Wednesday, April 10, 2013

Inflamação sistêmica e disfunção endotelial em cães com insuficiência cardíaca congestiva / Systemic Inflammation and Endothelial Dysfunction in Dogs with Congestive Heart Failure


Systemic Inflammation and Endothelial Dysfunction in Dogs with Congestive Heart Failure

  1. S.M. Cunningham*
  2. J.E. Rush, 
  3. L.M. Freeman
Article first published online: 10 APR 2012
DOI: 10.1111/j.1939-1676.2012.00923.x
Journal of Veterinary Internal Medicine

Journal of Veterinary Internal Medicine

Volume 26Issue 3pages 547–557May-June 2012

Keywords:

  • Cardiomyopathy;
  • C-reactive protein;
  • Reactive hyperemia;
  • Valvular disease

Background

Congestive heart failure (CHF) is associated with endothelial dysfunction in people and in dogs with experimentally induced CHF, but this is not well characterized in dogs with naturally occurring CHF.

Hypothesis/Objectives

To evaluate endothelial function via assessment of reactive hyperemia (RH) in healthy dogs and dogs with CHF, and to assess for relationships with plasma biomarkers of vascular function and clinical markers of disease severity.

Animals

Twenty client-owned animals with CHF due to myxomatous mitral valve disease (n = 15) or dilated cardiomyopathy (n = 5) and 17 healthy control dogs.

Methods

Prospective case-controlled observational study. Dogs underwent blood sampling, echocardiography, and Doppler assessment of brachial artery velocity (VTI) at baseline and during reactive hyperemia (RH-VTI). RH-VTIs between control dogs and dogs with CHF were compared, and the relationships between RH-VTI, clinical parameters, and plasma biomarkers were assessed.

Results

Dogs with CHF (96.5 ± 51.7%) had an attenuated % increase in VTI during RH compared to healthy controls (134.8 ± 58.7%; = .04). Increasing ISACHC class (R2 = 0.24; = .004), plasma NT-proBNP (R2 = 0.15; = .03) and CRP (R2 = 0.2; = .02) were associated with reduced RH-VTI. Increased plasma CRP, NOx, and NT-proBNP concentrations were found in dogs with CHF (< .02 for all). No differences were detected in other plasma markers.

Conclusions and Clinical Importance

Dogs with CHF have an attenuated RH response, and increased plasma CRP and NOx concentrations. Doppler assessment of RH velocity could represent a novel noninvasive method of evaluating endothelial function in the dog.

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