Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea.
Can J Vet Res. 2021 Oct;85(4):261-270.
This study evaluated changes in electrocardiographic (ECG) parameters according to the stage of myxomatous mitral valve disease (MMVD) in dogs, as well as the utility of ECG parameters as prognostic indicators for congestive heart failure (CHF). Medical records of dogs with MMVD were retrospectively searched. Dogs with MMVD (N = 101) were classified into stages B [B1 ( = 52) and B2 ( = 23)] and C ( = 26) according to the American College of Veterinary Internal Medicine guidelines. Baseline variables were collected; these included signalment, radiographic, echocardiographic, and ECG parameters. Corrected QT intervals (QTc) were calculated using the logarithmic (QTc1) and Fridericia (QTc2) formulas. The P wave duration, QTc1, and QTc2 were significantly longer in stage C than in stage B. The P wave duration cutoff of 43.5 ms had a diagnostic accuracy of 65% for differentiating CHF, with a sensitivity of 63% and a specificity of 90%. A cutoff value of 307.8 ms for QTc1 yielded a sensitivity of 62%, a specificity of 76%, and a diagnostic accuracy of 78%, and a cutoff value of 239.2 ms for QTc2 yielded a sensitivity of 62%, a specificity of 83%, and a diagnostic accuracy of 77% for diagnosing CHF. Therefore, prolonged P wave and QTc in dogs with MMVD may facilitate the prediction of CHF. Electrocardiography could provide clinicians with a readily available and cost-effective screening tool for predicting CHF, if the usefulness of ECG parameters can be verified.
本研究评估了根据黏液样心肌二尖瓣病(MMVD)的阶段变化的心电图(ECG)参数,以及 ECG 参数作为充血性心力衰竭(CHF)预后指标的效用。
回顾性搜索患有 MMVD 的犬的病历。根据美国兽医内科学会的指南,患有 MMVD 的犬(N = 101)分为 B 期[B1(= 52)和 B2(= 23)]和 C 期(= 26)。收集基线变量;这些变量包括特征、放射学、超声心动图和心电图参数。使用对数(QTc1)和 Fridericia(QTc2)公式计算校正 QT 间期(QTc)。与 B 期相比,C 期的 P 波持续时间、QTc1 和 QTc2 显著更长。P 波持续时间截断值为 43.5ms 时,对 CHF 的诊断准确性为 65%,敏感性为 63%,特异性为 90%。QTc1 的截断值为 307.8ms 时,敏感性为 62%,特异性为 76%,诊断准确性为 78%,QTc2 的截断值为 239.2ms 时,敏感性为 62%,特异性为 83%,诊断准确性为 77%,用于诊断 CHF。
因此,患有 MMVD 的犬的 P 波和 QTc 延长可能有助于预测 CHF。如果 ECG 参数的有用性能够得到验证,心电图可能为临床医生提供一种易于获得且具有成本效益的 CHF 预测筛选工具。