Aona Brent D, Rush John E, Rozanski Elizabeth A, Cunningham Suzanne M, Sharp Claire R, Freeman Lisa M
Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536.
J Vet Emerg Crit Care (San Antonio). 2017 Nov;27(6):631-637. doi: 10.1111/vec.12667. Epub 2017 Sep 28.
OBJECTIVE: To assess abnormalities in concentrations of cardiac troponin I (cTnI), lactate, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in relation to arrhythmias, echocardiographic measurements, and survival in dogs with gastric dilatation volvulus (GDV). DESIGN: Prospective observational study. SETTING: University hospital. ANIMALS: Twenty-two dogs with naturally occurring GDV. SAMPLES: Concentrations of cTnI, plasma lactate, and NT-proBNP were recorded at presentation to the emergency room, the time closest to echocardiography, and the highest recorded concentrations during hospitalization. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Cardiac rhythms were categorized on a 0-4 scale (0 = no ventricular premature complexes [VPCs], 1 = single VPCs, 2 = bigeminy or trigeminy, 3 = couplets or triplets, and 4 = R-on-T phenomenon or ventricular tachycardia). Echocardiography was performed 6-18 hours postoperatively. Fifteen dogs had ventricular arrhythmias during hospitalization (Grade 1 [n = 9], Grade 4 [n = 6]). The highest recorded cTnI concentration was significantly higher in the dogs with Grade 4 (P = 0.002) or Grade 1 (P = 0.001) arrhythmias compared to dogs without arrhythmias. Plasma lactate was significantly correlated with left ventricular internal diameter in diastole (r = -0.52, P = 0.01) and systole (r = -0.57, P = 0.006), left ventricular free wall in diastole (LWDd, r = 0.59, P = 0.004), and interventricular septal thickness in diastole (IVDs, r = 0.65, P = 0.001). Dogs that did not survive to 1 week postdischarge (3/22) had a significantly thicker LVWd (P = 0.04) and IVSd (P = 0.05), and received significantly less fluids in the first 24 (P = 0.02) and 48 hours (P = 0.03) of hospitalization. CONCLUSIONS: Concentrations of cTnI and NT-proBNP increased during hospitalization, but only cTnI concentrations were significantly higher in dogs with a higher arrhythmia grade. Additional research on the potential role of serial measurement of biomarkers in dogs with GDV is warranted.
目的:评估胃扩张扭转(GDV)犬的心肌肌钙蛋白I(cTnI)、乳酸和N末端B型利钠肽原(NT-proBNP)浓度异常与心律失常、超声心动图测量及生存情况的关系。 设计:前瞻性观察研究。 地点:大学医院。 动物:22只自然发生GDV的犬。 样本:在犬进入急诊室时、最接近超声心动图检查的时间以及住院期间记录到的最高浓度时,记录cTnI、血浆乳酸和NT-proBNP的浓度。 干预措施:无。 测量指标及主要结果:心律失常按0 - 4级分类(0 = 无室性早搏[VPCs],1 = 单个VPCs,2 = 二联律或三联律,3 = 成对或成三联律,4 = R-on-T现象或室性心动过速)。术后6 - 18小时进行超声心动图检查。15只犬在住院期间出现室性心律失常(1级[n = 9],4级[n = 6])。与无心律失常的犬相比,4级(P = 0.002)或1级(P = 0.001)心律失常的犬记录到的最高cTnI浓度显著更高。血浆乳酸与舒张末期左心室内径(r = -0.52,P = 0.01)、收缩末期左心室内径(r = -0.57,P = 0.006)、舒张末期左心室游离壁(LWDd,r = 0.59,P = 0.004)及舒张末期室间隔厚度(IVDs,r = 0.65,P = 0.001)显著相关。出院后未存活至1周的犬(3/22)左心室游离壁厚度(P = 0.04)和室间隔厚度(P = 0.05)显著更厚,且住院第1个24小时(P = 0.02)和48小时(P = 0.03)接受的液体显著更少。 结论:住院期间cTnI和NT-proBNP浓度升高,但仅心律失常分级较高的犬cTnI浓度显著更高。有必要对GDV犬生物标志物系列测量的潜在作用进行更多研究。
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