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胃扩张扭转犬的超声心动图与心脏生物标志物浓度评估

Evaluation of echocardiography and cardiac biomarker concentrations in dogs with gastric dilatation volvulus.

作者信息

Aona Brent D, Rush John E, Rozanski Elizabeth A, Cunningham Suzanne M, Sharp Claire R, Freeman Lisa M

机构信息

Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536.

出版信息

J Vet Emerg Crit Care (San Antonio). 2017 Nov;27(6):631-637. doi: 10.1111/vec.12667. Epub 2017 Sep 28.


DOI:10.1111/vec.12667
PMID:28960715
Abstract

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.

摘要

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。

相似文献

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