Rishniw Mark, Pion Paul D
Veterinary Information Network, Davis, CA 95616, USA.
J Feline Med Surg. 2011 Jul;13(7):487-97. doi: 10.1016/j.jfms.2011.05.006.
Feline hypertrophic cardiomyopathy (HCM) is the most common cardiac disease of cats. Treatment of HCM is usually directed at controlling signs of congestive heart failure (CHF), preventing occurrence or recurrence of systemic thromboembolism or delaying/preventing/reversing progression of subclinical disease.
Despite the laudable goals of therapy, however, little objective evidence supporting therapeutic decisions has been published. We, therefore, hypothesized that cardiologists base their treatment strategies on information other than published clinically relevant science. To gain insight into therapeutic decisions that cardiologists and clinicians with an interest in cardiology (n=99) make for cats with HCM, and on what information they base these decisions, we presented participants with, and asked them to select therapy for, 12 hypothetical scenarios of HCM (± CHF). Responses and justifications for treatment choices were compiled and compared with the results of a comprehensive literature search for published information about treatment of feline HCM.
Evaluation of the therapeutic strategies chosen for these hypothetical cases of HCM suggests that cardiologists or clinicians with a strong interest in cardiology often prescribe treatments knowing that little documented evidence supports their decisions.
猫肥厚型心肌病（HCM）是猫最常见的心脏疾病。HCM的治疗通常旨在控制充血性心力衰竭（CHF）的症状，预防全身性血栓栓塞的发生或复发，或延缓/预防/逆转亚临床疾病的进展。
然而，尽管治疗目标值得称赞，但支持治疗决策的客观证据却鲜有发表。因此，我们推测心脏病专家的治疗策略基于已发表的临床相关科学之外的信息。为了深入了解心脏病专家以及对心脏病感兴趣的临床医生（n = 99）针对患有HCM的猫所做出的治疗决策，以及他们做出这些决策所依据的信息，我们向参与者展示了12种HCM（±CHF）的假设病例，并要求他们选择治疗方案。对治疗选择的回答和理由进行了整理，并与针对猫HCM治疗的已发表信息进行全面文献检索的结果进行了比较。
对这些HCM假设病例所选择的治疗策略进行评估表明，对心脏病有浓厚兴趣的心脏病专家或临床医生在开出处方时往往知道几乎没有文献证据支持他们的决策。
