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超声心动图特征在继发于呼吸系统疾病的肺动脉高压犬。

Echocardiographic characteristics of dogs with pulmonary hypertension secondary to respiratory diseases.

机构信息

Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan.

出版信息

J Vet Intern Med. 2023 Sep-Oct;37(5):1656-1666. doi: 10.1111/jvim.16836. Epub 2023 Aug 18.

Abstract

BACKGROUND

Pulmonary hypertension (PH) secondary to respiratory disease is caused by pulmonary vascular remodeling and hypoxia. Severe PH can induce various clinical signs, including syncope and right-sided heart failure.

HYPOTHESIS/OBJECTIVES: To investigate the echocardiographic characteristics in dogs with PH secondary to respiratory diseases.

ANIMALS

Thirty-one dogs with respiratory diseases with or without PH and 15 healthy dogs.

METHODS

Prospective cross-sectional study. Dogs were classified according to respiratory disease (obstructive airway/lung disease [OALD] or restrictive lung disease [RLD]) and PH-relevant signs. The association between echocardiographic variables and PH (classified by respiratory disease and PH-relevant signs) was investigated.

RESULTS

Twenty-one dogs were diagnosed with PH; of these, 11 showed PH-related signs (OALD, n = 2; RLD, n = 9), 14 had right ventricular hypertrophy, and 19 had pulmonary arterial enlargement. Right ventricular dysfunction and dilatation were observed only in dogs with PH-related signs (n = 10). Left and right ventricular stroke volumes were significantly lower in dogs with PH (median [interquartile range]: 17.2 [12.4-20.8] and 16.8 [15.3-29.5] mL/m , respectively). Dogs with RLD had higher echocardiography-estimated pulmonary vascular resistance than those with OALD (median [interquartile range]: 3.1 [1.9-3.3] and 1.6 [1.3-2.2], respectively).

CONCLUSIONS AND CLINICAL IMPORTANCE

Pulmonary arterial enlargement was the most common echocardiographic finding in dogs with PH secondary to respiratory diseases. Right ventricular dysfunction, dilatation, and decreased left and right ventricular stroke volume were significantly associated with the PH-related signs, indicating that comprehensive echocardiography is recommended in dogs with respiratory disease. Restricted lung disease might induce more severe PH than OALD.

摘要

背景

由肺部血管重塑和缺氧引起的呼吸疾病相关肺动脉高压(PH)。严重的 PH 可引起各种临床体征,包括晕厥和右侧心力衰竭。

假说/目的:研究呼吸疾病继发 PH 的犬的超声心动图特征。

动物

31 只患有呼吸疾病的犬,包括有或无 PH 的犬,以及 15 只健康犬。

方法

前瞻性的病例对照研究。根据呼吸疾病(气道阻塞/肺部疾病[OALD]或限制性肺病[RLD])和 PH 相关的体征对犬进行分类。研究超声心动图变量与 PH(根据呼吸疾病和 PH 相关体征进行分类)之间的关系。

结果

21 只犬被诊断为 PH;其中,11 只出现 PH 相关体征(OALD,n=2;RLD,n=9),14 只出现右心室肥厚,19 只出现肺动脉扩张。仅在有 PH 相关体征的犬中观察到右心室功能障碍和扩张(n=10)。PH 犬的左、右心室搏出量明显降低(中位数[四分位距]:17.2[12.4-20.8]和 16.8[15.3-29.5]mL/m)。RLD 犬的超声心动图估测肺动脉阻力明显高于 OALD 犬(中位数[四分位距]:3.1[1.9-3.3]和 1.6[1.3-2.2])。

结论和临床意义

呼吸疾病继发 PH 犬最常见的超声心动图表现为肺动脉扩张。右心室功能障碍、扩张和左、右心室搏出量降低与 PH 相关体征显著相关,提示对呼吸疾病犬推荐进行全面的超声心动图检查。限制性肺病引起的 PH 可能比气道阻塞性肺病更严重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fb4/10472999/b71c090975d4/JVIM-37-1656-g001.jpg

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