Selcuk University, Faculty of Veterinary Medicine, Department of Internal Medicine, Konya, Turkey.
Selcuk University, Faculty of Veterinary Medicine, Department of Internal Medicine, Konya, Turkey; Department of Internal Medicine, Faculty of Veterinary Medicine, Kyrgyz Turkish Manas University, Bishkek, Kyrgyzstan.
Res Vet Sci. 2019 Oct;126:103-112. doi: 10.1016/j.rvsc.2019.08.009. Epub 2019 Aug 6.
Sepsis is associated with clinically relevant cardiovascular changes. The objectives of this study were to evaluate the clinical value of echocardiography for monitoring left ventricular (LV) systolic function in septic calves. A prospective longitudinal study was performed using a convenience sample. Twenty septic calves and 10 healthy calves were enrolled in the study. Arterial blood pressure (BP) was measured and M-mode echocardiography performed to characterize LV systolic function; the latter included measurement of ejection fraction, EF; stroke volume, SVI and cardiac output indexed to body weight, CI; E-point of septal separation, EPSS; pre-ejection period, PEP; ejection time, LVET; ratio of PEP to LVET; velocity of circumferential shortening, Vcf, LV end-diastolic volume index (LVEDVI) and LV end-systolic volume index (LVESVI) on admission and 6, 24, 48 and 72 h later in septic calves and once in healthy calves. Admission data were compared using the Mann-Whitney U test and P < .05 was considered significant. Decreased preload and afterload were present in septic calves, as indicated by marked decreases in BP, LVEDVI, LVESVI, SVI, CI, EPSS when compared to healthy calves. Systolic function appeared adequate in septic calves, based on EF and FS compared to control calves. There was no difference in heart rate, LVET, PEP:LVET, or Vcf between septic and health calves. We conclude that circulatory dysfunction, rather than systolic dysfunction predominates in septic calves. Positive associations on admission between CI and LVEDVI, LVESVI, and SVI support this conclusion. Echocardiographic determination of LVEDVI and CI appears useful in directing treatment in septic calves.
败血症与临床相关的心血管变化有关。本研究的目的是评估超声心动图监测败血症小牛左心室(LV)收缩功能的临床价值。采用便利抽样进行前瞻性纵向研究。纳入 20 例败血症小牛和 10 例健康小牛。测量动脉血压(BP)并进行 M 型超声心动图以描述 LV 收缩功能;后者包括射血分数(EF)、每搏输出量(SVI)和心输出量指数(CI)的测量,这些指数都与体重相关;间隔分离的 E 点(EPSS)、射血前期(PEP)、LVET;PEP 与 LVET 的比值;LV 收缩末期容积指数(LVESVI)的圆周缩短速度(Vcf)、LV 舒张末期容积指数(LVEDVI);败血症小牛在入院时以及之后 6、24、48 和 72 小时进行测量,健康小牛仅测量一次。使用 Mann-Whitney U 检验比较入院数据,P 值<.05 被认为有统计学意义。败血症小牛的前负荷和后负荷明显降低,表现为 BP、LVEDVI、LVESVI、SVI、CI、EPSS 显著降低。与对照组小牛相比,EF 和 FS 显示败血症小牛的收缩功能似乎正常。败血症和健康小牛之间的心率、LVET、PEP:LVET 或 Vcf 无差异。我们得出结论,循环功能障碍而不是收缩功能障碍是败血症小牛的主要表现。入院时 CI 与 LVEDVI、LVESVI 和 SVI 之间存在正相关,支持这一结论。超声心动图确定 LVEDVI 和 CI 似乎有助于指导败血症小牛的治疗。