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斑点追踪超声心动图在临床前期肥厚型心肌病猫中的应用。

Speckle tracking echocardiography in cats with preclinical hypertrophic cardiomyopathy.

机构信息

Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom.

出版信息

J Vet Intern Med. 2019 May;33(3):1232-1241. doi: 10.1111/jvim.15495. Epub 2019 Apr 16.

Abstract

BACKGROUND

Cats with hypertrophic cardiomyopathy (HCM) have decreased left ventricular (LV) longitudinal deformation detected by mitral annular plane systolic excursion (MAPSE) and speckle tracking echocardiography. People with preclinical HCM have decreased systolic LV longitudinal and radial strain (S) and strain rate (SR), with preserved circumferential S and SR.

HYPOTHESIS/OBJECTIVES: Cats with preclinical HCM have decreased systolic LV deformation compared to normal cats.

ANIMALS

Seventy-three client-owned cats with (n = 37) and without (n = 36) preclinical HCM.

METHODS

Retrospective echocardiographic study. Left and right ventricular longitudinal S and SR, LV radial and circumferential S and SR were calculated by STE. Left ventricular mass was also calculated. Correlation between STE variables and LV hypertrophy was determined and receiver-operating characteristic (ROC) curves were plotted for prediction of HCM.

RESULTS

Cats with HCM had smaller absolute longitudinal S (-14.8 ± 3.3% vs -19.7 ± 2.7%, P < .001), longitudinal SR (-2.36 ± 0.62 vs -2.95 ± 0.68 second , P < .001), radial S (46.2 ± 21.3% vs 66.7 ± 17.6%, P < .001), and radial SR (5.60 ± 2.08 vs 6.67 ± 1.8 second , P < .001) compared to healthy controls. No difference was observed for circumferential S and SR. Cats with HCM had greater LV mass (13.2 ± 3.7 g vs 8.6 ± 2.7 g, P < .001). The ROC with the greatest area under the curve (AUC) for the identification of HCM (0.974) was plotted from a logistic regression equation combining LV mass, MAPSE at the free wall, and LV internal diameter in diastole (LVIDd).

CONCLUSIONS AND CLINICAL IMPORTANCE

Cats with preclinical HCM have decreased long axis and radial deformation. Decreased longitudinal deformation and decreased LVIDd are factors that would support a diagnosis of HCM.

摘要

背景

患有肥厚型心肌病(HCM)的猫通过二尖瓣环平面收缩期位移(MAPSE)和斑点追踪超声心动图检测到左心室(LV)纵向变形减少。临床前 HCM 患者的 LV 纵向和径向收缩应变(S)和应变率(SR)减少,而圆周 S 和 SR 保留。

假设/目的:与正常猫相比,患有临床前 HCM 的猫的 LV 收缩期变形减少。

动物

73 只患有(n=37)和不患有(n=36)临床前 HCM 的患宠猫。

方法

回顾性超声心动图研究。通过 STE 计算左、右心室纵向 S 和 SR、LV 径向和圆周 S 和 SR。还计算了左心室质量。确定 STE 变量与 LV 肥厚的相关性,并绘制预测 HCM 的接收者操作特征(ROC)曲线。

结果

HCM 猫的绝对纵向 S(-14.8±3.3%比-19.7±2.7%,P<.001)、纵向 SR(-2.36±0.62 比-2.95±0.68 秒,P<.001)、径向 S(46.2±21.3%比 66.7±17.6%,P<.001)和径向 SR(5.60±2.08 比 6.67±1.8 秒,P<.001)较健康对照组降低。圆周 S 和 SR 无差异。HCM 猫的 LV 质量更大(13.2±3.7 g 比 8.6±2.7 g,P<.001)。ROC 绘制了一个具有最大曲线下面积(AUC)的逻辑回归方程,用于识别 HCM(0.974),该方程结合了 LV 质量、游离壁 MAPSE 和舒张期 LV 内径(LVIDd)。

结论和临床意义

患有临床前 HCM 的猫的长轴和径向变形减少。纵向变形减少和 LVIDd 减少是支持 HCM 诊断的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e47/6524080/ec51fb045bdb/JVIM-33-1232-g001.jpg

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