Rishniw M, Caivano D, Dickson D, Swift S, Rouben C, Dennis S, Sammarco C, Lustgarten J, Ljungvall I
Veterinary Information Network, Davis, California, 95616, USA.
Department of Veterinary Medicine, University of Perugia, Perugia, 06126, Italy.
J Small Anim Pract. 2019 Aug;60(8):493-498. doi: 10.1111/jsap.13015. Epub 2019 Apr 29.
To determine whether breed affects the ability of murmur intensity to predict the severity of stenosis in dogs with pulmonic stenosis or subaortic stenosis.
Retrospective multi-investigator study of dogs with pulmonic stenosis or subaortic stenosis. Murmur intensity, assessed by a four-level classification scheme, was compared with echocardiographically-determined pressure gradient across the affected valve. Breeds represented by at least 10 dogs at any murmur intensity were compared to determine the effect, if any, of breed.
A total of 1088 dogs (520 with pulmonic stenosis and 568 with subaortic stenosis, representing 106 breeds and the mixed breed group) were included; 208 dogs had soft, 210 had moderate, 283 had loud and 387 had palpable murmurs. Fifteen breeds were represented by at least 10 dogs: five breeds with at least 10 dogs had soft murmurs (132 dogs), nine breeds had moderate murmurs (149 dogs), 10 breeds had loud murmurs (188 dogs), and 11 breeds had palpable murmurs (286 dogs). No breeds differed in stenosis severity from any other breeds within any murmur grade. Post hoc power calculations suggested that we would have been able to detect at least a moderate or large effect size, had one existed. Several dogs with soft murmurs had more-than-mild disease severity.
Despite anecdotally perceived differences in the detection of heart murmurs between breeds, which have been proposed to potentially affect the interpretation of stenosis severity, we found no obvious breed effect in the ability to predict severity of stenosis.
确定品种是否会影响杂音强度对患有肺动脉瓣狭窄或主动脉瓣下狭窄犬只狭窄严重程度的预测能力。
对患有肺动脉瓣狭窄或主动脉瓣下狭窄的犬只进行回顾性多研究者研究。通过四级分类方案评估的杂音强度与经超声心动图测定的病变瓣膜两端压力阶差进行比较。对在任何杂音强度水平下至少有10只犬只的品种进行比较,以确定品种(若有影响)的作用。
共纳入1088只犬(520只患有肺动脉瓣狭窄,568只患有主动脉瓣下狭窄,代表106个品种及混种犬组);208只犬有柔和杂音,210只犬有中度杂音,283只犬有响亮杂音,387只犬有可触及的杂音。有至少10只犬只的品种有15个:5个品种至少有10只犬有柔和杂音(132只犬),9个品种有中度杂音(149只犬),10个品种有响亮杂音(188只犬),11个品种有可触及的杂音(286只犬)。在任何杂音分级内,各品种间的狭窄严重程度无差异。事后效能计算表明,若存在至少中度或大效应量,我们本应能够检测到。几只杂音柔和的犬患有超过轻度的疾病严重程度。
尽管传闻中认为不同品种在心脏杂音检测方面存在差异,这可能会影响对狭窄严重程度的解读,但我们发现品种对预测狭窄严重程度的能力没有明显影响。