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马的高血压性心肌病:5例(1995 - 2011年)

Hypertensive cardiomyopathy in horses: 5 cases (1995-2011).

作者信息

Navas de Solis Cristobal, Slack JoAnn, Boston Raymond C, Reef Virginia B

机构信息

New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348, USA.

出版信息

J Am Vet Med Assoc. 2013 Jul 1;243(1):126-30. doi: 10.2460/javma.243.1.126.

DOI:10.2460/javma.243.1.126
PMID:23786201
Abstract

OBJECTIVE

To describe the prognosis and clinical, echocardiographic, and pathological features of hypertensive cardiomyopathy in horses.

DESIGN

Retrospective case series.

ANIMALS

5 horses with cardiac hypertrophy and systemic hypertension.

PROCEDURES

Demographics, history, physical and cardiological examination findings, diagnosis, clinical progression, prognosis, and pathological findings were obtained from medical records.

RESULTS

The primary diagnosis was chronic laminitis in 3 horses and chronic renal failure in 2. Persistent tachycardia, hypertension, chronic laminitis, or a combination of these prompted the cardiac evaluations. Blood pressure values (median [range]), measured noninvasively, were determined as 190 mm Hg (183 to 261 mm Hg) for systolic pressure, 126 mm Hg (100 to 190 mm Hg) for diastolic pressure, and 155 mm Hg (126 to 222 mm Hg) for mean pressure. No arrhythmias were reported. For the left ventricle, all horses had increased relative wall thickness, mean wall thickness, and ventricular mass. The interventricular septum was thickened at end diastole (n = 5) and in peak systole (4). The left ventricular internal diameter was small at end diastole (n = 4) and in peak systole (3). The left ventricular free wall was thickened at end diastole (n = 3) and in peak systole (4). No associations between blood pressure and variables consistent with hypertrophy were detected. All horses were euthanized because of the grave prognosis of the primary diseases. All 3 horses that underwent postmortem evaluation had cardiovascular abnormalities.

CONCLUSIONS AND CLINICAL RELEVANCE

Hypertensive cardiomyopathy should be considered as a comorbid diagnosis in horses with laminitis or chronic renal failure. Information about the development, progression, reversibility, importance of early detection, and long-term sequelae of this condition is needed.

摘要

目的

描述马高血压性心肌病的预后以及临床、超声心动图和病理特征。

设计

回顾性病例系列研究。

动物

5匹患有心脏肥大和系统性高血压的马。

方法

从病历中获取人口统计学资料、病史、体格检查和心脏检查结果、诊断、临床病程、预后及病理检查结果。

结果

3匹马的主要诊断为慢性蹄叶炎,2匹马为慢性肾衰竭。持续性心动过速、高血压、慢性蹄叶炎或这些情况的组合促使进行心脏评估。通过非侵入性测量的血压值(中位数[范围]),收缩压为190 mmHg(183至261 mmHg),舒张压为126 mmHg(100至190 mmHg),平均压为155 mmHg(126至222 mmHg)。未报告心律失常。对于左心室,所有马匹的相对壁厚度、平均壁厚度和心室质量均增加。舒张末期(n = 5)和收缩期峰值(4)时室间隔增厚。舒张末期(n = 4)和收缩期峰值(3)时左心室内径较小。舒张末期(n = 3)和收缩期峰值(4)时左心室游离壁增厚。未检测到血压与符合肥大的变量之间存在关联。由于原发性疾病预后严重,所有马匹均实施安乐死。所有3匹接受尸检评估的马均有心血管异常。

结论及临床意义

在患有蹄叶炎或慢性肾衰竭的马匹中,应将高血压性心肌病视为合并诊断。需要有关这种疾病的发生发展过程、可逆性、早期检测的重要性以及长期后遗症的信息。

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