Dilated cardiomyopathy in 151 Irish Wolfhounds: Characteristic clinical findings, life expectancy and causes of death
Dilated cardiomyopathy in 151 Irish Wolfhounds: Characteristic clinical findings, life expectancy and causes of death
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DOI：
10.1016/j.tvjl.2018.12.018
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发表时间：
2019-03-01
影响因子：
2.2
通讯作者：
Kohn, B.
中科院分区：
文献类型：
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作者：
Vollmar, C.;Vollmar, A.;Kohn, B.
扩张性心肌病（DCM）是爱尔兰猎狼犬（1 W）发病的重要原因，该犬种也易患肿瘤和整形外科疾病，缩短预期寿命。本研究的目的是调查IW合并DCM患者的生存率和死亡原因，并观察DCM随时间推移的临床表现。回顾性评价了1591例IW患者的心血管检查数据，包括超声心动图和心电图。本研究纳入了接受药物治疗并进行长期纵向随访的IW伴DCM患者（n =151; 95例男性，56例女性）。根据首次诊断时的临床状态，将1 W分为三组：临床前DCM伴窦性心律（PC-DCM-SR，n =35）、临床前DCM伴房颤（PCDCM-AF，n =87）和充血性心力衰竭伴DCM和AF（CHF-DCM-AF，n =29）。生存数据采用累积发病率函数、Kaplan-Meier和考克斯回归分析。CHF主要特征为乳糜性胸膜和轻度心包积液。73/151只犬的死亡原因为心源性（CD），62/151只犬的死亡原因为非心源性（非CD）;研究结束时，16只犬仍存活。两个临床前DCM组中的大多数死亡为非CD（PC-DCM-AF=51.9%非CD，48.1% CD; PC-DCM-SR，65.5%非CD，34.5% CD）。在CHF-DCM-AF组中，大多数犬（89.6%）发生CD。CHF-DCM-AF组的中位生存期（7.3个月）明显短于PC-DCM-AF组（21.9个月）或PC-DCM-SR组（29.1个月，P=0.001）。CHF-DCM-AF在1周内与预期寿命和CD减少相关，而大多数临床前DCM的IW死于非心脏原因。(C)2018爱思唯尔有限公司版权所有
Dilated cardiomyopathy (DCM) is an important cause of morbidity in Irish Wolfhounds (1W), a breed also predisposed to neoplastic and orthopedic diseases that shorten life expectancy. The objective of this study was to investigate survival and causes of death in IW with DCM and to characterise the clinical findings of DCM over time. Data from cardiovascular examinations performed in 1591 IW, including echocardiography and electrocardiography, were retrospectively evaluated. IW with DCM on medical therapy with long term longitudinal follow-up were included in this study (n =151; 95 males, 56 females). Based on their clinical status at initial diagnosis, 1W were classified into one of three groups: preclinical DCM with sinus rhythm (PC-DCM-SR, n =35), preclinical DCM with atrial fibrillation (PCDCM-AF, n =87), and congestive heart failure with DCM and AF (CHF-DCM-AF, n =29). Survival data were analyzed using cumulative incidence functions, Kaplan-Meier and Cox regression.CHF was predominantly characterized by chylous pleural and mild pericardial effusions. Causes of death were cardiac (CD) in 73/151 and non-cardiac (non-CD) in 62/151; 16 dogs remained alive at study end. The majority of deaths in both preclinical DCM groups were non-CD (PC-DCM-AF=51.9% non-CD, 48.1% CD; PC-DCM-SR, 65.5% non-CD, 34.5% CD). In the CHF-DCM-AF group most dogs (89.6%) experienced a CD. Median survival of the CHF-DCM-AF group (7.3 months) was significantly shorter than in the PC-DCM-AF group (21.9 months) or PC-DCM-SR group (29.1 months, P=0.001).CHF-DCM-AF in 1W was associated with reduced life expectancy and CD, while most IW with preclinical DCM died from non-cardiac causes. (C) 2018 Elsevier Ltd. All rights reserved.