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新西兰一个非纯种猫群体中心肌病的患病率及心脏死亡率

Prevalence of cardiomyopathy and cardiac mortality in a colony of non-purebred cats in New Zealand.

作者信息

Seo J, Owen R, Hunt H, Luis Fuentes V, Connolly D J, Munday J S

机构信息

Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand.

Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK.

出版信息

N Z Vet J. 2025 Jan;73(1):1-9. doi: 10.1080/00480169.2024.2404684. Epub 2024 Sep 29.

DOI:10.1080/00480169.2024.2404684
PMID:39343434
Abstract

AIMS

To evaluate the prevalence of subclinical cardiomyopathy and cardiac mortality in a research colony of non-purebred cats, established as a model of the wider cat population in New Zealand.

METHODS

All apparently healthy, compliant, non-pregnant, non-neonatal cats in the colony at the Centre for Feline Nutrition (Massey University, Palmerston North, NZ) underwent physical examination and echocardiography using a 4.4-6.2-MHz probe by a board-certified veterinary cardiologist. Cardiac phenotype was classified following current guidelines. Hypertrophic cardiomyopathy (HCM) phenotype was defined as an end-diastolic left ventricular wall thickness ≥ 6 mm. Colony mortality data from February 2012 to February 2022 was reviewed to determine cardiac mortality.

RESULTS

Cats (n = 132; 65 females and 67 males) included in the study had a median age of 4.1 (IQR 3.0-8.0) years. Thirty-two (24%) cats had a heart murmur, and three (2%) cats had an arrhythmia. Echocardiography revealed heart disease in 24 (18.2%) cats, including 23 with an HCM phenotype and one with a restrictive cardiomyopathy phenotype. Of the cats with the HCM phenotype, 3/23 had systemic hypertension or hyperthyroidism or both, and these cats were excluded from the final diagnosis of HCM (20/132; 15.2 (95% CI = 9.5-22.4)%).Between 2012 and 2022, 168 colony cats died, with 132 undergoing post-mortem examination. Heart disease was considered the cause of death in 7/132 (5.3%; 95% CI = 2.2-10.6%) cats; five had HCM, one a congenital heart defect, and one myocarditis. The overall prevalence of death related to HCM in the colony during this period was 3.8% (95% CI = 1.2-8.6%). Three cats with HCM and the cat with a congenital heart defect died unexpectedly without prior clinical signs, while congestive heart failure was observed prior to death in two cats with HCM and the cat with myocarditis. Additionally, 30/132 (22.7%) cats had cardiac abnormalities but died for non-cardiac reasons.

CONCLUSIONS

Subclinical cardiomyopathy, specifically HCM, was common in cats in the colony. Given that the colony originated as a convenience selection of non-purebred cats in New Zealand, the true prevalence of HCM in the wider New Zealand population is likely to fall within the 95% CI (9.5-22%). The proportion of deaths of colony cats due to HCM was lower (3.8%) supporting the conclusion that subclinical cardiomyopathy may not progress to clinical disease causing death.

CLINICAL RELEVANCE

Veterinarians should be aware of the high prevalence of subclinical HCM when treating cats.

ABBREVIATIONS

CAM: Systolic anterior motion of the chordae tendineae; CFN: Centre for Feline Nutrition; HCM: Hypertrophic cardiomyopathy; LA/Ao: Left atrial to aortic ratio; LV FS: Left ventricular fractional shortening; LVIDd: Left ventricular internal diameters in end-diastole; LVIDs: Left ventricular internal diameter in end-systole; LVWT: Max Maximum left ventricular wall thickness; SAM: Systolic anterior motion of the mitral valve; 2D: Two-dimensional.

摘要

目的

评估一个非纯种猫研究群体中亚临床心肌病的患病率和心脏死亡率,该群体被建立为新西兰更广泛猫种群的模型。

方法

位于新西兰北帕默斯顿梅西大学猫科营养中心的所有明显健康、顺从、非怀孕、非新生的猫,由一位获得委员会认证的兽医心脏病专家使用4.4 - 6.2兆赫探头进行体格检查和超声心动图检查。根据当前指南对心脏表型进行分类。肥厚型心肌病(HCM)表型定义为舒张末期左心室壁厚度≥6毫米。回顾2012年2月至2022年2月的群体死亡率数据以确定心脏死亡率。

结果

纳入研究的猫(n = 132;65只雌性和67只雄性)中位年龄为4.1(四分位间距3.0 - 8.0)岁。32只(24%)猫有心脏杂音,3只(2%)猫有心律失常。超声心动图显示24只(18.2%)猫有心脏病,其中23只具有HCM表型,1只具有限制性心肌病表型。在具有HCM表型的猫中,3/23患有系统性高血压或甲状腺功能亢进或两者皆有,这些猫被排除在HCM的最终诊断之外(20/132;15.2(95%置信区间 = 9.5 - 22.4)%)。2012年至2022年期间,168只群体猫死亡,132只进行了尸检。7/132(5.3%;95%置信区间 = 2.2 - 10.6%)只猫的死亡原因被认为是心脏病;5只患有HCM,1只患有先天性心脏缺陷,1只患有心肌炎。在此期间该群体中与HCM相关的死亡总体患病率为3.8%(95%置信区间 = 1.2 - 8.6%)。3只患有HCM的猫和1只患有先天性心脏缺陷的猫在没有先前临床症状的情况下意外死亡,而在2只患有HCM的猫和1只患有心肌炎的猫死亡前观察到充血性心力衰竭。此外,30/132(22.7%)只猫有心脏异常但因非心脏原因死亡。

结论

亚临床心肌病,特别是HCM,在该群体的猫中很常见。鉴于该群体最初是对新西兰非纯种猫的便利选择,HCM在更广泛的新西兰猫种群中的真实患病率可能落在95%置信区间(9.5 - 22%)内。群体猫因HCM导致的死亡比例较低(3.8%),支持亚临床心肌病可能不会进展为导致死亡的临床疾病这一结论。

临床意义

兽医在治疗猫时应意识到亚临床HCM的高患病率。

缩写

CAM:腱索收缩期向前运动;CFN:猫科营养中心;HCM:肥厚型心肌病;LA/Ao:左心房与主动脉比值;LV FS:左心室短轴缩短率;LVIDd:舒张末期左心室内径;LVIDs:收缩末期左心室内径;LVWT:最大左心室壁厚度;SAM:二尖瓣收缩期向前运动;2D:二维

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