Caivano D, Rishniw M, Birettoni F, Patata V, Giorgi M E, Porciello F
Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy.
Veterinary Information Network, Davis, CA 95616, USA; Department of Clinical Sciences, Cornell University, Ithaca, NY 14853, USA.
J Vet Cardiol. 2018 Apr;20(2):102-114. doi: 10.1016/j.jvc.2018.01.002. Epub 2018 Feb 17.
Left atrial (LA) function can provide useful information in dogs with myxomatous mitral valve disease (MMVD). Recently, we have demonstrated the feasibility of measuring LA longitudinal deformation using speckle-tracking echocardiography (STE) to estimate LA function in healthy dogs. Whether LA strain and strain rate variables provide additional information about LA function and clinical cardiac status in dogs with MMVD remains unexplored.
Ninety-six client-owned dogs of different breeds with MMVD were prospectively enrolled.
LA longitudinal deformation was evaluated in each dog by STE and different STE variables were used to assess LA function.
No STE variables differed between American College of Veterinary Internal Medicine Stage B1 and B2 dogs but were lower in Stage C dogs. Peak atrial longitudinal average strain < 27.9%, left-atrial-to-aortic ratio > 2.2 and peak atrial contraction average strain < 7.25% discriminated symptomatic MMVD dogs by receiver operating characteristic analysis with sensitivity and specificity of 100% and 100% (95% confidence interval [CI] 91-100%), 92% (95% CI 78-98%) and 98% (95% CI 87-100%), 100% (95% CI 91-100%) and 95% (95% CI 83-99%), respectively. In 12 dogs with similar left-atrial-to-aortic ratio, peak atrial longitudinal average strain and peak atrial contraction average strain differentiated dogs with subclinical disease from those with congestive heart failure (CHF).
Dogs with MMVD in CHF appear to have lower LA longitudinal strain and strain rate variables compared with dogs with subclinical disease. Further studies are needed to establish if our initial findings can provide useful information for the diagnosis, treatment, and prognosis of dogs with MMVD.
左心房(LA)功能可为患有黏液瘤性二尖瓣疾病(MMVD)的犬提供有用信息。最近,我们已证明使用斑点追踪超声心动图(STE)测量LA纵向变形以评估健康犬LA功能的可行性。LA应变和应变率变量是否能为患有MMVD的犬的LA功能和临床心脏状态提供额外信息仍未得到探索。
前瞻性纳入了96只患有MMVD的不同品种的客户拥有犬。
通过STE评估每只犬的LA纵向变形,并使用不同的STE变量评估LA功能。
美国兽医内科学院B1和B2期犬之间的STE变量无差异,但C期犬的STE变量较低。通过受试者操作特征分析,心房纵向平均应变峰值<27.9%、左心房与主动脉比值>2.2以及心房收缩平均应变峰值<7.25%可区分有症状的MMVD犬,其敏感性和特异性分别为100%和100%(95%置信区间[CI]91-100%)、92%(95%CI 78-98%)和98%(95%CI 87-100%)、100%(95%CI 91-100%)和95%(95%CI 83-99%)。在12只左心房与主动脉比值相似的犬中,心房纵向平均应变峰值和心房收缩平均应变峰值可区分亚临床疾病犬和充血性心力衰竭(CHF)犬。
与亚临床疾病犬相比,患有CHF的MMVD犬似乎具有较低的LA纵向应变和应变率变量。需要进一步研究以确定我们的初步发现是否可为患有MMVD的犬的诊断、治疗和预后提供有用信息。