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具有原发性慢性退行性二尖瓣疾病且与黏液样变性相关的犬的生存特征和预后变量。

Survival characteristics and prognostic variables of dogs with preclinical chronic degenerative mitral valve disease attributable to myxomatous degeneration.

机构信息

Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA.

出版信息

J Vet Intern Med. 2012 Jan-Feb;26(1):69-75. doi: 10.1111/j.1939-1676.2011.00860.x. Epub 2011 Dec 23.

Abstract

BACKGROUND

Preclinical myxomatous mitral valve degeneration (MMVD) includes a heterogeneous group of dogs. Therefore, identifying risk factors for progression of the disease is of clinical importance.

OBJECTIVES

To investigate survival time and risk factors for clinical and echocardiographic variables taken at initial examination for clinical progression in preclinical MMVD dogs.

ANIMALS

A total of 256 dogs with stage B1 or B2 MMVD.

MATERIALS AND METHODS

Medical records of 256 dogs with preclinical MMVD were reviewed retrospectively. Long-term outcome was assessed by telephone interview. Dogs alive at the time of phone interview were asked to return to the hospital for re-evaluation of their cardiac status.

RESULTS

Seventy of 256 (27.3%) dogs died during the observation period. The median survival time, regardless of cause of death, was 588 (range 75-1,668) days. The presence of a murmur was associated with an increased risk of death (AHR 2.14; 95% CI 1.12, 4.11; P = 0.022). Thirty (12%) deaths were considered cardiac related. LA/Ao > 1.4 was the only negative predictor (AHR 2.64; 1.13, 6.13; P = 0.024) for cardiac-related deaths. Eighty-three dogs were re-examined, of which 34 progressed to a more advanced stage of MMVD. The presence of Emax > 1.2 (AHR 2.75; 95% CI 1.01, 7.48; P = 0.047) and cough (AHR 7.89; 95% CI 3.18, 20.07; P < 0.001) were significant in the multivariate analysis.

CONCLUSIONS AND CLINICAL IMPORTANCE

Preclinical MMVD represents a relatively benign condition in dogs. Clinicians might find stratification of this dog population according to risk factors based on clinical and echocardiographic findings helpful in determining treatment.

摘要

背景

临床前黏液样心肌变性(MMVD)包括一组异质性犬。因此,确定疾病进展的危险因素具有临床重要性。

目的

研究临床前 MMVD 犬在初始检查时的临床和超声心动图变量的生存时间和危险因素,以预测临床进展。

动物

共 256 只 B1 或 B2 期 MMVD 犬。

材料和方法

回顾性分析 256 只临床前 MMVD 犬的病历。通过电话访谈评估长期预后。在电话访谈时存活的犬被要求返回医院重新评估其心脏状况。

结果

在观察期间,256 只犬中有 70 只(27.3%)死亡。无论死因如何,中位生存时间为 588(范围 75-1668)天。存在杂音与死亡风险增加相关(AHR 2.14;95%CI 1.12,4.11;P = 0.022)。30 例(12%)死亡被认为与心脏相关。LA/Ao > 1.4 是唯一的负预测因子(AHR 2.64;95%CI 1.13,6.13;P = 0.024),与心脏相关的死亡相关。83 只犬重新检查,其中 34 只进展为更严重的 MMVD 期。Emax > 1.2(AHR 2.75;95%CI 1.01,7.48;P = 0.047)和咳嗽(AHR 7.89;95%CI 3.18,20.07;P < 0.001)在多变量分析中具有统计学意义。

结论和临床意义

临床前 MMVD 犬的状况相对良性。临床医生可能会发现,根据临床和超声心动图检查结果,根据危险因素对犬群进行分层,有助于确定治疗方案。

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