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44 只自然感染克氏锥虫的犬的心脏诊断检测结果和结局。

Cardiac diagnostic test results and outcomes in 44 dogs naturally infected with Trypanosoma cruzi.

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.

Department of Veterinary Integrative Bioscience, Texas A&M University, College Station, Texas, USA.

出版信息

J Vet Intern Med. 2021 Jul;35(4):1800-1809. doi: 10.1111/jvim.16166. Epub 2021 May 16.

Abstract

BACKGROUND

The protozoal parasite Trypanosoma cruzi causes myocarditis in dogs.

OBJECTIVES

To describe the cardiac diagnostic test results and outcomes of dogs naturally infected with T. cruzi.

ANIMALS

Forty-four client-owned dogs.

METHODS

Medical records were retrospectively reviewed to identify dogs with an indirect fluorescent antibody test result for T. cruzi ≥1 : 80. Data collected included signalment, cardiac diagnostic test results (ECG, echocardiography, cardiac troponin I) and outcome. Outcomes were categorized as alive, dead (cardiac or noncardiac) or lost to follow up.

RESULTS

ECG abnormalities were present in 41 dogs with ventricular arrhythmias (n = 28) and atrioventricular block (AVB) (n = 15) most commonly identified. Echocardiographic chamber enlargement was present in 28 dogs and most often included the right ventricle (RV) (n = 15) and left atrium (n = 12). Troponin was ≥2 times the reference range in 20/36 (56%) dogs. In univariate analysis using nonparametric Kaplan-Meier, ventricular arrhythmias with a modified Lown score ≥2 (P = .02), presence of AVB (P = .04), and RV enlargement (P = .006) were associated with decreased survival times. Right ventricular enlargement (HR 3.6; 95% confidence interval [CI] 1.4-9.3; P = .007) and higher body weight at presentation (HR 1.0; 95% CI 1.0-1.1; P = .04) were associated with decreased time to death in the final explanatory multivariable model.

CONCLUSIONS AND CLINICAL IMPORTANCE

Cardiac abnormalities were common and variable, and RV enlargement was associated with shorter survival time. A diagnostic evaluation that includes screening for arrhythmias, echocardiography, and cTnI can provide useful information related to the characterization of heart disease in dogs seropositive for T. cruzi.

摘要

背景

原生动物寄生虫克氏锥虫会导致犬的心肌炎。

目的

描述自然感染克氏锥虫的犬的心脏诊断检测结果和结局。

动物

44 只患犬。

方法

回顾性审查病历,以确定间接荧光抗体检测结果为克氏锥虫≥1:80 的犬。收集的数据包括特征、心脏诊断检测结果(心电图、超声心动图、心肌肌钙蛋白 I)和结局。结局分为存活、死亡(心脏或非心脏)或失访。

结果

41 只犬存在心电图异常,最常见的是室性心律失常(n=28)和房室传导阻滞(AVB)(n=15)。28 只犬存在超声心动图心室扩张,最常见的是右心室(RV)(n=15)和左心房(n=12)。20/36 只(56%)犬的肌钙蛋白≥参考范围的 2 倍。在使用非参数 Kaplan-Meier 的单变量分析中,改良 Lown 评分≥2 的室性心律失常(P=0.02)、AVB(P=0.04)和 RV 扩张(P=0.006)与存活时间缩短相关。右心室扩张(HR 3.6;95%置信区间 [CI] 1.4-9.3;P=0.007)和就诊时较高的体重(HR 1.0;95% CI 1.0-1.1;P=0.04)与最终解释性多变量模型中死亡时间缩短相关。

结论和临床意义

心脏异常常见且多变,RV 扩张与存活时间缩短相关。包括心律失常、超声心动图和 cTnI 筛查的诊断评估可为阳性犬的心脏病特征提供有用信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/788f/8295658/a6aa9908d95f/JVIM-35-1800-g001.jpg

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