Turkiye Klinikleri Journal of Veterinary Sciences

.: ORIGINAL RESEARCH
Mitral Kapak Hastalığı Saptanan Cavalier King Charles Spaniel Irkı Köpeklerde Saptanan Elektrokardiyografik Değişiklikler: Klinik Araştırma
Electrocardiographic Changes in Cavalier King Charles Spaniel Dogs with Mitral Valve Disease: Clinical Research
Ashkan SEDDIGH NIAa, Hande SOYLUa, Suzan MURATa, Onur İSKEFLİa, Lora KOENHEMSIa, Mehmet Erman ORa, Remzi GÖNÜLa
aİstanbul Üniversitesi-Cerrahpaşa Veteriner Fakültesi, İç Hastalıklar ABD, İstanbul, Türkiye
Turkiye Klinikleri J Vet Sci. 2022;13(1):6-10
doi: 10.5336/vetsci.2022-90789
Article Language: TR
Full Text
ÖZET
 Amaç: Miksomatöz mitral kapak hastalığı [myxamatous mitral valve disease (MMVD)], Cavalier King Charles Spaniel (CKCS) gibi küçük ve orta boy ırklarda sık görülen bir kalp hastalığıdır. MMVD'li köpekler genellikle uzun süre asemptomatik kalmakla birlikte mitral regürjitasyondan kaynaklanan hemodinamik değişikler ilerleyerek, özellikle sol atriyal genişleme ile ilişkili konjestif kalp yetersizliğine neden olmakta ve buna bağlı gelişen pulmoner ödem, aritmiler ve iskemik kalp hastalığı sonucu ani ölüm riskinde artışa yol açmaktadır. Yapılan bu çalışmada, kolay uygulanabilir ve pratik bir yöntem olan elektrokardiyografi ile hastalığın teşhis kriterlerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Yapılan bu çalışmada; hastalığın B1, B2 ve C safhalarında olduğu tespit edilen ve her grupta 6 hayvanın yer aldığı toplam 18 mitral kapak hastası CKCS ırkı köpek çalışma grubunu oluştururken, 6 sağlıklı CKCS ırkı köpek kontrol grubunu oluşturmuştur. Hastalığın klinik, radyografik, ekokardiyografik olarak teşhisinden sonra elektrokardiyografik bulgular detaylı bir şekilde incelenmiştir. Bulgular: Kliniğimize gelen hastalarda hastalığın şiddetiyle orantılı bir şekilde artan dispne ve egzersiz intolerans semptomlarıyla birlikte akciğer ödemi, kardiyak üfürüm sesleri gibi klinik bulgular olduğu saptandı. Çalışmada mitral kapak yetersizliğine sahip köpeklerde hastalığın şiddetiyle orantılı bir şekilde elektrokardiyografik incelemelerde R amplitüdü değerinin, P süresi ve PR süresi değerlerinin özellikle C safhasındaki hasta grubundakilerde diğer gruptakilere kıyasla istatistiksel olarak anlamlı bir şekilde arttığı (p<0,05) ve sinoatriyal blok, atriyal taşikardi ve atriyal fibrilasyon gibi çeşitli ritim-ileti problemlerinin geliştiği saptandı. Sonuç: MMVD hastalığı ile ilgili gelişen ritim-ileti problemleri ve kardiyak büyümelerin elektrokardiyografik olarak kolay ve hızlı bir şekilde teşhisi edilebileceği ve hastalığın takibinin yapılabileceği görülmüştür.

Anahtar Kelimeler: King Charles; mitral kapak; elektrokardiyografi
ABSTRACT
 Objective: Myxamatous mitral valve disease (MMVD) is a common heart disease in small and medium-sized breeds such as Cavalier King Charles Spaniel (CKCS). Although dogs with MMVD usually remain asymptomatic for a long time, the hemodynamic changes resulting from mitral regurgitation progress, leading to congestive heart failure especially associated with left atrial enlargement, may cause a sudden risk of death as a result of pulmonary edema, arrhythmias, and ischemic heart disease. This study, it was aimed to examine the diagnostic criteria of the disease with electrocardiography, which is an easily applicable and practical method. Material and Methods: In this study, 18 mitral valve patients in B1, B2, and C stages of the disease and 6 animals in each group, constituted the CKCS breed dog study group, while 6 healthy dogs formed the control group. After the clinical, radiographic, and echocardiographic diagnosis of the disease, electrocardiographic findings were examined. Results: The patients with dyspnea and exercise intolerance anemnesis with clinical findings such as pulmonary edema and cardiac murmur sounds; had increased severity of the disease. In proportion to the severity of the disease; R amplitude value, P time, and PR time values were statistically significantly increased especially in the C stage patient group compared to the other groups (p<0.05) and various rhythm-conduction problems such as sinoatrial block, atrial tachycardia and atrial fibrillation developed in electrocardiographic examinations. Conclusion: It has been observed that rhythm-conduction problems and cardiac enlargements related to MMVD disease can be easily and quickly diagnosed electrocardiographically and the disease can be followed up.

Keywords: King Charles; mitral valve; electrocardiography
REFERENCES:
  1. Borgarelli M, Haggstrom J. Canine degenerative myxomatous mitral valve disease: natural history, clinical presentation and therapy. Vet Clin North Am Small Anim Pract. 2010;40(4):651-63. [Crossref]  [PubMed] 
  2. Gordon SG, Saunders AB, Wesselowski SR. Asymptomatic canine degenerative valve disease: current and future therapies. Vet Clin North Am Small Anim Pract. 2017;47(5):955-75. [Crossref]  [PubMed] 
  3. Häggström J, Hamlin RL, Hansson K, Kvart C. Heart rate variability in relation to severity of mitral regurgitation in Cavalier King Charles spaniels. J Small Anim Pract. 1996;37(2):69-75. [Crossref]  [PubMed] 
  4. Kim SH, Seo KW, Song KH. An assessment of vertebral left atrial size in relation to the progress of myxomatous mitral valve disease in dogs. J Vet Clin. 2020;37(1):9-14. [Crossref] 
  5. Höllmer M, Willesen JL, Tolver A, Koch J. Left atrial volume and function in dogs with naturally occurring myxomatous mitral valve disease. J Vet Cardiol. 2017;19(1):24-34. [Crossref]  [PubMed] 
  6. Mikawa S, Nagakawa M, Ogi H, Akabane R, Koyama Y, Sakatani A, et al. Use of vertebral left atrial size for staging of dogs with myxomatous valve disease. J Vet Cardiol. 2020;30:92-9. [Crossref]  [PubMed] 
  7. Malcolm EL, Visser LC, Phillips KL, Johnson LR. Diagnostic value of vertebral left atrial size as determined from thoracic radiographs for assessment of left atrial size in dogs with myxomatous mitral valve disease. J Am Vet Med Assoc. 2018;253(8):1038-45. [Crossref]  [PubMed] 
  8. Vezzosi T, Puccinelli C, Citi S, Tognetti R. Two radiographic methods for assessing left atrial enlargement and cardiac remodeling in dogs with myxomatous mitral valve disease. J Vet Cardiol. 2021;34:55-63. [Crossref]  [PubMed] 
  9. Hansson K, Häggström J, Kvart C, Lord P. Left atrial to aortic root indices using two-dimensional and M-mode echocardiography in cavalier King Charles spaniels with and without left atrial enlargement. Vet Radiol Ultrasound. 2002;43(6):568-75. [Crossref]  [PubMed] 
  10. Keene BW, Atkins CE, Bonagura JD, Fox PR, Häggström J, Fuentes VL, et al. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med. 2019;33(3):1127-40. [Crossref]  [PubMed]  [PMC] 
  11. Gönül R, Or ME, Dodurka T. Electrocardiographically determination of cardiac enlargements in dogs [Köpeklerde gözlenen kardiak büyümelerin elektrokardiyografik olarak belirlenmesi]. Turk J Vet Anim Sci. 2002;(26):871-7. [Link] 
  12. Başoğlu A. Veteriner Kardiyoloji. Ankara: Çağrı Basın Yayın Organizasyon; 1992. p.1-100.
  13. Edwards NJ. Balton's Handbook of Canine and Feline ECG. 2nd ed. Philadelphia: W.B. Saunders Company; 1987. p.1-50.
  14. Rubin GJ. Applications of electrocardiology in canine medicine. J Am Vet Med Assoc. 1968;153(1):17-39. [PubMed] 
  15. Boineau JP, Hill JD, Spach MS, Moore EN. Basis of the electrocardiogram in right venricular hypertrophy. Relationship between ventricular depolarization and body surface potentials in dogs with spontaneous RVH-contrasted with normal dogs. Am Heart J. 1968;76(5):605-27. [Crossref]  [PubMed] 
  16. Vos MA, de Groot SH, Verduyn SC, van der Zande J, Leunissen HD, Cleutjens JP, et al. Enhanced susceptibility for acquired torsade de pointes arrhythmias in the dog with chronic, complete AV block is related to cardiac hypertrophy and electrical remodeling. Circulation. 1998;98(11):1125-35. [Crossref]  [PubMed] 
  17. Marks CA. Hypertrophic cardiomyopathy in a dog. J Am Vet Med Assoc. 1993;203(7):1020-2. [PubMed] 
  18. Bright JM, McEntee M. Isolated right ventricular cardiomyopathy in a dog. J Am Vet Med Assoc. 1995;207(1):64-6. [PubMed] 

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