Turan CİVELEK, Durmuş Fatih BAŞER

Bir Köpekte Sistolik Asenkroni Olgusu

Asenkroni; venriküler kasılma ve gevşeme prosesindeki bozulma ve sol ventriküler sistolik perfomans kaybı ile karakterizedir. Sunulan vakada, hastanemize egzersiz intoleransı şikayeti ile getirilen üç yaşlı, dişi Setter ırkı köpek tartışıldı. Gerçekleştirilen muayenede hastanın kalp ve solunum sayıları ve vücut ısısı normal olarak kaydedildi. Oskültasyonda akciğerin kraniyal loblarında bronşitis ile uyumlu sert veziküler sesler tespit edildi. Egzersiz intoleransı nedeniyle gerçekleştirilen ekokardiyografik muayenede, interventriküler septum ve sol ventrikülün dış duvarı arasında ventriküler asenkroni ile uyumlu hareket gözlendi. Sol parasternal apikal dört boşluk bakıda, her iki duvar arasında asenkronik hareket izlendi. Kardiak asenkroni köpeklerde muhtemelen sık karşılaşılan bir durum olmasına rağmen, Veteriner sahada konu ile ilgili klinik bilgi eksikliği nedeniyle, beşeri hekimlikte olduğu gibi göz ardı edilmektedir. Sonuç olarak; bu hastalık kalp yetmezliğine neden olma ihtimali nedeniyle klinik olarak önem arz eder ve ekokardiyografik muayene sırasında dikkate alınmalıdır.

Anahtar Kelimeler:

EKG, Ekokardiyograrafi, Kalp, Sistolik fonksiyon, Resenkronizasyon

Ventricular Systolic Asynchrony in a Dog

Asynchrony is characterized by the disruption of ventricular contraction and relaxation and left ventricle systolic performance loss. In this report, three years old female setter who was handed to animal hospital with exercise intolerance was disscussed. At echocardiographic examination carried out because exercise intolerance, interventricular septum among with left ventricul post wall asynchronic movement compatible with ventricular asynchrony was monitored. During left parasternal apical four chamber examination, asynchronic movement was detected at both walls. Although cardiac asynchrony is probably a common case in dogs, it is ruled out because of the lack of clinical evidence in veterinary area like in the case of human medicine. It can be concluded that this disease has clinical significance because of the probability of heart failure, and therefore, needs to be considered in the echocardiographic examinations.

Keywords:

ECG, Echocardiography, Heart, Systolic Function,

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Bax JJ, Molhoek SG, Van Erven L, Voogd PJ, Somer S, Boersma E, Steendijk P, Schalij MJ, Van Der Wall EE. Usefulness of myocardial tissue Doppler echocardiography to evaluate left ventricular dyssynchrony before and after biventricular pacing in patients with idiopathic dilated cardiomyopathy. Am. J. Cardiol. 2003, 91, 94–97.
Breithardt OA, Stellbrink C, Kramer AP, Sinna AM, Franke A, Salo R, Schiffgens B, Huvelle E, Aurıcchio A. Echocardiographic quantification of left ventricular asynchrony predicts an acute hemodynamic benefit of cardiac resynchronization therapy. J. Am. Coll. Cardiol. 2002; 40, 536–545.
Heyndrickx GR, Vantrımpont PJ, Rousseau MF, Pouleur H. Effects of asynchrony on myocardial relaxation at rest and during exercise in conscious dogs. Am. J. Physiol. 1988; 254(5): 817–822.
Mullens W, Tang W, Grimm RA. Using echocardiography in cardiac resynchronization therapy. Am. Heart J. 2007; 154, 1011-1020.
Otsuji Y, Handschumacher MD, Schwammenthal E, Jiang L, Song JK, Guerrero RJ, Vlahakes GJ, Levine RA. Insights from threedimensional echocardiography into the mechanism of functiona mitral regurgitation: direct in vivo demonstration of altered leaflet tethering geometry. Circulation, 1997; 96(6): 1999-2008.
Packer M, Antonopoulos GV, Berlin JA, Chittams J, Konstam MA, Udelson JE. Comperative effects of carvedilol and metoprolol on left ventricular ejection fraction in heart failure: result of a meta-analysis. Am. Heart. J. 2001a; 141: 899-907.
Packer M, Bristow MR, Cohn NJ, Colucci WS, Fowler MB, Gilbert EM, Shusterman MD. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N. Engl. J. Med. 1996; 334: 1349-1355.
Packer M, Coats AJS, Fowler MB, Katus HA, Krum H, Mohacsi P, Rouleau JL, Tendera M, Castaigne A, Roecker EB. Effect of carvedilol on survival in severe chronic heart failure. N. Engl. J. Med. 2001b; 344; 1651-1658.
Park RC, Little WC, O’rourke RA. Effect of alteration of left ventricular activation sequence on the left ventricular end-systolic pressure-volume relation in closed-chest dogs. Circ. Res. 1985; 57: 706–717.
Pitzalis MV, Iacovıello M, Romito R, Massari F, Rizzon B, Luzzi G, Guida P, Andrıani A, Mastropasqua F, Rizzon P. Cardiac resynchronization therapy tailored by echocardiographic evaluation of ventricular asynchrony. J. Am. Coll. Cardiol. 2002; 40, 1615-1622.