Harris J D, Little C J L, Dennis J M, Patteson M W
HeartVets, The Animal Hospital, Stinchcombe, Dursley, Gloucestershire, GL11 6AJ, UK.
Barton Veterinary Hospital, 34 New Dover Road, Canterbury, Kent, CT1 3BH, UK.
J Vet Cardiol. 2017 Oct;19(5):421-432. doi: 10.1016/j.jvc.2017.08.005. Epub 2017 Sep 25.
To describe the measurement of heart rate turbulence (HRT) after ventricular premature beats and compare HRT in healthy Doberman pinschers and those with dilated cardiomyopathy (DCM), with and without congestive heart failure (CHF).
Sixty-five client-owned Dobermans: 20 healthy (NORMAL), 31 with preclinical DCM and 14 with DCM and CHF (DCM + CHF).
A retrospective study of data retrieved from clinical records and ambulatory ECG (Holter) archives, including data collected previously for a large-scale prospective study of Dobermans with preclinical DCM. Holter data were reanalysed quantitatively, including conventional time-domain heart rate variability and the HRT parameters turbulence onset and turbulence slope.
Heart rate turbulence could be measured in 58/65 dogs. Six Holter recordings had inadequate ventricular premature contractions (VPCs) and one exhibited VPCs too similar to sinus morphology. Heart rate turbulence parameter, turbulence onset, was significantly reduced in DCM dogs, whereas conventional heart rate variability measures were not. Heart rate variability and HRT markers were reduced in DCM + CHF dogs as expected.
Heart rate turbulence can be measured from the majority of good quality standard canine 24-hour Holter recordings with >5 VPCs. Turbulence onset is significantly reduced in Dobermans with preclinical DCM which indicates vagal withdrawal early in the course of disease. Heart rate turbulence is a powerful prognostic indicator in human cardiac disease which can be measured from standard 24-hour ambulatory ECG (Holter) recordings using appropriate computer software. Further studies are warranted to assess whether HRT may be of prognostic value in dogs with preclinical DCM and in other canine cardiac disease.
描述室性早搏后心率震荡（HRT）的测量方法，并比较健康杜宾犬与患有扩张型心肌病（DCM）且伴有或不伴有充血性心力衰竭（CHF）的杜宾犬的HRT情况。
65只客户拥有的杜宾犬，其中20只健康（正常组），31只患有临床前期DCM，14只患有DCM且伴有CHF（DCM + CHF组）。
一项回顾性研究，数据取自临床记录和动态心电图（Holter）档案，包括先前为一项关于患有临床前期DCM的杜宾犬的大规模前瞻性研究收集的数据。对Holter数据进行定量重新分析，包括传统的时域心率变异性以及HRT参数震荡起始和震荡斜率。
65只犬中有58只可测量心率震荡。6份Holter记录的室性早搏（VPC）不足，1份记录的VPC与窦性形态过于相似。DCM犬的HRT参数震荡起始显著降低，而传统心率变异性测量结果未出现此情况。正如预期，DCM + CHF组犬的心率变异性和HRT指标降低。
大多数具有>5次VPC的高质量标准犬24小时Holter记录可测量心率震荡。临床前期DCM的杜宾犬震荡起始显著降低，这表明在疾病早期迷走神经张力减退。心率震荡是人类心脏病的有力预后指标，可使用适当的计算机软件从标准24小时动态心电图（Holter）记录中测量。有必要进一步研究评估HRT在患有临床前期DCM的犬和其他犬类心脏病中是否具有预后价值。
