Sensibilidade e especificidade do exame eletrocardiográfico na detecção de sobrecargas atriais e/ou ventriculares em gatos da raça Persa com cardiomiopatia hipertrófica

Abstract

ABSTRACT.-Pellegrino A., Daniel A.G.T., Pessoa R., Guerra J.M., Lucca G. Hypertrophic cardiomyopathy (HCM) is the most common feline heart disease and is characterized by increased cardiac mass with a hypertrophied and not dilated left ventricle. The echocardiography is the best noninvasive diagnostic tool for the differentiation of cardiomyopathies and is considered the gold standard for detection of ventricular hypertrophy present in HCM. Electrocardiographic changes are also common in animals with HCM and the electrocardiogram (ECG) is quick, easy and highly available screening test for the detection of ventricular hypertrophy in humans. In cats, few studies have been conducted regarding the sensitivity and specificity of ECG in detecting ventricular hypertrophy. With the intention of evaluating the use of ECG as a screening tool for diagnosis of HCM in cats, Persian cats (n=82) were evaluated by echocardiographic and electrocardiographic examinations. Animals with blocks and/or conduction disturbances were excluded from statistical analysis (n=22). Subsequently the animals included were classified as normal (n=38), suspicious (n=6) and affected by HCM (n=16). Statistical differences were observed in the P-wave amplitude in DII and R-wave amplitude in DII, CV6LL and CV6LU, with higher values in animals with HCM. Velocities and pressure gradient of aortic flow, left atrial diameter (LA) and LA/Ao ratio were higher in cats with HCM. Among the animals with ECG changes suggestive of left atrial enlargement (n=7), only two actually had LA enlargement on echocardiography, and among animals with left atrial enlargement on echocardiogram (n=7), only two had ECG changes suggestive of overload AE (40,4% of sensibility and 90,9% of specificity). Among the animals with ECG changes suggestive of left ventricular hypertrophy (n=6), five actually had ventricular hypertrophy on echocardiography, and among animals with HCM by echocardiography (n=16), only five showed electrocardiographic abnormalities suggestive of LV hypertrophy (31,25% of sensibility and 97,72% of 1 Recebido em 6 de abril de 2015.Aceito para publicação em 2 de fevereiro de 2016.

Diagnostic Accuracy of the Electrocardiogram for Detection of Atrial and Ventricular Overloads in Dogs

“…The results of this study suggest that electrocardiographic criteria for evaluation of atrial and ventricular overload are similar to those reported by Schober et al [18], who found accuracy of the ECG for detecting left atrial overload, which resulted in relative specificity and low sensitivity in cats with cardiomyopathy. Another recent study showed good specificity in the detection of ventricular hypertrophy in cats and low sensitivity, with a large number of false negative animals [17]. However, in human patients the ECG is considered a screening test for the detection of atrioventricular overloads and a sensitive indicator of heart disease [11,15].…”

Sedative and electrocardiographic effects of low dose dexmedetomidine in healthy cats

“…The electrocardiography (ECG) is a widely used exam in veterinary medicine, mainly to detect/exclude arrhythmias, as part of pre-anesthetic evaluation, and/or cardiac monitoring in patients under intensive care unit, or during general anesthesia. In cats, additional clinical applications include assessment of cardiac dimensions, for which an ECG is a poor substitute for an echocardiogram (Pellegrino et al 2016), and monitoring of extracardiac disturbances that could possible lead to cardiac impairments, such as hyperkalemia in cats with urethral obstruction, oliguric/anuric renal failure, reperfusion injury (Schaer 1977, Côté 2010, Garcia de Carellan Mateo et al 2015, or hypoxemia (Boyden 1992). The aim of this study was to prospectively investigate how the sedative and electrocardiographic effects of a low dose of DEX performing in healthy cats.…”