Université Paris-Est, École Nationale Vétérinaire d'Alfort, Pôle Anesthésie-Réanimation-Urgence-Soins Intensifs, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704 Maisons-Alfort Cedex, France; INSERM (Institut national de la santé et de la recherche médicale), U955, Equipe 03, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France.
INSERM (Institut national de la santé et de la recherche médicale), U955, Equipe 03, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France.
Res Vet Sci. 2021 Dec;141:129-137. doi: 10.1016/j.rvsc.2021.09.014. Epub 2021 Oct 4.
Dexmedetomidine and acepromazine, sedatives commonly used in dogs have opposite vascular effects, resulting in afterload increase and decrease, respectively. This could variably affect systolic myocardial function. Previous echocardiographic studies assessing the cardiovascular effects of these drugs used conventional echocardiography, while advanced techniques such as speckle tracking echocardiography (STE) and tissue Doppler imaging (TDI), which are known to provide a more accurate assessment of systolic function, have been rarely used for this aim. Moreover, in the few studies using advanced techniques, the drugs where combined with opioids. Therefore, the main objective of this prospective study was to assess systolic myocardial function by conventional and advanced echocardiography (STE and TDI), in dogs sedated exclusively with dexmedetomidine or acepromazine not combined with other drugs. Twenty healthy dogs were randomly divided into two groups, Group A (acepromazine, 20 μg/kg IM), and Group D (dexmedetomidine, 5 μg/kg IM), cardiovascular parameters were assessed before sedation (T0), and thirty minutes afterwards (T1). Systolic arterial pressure and heart rate decreased in both groups at T1 as compared to T0. Only one conventional echocardiographic raw variable (left ventricular internal dimension in systole) and three out of five advanced echocardiographic variables (radial TDI systolic velocities at the epicardial region of the left ventricular free wall, longitudinal TDI systolic velocities of the septal mitral valve annulus and the STE-derived left ventricular global strain), were affected in Group D. A systolic impairment was observed in Group D and better estimated by advanced echocardiography. In Group A, only the end diastolic voume index (conventional echocardiography) was decreased. Both protocols seem to induce echocardiographic changes more likely secondary to their vascular action.
右美托咪定和乙酰丙嗪是犬中常用的镇静剂，它们具有相反的血管作用，分别导致后负荷增加和减少。这可能会对收缩期心肌功能产生不同的影响。以前使用传统超声心动图评估这些药物心血管影响的超声心动图研究，而斑点追踪超声心动图（STE）和组织多普勒成像（TDI）等先进技术，这些技术被认为可以更准确地评估收缩功能，很少用于这一目的。此外，在使用先进技术的少数研究中，这些药物与阿片类药物联合使用。因此，本前瞻性研究的主要目的是通过常规和先进的超声心动图（STE 和 TDI）评估镇静犬的收缩期心肌功能，镇静仅使用右美托咪定或乙酰丙嗪，不与其他药物联合使用。20 只健康犬随机分为两组，A 组（乙酰丙嗪，20μg/kg IM）和 D 组（右美托咪定，5μg/kg IM），在镇静前（T0）和 30 分钟后（T1）评估心血管参数。与 T0 相比，两组在 T1 时收缩压和心率均降低。只有一个常规超声心动图原始变量（收缩期左心室内径）和五个先进超声心动图变量中的三个（左心室游离壁心外膜区域的径向 TDI 收缩期速度、室间隔二尖瓣环的纵向 TDI 收缩期速度和 STE 衍生的左心室整体应变）在 D 组受到影响。D 组观察到收缩期功能障碍，先进的超声心动图可以更好地评估。在 A 组，只有舒张末期容积指数（常规超声心动图）降低。这两种方案似乎都引起了超声心动图变化，更可能是由于它们的血管作用。
