Miksömatöz Mitral Kapak Hastalığı Nedenli Mitral Regürgitasyonu Bulunan Köpeklerde Kardiyak Aritmiler

Abstract

Mitral regürgitasyonlu (MR) köpeklerde kardiyak remodeling bir çok supraventriküler aritmiyi stimüle edebilmektedir. Bu çalışmanın amacı, MR’li köpeklerde kardiyak remodelingle ilişkili aritmi potansiyeline dikkat çekmektir. Çalışma miksömatöz mitral kapak hastalığı (MMVD) belirtilerini taşıyan sahipli 30 köpekle yapıldı. Kardiyak muayene, kan analizleri ve görüntüleme prosedürlerini kapsayan rutin klinik uygulamalar gerçekleştirildi. Çalışmaya sol apikal kalp üfürümü olan hastalar dahil edildi. Regürgitant akımın sol atriumun % 20’sinden daha az alan kapladığı hafif şiddetli MR’li hastalar grup 1’e (n:10) dahil edilirken; regürgitant akımın sol atriumun % 20-40’ını kaplayan orta şiddetli MR’li hastalar ise grup 2’ye (n:10) alındı. Regürgitant akımın sol atriumun % 40’ından daha fazla alan kapladığı şiddetli MR’li hastalar ise grup 3’e (n:10) dahil edildi. EKG kayıtları 6 derivasyonlu cihaz ile kaydedildi. MMVD’li köpeklerdeki aritmiler sırasıyla; Sinüs taşikardi (n:11, 37%), sinus aritmi (n:10, 33%), supraventriküler prematüre kompleks (n:4, 13%), atrial fibrilasyon (n:4, 13%), taşikardi-bradikardi sendrom (n:2, 6%), 2. derece atriyoventriküler blok (n:2, 6%), sol dal bloğu (n:1, 3%) ve sinus pause’du (n:1, 3%). Kardiyak aritmilerin frekans dağılımları ile MR’nin şiddeti arasında bir ilişki bulunmadı (p>0.05). MR’li köpeklerde kardiyak remodelingin birçok supraventriküler aritmiyi stimüle edebileceği sonucuna varıldı. Her ne kadar kardiyak aritmiler ile MR’nin şiddeti arasında ilişki bulunamadıysa da, bu konuda daha geniş olgu sayılı ileri çalışmalara ihtiyaç vardır.

Keywords

• Aritmi,kalp,köpek,mitral regürgitasyon

Cardiac Arrhythmias in Dogs with Mitral Regurgitation due to Myxomatous Mitral Valve Disease

Abstract

Cardiac remodeling in dogs with mitral regurgitation (MR) may stimulate several supraventricular arrhythmias. The purpose of this study was to point out the potential of cardiac arrhythmias related to remodeling in dogs with MR. The study was carried out in 30 client-owned dogs with the signs of myxomatous mitral valve disease (MMVD). Routine clinical applications including cardiac examination, blood analyses and imaging procedures were performed. The inclusion criterion was the presence of left apical heart murmur. While group 1 (n:10) was defined as mild MR with regurgitant jet occupying less than 20% of the left atrial area, group 2 (n:10) was defined as moderate MR with regurgitant jet occupying between 20-40% of the left atrial area. Group 3 (n:10) was also defined as severe MR with regurgitant jet occupying more than 40% of the left atrial area. ECG variables were recorded by a 6-lead ECG machine. Arrhythmias in dogs with MMVD included Sinus Tachycardia (n:11, 37%), Sinus Arrhythmia (n:10, 33%), Supraventricular Premature Complex (n:4, 13%), Atrial Fibrillation (n:4, 13%), Tachycardia-Bradycardia Syndrome (n:2, 6%), 2^nd Degree Atrioventricular Block (n:2, 6%), Left Bundle Branch Block (n:1, 3%) and Sinus Pause (n:1, 3%). No significant association were found between the presence of cardiac arrhythmias and the severity of MR groups (p>0.05). In conclusion, cardiac remodeling in dogs with MR can induce several supraventricular arrhythmias. Although we could not find significant correlations between the presence of cardiac arrhythmias and the severity of MR groups, further studies with larger case series are required.

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