Avaliação morfogeométrica do ventrículo e do anel atrioventricular esquerdos em cães sadios: estudo computadorizado
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Data
2021-05-03
Autores
Cardoso, Catarina Borges [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A anatomia é um campo de conhecimento extremamente necessário para o desenvolvimento de terapêuticas, em especial, as cirúrgicas. Faz-se importante o estudo das alterações morfogeométricas cardíacas em decorrência do remodelamento patológico, fenômeno presente em muitas cardiopatias, e que contribui com a evolução para insuficiência cardíaca e morte. Estes são raros em cães, considerando peças anatômicas. Adicionalmente a geometria ventricular pode atuar como um indicador da função cardíaca. Assim, objetivou-se obter medidas do anel atrioventricular esquerdo e ventrículo esquerdo; analisar a proporcionalidade entre os segmentos da câmara cardíaca esquerda de corações normais e estabelecer parâmetros para análise morfogeométrica. Para tal, 50 corações, provenientes de cães de pequeno porte (≤10 kg, G1) e médio a grande porte (≥10kg, G2), foram laminados em segmentos apical, basal e equatorial. Estes foram submetidos a análises computadorizadas para identificação dos perímetros segmentares e do anel atrioventricular esquerdo, espessuras parietais e distância do sulco atrioventricular ao ápice. O maior perímetro interno foi o do segmento equatorial (p<0,001, G1). O segmento basal apresentou maior média para espessura parietal ventral, sugerindo maior reserva contrátil nesta localização. Sobre as relações de proporcionalidade, não houve diferença estatística entre os índices perimetrais intersegmentares para os dois grupos, isto permite sugerir que embora o peso dos animais varie, as proporções entre os segmentos do ventrículo esquerdo se mantem. Portanto, este estudo traz informações que poderão ser utilizadas como padrão de comparação para avaliações geométricas de quaisquer afecções cardíacas, bem como base para desenvolvimento de medidas terapêuticas em face do remodelamento cardíaco adverso.
Anatomy is an extremely necessary field of knowledge for the development of any therapeutics, especially surgical ones. It is important to study cardiac morphogeometric changes as a result of pathological remodeling, a phenomenon present in many heart diseases, which contributes to the evolution to heart failure and death. These are rare in dogs, considering anatomical parts. In addition, ventricular geometry can act as an indicator of cardiac function. Thus, we aim to obtain measurements of the left atrioventricular ring and left ventricle, to analyze the proportionality between the segments of the normal left cardiac chamber and to establish parameters for morphogeometric analysis. For this purpose, 50 hearts from small (≤10 kg, G1) and medium to large (≥10 kg, G2) dogs, were laminated in apical, basal and equatorial segments, which were subjected to computerized analysis to identify values such as segmental perimeters and mitral valve annulus, wall thickness and distance from the atrioventricular groove to the apex. The largest internal perimeter was the equatorial segment (p <0.001, G1). The basal segment showed a higher mean for ventral wall thickness, suggesting a greater contractile reserve in this location. Regarding the proportionality relations, there was no statistical difference between the perimeter intersegmental indexes for the two groups; this allows us to suggest that although the animal´s weight varies, the proportions between the left ventricular segments remains. Therefore, this study provides useful information as a comparison standard for geometric assessments of any cardiac disorders, as well as a basis for the development of therapeutic procedures in the face of adverse cardiac remodeling.
Anatomy is an extremely necessary field of knowledge for the development of any therapeutics, especially surgical ones. It is important to study cardiac morphogeometric changes as a result of pathological remodeling, a phenomenon present in many heart diseases, which contributes to the evolution to heart failure and death. These are rare in dogs, considering anatomical parts. In addition, ventricular geometry can act as an indicator of cardiac function. Thus, we aim to obtain measurements of the left atrioventricular ring and left ventricle, to analyze the proportionality between the segments of the normal left cardiac chamber and to establish parameters for morphogeometric analysis. For this purpose, 50 hearts from small (≤10 kg, G1) and medium to large (≥10 kg, G2) dogs, were laminated in apical, basal and equatorial segments, which were subjected to computerized analysis to identify values such as segmental perimeters and mitral valve annulus, wall thickness and distance from the atrioventricular groove to the apex. The largest internal perimeter was the equatorial segment (p <0.001, G1). The basal segment showed a higher mean for ventral wall thickness, suggesting a greater contractile reserve in this location. Regarding the proportionality relations, there was no statistical difference between the perimeter intersegmental indexes for the two groups; this allows us to suggest that although the animal´s weight varies, the proportions between the left ventricular segments remains. Therefore, this study provides useful information as a comparison standard for geometric assessments of any cardiac disorders, as well as a basis for the development of therapeutic procedures in the face of adverse cardiac remodeling.
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Palavras-chave
Geometria ventricular, Anatomia, Cirurgia cardíaca, Remodelamento cardíaco, Miocárdio, Ventricular geometry, Anatomy, Cardiac surgery, Cardiac remodeling, Myocardial