Wess G
Clinic of Small Animal Medicine, LMU University, Veterinärstrasse 13, Munich, 80539, Germany.
J Vet Cardiol. 2022 Apr;40:51-68. doi: 10.1016/j.jvc.2021.09.004. Epub 2021 Oct 1.
Dilated cardiomyopathy (DCM) is the most common cardiac disease in large breed dogs. The disease can start with arrhythmias or with systolic dysfunction of the myocardium.
To describe screening methods for DCM in various breeds and provide a new, modified staging system.
Screening for occult DCM should start at three years of age and use Holter monitoring in Boxers and Dobermans and might be useful also in other breeds. Single ventricular premature complexes (VPCs) can be detected in many healthy dogs, but healthy animals typically have <50 VPCs in 24 h and demonstrate minimal complexity most often occurring only as single ectopic beats. In general, >100 VPCs in 24 h was recommended as the cut-off value for establishing a diagnosis of DCM. However, there are breed-specific recommendations related to Holter recording diagnosis of DCM in Dobermans and Boxers. Yearly screening over the life of a dog is recommended, as a one-time screening is not sufficient to rule out the future development of DCM. Several echocardiographic methods such as M-mode derived measurements, the measurement of the left ventricular (LV) volume by Simpson's method of discs (SMOD), and E-point to septal separation (EPSS) are recommended for screening purposes. The value of additional tests such as cardiac biomarkers (troponin I and N-terminal pro-B-type natriuretic peptide) as well as a 5-min resting electrocardiogram (ECG) or newer echocardiographic methods such as strain measurements is discussed.
This review suggests some guidelines for screening for DCM in various breeds.
扩张型心肌病(DCM)是大型犬中最常见的心脏疾病。该病可始于心律失常或心肌收缩功能障碍。
描述不同品种犬DCM的筛查方法,并提供一种新的改良分期系统。
隐匿性DCM的筛查应从3岁开始,对拳师犬和杜宾犬采用动态心电图监测,对其他品种犬可能也有用。许多健康犬可检测到单源性室性早搏(VPC),但健康动物通常24小时内VPC少于50次,且复杂性最低,最常仅表现为单个异位搏动。一般而言,建议将24小时内>100次VPC作为诊断DCM的临界值。然而,对于杜宾犬和拳师犬的DCM动态心电图记录诊断有特定品种的建议。建议在犬的一生中每年进行筛查,因为一次性筛查不足以排除DCM未来的发展。推荐几种超声心动图方法用于筛查,如M型衍生测量、用辛普森圆盘法(SMOD)测量左心室(LV)容积以及E点至室间隔距离(EPSS)。还讨论了心脏生物标志物(肌钙蛋白I和N末端B型利钠肽原)等其他检查以及5分钟静息心电图(ECG)或应变测量等更新的超声心动图方法的价值。
本综述提出了一些不同品种犬DCM筛查的指导原则。