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甲状腺功能减退症犬在左甲状腺素补充前后的心电图和超声心动图评估:一项前瞻性对照研究。

Electrocardiographic and echocardiographic evaluation in dogs with hypothyroidism before and after levothyroxine supplementation: A prospective controlled study.

机构信息

The Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy.

The Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy.

出版信息

J Vet Intern Med. 2019 Sep;33(5):1935-1942. doi: 10.1111/jvim.15600. Epub 2019 Aug 29.

Abstract

BACKGROUND

Improvement in cardiac function has been demonstrated after thyroxine treatment in humans with hypothyroidism using the myocardial performance index (MPI). Cardiac changes after thyroxine supplementation are poorly documented in dogs with spontaneous hypothyroidism and comparison with clinically healthy dogs is lacking.

OBJECTIVES

To evaluate the electrical activity and mechanical function of the heart in dogs with primary hypothyroidism at baseline (T0) and after thyroxine supplementation (T60).

ANIMALS

Forty client-owned dogs with hypothyroidism and 20 clinically healthy dogs.

METHODS

Prospective cohort study. Selected electrocardiographic and echocardiographic variables, including the MPI, were measured in all dogs at T0 and in 30 hypothyroid dogs at T60.

RESULTS

Hypothyroid dogs had significantly decreased median or mean heart rate (HR), P wave amplitude, and R wave amplitude (P = .04, P = .002, and P = .003, respectively) and E-point-to-septal separation normalized to body weight (EPSSn) and trans-mitral E wave velocity (E max; P < .001 and P = .025, respectively) at T0 compared to control dogs. At T60, significantly increased median or mean HR, P wave amplitude, fractional shortening, and E max (P < .001, P = .004, P = .002, and P = .009, respectively) and significantly decreased left ventricular end-diastolic volume index, and normalized systolic diameter and EPSSn (P = .03, P = .03, and P = .001, respectively) were found.

CONCLUSIONS AND CLINICAL IMPORTANCE

Hypothyroidism in dogs induces mild and reversible changes of electromechanical cardiac function. The MPI does not have clinical importance in identifying cardiac dysfunction in affected dogs.

摘要

背景

在甲状腺功能减退症患者中,甲状腺素治疗已被证明可改善心肌功能指数(MPI)。然而,自发性甲状腺功能减退犬的甲状腺素补充后心脏变化的相关报道很少,与临床健康犬的比较也缺乏。

目的

评估原发性甲状腺功能减退犬在基础状态(T0)和甲状腺素补充后(T60)的心脏电活动和机械功能。

动物

40 只患有甲状腺功能减退症的患犬和 20 只临床健康犬。

方法

前瞻性队列研究。所有犬在 T0 时以及 30 只甲状腺功能减退犬在 T60 时测量选定的心电图和超声心动图变量,包括 MPI。

结果

甲状腺功能减退犬的心率(HR)、P 波幅度和 R 波幅度中位数或平均值显著降低(P = .04、P = .002 和 P = .003),E 点到室间隔的分离与体重的比值(EPSSn)和经二尖瓣的 E 波速度(E max)中位数或平均值也显著降低(P < .001 和 P =.025)。在 T60 时,发现中位数或平均值 HR、P 波幅度、缩短分数和 E max显著增加(P < .001、P =.004、P =.002 和 P =.009),左心室舒张末期容积指数、标准化收缩直径和 EPSSn显著降低(P =.03、P =.03 和 P =.001)。

结论和临床意义

犬甲状腺功能减退症引起轻微和可逆的机电心脏功能变化。MPI 对识别受影响犬的心脏功能障碍没有临床意义。

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