Yu Ivarosa Bing-Ye, Huang Hui-Pi
Institute of Veterinary Clinical Science, Veterinary School, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei 100, Taiwan.
Biomed Res Int. 2016;2016:4727054. doi: 10.1155/2016/4727054. Epub 2016 Oct 20.
In humans, heart failure (HF) and renal insufficiency (RI) have negative reciprocal effects, and anemia can exacerbate their progression. In this retrospective study, the prevalence and prognostic significance of anemia in 114 dogs with degenerative mitral valve disease (DMVD) was investigated. Pretreatment clinical parameters, prevalence of anemia and azotemia, and survival time were analyzed in relation to HF severity. The prevalence of anemia was highest in dogs with the modified New York Heart Association (NYHA) class IV HF (33.3%), followed by classes III (15.2%) and II (0%; < 0.001). The presence of anemia was associated with HF severity and blood creatinine > 1.6 mg/dL (both < 0.001). Anemic dogs had a shorter median survival [13 months; 95% confidence interval (CI): 0.7-19.1] than nonanemic dogs (28 months; 95% CI: 15.3-40.7; < .001). NYHA class IV (hazard ratio (HR): 3.1, 95% CI: 2.2-4.3; < 0.001), left atrium/aorta ratio > 1.7 (HR: 2.7, 95% CI: 1.7-4.2; = 0.001), and presence of anemia (HR: 1.43, 95% CI: 1.1-1.9; = 0.004) emerged as predictors of mortality. A cardiorenal-anemia syndrome-like triangle was observed and anemia was a prognostic factor for survival in dogs with DMVD.
在人类中,心力衰竭(HF)和肾功能不全(RI)具有负向相互作用,并且贫血会加剧它们的进展。在这项回顾性研究中,调查了114只患有退行性二尖瓣疾病(DMVD)的犬只贫血的患病率及其预后意义。分析了治疗前的临床参数、贫血和氮质血症的患病率以及生存时间与心力衰竭严重程度的关系。贫血患病率在改良纽约心脏病协会(NYHA)IV级心力衰竭犬中最高(33.3%),其次是III级(15.2%)和II级(0%;P<0.001)。贫血的存在与心力衰竭严重程度和血肌酐>1.6mg/dL相关(均P<0.001)。贫血犬的中位生存期[13个月;95%置信区间(CI):0.7 - 19.1]比非贫血犬(28个月;95%CI:15.3 - 40.7;P<0.001)短。NYHA IV级(风险比(HR):3.1,95%CI:2.2 - 4.3;P<0.001)、左心房/主动脉比值>1.7(HR:2.7,95%CI:1.7 - 4.2;P = 0.001)以及贫血的存在(HR:1.43,95%CI:1.1 - 1.9;P = 0.004)成为死亡的预测因素。观察到一种心肾贫血综合征样三角关系,并且贫血是DMVD犬生存的一个预后因素。