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犬扩张型心肌病伴充血性心力衰竭中亚搏的预后作用。

The role of atrial fibrillation as a prognostic factor in doberman pinschers with dilated cardiomyopathy and congestive heart failure.

机构信息

Clinic of Small Animal Medicine, LMU University, Veterinärstr. 13, 80539, Munich, Germany.

Clinic of Small Animal Medicine, LMU University, Veterinärstr. 13, 80539, Munich, Germany.

出版信息

Vet J. 2020 Oct;264:105535. doi: 10.1016/j.tvjl.2020.105535. Epub 2020 Sep 4.

DOI:10.1016/j.tvjl.2020.105535
PMID:33012438
Abstract

Atrial fibrillation (AF) in congestive heart failure (CHF) is associated with a high risk of mortality and shorter survival times in human and veterinary medicine. A retrospective review of medical records was performed to evaluate the impact of AF on survival times in Doberman Pinschers with dilated cardiomyopathy (DCM). Time of first onset of CHF and its role as a prognostic factor were also determined, as were predictors of AF development. Forty-eight client-owned purebred Doberman Pinschers with DCM and CHF were included; 23 dogs presented with AF and 25 dogs did not develop AF until immediately before cardiac-related death. Dogs with AF survived for significantly shorter times than those without AF (P = 0.043). For dogs with AF, mean and median survival times were 88.2 days and 22 days, respectively (range, 42.1-134.4 days); mean and median survival times for dogs without AF were 150.7 days and 98 days, respectively (range, 98.5-203 days). AF increased the risk of cardiac-related death (hazard ratio [HR], 2.371; 95% confidence intervals [CI], 1.14-4.95; P = 0.021). Biventricular and right atrial dilation was only present in dogs with AF and right atrial enlargement was the only significant predictor of AF after multivariate analysis (P < 0.001). Dogs with AF had significantly higher mean heart rates than dogs without AF (201 beats per min [bpm] vs. 132 bpm; P < 0.001). In conclusion, AF in Doberman Pinschers with DCM and CHF increased the risk of cardiac-related death and reduced survival time.

摘要

充血性心力衰竭(CHF)合并心房颤动(AF)与人类和兽医医学中的高死亡率和较短的生存时间相关。进行了医学记录的回顾性审查,以评估 AF 对患有扩张型心肌病(DCM)的杜宾犬的生存时间的影响。还确定了 CHF 的首次发作时间及其作为预后因素的作用,以及 AF 发展的预测因素。共纳入 48 只患有 DCM 和 CHF 的纯种杜宾犬;23 只狗出现 AF,25 只狗在与心脏相关的死亡前立即未出现 AF。患有 AF 的狗的存活时间明显短于未患有 AF 的狗(P = 0.043)。对于患有 AF 的狗,平均和中位数生存时间分别为 88.2 天和 22 天(范围,42.1-134.4 天);未患有 AF 的狗的平均和中位数生存时间分别为 150.7 天和 98 天(范围,98.5-203 天)。AF 增加了与心脏相关的死亡风险(危险比[HR],2.371;95%置信区间[CI],1.14-4.95;P = 0.021)。只有在患有 AF 的狗中才存在双心室和右心房扩张,并且在多变量分析后,只有右心房增大是 AF 的唯一重要预测因素(P < 0.001)。患有 AF 的狗的平均心率明显高于未患有 AF 的狗(201 次/分钟[bpm]比 132 bpm;P < 0.001)。总之,患有 DCM 和 CHF 的杜宾犬的 AF 增加了与心脏相关的死亡风险并缩短了生存时间。

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