Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, 060-0818, Japan.
Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, 060-0818, Japan.
J Vet Cardiol. 2022 Feb;39:51-62. doi: 10.1016/j.jvc.2021.12.002. Epub 2021 Dec 6.
Few studies have evaluated the utility of echocardiographic indices of right ventricular (RV) function in predicting prognosis in dogs with myxomatous mitral valve disease (MMVD).
Sixty-seven client-owned dogs were diagnosed with MMVD.
clinical cohort study. Dogs diagnosed with American college of veterinary internal medicine (ACVIM) stage B2, C or D between April 2014 and March 2017 were enrolled. Long-term outcomes were assessed by telephone or from the medical record. The primary end-point was defined as cardiac-related death. Echocardiographic indices of RV function, including the RV Tei index, free wall and septal RV longitudinal strain, were obtained. Univariable and multivariable Cox proportional hazard analyses were used to identify variables predictive of cardiac-related death.
Twenty-four dogs died during the follow-up period. The median follow-up time was 482 days, and the median survival time for dogs with cardiac-related death was 230 days. For cardiac-related death, peak early diastolic mitral inflow velocity, ACVIM stage C or D, tricuspid regurgitation velocity, RV Tei index and RV end-diastolic area were predictors in univariable Cox proportional hazard analysis. In multivariable Cox proportional analysis adjusted for the left atrial to aorta ratio, peak early diastolic mitral inflow velocity and ACVIM stage, an increase in the Tei index by 0.1 increased the hazard ratio of cardiac-related death by 33% (95% confidence interval, 16-70%; P = 0.002).
In dogs with MMVD, RV dysfunction assessed by the Tei index is an independent predictor of cardiac-related death.
很少有研究评估超声心动图右心室（RV）功能指数在预测黏液样变性二尖瓣疾病（MMVD）犬预后中的作用。
67 只患 MMVD 的患犬。
临床队列研究。2014 年 4 月至 2017 年 3 月期间，诊断为美国兽医内科学院（ACVIM）B2、C 或 D 期的犬被纳入研究。通过电话或病历评估长期预后。主要终点定义为与心脏相关的死亡。获得 RV 功能的超声心动图指数，包括 RV Tei 指数、游离壁和间隔 RV 纵向应变。使用单变量和多变量 Cox 比例风险分析来识别与心脏相关死亡相关的变量。
24 只犬在随访期间死亡。中位随访时间为 482 天，与心脏相关死亡的犬中位生存时间为 230 天。对于与心脏相关的死亡，早期舒张期二尖瓣血流速度峰值、ACVIM 分期 C 或 D、三尖瓣反流速度、RV Tei 指数和 RV 舒张末期面积是单变量 Cox 比例风险分析的预测因素。在多变量 Cox 比例分析中，调整左心房到主动脉的比例、早期舒张期二尖瓣血流速度峰值和 ACVIM 分期后，Tei 指数增加 0.1，使与心脏相关的死亡的危险比增加 33%（95%置信区间，16-70%；P=0.002）。
在 MMVD 犬中，Tei 指数评估的 RV 功能障碍是与心脏相关死亡的独立预测因子。
