Navas de Solis Cristobal, Dallap Schaer Barbara L, Boston Ray, Slack JoAnn
Sections of Sports Medicine and Imaging, Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, 19348; Universidad Autonoma de Barcelona, Bellaterra, Barcelona, Spain.
J Vet Emerg Crit Care (San Antonio). 2015 Mar-Apr;25(2):248-55. doi: 10.1111/vec.12295. Epub 2015 Mar 5.
The objectives of this investigation were to: (1) Determine if acute hemorrhage is associated with increased plasma cardiac troponin I (cTnI) concentration or cardiac arrhythmias, (2) to describe the types of arrhythmias and their clinical course in horses following acute hemorrhage, (3) to determine the ability of clinical or clinicopathological variables to predict an increase in cTnI concentration and the presence of arrhythmias, and (4) to determine the associations of cTnI and cardiac arrhythmias with outcome.
Prospective observational study.
Large animal veterinary teaching hospital.
Eleven client-owned adult horses admitted for treatment of acute hemorrhage (HG) and 4 adult horses undergoing controlled blood collection (BDG).
Serial cTnI concentrations were measured and continuous ECGs were obtained from the HG and BDG groups. Statistical tests were used to determine associations among acute hemorrhage and plasma cTnI concentrations, the presence of cardiac arrhythmias, clinicopathologic data (heart rate [HR], packed cell volume [PCV], total plasma protein [TPP], plasma lactate, and plasma creatinine concentrations), and outcome.
Plasma cTnI concentration and ECG were within reference intervals at all time points in the BDG. All horses in the HG had increased cTnI (ranging from 0.1-29.9 ng/mL). Arrhythmias were detected in 8 of these horses. There was an association between acute hemorrhage and increased cTnI (P = 0.004, ρ = 0.77), and the presence of arrhythmias (P = 0.026, ρ = 0.64). There were associations among plasma cTnI concentration and the presence of arrhythmias (P = 0.005), arrhythmias requiring treatment (P = 0.036), and poor outcome (P = 0.024).
Acute hemorrhage results in myocardial injury that can be detected by measuring cTnI concentration. Arrhythmias were frequent in hospitalized horses following acute hemorrhage.
本研究的目的是：（1）确定急性出血是否与血浆心肌肌钙蛋白I（cTnI）浓度升高或心律失常有关；（2）描述急性出血后马匹心律失常的类型及其临床病程；（3）确定临床或临床病理变量预测cTnI浓度升高和心律失常存在的能力；（4）确定cTnI和心律失常与预后的关联。
前瞻性观察性研究。
大型动物兽医教学医院。
11匹因急性出血接受治疗的客户拥有的成年马（HG组）和4匹接受控制性采血的成年马（BDG组）。
测量HG组和BDG组的系列cTnI浓度，并获取连续心电图。使用统计检验来确定急性出血与血浆cTnI浓度、心律失常的存在、临床病理数据（心率[HR]、血细胞比容[PCV]、总血浆蛋白[TPP]、血浆乳酸和血浆肌酐浓度）以及预后之间的关联。
BDG组所有时间点的血浆cTnI浓度和心电图均在参考区间内。HG组所有马匹的cTnI均升高（范围为0.1 - 29.9 ng/mL）。其中8匹马检测到心律失常。急性出血与cTnI升高（P = 0.004，ρ = 0.77）以及心律失常的存在（P = 0.026，ρ = 0.64）之间存在关联。血浆cTnI浓度与心律失常的存在（P = 0.005）、需要治疗的心律失常（P = 0.036）以及不良预后（P = 0.024）之间存在关联。
急性出血导致心肌损伤，可通过测量cTnI浓度检测到。急性出血后的住院马匹中心律失常很常见。
