Stepien R L, Kellihan H B, Luis Fuentes V
Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, WI, USA.
Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, WI, USA.
J Vet Cardiol. 2017 Aug;19(4):317-324. doi: 10.1016/j.jvc.2017.04.004. Epub 2017 Jun 27.
To assess the prevalence of functional ejection murmurs and murmurs of mitral regurgitation (MR) due to myxomatous mitral valve disease in healthy whippets; to assess the diagnostic value of auscultation to detect MR; and investigate the relationship between age and presence of echocardiographically documented MR (MR).
A total of 200 healthy client-owned Whippets, recruited at national shows between 2005 and 2009 were involved in this study.
Cross-sectional study. Dogs were examined by auscultation by one examiner and Doppler echocardiography by another, and results were compared. Prevalence of types of murmurs and MR were calculated and correlated to age. Accuracy of auscultation to predict MR was calculated.
Left-sided systolic heart murmurs were detected in 185/200 (93%) of dogs. Left apical systolic murmurs (L) were detected in 57/200 (29%) and left basilar systolic murmurs (L) in 128/200 of the dogs (64%). MR was present in 76/200 (38%) dogs. Prevalence MR was correlated with age (r = 0.96, p=0.0028). Mitral regurgitation detected by echocardiography was present in 12/78 (15%) of the dogs ≤ 2 years of age and in 59% of the dogs at 7-8 years old. Detection of L predicted MR with sensitivity 65%, specificity 94%, positive predictive value 86%, and negative predictive value 81%; and accuracy improved when only dogs with more intense L (grade ≥ 3/6) were considered.
Systolic murmurs are common in North American Whippets and this breed exhibits a high prevalence of MR, which may be documented at a relatively early age. Whippets with non-clinical MR may not be identifiable by auscultation alone; echocardiographic examination may be required to exclude a diagnosis of MR. Louder heart murmurs allow more accurate localization in this population.
评估健康惠比特犬功能性喷射性杂音及黏液瘤样二尖瓣疾病所致二尖瓣反流（MR）杂音的患病率；评估听诊对检测MR的诊断价值；并研究年龄与经超声心动图证实的MR之间的关系。
200只健康的客户拥有的惠比特犬参与了本研究，这些犬于2005年至2009年在全国犬展上招募。
横断面研究。由一名检查者进行听诊，另一名检查者进行多普勒超声心动图检查，并比较结果。计算杂音类型和MR的患病率，并与年龄相关联。计算听诊预测MR的准确性。
在200只犬中有185只（93%）检测到左侧收缩期心脏杂音。在200只犬中有57只（29%）检测到左心尖收缩期杂音（L），128只（64%）检测到左基底收缩期杂音（L）。76只（38%）犬存在MR。MR患病率与年龄相关（r = 0.96，p = 0.0028）。经超声心动图检测，≤2岁的犬中有12/78（15%）存在二尖瓣反流，7 - 8岁的犬中有59%存在二尖瓣反流。检测到L对MR的预测敏感性为65%，特异性为94%，阳性预测值为86%，阴性预测值为81%；当仅考虑L更响亮（≥3/6级）的犬时，准确性提高。
收缩期杂音在北美惠比特犬中很常见，该品种MR患病率高，且可能在相对较早的年龄被记录。仅通过听诊可能无法识别无临床症状的MR惠比特犬；可能需要超声心动图检查以排除MR诊断。在此群体中，更响亮的心脏杂音可实现更准确的定位。
