Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK.
Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK; HS Cardiology Ltd, Dalton House, 9 Dalton Square, Lancaster LA1 1WD, UK.
J Vet Cardiol. 2024 Aug;54:44-56. doi: 10.1016/j.jvc.2024.05.006. Epub 2024 Jun 25.
Right ventricular (RV) dysfunction is a significant negative prognostic indicator in human dilated cardiomyopathy (DCM). Many RV indices are weight-dependent, and there is a lack of reference values for the right heart in giant breed dogs (over 50 kg), including Great Danes (GDs). This study aimed to compare indices of RV function in echocardiographically normal GDs, those with preclinical DCM (PC-DCM), and those with DCM and congestive heart failure (DCM-CHF).
A total of 116 client-owned adult GDs: 74 normal, 31 with PC-DCM, and 11 with DCM-CHF.
A retrospective, single-center cohort study assessed RV function using free-wall RV longitudinal strain (RVLS), strain rate, fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and pulsed-wave tissue Doppler imaging-derived systolic myocardial velocity of the lateral tricuspid annulus (TDI S'). Relationships between DCM status and RV function indices were analyzed.
RV function, measured by TAPSE (P=0.001), FAC (P<0.001), and TDI S' (P<0.001), decreased in dogs with PC-DCM and DCM-CHF compared to healthy dogs, with FAC being lower in DCM-CHF compared to PC-DCM (P=0.048). RVLS impairment was more significant in the DCM-CHF group than in the PC-DCM group (P=0.048). RVLS had the highest area under the curve (0.899) for differentiating between normal and DCM-CHF dogs.
As DCM progresses, echocardiographic variables of RV function, including TAPSE, FAC, TDI S', RVLS, and strain rate, worsen, indicating impaired RV systolic function in GDs affected by DCM.
右心室(RV)功能障碍是人类扩张型心肌病(DCM)的一个重要负性预后指标。许多 RV 指数与体重有关,巨型犬(超过 50 公斤),包括大丹犬(GDs)的右心缺乏参考值。本研究旨在比较超声心动图正常的 GDs、有临床前 DCM(PC-DCM)的 GDs 和有 DCM 伴充血性心力衰竭(DCM-CHF)的 GDs 的 RV 功能指数。
共 116 只客户所有的成年 GDs:74 只正常,31 只患有 PC-DCM,11 只患有 DCM-CHF。
回顾性单中心队列研究使用游离壁 RV 纵向应变(RVLS)、应变率、分数面积变化(FAC)、三尖瓣环平面收缩期位移(TAPSE)和脉冲波组织多普勒成像衍生的外侧三尖瓣环收缩心肌速度(TDI S')评估 RV 功能。分析 DCM 状态与 RV 功能指数之间的关系。
与健康犬相比,患有 PC-DCM 和 DCM-CHF 的犬的 RV 功能,通过 TAPSE(P=0.001)、FAC(P<0.001)和 TDI S'(P<0.001)测量,降低,DCM-CHF 犬的 FAC 比 PC-DCM 犬更低(P=0.048)。与 PC-DCM 组相比,DCM-CHF 组的 RVLS 损伤更显著(P=0.048)。RVLS 区分正常和 DCM-CHF 犬的曲线下面积最高(0.899)。
随着 DCM 的进展,RV 功能的超声心动图变量,包括 TAPSE、FAC、TDI S'、RVLS 和应变率,恶化,表明 DCM 影响的 GDs 存在 RV 收缩功能障碍。