Prevalence of Patent Foramen Ovale with Right-to-Left Shunting in Dogs with Pulmonic Stenosis
Prevalence of Patent Foramen Ovale with Right-to-Left Shunting in Dogs with Pulmonic Stenosis
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DOI：
10.1111/j.1939-1676.2011.00839.x
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发表时间：
2012-01-01
影响因子：
2.6
通讯作者：
Aoki, T.
中科院分区：
文献类型：
--
作者：
Fujii, Y.;Nishimoto, Y.;Aoki, T.
背景：卵圆孔未闭合并肺狭窄所致的右向左(R-L)分流常见，但尚无公开证据。目的：探讨卵圆孔未闭合并肺动脉狭窄(PS)犬右向左分流的发生率。动物：31只客户所有的PS犬，临床检查未发现明显的心外病变。方法：病例对照研究：超声心动图(气泡阳性犬)左房水平静脉注射微泡时诊断为R-L分流可能是由PFO引起的。比较气泡阳性犬和气泡阴性犬PS合并三尖瓣反流的严重程度、右室相对厚度和相对右房面积。结果：31例患者中12例出现R-L分流，发生率为39%。与气泡阴性组相比，气泡阳性组跨肺瓣瞬时压力梯度(Pg)和右室相对厚度显著增加。轻、中度PS(压力梯度+lt；80 mm Hg，n=2)犬均无R-L分流。气泡阳性犬的TR患病率明显高于气泡阴性犬。讨论和临床相关性：卵圆孔未闭合并R-L分流术在重度PS犬中更为常见，而在轻度PS犬中则不常见。
Background: Right-to-left (R-L) shunt caused by patent foramen ovale (PFO) concurrent with pulmonic stenosis (PS) is considered common, although there is a lack of published evidence.Objectives: To investigate the prevalence of R-L shunt caused by a PFO in dogs with PS.Animals: Thirty-one client-owned dogs with PS, without obvious extracardiac disease detected on the clinical examinations.Methods: Case control study: R-L shunt probably caused by PFO was diagnosed when IV injected microbubbles appeared at the left atrial level with an intact atrial septum on echocardiography (bubble-positive dogs). The severity of PS concurrent tricuspid regurgitation (TR), relative thickness of the right ventricle, and relative right atrial area were compared between bubble-positive and bubble-negative dogs.Results: The prevalence of R-L shunts caused by PFO was 39% (12 of 31 cases). The instantaneous pressure gradient (PG) across the pulmonic valve and relative thickness of the right ventricle were significantly increased in bubble-positive compared with those in bubble-negative dogs. None of the dogs with mild or moderate PS (pressure gradient < 80 mm Hg, n = 2) demonstrated R-L shunt. The prevalence of TR in bubble-positive dogs was significantly higher than that in bubble-negative dogs.Discussion and Clinical Relevance: Patent foramen ovale PFO with R-L shunt was more common in dogs with very severe PS and absent in dogs with mild PS.