评估临床前肥厚型心肌病猫和明显健康猫的心血管风险及评估长期健康状况的国际合作研究：REVEAL研究。
International collaborative study to assess cardiovascular risk and evaluate long-term health in cats with preclinical hypertrophic cardiomyopathy and apparently healthy cats: The REVEAL Study.
作者信息
Fox Philip R, Keene Bruce W, Lamb Kenneth, Schober Karsten A, Chetboul Valerie, Luis Fuentes Virginia, Wess Gerhard, Payne Jessie Rose, Hogan Daniel F, Motsinger-Reif Alison, Häggström Jens, Trehiou-Sechi Emilie, Fine-Ferreira Deborah M, Nakamura Reid K, Lee Pamela M, Singh Manreet K, Ware Wendy A, Abbott Jonathan A, Culshaw Geoffrey, Riesen Sabine, Borgarelli Michele, Lesser Michael B, Van Israël Nicole, Côté Etienne, Rush John E, Bulmer Barret, Santilli Roberto A, Vollmar Andrea C, Bossbaly Maribeth J, Quick Nadine, Bussadori Claudio, Bright Janice M, Estrada Amara H, Ohad Dan G, Fernández-Del Palacio Maria Josefa, Lunney Brayley Jenifer, Schwartz Denise S, Bové Christina M, Gordon Sonya G, Jung Seung Woo, Brambilla Paola, Moïse N Sydney, Stauthammer Christopher D, Stepien Rebecca L, Quintavalla Cecilia, Amberger Christophe, Manczur Ferenc, Hung Yong-Wei, Lobetti Remo, De Swarte Marie, Tamborini Alice, Mooney Carmel T, Oyama Mark A, Komolov Andrey, Fujii Yoko, Pariaut Romain, Uechi Masami, Tachika Ohara Victoria Yukie
机构信息
Department of Cardiology and Caspary Research Institute, The Animal Medical Center, New York, New York, U.S.A.
Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, U.S.A.
出版信息
J Vet Intern Med. 2018 May;32(3):930-943. doi: 10.1111/jvim.15122. Epub 2018 Apr 16.
BACKGROUND
Hypertrophic cardiomyopathy is the most prevalent heart disorder in cats and principal cause of cardiovascular morbidity and mortality. Yet, the impact of preclinical disease is unresolved.
HYPOTHESIS/OBJECTIVES: Observational study to characterize cardiovascular morbidity and survival in cats with preclinical nonobstructive (HCM) and obstructive (HOCM) hypertrophic cardiomyopathy and in apparently healthy cats (AH).
ANIMALS
One thousand seven hundred and thirty client-owned cats (430 preclinical HCM; 578 preclinical HOCM; 722 AH).
METHODS
Retrospective multicenter, longitudinal, cohort study. Cats from 21 countries were followed through medical record review and owner or referring veterinarian interviews. Data were analyzed to compare long-term outcomes, incidence, and risk for congestive heart failure (CHF), arterial thromboembolism (ATE), and cardiovascular death.
RESULTS
During the study period, CHF, ATE, or both occurred in 30.5% and cardiovascular death in 27.9% of 1008 HCM/HOCM cats. Risk assessed at 1, 5, and 10 years after study entry was 7.0%/3.5%, 19.9%/9.7%, and 23.9%/11.3% for CHF/ATE, and 6.7%, 22.8%, and 28.3% for cardiovascular death, respectively. There were no statistically significant differences between HOCM compared with HCM for cardiovascular morbidity or mortality, time from diagnosis to development of morbidity, or cardiovascular survival. Cats that developed cardiovascular morbidity had short survival (mean ± standard deviation, 1.3 ± 1.7 years). Overall, prolonged longevity was recorded in a minority of preclinical HCM/HOCM cats with 10% reaching 9-15 years.
CONCLUSIONS AND CLINICAL IMPORTANCE
Preclinical HCM/HOCM is a global health problem of cats that carries substantial risk for CHF, ATE, and cardiovascular death. This finding underscores the need to identify therapies and monitoring strategies that decrease morbidity and mortality.
背景
肥厚型心肌病是猫最常见的心脏疾病，也是心血管疾病发病和死亡的主要原因。然而，临床前疾病的影响尚未明确。
假设/目标：进行观察性研究，以描述临床前非梗阻性（HCM）和梗阻性（HOCM）肥厚型心肌病猫以及明显健康猫（AH）的心血管疾病发病情况和生存率。
动物
1730只客户拥有的猫（430只临床前HCM；578只临床前HOCM；722只AH）。
方法
回顾性多中心纵向队列研究。通过病历审查以及与猫主人或转诊兽医访谈，对来自21个国家的猫进行随访。分析数据以比较充血性心力衰竭（CHF）、动脉血栓栓塞（ATE）和心血管死亡的长期结局、发病率和风险。
结果
在研究期间，1008只HCM/HOCM猫中，30.5%发生了CHF、ATE或两者兼有，27.9%发生了心血管死亡。研究开始后1年、5年和10年评估的CHF/ATE风险分别为7.0%/3.5%、19.9%/9.7%和23.9%/11.3%，心血管死亡风险分别为6.7%、22.8%和28.3%。HOCM与HCM在心血管疾病发病率或死亡率、从诊断到发病的时间或心血管生存率方面无统计学显著差异。发生心血管疾病的猫生存时间短（平均±标准差，1.3±1.7年）。总体而言，少数临床前HCM/HOCM猫寿命延长，10%达到9至15岁。
结论及临床意义
临床前HCM/HOCM是猫的一个全球性健康问题，具有发生CHF、ATE和心血管死亡的重大风险。这一发现强调了识别降低发病率和死亡率的治疗方法及监测策略的必要性。
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