Saunders A B, Gordon S G, Boggess M M, Miller M W
Department of Small Animal Clinical Sciences, and the Michael E. DeBakey Institute for Comparative Cardiovascular Sciences and Biomedical Devices, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
J Vet Intern Med. 2014 Mar-Apr;28(2):401-10. doi: 10.1111/jvim.12267. Epub 2013 Dec 26.
Published information regarding survival and long-term cardiac remodeling after patent ductus arteriosus (PDA) closure in dogs is limited.
To report outcome and identify prognostic variables in dogs with PDA, and to identify risk factors for persistent remodeling in dogs with a minimum of 12 months of follow-up after closure.
Five hundred and twenty client-owned dogs.
Retrospective review of medical records of 520 dogs with PDA. Outcome was determined by contacting owners and veterinarians. Dogs with PDA closure and ≥ 12 months of follow-up were asked to return for a re-evaluation.
In multivariable analysis of 506 dogs not euthanized at the time of diagnosis, not having a PDA closure procedure negatively affected survival (HzR = 16.9, P < .001). In 444 dogs undergoing successful PDA closure, clinical signs at presentation (HzR = 17, P = .02), concurrent congenital heart disease (HD) (HzR = 4.8, P = .038), and severe mitral regurgitation (MR) documented within 24 hours of closure (HzR = 4.5, P = .028) negatively affected survival. Seventy-one dogs with ≥ 12 months follow-up demonstrated a significant reduction in radiographic and echocardiographic measures of heart size (P = 0) and increased incidence of acquired HD (P = .001) at re-evaluation. Dogs with increased left ventricular size and low fractional shortening at baseline were more likely to have persistent remodeling at re-evaluation.
Patent ductus arteriosus closure confers important survival benefits and results in long-term reverse remodeling in most dogs. Clinical signs at presentation, concurrent congenital HD, and severe MR negatively affect survival. Increased left ventricular systolic dimensions and systolic dysfunction at baseline correlated significantly with persistent remodeling.
关于犬动脉导管未闭（PDA）闭合术后生存情况及长期心脏重塑的已发表信息有限。
报告PDA犬的预后情况并确定预后变量，识别闭合术后至少随访12个月的犬持续性重塑的危险因素。
520只客户拥有的犬。
对520只PDA犬的病历进行回顾性研究。通过联系犬主和兽医确定预后情况。对已进行PDA闭合术且随访时间≥12个月的犬，要求其返回进行重新评估。
在对诊断时未实施安乐死的506只犬进行的多变量分析中，未进行PDA闭合术对生存有负面影响（危险比[HzR]=16.9，P<.001）。在444只成功进行PDA闭合术的犬中，就诊时的临床症状（HzR=17，P=.02）、并存的先天性心脏病（HD）（HzR=4.8，P=.038）以及闭合术后24小时内记录到的严重二尖瓣反流（MR）（HzR=4.5，P=.028）对生存有负面影响。71只随访时间≥12个月的犬在重新评估时，心脏大小的X线和超声心动图测量值显著减小（P=0），获得性HD的发生率增加（P=.001）。基线时左心室大小增加且射血分数降低的犬在重新评估时更有可能出现持续性重塑。
PDA闭合术可带来重要的生存益处，并使大多数犬出现长期逆向重塑。就诊时的临床症状、并存的先天性HD以及严重MR对生存有负面影响。基线时左心室收缩维度增加和收缩功能障碍与持续性重塑显著相关。
