between heart murmurs and Doppler echocardiographic velocity profiles indicative of dynamic ventricular outflow tract obstruction were evaluated.
Heart murmurs were detected in 16 (15.5%; 95% confidence interval, 9.2% to 24.0%) cats; of these, 5 had cardiomyopathy. Cardiomyopathy was also identified in 16 (15.5%; 95% confidence interval, 9.2% to 24.0%) cats; 15 had HCM, and 1 had arrhythmogenic right ventricular cardiomyopathy. Of the cats with HCM, 11 had segmental left ventricular hypertrophy, 3 had diffuse left ventricular hypertrophy, and 1 had borderline left ventricular hypertrophy with marked systolic anterior motion of the mitral valve. Sensitivity and specificity of auscultatory detection of a heart murmur for diagnosing cardiomyopathy were 31% and 87%, respectively. Echocardiographic evidence of late systolic acceleration within ventricular outflow tracts was associated with the existence of a heart murmur.
Cardiomyopathy was common in the healthy cats evaluated in this study. In apparently healthy cats, detection of a heart murmur is not a reliable indicator of cardiomyopathy.
确定看似健康的猫心肌病的患病率以及心肌病与心脏杂音之间的关系。
横断面研究。
103只 privately owned、看似健康的家猫。
由2名研究者分别对猫进行体格检查和超声心动图检查。通过二维超声心动图在短轴和长轴平面测定左心室壁厚度。当室间隔或后壁舒张末期测量值≥6mm时,确定为左心室肥厚。左心室肥厚但无左心室扩张的猫被认为患有肥厚型心肌病(HCM)。评估心脏杂音与提示动态心室流出道梗阻的多普勒超声心动图速度剖面之间的关联。
16只(15.5%;95%置信区间为9.2%至24.0%)猫检测到心脏杂音;其中5只患有心肌病。16只(15.5%;95%置信区间为9.2%至24.0%)猫也被确定患有心肌病;15只患有HCM,1只患有致心律失常性右室心肌病。在患有HCM的猫中,11只出现节段性左心室肥厚,3只出现弥漫性左心室肥厚,1只出现边界性左心室肥厚伴二尖瓣明显收缩期前向运动。听诊检测心脏杂音诊断心肌病的敏感性和特异性分别为31%和87%。心室流出道晚期收缩期加速的超声心动图证据与心脏杂音的存在相关。
在本研究评估的健康猫中,心肌病很常见。在看似健康的猫中,检测到心脏杂音并不是心肌病的可靠指标。