Auburn University College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA.
Veterinary Specialty Center, Buffalo Grove, Illinois, USA.
Vet Radiol Ultrasound. 2023 May;64(3):501-510. doi: 10.1111/vru.13199. Epub 2022 Nov 29.
Systemic hypertension (SH) in cats may occur secondary to renal disease, hyperthyroidism, or idiopathic causes. Asymmetric dilation of the sinuses of Valsalva has been recognized in people with systemic hypertension as target organ damage (TOD). Aortic knob formation (lateral bowing of the aortic arch to proximal descending aorta on the posteroanterior/anteroposterior radiographic projection) is recognized as TOD in people due to SH. None of these changes have been reported in feline patients. The first objective of this retrospective case-controlled study was to compare echocardiographic changes in the aorta of 76 cats with systemic hypertension (SH) to those seen in 76 cats with normal blood pressure (NBP). Our second objective was to have blinded reviewers assess heart size and aortic shape and size from available thoracic radiographs of 49/76 cats with SH and 46/76 cats with NBP. A two-way unpaired t-test with significance set at alpha = 0.01 was used to evaluate aortic echocardiographic parameters. The mean of the aortic diameter and length of each aortic cusp was significantly larger in cats with SH than in cats with NBP. The aortic cusps were considered altered in size in 62 of 76 cats with SH, 12/62 ≥ with 0.5 mm, and 50/62 ≥ 1.0 mm. No significant difference in the vertebral heart score (VHS) was noted between groups. The aortic knob to lateral margin of the trachea in cats with SH had an area under the curve (AUC) of 0.74 (95% CI:0.61-0.87) with best cutoff of 1.12 cm with sensitivity of 81% and specificity of 69%.
猫的系统性高血压（SH）可能继发于肾脏疾病、甲状腺功能亢进症或特发性原因。在患有系统性高血压的人群中，已经认识到窦状 Valsalva 的不对称扩张是靶器官损伤（TOD）。由于 SH，主动脉结形成（主动脉弓在前后/前后放射摄影投影上向近端降主动脉的侧向弯曲）被认为是 TOD。这些变化在猫患者中均未报道。这项回顾性病例对照研究的首要目标是比较 76 只患有系统性高血压（SH）的猫和 76 只血压正常（NBP）的猫的主动脉超声心动图变化。我们的第二个目标是让盲审员评估 49/76 只 SH 猫和 46/76 只 NBP 猫的可用胸部 X 光片上的心脏大小和主动脉形状和大小。使用具有显著意义的双侧未配对 t 检验（alpha = 0.01）评估主动脉超声心动图参数。与 NBP 猫相比，SH 猫的主动脉直径和每个主动脉瓣长度的平均值明显更大。62/76 只 SH 猫的主动脉瓣被认为大小改变，12/62 只≥0.5 毫米，50/62 只≥1.0 毫米。两组之间的椎体心脏评分（VHS）没有显著差异。SH 猫的主动脉结到气管外侧缘的曲线下面积（AUC）为 0.74（95%CI：0.61-0.87），最佳截断值为 1.12cm，灵敏度为 81%，特异性为 69%。
