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肥厚型心肌病猫左心室几何形态及二尖瓣装置的超声心动图评估

Echocardiographic assessment of left ventricular geometry and the mitral valve apparatus in cats with hypertrophic cardiomyopathy.

作者信息

Schober Karsten, Todd Amanda

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp Street, Columbus, OH 43210, USA.

出版信息

J Vet Cardiol. 2010 Apr;12(1):1-16. doi: 10.1016/j.jvc.2009.09.004. Epub 2010 Feb 24.

Abstract

OBJECTIVES

This retrospective study addressed the general hypothesis that abnormalities of the mitral valve apparatus are common in cats with idiopathic hypertrophic cardiomyopathy (HCM) and contribute to dynamic obstruction of the left ventricular outflow tract (LVOT).

ANIMALS, MATERIALS AND METHODS: 106 cats (28 controls and 78 with HCM) had transthoracic two-dimensional and Doppler echocardiography performed with quantification of 33 variables. Three groups of cats (control [Group-1], HCM without obstruction [Group-2], and HCM with obstruction [Group-3]) were identified and compared by analysis of variance, chi(2) analysis, and correlation analysis.

RESULTS

Cats in Group-3 had more LV and papillary muscle hypertrophy, increased length of the anterior mitral valve leaflet, and a higher prevalence of false tendons in the LVOT compared to cats in Group-2 (P < or = 0.05). The length of the anterior mitral valve leaflet was correlated to the severity of dynamic obstruction (P < or = 0.05) and the magnitude of LV hypertrophy (P < or = 0.001). Systolic anterior motion of chordae tendineae (CAM) was observed in 16% of control cats and >50% of cats with HCM (P < or = 0.05).

CONCLUSIONS

Abnormalities of the mitral valve are common in cats with HCM suggesting a possible role in the pathogenesis of dynamic outflow tract obstruction.

摘要

目的

本回顾性研究探讨了一个总体假设,即二尖瓣装置异常在特发性肥厚型心肌病(HCM)猫中很常见,并导致左心室流出道(LVOT)的动态梗阻。

动物、材料与方法:对106只猫(28只对照猫和78只患有HCM的猫)进行经胸二维和多普勒超声心动图检查,并对33个变量进行量化。通过方差分析、卡方分析和相关性分析,确定并比较了三组猫(对照组[第1组]、无梗阻的HCM组[第2组]和有梗阻的HCM组[第3组])。

结果

与第2组猫相比,第3组猫的左心室和乳头肌肥厚更明显,二尖瓣前叶长度增加,LVOT中假腱索的患病率更高(P≤0.05)。二尖瓣前叶长度与动态梗阻的严重程度相关(P≤0.05),也与左心室肥厚程度相关(P≤0.001)。在16%的对照猫和>50%的HCM猫中观察到腱索收缩期向前运动(CAM)(P≤0.05)。

结论

二尖瓣异常在HCM猫中很常见,提示其在动态流出道梗阻的发病机制中可能起作用。

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