[fr] L’insuffisance mitrale (IM) est l’une des pathologies cardiaques les plus fréquemment rencontrées dans l’espèce équine. C’est, en outre, la pathologie valvulaire qui présente le plus de risque d’entraver les performances sportives, d’évoluer en insuffisance cardiaque congestive (ICC) et donc de mettre en jeu la vie de l’animal affecté.
Le diagnostic clinique de l’IM dépend beaucoup l’expertise du vétérinaire en cardiologie et repose en grande partie sur l’auscultation cardiaque. Dans tous les cas, la confirmation du diagnostic et la gradation de la sévérité de la pathologie nécessite la réalisation d’une échocardiographie Doppler. La mise en évidence de signes de surcharge volumique du ventricule et/ou de l’oreillette gauche, d’un flux régurgitant important, d’une hypertension artérielle pulmonaire ou d’arythmies significatives à l’échocardiographie. Ces élemnts constituent des facteurs de pronostic défavorable. Ce dernier est aggravé si l’animal affecté présente de plus des signes cliniques d’ICC.
D’autres paramètres échocardiographiques sont utilisés chez l’homme ou le chien pour déterminer la sévérité de l’IM mais n’ont pas été validé chez le cheval.
Le traitement de l’IM dans l’espèce équine est symptomatique et dirigé contre le développement de l’ICC. De nombreux médicaments utilisés chez l’homme ou le chien ont une utilisation limitée chez le cheval en raison de leur coût prohibitif et/ou d’un manque de données de pharmacocinétique et d’efficacité. [en] Abstract
Mitral regurgitation (MR) is a one of the most common cardiac disease in the equine species. Furthermore, it is the valvular disease that presents the higher risk to be associated with reduced athletic performance, to evolve into congestive heart failure and to become life threatening.
The clinical diagnosis of MR depends mainly on the expertise of the veterinarian in cardiology and is above all based on cardiac auscultation. In all of the cases, the definitive diagnosis and the evaluation of the disease severity require performing a Doppler echocardiographic examination. Signs of left ventricular and/or left atrial overload, large regurgitation jet, pulmonary arterial hypertension or significant arrhythmias are negative prognosis factors. Clinical signs of congestive heart failure make the prognosis worse.
Other echocardiographic parameters are used in human and dogs in order to determine the severity of the MR, but have been not validated in horses.
Treatment of mitral regurgitation in the equine species is symptomatic and directed against the development of a congestive heart failure. A lot of drugs that are used in human or dogs are of limited value in horses for financial reasons and/or lack of pharmacokinetics and pharmacologic data in equine species.
Disciplines :
Veterinary medicine & animal health
Author, co-author :
Al Haidar, Ali
Leroux, Aurélia ; Université de Liège - ULiège > Département clinique des animaux de compagnie et des équidés > Médecine interne des équidés
Amory, Hélène ; Université de Liège - ULiège > Département clinique des animaux de compagnie et des équidés > Médecine interne des équidés
Language :
French
Title :
L’insuffisance mitrale chez le cheval : revue de la littérature et comparaison avec la pathologie chez l’homme et chez le chien
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