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右心室流出道缩短分数:肺动脉高压犬右心室收缩功能的超声心动图指标

Right ventricular outflow tract fractional shortening: an echocardiographic index of right ventricular systolic function in dogs with pulmonary hypertension.

作者信息

Caivano D, Rishniw M, Birettoni F, Patata V, Giorgi M E, Dei K, Porciello F

机构信息

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.

出版信息

J Vet Cardiol. 2018 Oct;20(5):354-363. doi: 10.1016/j.jvc.2018.07.007. Epub 2018 Aug 23.

Abstract

OBJECTIVES

To create reference intervals for right ventricular outflow tract fractional shortening (RVOT-FS) in healthy dogs and examine diagnostic performance of this index in dogs with pulmonary hypertension (PH). In addition, we examine the impact of myxomatous mitral valve disease (MMVD) without PH on RVOT-FS.

ANIMALS, MATERIALS AND METHODS: The study population included 52 healthy adult dogs, 51 dogs with MMVD but without PH, and 51 dogs with PH. This is a prospective study. Complete echocardiographic evaluations were performed on all dogs. Right ventricular outflow tract fractional shortening was obtained by two-dimensional guided M-mode recordings from the right parasternal short axis view. Right ventricular outflow tract fractional shortening was evaluated in healthy dogs of various breeds, and reference intervals were generated. We examined the effect of PH on RVOT-FS with receiver operating characteristic analysis and evaluated the effect of MMVD on RVOT-FS in dogs without PH. Intraobserver and interobserver reproducibility was calculated.

RESULTS

Healthy dogs had RVOT-FS > 44%. Right ventricular outflow tract fractional shortening values of healthy dogs and MMVD dogs without PH did not differ (p=0.84). In dogs with PH, RVOT-FS decreased with increasing tricuspid regurgitation velocity (p<0.0001). Pimobendan use in dogs with PH increased RVOT-FS as PH worsened. Right ventricular outflow tract fractional shortening was acquired with clinically acceptable intraobserver and interobserver reproducibility.

CONCLUSIONS

Right ventricular outflow tract fractional shortening is a novel, easy applicable, and repeatable index for evaluating RV systolic function. Studies comparing this index with common echocardiographic indices used to assess RV function in dogs are needed.

摘要

目的

建立健康犬右心室流出道缩短分数(RVOT-FS)的参考区间,并评估该指标在肺动脉高压(PH)犬中的诊断性能。此外,我们还研究了无PH的黏液瘤性二尖瓣疾病(MMVD)对RVOT-FS的影响。

动物、材料与方法:研究群体包括52只健康成年犬、51只患有MMVD但无PH的犬以及51只患有PH的犬。这是一项前瞻性研究。对所有犬进行了完整的超声心动图评估。通过从右胸骨旁短轴视图进行二维引导M型记录获得右心室流出道缩短分数。在不同品种的健康犬中评估右心室流出道缩短分数,并生成参考区间。我们通过受试者工作特征分析研究了PH对RVOT-FS的影响,并评估了MMVD对无PH犬RVOT-FS的影响。计算了观察者内和观察者间的可重复性。

结果

健康犬的RVOT-FS>44%。健康犬和无PH的MMVD犬的右心室流出道缩短分数值无差异(p=0.84)。在患有PH的犬中,RVOT-FS随着三尖瓣反流速度的增加而降低(p<0.0001)。随着PH病情加重,在患有PH的犬中使用匹莫苯丹可增加RVOT-FS。右心室流出道缩短分数具有临床可接受的观察者内和观察者间可重复性。

结论

右心室流出道缩短分数是评估右心室收缩功能的一种新颖、易于应用且可重复的指标。需要开展将该指标与用于评估犬右心室功能的常见超声心动图指标进行比较的研究。

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