Echocardiographic indices and severity of mitral regurgitation in dogs with preclinical degenerative mitral valve disease
Echocardiographic indices and severity of mitral regurgitation in dogs with preclinical degenerative mitral valve disease
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DOI：
10.1111/jvim.15461
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发表时间：
2019-03-01
影响因子：
2.6
通讯作者：
Oyama, Mark A.
中科院分区：
文献类型：
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作者：
Larouche-Lebel, Eva;Loughran, Kerry A.;Oyama, Mark A.
背景：描述退行性二尖瓣病变(DMVD)犬二尖瓣反流(MR)的严重程度是具有挑战性的。假设/目的：二尖瓣返流分数(Rf)、有效返流口面积(EROA)和二尖瓣反流与主动脉血流的比率(Q(MR)：Q(Ao))可以从常规超声心动图测量中计算出来，并提供有关MR严重程度的额外信息。动物：57只临床前DMVD犬，其中36只没有心脏功能障碍，21只有心脏功能不全。对RF、EROA和Q(MR)：Q(Ao)与一维测量结果之间的预期关系进行了数学推导和计算，其中包括左房/主动脉根部直径比(LA：Ao)和标准左室舒张末期内径(LVIDdN)。通过计算均方根标准误差来确定非线性拟合优度。结果：RF、EROA、Q(MR)：Q(Ao)、LA：Ao和LVIDdN呈曲线关系，多维指标可区分不同严重程度的MR。相比之下，一维测量对MR严重程度不敏感，直到RF等于或超过50%。反流分数和反流分数=50%，反流率与体表面积之比和Q(MR)：Q(Ao)>；=0.347与LA：Ao>；=1.6和LVIDdN>；=1.7密切相关。结论和临床意义：反流分数、反流率和Q(MR)：Q(Ao)以一维测量不能量化的方式量化临床前DMVD犬的MR严重程度。
Background: Describing severity of mitral regurgitation (MR) in dogs with degenerative mitral valve disease (DMVD) is challenging.Hypothesis/Objectives: Mitral regurgitant fraction (RF), effective regurgitant orifice area (EROA), and the ratio of mitral regurgitant to aortic flow (Q(MR):Q(Ao)) can be calculated from routine echo-cardiographic measurements and provide additional information regarding MR severity.Animals: Fifty-seven dogs with preclinical DMVD including 36 without and 21 with cardiomegaly.Methods: Prospective observational study. The expected relationships among RF, EROA, and Q(MR):Q(Ao) and 1-dimensional measurements including left atrium to aortic root diameter ratio (LA: Ao) and normalized left ventricular internal dimension at end-diastole (LVIDdN) were mathematically derived and calculated using echocardiographic data from the study population. Nonlinear goodness of fit was determined by calculation of the root mean standard error. The correlations between 1-dimensional and multidimensional indices were analyzed using receiver operating characteristic curves.Results: The relationships among RF, EROA, Q(MR) :Q(Ao), and both LA:Ao and LVIDdN were curvi-linear, and the multidimensional indices differentiated MR of variable severity. By contrast, 1-dimensional measurements were insensitive to MR severity until RF equaled or exceeded 50%. Regurgitant fraction >= 50%, EROA to body surface area >= 0.347 and Q(MR):Q(Ao) >= 0.79 were strongly associated with LA:Ao >= 1.6 and LVIDdN >= 1.7.Conclusions and Clinical Importance: Regurgitant fraction, EROA, and Q(MR):Q(Ao) quantify MR severity in dogs with preclinical DMVD in a manner that 1-dimensional measurements do not.