Ven S, Decloedt A, De Clercq D, Vera L, Rademakers F, van Loon G
Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
Division of Cardiovascular Imaging and Dynamics, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
Equine Vet J. 2018 Sep;50(5):587-593. doi: 10.1111/evj.12805. Epub 2018 Feb 1.
Aortic regurgitation (AR) can have an important clinical impact and in some cases leads to left ventricular (LV) failure. Tissue Doppler imaging (TDI) is an echocardiographic technique that has been used in horses to detect LV dysfunction.
To examine whether TDI detects changes in radial myocardial wall motion in horses with AR compared with control horses.
Case-control study.
Echocardiography was performed in 30 healthy Warmblood horses and 34 Warmblood horses with AR, subdivided in groups with mild, moderate or severe AR. TDI measurements were performed on six segments of the short-axis images of the LV myocardial wall. Myocardial wall motion was evaluated by measuring velocity and deformation during isovolumetric contraction, systole, early and late diastole. Timing of different events was also measured.
In most segments, a significantly higher systolic myocardial velocity was found in horses with AR compared with controls. Horses with AR also had higher late diastolic velocity, although the difference was not significant in all segments. TDI measurement of timing intervals demonstrated less difference between groups.
There was a significant difference in age between the control group and horses with AR, which may confound the results. The assessment of AR severity was based on subjective criteria as there is no gold standard.
TDI showed significant differences in radial systolic and late diastolic myocardial velocity in horses with AR. This could indicate an altered LV function in these horses, but further research is needed to investigate the prognostic value of these measurements.
主动脉瓣反流(AR)可产生重要的临床影响,在某些情况下会导致左心室(LV)衰竭。组织多普勒成像(TDI)是一种超声心动图技术,已用于马匹以检测左心室功能障碍。
研究与对照马匹相比,TDI能否检测出患有AR的马匹径向心肌壁运动的变化。
病例对照研究。
对30匹健康温血马和34匹患有AR的温血马进行超声心动图检查,将患有AR的马再细分为轻度、中度或重度AR组。在左心室心肌壁短轴图像的六个节段上进行TDI测量。通过测量等容收缩期、收缩期、舒张早期和舒张晚期的速度和变形来评估心肌壁运动。还测量了不同事件的时间。
在大多数节段中,与对照组相比,患有AR的马匹收缩期心肌速度明显更高。患有AR的马匹舒张晚期速度也更高,尽管并非在所有节段中差异都显著。TDI对时间间隔的测量显示各组之间差异较小。
对照组与患有AR的马匹之间年龄存在显著差异,这可能会混淆结果。由于没有金标准,AR严重程度的评估基于主观标准。
TDI显示患有AR的马匹在径向收缩期和舒张晚期心肌速度上存在显著差异。这可能表明这些马匹的左心室功能发生了改变,但需要进一步研究来调查这些测量的预后价值。