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5 分钟心电图(ECG)预测心肌病杜宾犬心律失常的能力与 24 小时动态心电图比较。

Ability of a 5-minute electrocardiography (ECG) for predicting arrhythmias in Doberman Pinschers with cardiomyopathy in comparison with a 24-hour ambulatory ECG.

机构信息

Clinic of Small Animal Medicine, LMU University, Munich, Germany.

出版信息

J Vet Intern Med. 2010 Mar-Apr;24(2):367-71. doi: 10.1111/j.1939-1676.2010.0477.x.

Abstract

BACKGROUND

Ventricular premature contractions (VPCs) are common in the occult stage of cardiomyopathy in Doberman Pinschers. Although the gold standard for detecting arrhythmia is the 24-hour ambulatory electrocardiography (ECG) (Holter), this method is more expensive, time-consuming and often not as readily available as common ECG.

OBJECTIVES

Comparison of 5-minute ECGs with Holter examinations.

ANIMALS

Eight hundred and seventy-five 5-minute ECGs and Holter examinations of 431 Doberman Pinschers.

METHODS

Each examination included a 5-minute ECG and Holter examination. A cut-off value of > 100 VPCs/24 hours using Holter was considered diagnostic for the presence of cardiomyopathy. Statistical evaluation included calculation of sensitivity, specificity, positive predictive value, and negative predictive value.

RESULTS

Holter examinations revealed > 100 VPCs/24 hours in 204/875 examinations. At least 1 VPC during a 5-minute ECG was detected in 131 (64.2%) of these 204 examinations. No VPCs were found in the 5-minute ECG in 73 (35.8%) examinations of affected Doberman Pinschers. A 5-minute ECG with at least 1 VPC as cut-off had a sensitivity of 64.2%, a specificity of 96.7%, a positive predictive value of 85.6% and a negative predictive value of 89.9% for the presence of > 100 VPCs/24 hours.

CONCLUSIONS AND CLINICAL IMPORTANCE

A 5-minute ECG is a rather insensitive method for detecting arrhythmias in Doberman Pinschers. However, the occurrence of at least 1 VPC in 5 minutes strongly warrants further examination of the dog, because specificity (96.7%) and positive predictive value (85.6%) are high and could suggest occult cardiomyopathy.

摘要

背景

在杜宾犬心肌病的隐匿阶段,室性期前收缩(VPC)很常见。虽然检测心律失常的金标准是 24 小时动态心电图(ECG)(Holter),但这种方法更昂贵、耗时,而且往往不如普通 ECG 方便。

目的

比较 5 分钟 ECG 和 Holter 检查。

动物

431 只杜宾犬的 875 次 5 分钟 ECG 和 Holter 检查。

方法

每次检查均包括 5 分钟 ECG 和 Holter 检查。Holter 检查中 > 100 VPCs/24 小时的截止值被认为是心肌病存在的诊断标准。统计评估包括灵敏度、特异性、阳性预测值和阴性预测值的计算。

结果

Holter 检查显示 875 次检查中有 204 次 > 100 VPCs/24 小时。在这些 204 次检查中,有 131 次(64.2%)至少在 1 次 5 分钟 ECG 中检测到 1 个 VPC。在受影响的杜宾犬的 73 次(35.8%)检查中,5 分钟 ECG 中未发现 VPC。以至少 1 个 VPC 为截止值的 5 分钟 ECG 的灵敏度为 64.2%,特异性为 96.7%,阳性预测值为 85.6%,阴性预测值为 89.9%,用于检测 > 100 VPCs/24 小时。

结论和临床意义

5 分钟 ECG 是检测杜宾犬心律失常的一种相对不敏感的方法。然而,在 5 分钟内至少发生 1 次 VPC 强烈提示需要进一步检查犬,因为特异性(96.7%)和阳性预测值(85.6%)较高,可能提示隐匿性心肌病。

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