Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/13868
標題: 應用M-mode及脈衝式都卜勒心臟超音波評估二尖瓣逆流犬隻之左心室Tei index
Evaluation of the Left Ventricular Tei Index Derived from M-mode and Pulsed Wave Doppler Echocardiography in Dogs with Mitral Regurgitation
作者: 郭宜珊
Kuo, Yi-Shan
關鍵字: Tei index;Tei指數;Echocardiography;Mitral regurgitation;Doppler;M-mode;Dog;心臟超音波;二尖瓣逆流;都卜勒;M模式;犬
出版社: 獸醫學系暨研究所
引用: Arnlov J, Ingelsson E, Riserus U, Andren B, Lind L. Myocardial performance index, a Doppler-derived index of global left ventricular function, predicts congestive heart failure in elderly men. Eur Heart J 25: 2220-2225, 2004. Atkins CE, Keene BW, Brown WA, Coats JR, Crawford MA, DeFrancesco TC, Edwards NJ, Fox PR, Lehmkuhl LB, Luethy MW, Meurs KM, Petrie JP, Pipers FS, Rosenthal SL, Sidley JA, Straus JH. Results of the veterinary enalapril trial to prove reduction in onset of heart failure in dogs chronically treated with enalapril alone for compensated, naturally occurring mitral valve insufficiency. J Am Vet Med Assoc. 231: 1061-1069, 2007 Baykan M, Erem C, Gedikli O, Hacihasanoglu A, Erdogan T, Kocak M, Kaplan S, Kiriş A, Orem C, Celik S. Assessment of left ventricular diastolic function and Tei index by tissue Doppler imaging in patients with Cushing''s Syndrome. Echocardiography 25: 182-190, 2008. Borgarelli M, Zini E, D''Agnolo G, Tarducci A, Santilli RA, Chiavegato D, Tursi M, Prunotto M, Haggström J. Comparison of primary mitral valve disease in German Shepherd dogs and in small breeds. J Vet Cardiol 6: 27-34, 2004. Bruch C, Schmermund A, Dagres N, Katz M, Bartel T, Erbel R. Tei-index in symptomatic patients with primary and secondary mitral regurgitation. Int J Cardiovasc Imaging 18: 101-110, 2002. Bruch C, Schmermund A, Marin D, Katz M, Bartel T, Schaar J, Erbel R. Tei-index in patients with mild-to-moderate congestive heart failure. Eur Heart J 21: 1888-1895, 2000. Buchanan JW. Vertebral scale system to measure heart size in radiographs. Vet Clin North Am Small Anim Pract 30: 379-393,2000. Carabello BA. The pathophysiology of mitral regurgitation. J Heart Valve Dis. 9: 600-608, 2000. Chetboul V, Lefebvre HP, Sampedrano CC, Gouni V, Saponaro V, Serres F, Concordet D, Nicolle AP, Pouchelon JL. Comparative adverse cardiac effects of pimobendan and benazepril monotherapy in dogs with mild degenerative mitral valve disease: a prospective, controlled, blinded, and randomized study. J Vet Intern Med 21: 742-753, 2007. Cui W, Roberson DA. Left ventricular Tei index in children: comparison of tissue Doppler imaging, pulsed wave Doppler, and M-mode echocardiography normal values. J Am Soc Echocardiogr 19: 1438-1445, 2006. Dujardin KS, Tei C, Yeo TC, Hodge DO, Rossi A, Seward JB. Prognostic value of a Doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy. Am J Cardiol 82: 1071-1076, 1998. Eckberg DL, Gault JH, Bouchard RL, Karliner JS, Ross J Jr. Mechanics of left ventricular contraction in chronic severe mitral regurgitation. Circulation 47: 1252-1259, 1973. Ettinger SJ. Ordering diagnostic tests in cardiovascular disease. Vet Clin North Am Small Anim Pract. 21: 1081-1102, 1991. Fontes-Sousa AP, Moura C, Carneiro CS, Teixeira-Pinto A, Areias JC, Leite-Moreira AF. Echocardiographic evaluation including tissue Doppler imaging in New Zealand white rabbits sedated with ketamine and midazolam. Vet J 181: 326-331, 2009. Griffiths LG, Orton EC, Boon JA. Evaluation of techniques and outcomes of mitral valve repair in dogs. J Am Vet Med Assoc 224: 1941-1945, 2004. Haggstrom J, Boswood A, O''Grady M, Jöns O, Smith S, Swift S, Borgarelli M, Gavaghan B, Kresken JG, Patteson M, Ablad B, Bussadori CM, Glaus T, Kovacevic A, Rapp M, Santilli RA, Tidholm A, Eriksson A, Belanger MC, Deinert M, Little CJ, Kvart C, French A, Ronn-Landbo M, Wess G, Eggertsdottir AV, O''Sullivan ML, Schneider M, Lombard CW, Dukes-McEwan J, Willis R, Louvet A, DiFruscia R. Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study. J Vet Intern Med. 22: 1124-1135, 2008. Orton EC, Hackett TB, Mama K, Boon JA. Technique and outcome of mitral valve replacement in dogs. J Am Vet Med Assoc. 226: 1508-1511, 2005. Haggstrom J, Hansson K, Kvart C, Swenson L. Chronic valvular disease in the cavalier King Charles spaniel in Sweden. Vet Rec 131549-553, 1992. Haggstrom J, Kvart C, Hansson K. Heart sounds and murmurs: changes related to severity of chronic valvular disease in the Cavalier King Charles spaniel. J Vet Intern Med 9: 75-85, 1995. Haggstrom J, Pedersen HD, Kvart C. New insights into degenerative mitral valve disease in dogs. Vet Clin Small Anim 34: 1209-1226, 2004. Hamlin RL. Geriatric heart disease in dogs. Vet Clin North Am Small Anim Pract 35: 597-615: 2005. Hori Y, Kunihiro S, Hoshi F, Higuchi S. Comparison of the myocardial performance index derived by use of pulsed Doppler echocardiography and tissue Doppler imaging in dogs with volume overload. Am J Vet Res 68 : 1177-1182, 2007. Hori Y, Uechi M, Indou A. Effects of changes in loading conditions and heart rate on the myocardial performance index in cats. Am J Vet Res 68:1183-1187, 2007. Kitchiner DJ, Lewis BS, Gotsman MS. Systolic time intervals in mitral incompetence. Chest 64: 711-718, 1973. Kittleson MD, Brown WA. Regurgitant fraction measured by using the proximal isovelocity surface area method in dogs with chronic myxomatous mitral valve disease. J Vet Intern Med 17: 84-88, 2003. Kittleson MD, Eyster GE, Knowlen GG, Bari Olivier N, Anderson LK. Myocardial function in small dogs with chronic mitral regurgitation and severe congestive heart failure. J Am Vet Med Assoc 184: 455-459, 1984. Lavine SJ. Effect of heart rate and preload on index of myocardial performance in the normal and abnormal left ventricle. J Am Soc Echocardiogr 18: 133-141, 2005. Lee BH, Dukes-McEwan J, French AT, Corcoran BM. Evaluation of a novel doppler index of combined systolic and diastolic myocardial performance in Newfoundland dogs with familial prevalence of dilated cardiomyopathy. Vet Radiol Ultrasound 43: 154-165, 2002. Mabrouk-Zerguini N, Léger P, Aubert S, Ray R, Leprince P, Riou B, Coriat P, Ouattara A. Tei index to assess perioperative left ventricular systolic function in patients undergoing mitral valve repair. Br J Anaesth 101: 479-485, 2008. Marcondes-Santos M, Tarasoutchi F, Mansur AP, Strunz CM. Effects of carvedilol treatment in dogs with chronic mitral valvular disease. J Vet Intern Med. 21: 996-1001, 2007. Nakano K, Swindle MM, Spinale F, Ishihara K, Kanazawa S, Smith A, Biederman RW, Clamp L, Hamada Y, Zile MR, Carabello BA. Depressed contractile function due to canine mitral regurgitation improves after correction of the volume overload. J Clin Invest. 1991 Jun; 87(6):2077-86. Erratum in: J Clin Invest 1991 Aug; 88(2):723. Nakayama T, Wakao Y, Nemoto H, Uechi M, Kageyama T, Muto M, Takahashi M. Mitral valve protrusion assessed by use of B-mode echocardiography in dogs with mitral regurgitation. Am J Vet Res 57: 791-797, 1996. Okawa M, Kitaoka H, Matsumura Y, Kubo T, Yamasaki N, Furuno T, Doi Y. Functional assessment by myocardial performance index (Tei index) correlates with plasma brain natriuretic peptide concentration in patients with hypertrophic cardiomyopathy. Circ J 69: 951-957, 2005. Olsen LH, Fredholm M, Pedersen HD. Epidemiology and inheritance of mitral valve prolapsed in Dachshunds. J Vet Intern Med 13: 448-456, 1999. Olsen LH, Martinussen T, Pedersen HD. Early echocardiographic predictors of myxomatous mitral valve disease in dachshunds. Vet Rec 152: 293-297, 2003. Oyama MA. Advances in echocardiography. Vet Clin North Am Small Anim Pract 34: 1083-1104, 2004. Pedersen HD, Lorentzen KA, Kristensen BO. Echocardiographic mitral valve prolapse in cavalier King Charles spaniels: epidemiology and prognostic significance for regurgitation. Vet Rec 144: 315-320, 1999. Pellett AA, Tolar WG, Merwin DG, Kerut EK. The Tei index: methodology and disease state values. Echocardiography 21:669-672, 2004. Perloff JK, Roberts WC. The mitral apparatus. Functional anatomy of mitral regurgitation. Circulation 46: 227-239, 1972. Rishniw M, Erb HN. Evaluation of four 2-dimensional echocardiographic methods of assessing left atrial size in dogs. J Vet Intern Med 14: 429-435, 2000. Saida Y, Tanaka R, Yamane Y, Suzuki K, Maruyama R, Koie H, Matsumoto T, Asano R. Relationships between vertebral heart size (VHS) and echocardiographic parameters in dogs with mitral regurgitation. Adv Anim Cariol 39: 55-62, 2006. Serres F, Chetboul V, Tissier R, Poujol L, Gouni V, Carlos Sampedrano C, Pouchelon JL. Comparison of 3 ultrasound methods for quantifying left ventricular systolic function: correlation with disease severity and prognostic value in dogs with mitral valve disease. J Vet Intern Med 22: 566-577, 2008. Swenson L, Haggstrom J, Kvart C, Juneja RK. Relationship between parental cardiac status in Cavalier King Charles spaniels and prevalence and severity of chronic valvular disease in offspring. J Am Vet Med Assoc 208: 2009-2012, 1996. Takasaki K, Gillinov AM, Yamano T, Matsumura Y, Toyono M, Shiota T. Detection of left ventricular dysfunction with Tei index in normal ejection fraction patients with mitral regurgitation before mitral valve surgery. Am J Cardiol 103:1011-1014, 2009. Tei C, Nishimura RA, Seward JB, Tajik AJ. Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr 10 : 169-178, 1997. Tei C. New non-invasive index for combined systolic and diastolic ventricular function. J Cardiol 26: 135-136, 1995. Teshima K, Asano K, Iwanaga K, Koie H, Uechi M, Kato Y, Kutara K, Edamura K, Hasegawa A, Tanaka S. Evaluation of right ventricular Tei index (index of myocardial performance) in healthy dogs and dogs with tricuspid regurgitation. J Vet Med Sci 68:1307-1313, 2006. Teshima K, Asano K, Iwanaga K, Koie H, Uechi M, Kato Y, Kutara K, Kanno N, Seki M, Edamura K, Hasegawa A, Tanaka S. Evaluation of left ventricular Tei index (index of myocardial performance) in healthy dogs and dogs with mitral regurgitation. J Vet Med Sci 69: 117-123, 2007. Thadani U, Jacob RG. Isosorbide dinitrate/hydralazine: its role in the treatment of heart failure. Drugs Today (Barc). 44: 925-937, 2008. Thomas L, Foster E, Hoffman JI, Schiller NB. Prospective validation of an echocardiographic index for determining the severity of chronic mitral regurgitation. Am J Cardiol 90: 607-612, 2002. Thruafield MV, Aitken GG, Dark PGG. Observations on breed and sex in relation to canine heart incompetence. J Small Anim Pract 26: 709-717, 1985. Uehara T, Takahashi M. Quantitative evaluation of the severity of mitral insufficiency in dogs by color Doppler method. J Vet Med Sci 58: 249-253, 1996. Wandt B, Bojo L, Tolagen K, Wranne B. Echocardiographic assessment of ejection fraction in left ventricular hypertrophy. Heart 82: 192-198, 1999. Whitney JC. Observations on the effect of age on the severity of heart valve lesions in the dog. J Small Anim Pract 15: 511-522, 1974. Yuasa T, Otsuji Y, Kuwahara E, Takasaki K, Yoshifuku S, Yuge K, Kisanuki A, Toyonaga K, Lee S, Toda H, Kumanohoso T, Hamasaki S, Matsuoka T, Biro S, Minagoe S, Tei C. Noninvasive prediction of complications with anteroseptal acute myocardial infarction by left ventricular Tei index. J Am Soc Echocardiogr 18: 20-25, 2005.
摘要: 
二尖瓣閉鎖不全造成之二尖瓣逆流為犬隻最常見的後天性心臟疾病。二尖瓣逆流造成慢性的容積過量和左心室病理性的重塑導致心肌收縮功能不良。在二尖瓣逆流,心臟容積狀態隨疾病嚴重程度改變;傳統測量心臟功能的超音波參考值易受到心臟負荷狀況影響,而降低準確度。Tei index能評估心肌整體的收縮及舒張狀況,且不受心跳、血壓,及心室容積狀態影響。定義為等容收縮期 (isovolumic contraction time, ICT) 與等容舒張期 (isovolumic relaxation time, IRT) 之和除以射出時間 (ejection time, ET)。此次研究使用M-mode及脈衝式都卜勒 (pulsed wave Doppler, PWD) 兩種不同超音波模式測量二尖瓣逆流犬隻的左心室Tei index,目的為探討Tei index與疾病嚴重程度的相關性,並比較此兩種測量方式之間的相關性。本研究實驗組收集67例二尖瓣逆流病例和55例臨床表徵健康的犬隻作為正常對照組,實驗組依紐約心臟病協會之心衰竭分級標準 (New York Heart Association functional classification, NYHA) 分為四個等級。研究結果顯示Tei index與心跳、平均動脈壓無顯著相關性。兩種測量方法Tei index數值隨心衰竭嚴重程度的增加呈現上升趨勢,實驗組與正常組間具顯著差異 (p<0.05)。造成Tei index的上升的原因為等容時間延長,及射出時間顯著縮短所致。射出時間縮短的原因推測為左心收縮功能不良所致。兩種方法量測之a interval與b interval數值呈現顯著線性相關,顯示兩測量方法間相關性高。M-mode測得之Tei index顯著小於PWD之數值,推測其原因為M-mode所測量的a interval顯著小於PWD之值。因M-mode測量方式較PWD容易,能區分不同嚴重程度的二尖瓣逆流。在心衰竭嚴重的動物下,M-mode可以代替PWD來測量Tei index,作為心臟功能的參考數值。

Mitral regurgitation (MR) is the most commonly acquired cardiac disease in dogs. Chronic volume overload due to MR eventually lead to left ventricular (LV) contractile dysfunction. In dogs with MR, it is difficult to evaluate LV function using conventional echocardiographic indices because of the loading conditions of the diseased heart. The Tei index is a valuable quantitative parameter for assessment of global systolic and diastolic function. It is defined as the sum of isovolumic contraction and relaxation time (ICT+IRT, “a” interval) divided by ejection time (ET, “b” interval). The Tei index is independent of heart rate, blood pressure and also relatively independent of loading condition. The aim of this study was to establish LV Tei index measured by M-mode and pulsed wave Doppler (PWD) and to validate the correlation between two methods. The dogs with MR were divided into four groups based on modified New York Heart Association functional (NYHA) classification of heart failure. The Tei index is relatively independent of heart rate and mean blood pressure. Both of the Tei indices increased in MR dogs (n=67) as compared to the normal healthy dogs (n=55) while Tei indices increased with progression of MR. The elevation of the LV Tei index in dogs with MR is associated with shortening of ET, suggesting systolic dysfunction. A close correlation between the “a” and “b” intervals obtained from M-mode and PWD was detected. The values of Tei index obtained by M-mode is lesser than PWD method, is due to the shorter “a” interval in M-mode measurement. M-mode measurement is easily performed and reproducible, thus can provide an alternative method for measuring the Tei index, especially in severe MR cases.
URI: http://hdl.handle.net/11455/13868
其他識別: U0005-2008200911323600
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