Ward Jessica, Ware Wendy, Viall Austin
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 S. Riverside Drive, Ames, IA 50011, USA.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 S. Riverside Drive, Ames, IA 50011, USA.
J Vet Cardiol. 2019 Feb;21:18-27. doi: 10.1016/j.jvc.2018.10.006. Epub 2018 Dec 11.
To determine whether dogs with atrial fibrillation (AF) are more likely to develop right-sided manifestations of congestive heart failure (R-CHF) than dogs without AF.
Two hundred twenty dogs diagnosed with congestive heart failure (CHF) secondary to degenerative mitral valve disease (DMVD, n = 155) or dilated cardiomyopathy (DCM, n = 65) at a referral institution.
Medical records were reviewed to extract relevant clinical and echocardiographic data.
Fifty dogs had AF at the time of CHF diagnosis, including 17/155 (11.0%) dogs with DMVD and 33/65 (50.8%) dogs with DCM. Sixty dogs had R-CHF evidenced by cavitary effusions. Among DMVD dogs, R-CHF occurred in 13/17 (76.5%) dogs with AF compared with 10/138 (7.2%) dogs without AF; among DCM dogs, R-CHF occurred in 24/33 (72.7%) dogs with AF compared with 13/32 (40.6%) dogs without AF. Dogs with AF were more likely to manifest R-CHF signs than dogs without AF (p < 0.0001 for DMVD; p = 0.0125 for DCM). The presence of AF, diagnosis of DCM, and moderate to severe tricuspid regurgitation were associated with R-CHF in multivariate analysis. AF was the strongest predictor of R-CHF (odds ratio, 14.44; 95% confidence interval, 5.75-36.26).
Dogs with AF are more likely to manifest R-CHF than dogs without AF. Cavitary effusions are an expected finding in approximately three-quarters of dogs with AF and CHF secondary to either DCM or DMVD.
确定患有心房颤动(AF)的犬只是否比未患AF的犬只更易出现充血性心力衰竭的右侧表现(R-CHF)。
在一家转诊机构诊断为继发于退行性二尖瓣疾病(DMVD,n = 155)或扩张型心肌病(DCM,n = 65)的充血性心力衰竭(CHF)的220只犬。
回顾病历以提取相关临床和超声心动图数据。
50只犬在CHF诊断时患有AF,其中包括17/155(11.0%)患有DMVD的犬和33/65(50.8%)患有DCM的犬。60只犬有腔隙积液证明存在R-CHF。在DMVD犬中,13/17(76.5%)患有AF的犬出现R-CHF,而未患AF的犬为10/138(7.2%);在DCM犬中,24/33(72.7%)患有AF的犬出现R-CHF,而未患AF的犬为13/32(40.6%)。患有AF的犬比未患AF的犬更易出现R-CHF体征(DMVD时p < 0.0001;DCM时p = 0.0125)。多因素分析中,AF的存在、DCM的诊断以及中度至重度三尖瓣反流与R-CHF相关。AF是R-CHF的最强预测因素(比值比,14.44;95%置信区间,5.75 - 36.26)。
患有AF的犬比未患AF的犬更易出现R-CHF。在约四分之三继发于DCM或DMVD且患有AF和CHF的犬中可预期出现腔隙积液。