Spence S, French A, Penderis J, Macfarlane L, Gutierrez-Quintana R, Dickson L, Holmes K, McLauchlan G
Small Animal Hospital, University of Glasgow, Glasgow G61 1QH, UK.
Vet Extra Neurology, Broadleys Veterinary Hospital, Stirling FK7 7LE, UK.
J Small Anim Pract. 2019 Apr;60(4):204-211. doi: 10.1111/jsap.12984. Epub 2019 Feb 11.
To document the prevalence of cardiac abnormalities in dogs with steroid-responsive meningitis arteritis and to assess resolution of these abnormalities following corticosteroid therapy.
Steroid-responsive meningitis arteritis was diagnosed based on signalment, physical examination findings, complete blood count, biochemistry and CSF analysis. Echocardiography, C-reactive protein and cardiac troponin I were measured in all cases before and 10 to 14 days after commencing corticosteroid therapy. Fibrinogen was also measured in a proportion of dogs.
Fourteen dogs were prospectively enrolled. Increased cardiac troponin I was identified in five of 14 dogs and echocardiographic abnormalities were detected in 12 of 14 dogs, including spontaneous echo contrast (12 of 14), mild pericardial effusion (five of 14) and mildly decreased fractional shortening (five of 14). All dogs had increased C-reactive protein and fibrinogen was increased in 11 of 12. Corticosteroid treatment was associated with clinical improvement and normalisation of C-reactive protein in all dogs. The cardiac troponin I levels normalised in four of five and fibrinogen had normalised in all five dogs which were retested. Spontaneous echo contrast improved or completely resolved in 12 of 12 and pericardial effusion resolved in five of five dogs. Fractional shortening normalised in two of five dogs.
Cardiac changes are common in dogs with steroid-responsive meningitis arteritis and most resolve with therapy. Further investigation into the cause and significance of these changes is necessary in determining whether antithrombotic therapy or positive inotropic therapy is indicated.
记录患有类固醇反应性脑膜炎动脉炎的犬类心脏异常的患病率，并评估皮质类固醇治疗后这些异常的缓解情况。
根据信号、体格检查结果、全血细胞计数、生化检查和脑脊液分析诊断类固醇反应性脑膜炎动脉炎。在所有病例中，在开始皮质类固醇治疗前及治疗后10至14天测量超声心动图、C反应蛋白和心肌肌钙蛋白I。还对一部分犬测量了纤维蛋白原。
前瞻性纳入14只犬。14只犬中有5只心肌肌钙蛋白I升高，14只犬中有12只检测到超声心动图异常，包括自发回声增强（14只中的12只）、轻度心包积液（14只中的5只）和轻度缩短分数降低（14只中的5只）。所有犬C反应蛋白均升高，12只中有11只纤维蛋白原升高。皮质类固醇治疗与所有犬的临床改善和C反应蛋白正常化相关。5只犬中有4只心肌肌钙蛋白I水平恢复正常，重新检测的5只犬中纤维蛋白原均恢复正常。12只犬中有12只自发回声增强改善或完全消失，5只犬中心包积液消失。5只犬中有2只缩短分数恢复正常。
患有类固醇反应性脑膜炎动脉炎的犬类常见心脏变化，大多数经治疗后可缓解。在确定是否需要抗血栓治疗或正性肌力治疗时，有必要进一步研究这些变化的原因和意义。
