Keating S, Eberhard J, Friederich J, Wess G
Clinic for Small Animal Medicine, Department of Veterinary Medicine, Ludwig-Maximilians-Universität Munich, Veterinärstrasse 13, 80469 Munich, Germany.
Clinic for Small Animal Medicine, Department of Veterinary Medicine, Ludwig-Maximilians-Universität Munich, Veterinärstrasse 13, 80469 Munich, Germany.
J Vet Cardiol. 2023 Apr;46:40-54. doi: 10.1016/j.jvc.2023.03.004. Epub 2023 Mar 21.
INTRODUCTION/OBJECTIVES: Pulmonic stenosis (PS) is one of the most common congenital heart diseases in dogs leading to right ventricular (RV) pressure overload, myocardial remodeling, and potential RV dysfunction. Our objectives were to investigate the extent of RV systolic dysfunction in canine PS and to examine the immediate influence of balloon valvuloplasty (BV) on systolic function.
ANIMALS, MATERIALS AND METHODS: This prospective study evaluated 72 dogs with PS and 86 healthy dogs. Echocardiographic parameters of systolic function included normalized tricuspid annular plane systolic excursion (N-TAPSE), normalized systolic myocardial tissue Doppler velocity of the lateral tricuspid annulus (N-RVFW-S'), fractional area change, and speckle-tracking longitudinal endocardial RV strain. Forty-four dogs underwent BV and were re-examined after surgery.
Systolic function at the basal segment of the RV was significantly lower in the PS group when compared to healthy dogs (mean N-TAPSE 4.29 ± standard deviation 1.18 mm/kg vs. 5.60 ± 1.29 mm/kg; median N-RVFW-S' 5.28 [lower-upper 25% quantile 4.35-6.43 cm/s/kg] vs. 7.82 [6.73-8.79 cm/s/kg]; all P<0.001). Global longitudinal RV endocardial strain showed no significant difference between the two groups (-28.50 ± 6.23% vs. 28.61 ± 4.64%; P=0.886), but segmental strain analyses revealed basal hypo- and potential compensatory hyperkinesis of the apical RVFW. Furthermore, BV affected most parameters of systolic function, but not the segmental strain values and N-TAPSE.
Right ventricular basal longitudinal systolic function is decreased in dogs with PS in comparison to a healthy cohort. Regional and global function does not necessarily coincide.
引言/目的：肺动脉狭窄（PS）是犬类最常见的先天性心脏病之一，可导致右心室（RV）压力过载、心肌重塑以及潜在的右心室功能障碍。我们的目的是研究犬类PS中右心室收缩功能障碍的程度，并检查球囊瓣膜成形术（BV）对收缩功能的即时影响。
动物、材料与方法：这项前瞻性研究评估了72只患有PS的犬和86只健康犬。收缩功能的超声心动图参数包括标准化三尖瓣环平面收缩期位移（N-TAPSE）、三尖瓣环外侧收缩期心肌组织多普勒速度标准化值（N-RVFW-S'）、面积变化分数以及斑点追踪右心室内膜纵向应变。44只犬接受了BV治疗，并在术后进行了复查。
与健康犬相比，PS组右心室基底段的收缩功能显著降低（平均N-TAPSE 4.29±标准差1.18mm/kg，健康犬为5.60±1.29mm/kg；N-RVFW-S'中位数5.28[四分位数间距下限-上限25%为4.35-6.43cm/s/kg]，健康犬为7.82[6.73-8.79cm/s/kg]；所有P<0.001）。两组间右心室内膜整体纵向应变无显著差异（-28.50±6.23%对28.61±4.64%；P=0.886），但节段应变分析显示右心室游离壁基底段运动减弱以及心尖段可能存在代偿性运动增强。此外，BV影响了大多数收缩功能参数，但未影响节段应变值和N-TAPSE。
与健康犬群相比，患有PS的犬右心室基底纵向收缩功能降低。局部和整体功能不一定一致。
