Incremental predictive value of echocardiographic indices of right ventricular function in the assessment of long-term prognosis in dogs with myxomatous mitral valve disease
Incremental predictive value of echocardiographic indices of right ventricular function in the assessment of long-term prognosis in dogs with myxomatous mitral valve disease
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DOI：
10.1016/j.jvc.2021.12.002
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发表时间：
2022-02-01
影响因子：
1.2
通讯作者：
Takiguchi, M.
中科院分区：
文献类型：
--
作者：
Morita, T.;Nakamura, K.;Takiguchi, M.
导言：很少有研究评估右心室（RV）功能超声心动图指标在预测二尖瓣黏液瘤病（MMVD）犬预后中的应用。动物：67只客户拥有的狗被诊断患有MMVD。材料和方法：临床队列研究。在2014年4月至2017年3月期间被诊断为美国兽医内科学院（ACVIM） B2、C或D期的狗被纳入研究。通过电话或医疗记录评估长期结果。主要终点定义为心脏相关死亡。超声心动图指标包括左室Tei指数、左室自由壁和左室间隔纵向应变。单变量和多变量Cox比例风险分析用于识别预测心脏相关死亡的变量。结果：随访期间死亡24只。中位随访时间为482天，心脏相关死亡犬的中位生存时间为230天。对于心脏相关死亡，单变量Cox比例风险分析中，舒张早期二尖瓣流入速度峰值、ACVIM C期或D期、三尖瓣反流速度、右室Tei指数和右室舒张末期面积是预测因素。在校正左心主动脉比、舒张早期尖顶二尖瓣流入速度和ACVIM分期的多变量Cox比例分析中，Tei指数每增加0.1，心脏相关死亡的危险比增加33%（95%可信区间，16-70%;P 1/4 0.002）。结论：在患有MMVD的狗中，Tei指数评估的RV功能障碍是心脏相关死亡的独立预测因子。2021 Elsevier B.V.版权所有
Introduction: Few studies have evaluated the utility of echocardiographic indices of right ventricular (RV) function in predicting prognosis in dogs with myxomatous mitral valve disease (MMVD). Animals: Sixty-seven client-owned dogs were diagnosed with MMVD.Materials and methods: clinical cohort study. Dogs diagnosed with American college of veterinary internal medicine (ACVIM) stage B2, C or D between April 2014 and March 2017 were enrolled. Long-term outcomes were assessed by telephone or from the medical record. The primary end-point was defined as cardiac related death. Echocardiographic indices of RV function, including the RV Tei index, free wall and septal RV longitudinal strain, were obtained. Univariable and multi variable Cox proportional hazard analyses were used to identify variables predictive of cardiac-related death. Results: Twenty-four dogs died during the follow-up period. The median follow-up time was 482 days, and the median survival time for dogs with cardiac-related death was 230 days. For cardiac-related death, peak early diastolic mitral inflow velocity, ACVIM stage C or D, tricuspid regurgitation velocity, RV Tei index and RV end-diastolic area were predictors in univariable Cox proportional hazard analysis. In multivariable Cox proportional analysis adjusted for the left atrial to aorta ratio, peak early diastolic mitral inflow velocity and ACVIM stage, an increase in the Tei index by 0.1 increased the hazard ratio of cardiac-related death by 33% (95% con-fidence interval, 16-70%; P 1/4 0.002).Conclusions: In dogs with MMVD, RV dysfunction assessed by the Tei index is an in-dependent predictor of cardiac-related death. 2021 Elsevier B.V. All rights reserved.